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robbypowell's version from 2016-12-01 03:29

General Anesthesia (not inhaled)

Question Answer
What type of GA agents are commonly used for induction of anesthesia before inhalation anesthetics?Intravenous
Intravenous anesthesia can be used in maintenance anesthesia in a technique called _____ _____ anesthesiaTotal Intravenous (continuous infusion)
This barbiturate general anesthetic is also used for seizures and elevated intracranial pressure but should NOT be given in acute asthma, shock states or CHFThiopental
Most barbiturates cause bronchospasm and coughing due to _____ releaseHistamine
What is the half-life of Thiopental?4-8 min
Is the onset of Thiopental slow or rapid?Rapid (Highly lipid soluble and most (80%) is plasma protein bound)(mainly used to induce; sometimes used for maintenance in short term surgery as ambulatory service)
T/F: Thiopental and other barbiturates are hyperalgesicTrue (you must include analgesic when used for anesthesia)***
T/F: Thiopental and other barbiturates are analgesicFalse (HYPERALGESIC, so you must include analgesic when used for anesthesia)***
In what 3 conditions should Thiopental NOT be given?Acute Asthma, Shock States, & CHF
What class of drugs can be used as general anesthetics, anticonvulsants and to decrease intracranial pressure?Barbiturates (e.g. Thiopental)
This IV barbiturate GA agent is less commonly used for induction, but is widely used GA (including in dentistry)Methohexital
Adverse effects associated with Methohexital (greater than other barbiturates)Hiccups, spontaneous movement, & seizures
Which Barbiturate IV GA agent is associated with adverse effects of seizures, spontaneous movement and hiccupsMethohexital
This barbiturate IV GA agent is better than Thiopental for outpatient procedures because it has a lower cumulative effect and a more rapid recoveryMethohexital
This relatively new anesthetic may be an allergy concern because it is formulated in an emulsion containing soybean oil, glycerol, and egg lecithinPropofol ((2, 6- diisopropylphenol)
This IV GA agent can be given to asthmatics and is not a barbituratePropofol (2, 6- diisopropylphenol)
What is the most important adverse effect of Propofol?Apnea (30%) with induction dose
T/F: Propofol should be used cautiously with epileptics because it may cause seizures at high dosesTrue
Most common side effect of PropofolPain on injection (hyperalgesic) (decreases as it is diluted in blood)
T/F: Propofol is hyperalgesicTrue (but decreases as it is diluted in blood, hyperalgesic effect is pain on injection)
What is commonly administered with Propofol to counteract its most common side effect?Lidocaine (pain on injection)
The main advantage of Propofol is that it can be used for what types of anesthesia?induction AND maintenance of anesthesia, as well as for conscious sedation
What anesthetic drug produces Dissociative Fugue?Ketamine
What anesthetic is a hallucinogenic/psychedelic drug related to PCP?Ketamine
Ketamine makes patient feel dissociated from the environment by causing dissociation between ______ and ____ systemsThalamo-neo-cortical & Limbic systems
This anesthetic drug is NMDA-glutamate receptor ANTAGONISTKetamine
T/F: Ketamine is NMDA-glutamate receptor ANTAGONISTTrue
T/F: Ketamine is NMDA-glutamate receptor AGONISTFalse (antagonist)
Only anesthetic that stimulates the cardiovascular system and does not depress respirationKetamine
T/F: it is recommended that antimuscarinic drugs like Atropine should be used with KetamineTrue (stimulates salivary and tracheobronchial secretions)
T/F: Ketamine is safe for patients with Malignant HyperthermiaTrue
This anesthetic is often used an adjuvant with Inhaled anesthetics and is an Alpha-2 Adrenergic AgonistDexmedetomidine
T/F: Dexmedetomidine decreases MAC of inhalation anesthesiaTrue (making them more potent)
T/F: Dexmedetomidine increases MAC of inhalation anesthesiaFalse (decreases, making them more potent)
This general anesthetic is long-acting with a single IV dose, but is water insoluble and can cause ThrombophlebitisDiazepam (Benzodiazepine)
This benzodiazepine has interactions with Cimetidine (H2 receptor antagonist; antacid) and Erythromycin (Antibiotic; Macrolide) which both inhibit its biotransformation (causing over-sedation)Midazolam
What antagonist is given to reverse over-sedation with Midazolam?Flumazenil
This Benzodiazepine is short-acting (short duration) and is suitable for oral useTriazolam
This benzodiazepine is fast acting and used as a PremedicantLorazepam
This class of drugs is used primarily as analgesic adjuncts in combo with other anesthetic agents (esp hyperalgesic ones)Opioids (e.g. Morphine)
This class of drugs decrease the MAC of inhalation anesthetics and also have antitussive actionOpioids (e.g. Morphine)
T/F: Opioids are contraindicated for patients with COPDTrue (main disadvantage: Resp Depression)
Widely used synthetic opioid in outpatient sedation (less potent than morphine) that has Atropine-like properties (antimuscarinic) and is NOT given with MAOi or amphetamines (due to interactions)Meperidine (Demerol)
Synthetic opioid that is highly lipid-soluble, 100x more potent analgesic than morphine, is a POTENT respiratory depressant than can be used as an adjunct or as sole general anesthetic agentFentanyl
What is the OPIOID OF CHOICE for TOTAL IV ANESTHESIA (continuous infusion) that is useful because it has a rapid elimination rate (1/3rd that of fentanyl) (and so is not prone to accumulate)ALFentanil
This alcohol is used in pediatric dentistry as a sedative (in combo with others)Chloral Hydrate
This antimuscarinic drug is used with opioids and barbiturates decrease secretion (salivary and respiratory)Scopolamine
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