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26 Cards in this Set
- Front
- Back
Inhalant Agents
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Nitrous Oxide
Halothane (Flourothane) Isoflurane (Forane) Sevoflurane (Ultane) Desflurane (Suprene) |
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Intravenous Agents
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Midazolam (Versed)
Propofol (Diprivan) Etomidate (Amidate) Ketamine (Ketalar) |
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Opioid Analgesics
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Fentanyl (Sublimaze)
|
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Halothane (Fluothane)
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1) MAC: 0.75; Blood/gas 2.54
2) Slow induction, rapid awakening |
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Halothane (Fluothane)
Side effects |
1) Uterine Relaxation
2) Respiratory depression 3) Blood Pressure decreases linearly with amount 4) Sensatization to catecholamines, arrythmias 5) Uterine relaxation/ miscarriages 6) reduced renal function/ urine flow 7) Hepatic Necrosis with repeated administration 8) Malignant Hyperthermia with succinylcholine |
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Enflurane
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Contraindicated in patients with seizure disorders.
May cause CNS stimulation and seizures. Floride production=reversible kidney damage |
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Isoflurane (Forane)
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Rapid induction emergence
Useful in neurosurgery Low liver kidney Toxicity Coronary steal Does not depress myocardium or sensitize it to catecholamines |
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Sevoflurane (Ultane)
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Rapid effect
Least airway irritation Safest in Cardiovascular disease |
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Desflurane (Suprane)
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Rapid emergence, induction
Good for outpatient surgery Pungent odor, irritates airway Not used for induction |
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Metabolism of Inhaled anesthetics
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1) Cl and Br may be removed from Halothane causing immune reaction and hepatitis
2) Evoflurane and Sevoflurane release Floride-kidney toxicity (rare) |
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Malignant Hyperthermia
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Rapid rise in heat production
Caused by use of succinylcholine with inhaled anesthetics. May be fatal Treat with Dantrolene |
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Effects of General Anesthetics
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Decrease BP
Decrease Respiratory Drive Increase Cerebral blood flow Increase Intracranial pressure Hypothermia |
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Effects of General Anesthetics
Emergence |
Hypertension
Tachycardia Myocardial ischemia (CAD patients) Excitment(Crying, thrashing, moaning) Shivering Can Reduce with Opioids |
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Mechanism of action General Anesthetics
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1) GABAa agonist (Barbituates, Benzodiazepines, Propofol)
2) Block NMDA (Ketamine) 3) Opioid Receptor (Opiates) |
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Nitrous Oxide
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Low potency for Anesthesia
Good Analgesia (Dental) Attenuates Hypotension Cause Diffusion Hypoxia No malignant Hyperthermia Little respiratory depression |
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Nitrous Oxide
Adverse effects |
1) Causes Euphoria-abuse
2) Trapped gas will expand 3) Chronic low level exposure-Peripheral neuropathy 4) Megaloblastic anemia 5) Don't use within three months of eye surgery |
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Nitrous Oxide
Uses |
Speeds induction
With other drugs for "Balanced anesthesia" |
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Thiopental (pentothal)
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Induction for short procedures (onset 30-60sec)
Contraindicated in patients with acute intermittent porphyria- causes demyelination of nerves |
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Midazolam (Versed)
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1) Sedation, Anxiety relief,
Anterograde amnesia 2) Preanesthetic and induction 3)Short procedures it is combined with Fentanyl 4) Reversed by flumanzenil |
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Propofol (Diprivian)
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1) DOC for most procedures
I2) nduction and maintenance 3) Induction equal to thiopental emergence 10 times faster 4) Decrease cerebral blood flow, metabolism and intracranial pressure= good for neurosurg 5) Safe in pregnancy |
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Propofol (Diprivian)
Adverse effects |
1) Severe Respiratory depression
2) Pain at injection site 3) Anaphylactic reactions 4)LESS nausea and vomiting |
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Etomidate (Amidate)
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Increase GABA receptors and displace inhibitors
Rapid onset short duration No hypotension |
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Etomidate (Amidate)
Adverse effects |
1) Nausea and vomiting
2) Decrease seizure threshold 3) Hiccups |
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Ketamine (Ketalar)
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1) Catatonic state
2) Dissociative anesthesia, profound analgesia 3) Little respiratory depression 4) Used in children 5) Uncommon Nausea and vomiting |
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Ketamine (Ketalar)
Adverse effects |
1) Increase BP and HR
2) Emergence delerium: bizzare dreams hallucination, even psychosis 3) Date rape drug 4) Abused |
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Fentanyl (Sublimaze) Sufentalnil (Sufenta)
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1) IV
2) Rapid onset, Good analgesia 3) Lollipops for kids 4) Midazolam combined for short procedures |