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62 Cards in this Set
- Front
- Back
MAC awake
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50% of patients can be awakened
= 1/2 MAC |
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MAC
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50% of patients will not move at surgical incision
|
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ED 95
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95% of patients will not move at surgical incision
=1.3 x MAC |
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MAC-BAR
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50% of patients have blocked autonomic response
= 1.5-2 x MAC |
|
inhalation anesthetics
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N HIDES
Nitrous oxide Halothane Isoflurane Desflurane Enflurane Sevoflurane |
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IV anesthetics
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sedatives- (BBEP) barbituates, benzodiazepine, etomidate, propofol,
opiods- -tanyl's dissociative- ketamine |
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analgesia only
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Stage of Analgesia
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delirious, excited, amnestic, irregular respirations, struggling, retching, vomiting
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Stage of Excitement
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loss of corneal, swallowing, and eyelid reflexes
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Stage of surgical anesthesia
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cessation of spontaneous respiration
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stage of medullary depression
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To increase speed of induction dec/inc...
inspired concentration pulmonary ventilation pulmonary blood flow arterio-venous conc. gradient |
inc
inc dec dec |
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Major route of elimination for inhalation anesthetics
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lung
|
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elimination only important for...
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halothane
|
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Myer-Overton principle
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interactions with the lipid matrix of the neuronal membrane
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age
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effects the MAC
|
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concomitant drugs
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effects the MAC
|
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temp
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effects the MAC
|
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certain disease states
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effects the MAC
|
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height
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does not effect the MAC
|
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sex
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does not effect the MAC
|
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weight
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does not effect the MAC
|
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decreases SVR
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isoflurane and desflurane
|
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myocardial depressant
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halothane and enflurane
|
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reduce myocardial oxygen consumption
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all
|
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sensitizes myocardium to catecholamines
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halothane
|
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may predispose to ventricular arrhythmias
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halothane
|
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tidal volume
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decreased
|
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respiratory rate
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increased
|
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greatest decrease in ventilatory response to PaCO2
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influrane
|
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ventilatory response to hypoxia
|
dec
|
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metabolic rate of brain
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decreased
|
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brain blood flow
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increased
|
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causes seizure activity on EEG
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enflurane
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renal blood flow
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decreased
|
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hepatic blood flow
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decreased
|
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possibly hepatotoxic
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halothane
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cause of acute liver toxicity
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halothane related oxidative metabolites
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cause of acute kidney damage
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sevoflurane causing fluoride ion toxicity
|
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decreased methionine synthase activity
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prolonged N2O
- may cause megaloblastic anemia and peripheral neuropathies |
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treatment for malignant hyperthermia
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dantrolene
|
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most widely used inhaled agent in the world
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halothane
|
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high solubility
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halothane
|
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most widely used inhaled agent in moder countries
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isoflurane
|
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lowest solubility
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sevoflurane
|
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fastest onset/ on/off changes
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sevoflurane
|
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fluoride toxicity
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sevoflurane
|
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MAC > 100%
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N2O
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most common agent for induction of GA
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thiopental (barbituate)
|
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dose dependent decreases in SV, MAP, CO; and potent respiratory depressent
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thiopental
|
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myoclonic movements
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etomidate
|
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amnestic, anti-emetic, Total intravenous anesthesia
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propofol
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sedative mechanism of action
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CNS depression via enhancement of GABAa actions
|
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act at mu, kappa and delta receptors
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opiods
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best of the IV analgesics
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opiods
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dose dependent respiratory depression and potential chest wall rigidity
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opiods
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4 most common opiods
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fentanyl
sufentanil alfentanil remifentanil (new and ultra-short action) |
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opiod antagonist
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naloxone
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anxiolytic/amnestic
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benzodiazepines
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most common IV benzodiazepine
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midazolam
|
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benzodiazepine antagonist
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flumazenil
|
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phenylcyclidine derivative which produces dissociative anesthesia- catatonia, amnesia, analgesia
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ketamine
|
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CV stimulation, increased cerebral metabolic rate, increased cerebral bood flow
post-op hallucinations and disorientation |
ketamine
|