Term
| What is stage 1 anesthesia? |
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Definition
| Analgesia - decreased awareness of pain, sometimes with amnesia, consciousness may be impaired but is not lost |
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Term
| decreased awareness of pain, sometimes with amnesia, consciousness may be impaired but is not lost -- Which stage of anesthesia is this? |
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Definition
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Term
| What is stage 2 anesthesia? |
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Definition
| disinhibition - pt is delirious, excited, amnesia occurs, reflexes are enhanced, respiration is irregular, retching and incontinence may occur |
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Term
| pt is delirious, excited, amnesia occurs, reflexes are enhanced, respiration is irregular, retching and incontinence may occur -- which stage of anesthesia is this? |
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Definition
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Term
| What is stage 3 anesthesia? |
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Definition
| surgical anesthesia - pt is unconscious, has no pain reflexes, respiration is very regular, BP is maintained |
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Term
| pt is unconscious, has no pain reflexes, respiration is very regular, BP is maintained -- which stage of anesthesia is this? |
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Definition
| stage 3 - surgical anesthesia |
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Term
| what is stage 4 anesthesia? |
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Definition
| medullary depression - pt develops severe respiratory and cardiovascular depression that requires mechanical and pharmacologic support |
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Term
| pt develops severe respiratory and cardiovascular depression that requires mechanical and pharmacologic support -- what stage of anesthesia is this? |
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Definition
| stage 4 - medullary depression |
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Term
| what is the standard method for measuring depth of anesthesia? |
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Definition
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Term
| general anesthetics usually have what effect on threshold for firing of CNS neurons? |
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Definition
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Term
| the potency of inhaled anesthetics is roughly proportionate to _______ solubility |
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Definition
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Term
| inhaled anesthetics, barbiturates, benzos, etomidate, propofol - MOA? |
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Definition
| facilitate GABA-mediated inhibition at GABAa recepts |
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Term
| which drugs facilitate GABA-mediated inhibition at GABAa recepts? |
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Definition
| inhaled anesthetics, barbiturates, benzos, etomidate, propofol |
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Term
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Definition
| antagonism of NMDA glutamate recep |
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Term
| 50% nitrous oxide in the inhaled air would have a partial pressure of ______ mm Hg |
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Definition
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Term
| drugs with low solubility have a ____ blood:gas partition coefficient and will produce effects more ______ (quickly or slowly?) |
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Definition
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Term
| nitrous oxide has a ____ blood:gas partition coefficient, so its effect is ______, and a _______ MAC, so its potency is ______ |
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Definition
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Term
| name an inhaled anesthetic with a very low blood:gas partition coefficient and a very high MAC |
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Definition
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Term
| Methoxyflurane has a _____ blood:gas coefficient so its effect is ______, and a _____ MAC so its potency is ______ |
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Definition
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Term
| name an inhaled anesthetic with a high blood:gas partition coefficient and a very low MAC |
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Definition
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Term
| The speed of onset of anesthesia is ______ when pulmonary blood flow is high |
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Definition
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Term
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Definition
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Term
| which two inhaled anesthetics are metabolized by liver enzymes to a significant extent? |
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Definition
| halothane and methoxyflurane |
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Term
| MAC values for infants and elderly patients are _____ |
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Definition
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Term
| when several anesthetic agents are used simultaneously, their MAC values are... |
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Definition
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Term
| What do inhaled anesthetics do to brain metabolic rate? Vascular resistance? Cerebral blood flow? |
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Definition
| decrease brain metabolic rate, reduce vascular resistance, increase cerebral blood flow (which may increase intracranial pressure) |
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Term
| high concentrations of _______ may cause spike-and-wave activity and muscle twitching |
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Definition
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Term
| most inhaled anesthetics ____ arterial BP moderately |
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Definition
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Term
| Which two inhaled anesthetics are myocardial depressants? |
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Definition
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Term
| enflurane and halothane are myocardial _____ |
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Definition
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Term
| which inhaled anesthetics cause peripheral vasodilation? |
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Definition
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Term
| which inhaled anesthetic is less likely to lower BP than the others? |
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Definition
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Term
| blood flow to liver and kidney is _____ by most inhaled agents |
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Definition
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Term
| which drug has the least depressant effect on myocardium? |
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Definition
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Term
| Which inhaled agents may sensitize the myocardium to the arrhythmogenic effects of catecholamines? |
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Definition
| halothane, and to a lesser degree isoflurane |
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Term
| What effects do inhaled anesthetics have on the respiratory system? |
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Definition
| decrease in tidal volume and minute ventilation, increase in arterial CO2, decrease ventilatory response to hypoxia |
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Term
| which inhaled agent has the smallest effect on respiration? |
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Definition
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Term
| most inhaled agents are bronchodilators, but _______ is a pulmonary irritant and may cause bronchospasm |
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Definition
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Term
| Which drug has a pungency that limits its use in anesthesia induction? |
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Definition
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Term
| Which drug has rarely caused postop hepatitis? |
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Definition
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Term
| fluoride released by metabolism of methoxyflurane (and possibly enflurane and sevoflurane) may cause... |
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Definition
| renal insufficiency after prolonged anesthesia |
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Term
| prolonged exposure to nitrous oxide causes... |
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Definition
| megaloblastic anemia due to decrease in methionine synthase |
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Term
| What causes malignant hyperthermia? |
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Definition
| uncontrolled release of Ca by the SR of skeletal muscle |
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Term
| What is the treatment for malignant hyperthermia |
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Definition
|
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Term
| describe the lipid solubility and onset of thiopental and methohexital |
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Definition
| high lipid solubility, rapid onset |
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Term
| the anesthetic effects of thiopental are terminated by.. |
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Definition
| redistribution from brain to other highly perfused tissues, but hepatic metabolism is required for elimination |
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Term
| What are the effects of barbiturates on respiratory and circulatory systems, and on cerebral blood flow and pressure? |
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Definition
| respiratory and circulatory depressants, depress cerebral blood flow, can decrease ICP |
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Term
| With midazolam, cases of severe postop _______ _______ have occurred |
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Definition
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Term
| What is "dissociative anesthesia?" What drug induces it? |
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Definition
| pt remains conscious but has catatonia, analgesia, amnesia - ketamine |
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Term
| What effect does ketamine have on the cardiovascular system and ICP? |
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Definition
| it's a cardiovascular stimulant, may lead to increase in ICP |
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Term
| Emergence reactions including disorientation, excitation and hallucination can occur during recovery from which drug? Pre-op use of what drug can reduce this effect? |
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Definition
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Term
| Opioids are used with other CNS depressants, especially for what kind of pts? |
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Definition
| high risk pts who might not survive full general anesthetic |
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Term
| What drugs may cause chest wall rigidity that can impair ventilation? |
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Definition
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Term
| ________ is a state on analgesia and amnesia produced when fentanyl is used with droperidol and nitrous oxide |
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Definition
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Term
| what is neuroleptanesthesia? |
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Definition
| a state on analgesia and amnesia produced when fentanyl is used with droperidol and nitrous oxide |
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Term
| recovery from the actions of ______ is faster than recovery from other opioids used in anesthesia bc of its rapid metabolism by blood and tissue esterases |
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Definition
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Term
| What is special about remifentanil? |
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Definition
| recovery is faster than recovery from other opioids used in anesthesia bc of its rapid metabolism by blood and tissue esterases |
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Term
| Describe rapidity of propofol anesthesia and recovery from anesthesia compared to IV barbituates. |
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Definition
| propofol produces anesthesia as rapidly, with more rapid recovery |
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Term
| Which IV agent has antiemetic actions? Is recovery delayed after prolonged infusion? |
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Definition
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Term
| propofol may cause marked _____ during induction, primary through ______ peripheral resistance |
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Definition
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Term
| Etomidate - describe rapidity of induction, change in cardiac and respiratory function, and duration of action |
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Definition
| rapid induction, minimal change in cardiac or respiratory function, short DOA |
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Term
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Definition
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Term
| which IV drug is NOT analgesic? |
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Definition
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Term
| side effects of etomidate? What about with prolonged administration? |
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Definition
| pain and myoclonus in injection, postop nausea. long term - adrenal suppression |
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Term
| which drug may cause pain and myoclonus on injection and postop nausea? |
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Definition
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Term
| the long term use of which IV drug may cause adrenal suppression? |
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Definition
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