DAANCE ANESTHETIC MEDICATIONS – Flashcards
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What medication is not as highly bound to fat as others?
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Brevital
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This may cause hiccups, tachycardia, and respiratory depression
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Brevital
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You should use this cautiously in patients with cardiac dysrhythmias
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Local Anesthetic
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What is Valium (Diazepam) used for?
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To sedate the patient
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What medication is used as an antagonist for narcotics?
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Naloxone (Narcan)
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This medication can cause bad dreams with emergence
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Ketamine
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What organ detoxifies barbituates?
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Liver
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What are the 4 important characteristics that apply to anesthetic agents?
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1. Not Toxic 2. Non Flammable 3. Non addictive 4. Minimal Allergenicity
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This medication causes amnesia?
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Versed
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Name a benzodiazepine?
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Versed
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Versed, Propofol, Brevital, and Ketmine are used for?
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Relaxation and immobility
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What medication is the most effective in causing hypnosis (loss of consciousness)?
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Propofol and barbiturates
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Name a barbiturate
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Brevital
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What medication helps to prevent laryngospasms?
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Robinol and Atropine
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What medication relieves Angina?
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Nytroglycerine
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Microscopic channels within the membranes of neurons through which charged particles or ions pass during conduction of the nerve impulse.
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Ion Channels
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A reversal of charge across the neuronal membrane caused by the movement of positively and negatively charged ions through ion channels.
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Depolarization
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An advancing wave of charge reversal as the nerve impulse advances along the neuron
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Wave of depolarization
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Reestablishment of the normal distribution of charge across a neuronal membrane
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Repolarization
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The junction between two nerves, the impulse "jumps across"
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Synapse
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Bulge at the end of a nerve
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Terminal button
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What is the gap between two nerves called
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Synaptic Cleft
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Chemical substance that crosses the synaptic cleft and activates opening of ion channels in the postsynaptic nerve, and thereby enables the nerve impulse to passed from on nerve to the next.
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Neurotransmitter
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Specialized sites on ion channels to which natural neurotransmitter substances or drugs attach, usually leading to the opening of the ion channel for passage of positively or negatively charged ions.
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Receptor Sites
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What maintains the state of consciousness?
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Wakefulness System
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Where is the wakefulness system located?
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The brainstem
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Unconsciousness induced by an anesthetic agent
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Hypnotic
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Regulate the spectrum of emotion, can go from calm to anxious or rage
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Center of emotion
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What type of medications calm anxiety?
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Anxiolytics
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This ovoid structure in the central portion of the brain relays sensory input to the cerebral cortex
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Relay Center
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A feeling of elation or well-being caused by a drug or anesthetic agent
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Euphoria
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Naturally occurring substances that have analgesic properties similar to those of opioid drugs
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Endorphins
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What center is located in the brainstem that controls such physiologic process as blood pressure and pulse, depth and rate of respiration
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Vital Center
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Almond shaped structure, located in the upper most part of the brainstem and serves as a bridge to the midbrain
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Pons
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Contains the vital center with the pons
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Medulla
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Normal state of vitals
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Hemostasis
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Effect the drug has on the body
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Pharmacodynamics
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Effect the body has on the drug
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Pharmacokinetics
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Release of a drug from its initial receptor site, movement through the blood stream to other body structures
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Redistribution
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Chemical alteration of drugs and other substances that usually takes place in the liver.
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Metabolism
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Anesthesia that relies on the use of several agents together, capitalizing on the best aspects of each agent, but using each at a smaller does than would be required if it were used alone.
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Balanced Anesthesia
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per os means what
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By mouth
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Per os, topical, subcutaneous, rectal, intramuscular, intravenous, inhalation route, or intravenous via infusion pump are all routes of what?
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Routes of administration of medication
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How do you find the percent of concentration for a solution?
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Concentration % = mg/cc (1% = 1g/100mL)
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What are the 4 levels of anesthesia?
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1. Minimal Sedation/Anxiolysis 2. Moderate Sedation/ Conscious Sedation 3. Deep Sedation/Analgesia 4. General Anesthesia
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Describe Minimal Sedation (Anxiolysis)
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Normal response to verbal stimuli. Airway, ventilation, and cardiovascular functions are unaffected.
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Describe Moderate Sedation/Conscious sedation
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Purposeful response to verbal or tactile stimulation. Ventilation, cardiovascular, and airway functions are maintained
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Describe Deep Sedation
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Purposeful response after repeated or painful stimulation with possible need for maintenance of airway, ventilation, and cardiovascular function usually maintained.
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Describe General Anesthesia
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The patient is unarousable, even with painful stimulation, airway intervention required with possible support of ventilation and possible impairment of cardiovascular function.
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A phenomenon during emergence from anesthesia that follows the discontinuation of nitrous oxide and during which nitrous oxide rapidly passes from the bloodstream into the alveoli and displaces other gases, including oxygen
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Diffusion Hypoxia
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Low levels of oxygen in the body's tissue
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Hypoxia
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Increase in the level of carbon dioxide
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Hypercarbia
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Leakage of intravenous fluid into the tissue surrounding an intravenous cannula during an intravenous infusion.
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Extravasation
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The depression between the forearm and the upper arm that is literally "in front of the elbow"
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Antecubital Fossa
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The back or posterior aspect of an anatomic part, eg, the dorsum of the hand
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Dorsum
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What does EMLA stand for
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Eutectic Mixture of Local Anesthetic
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What medication can be irritating upon administration through an IV?
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Valium
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Initiation of a state of unconsciousness during anesthesia
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Induction
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Failure to remember events related to surgery
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Amnesia
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Insensitivity to pain
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Analgesia
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The phenomenon that exists when two drugs are administered together, and the combined effect is greater than the sum of its parts
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Synergistic
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Anesthetic administration fairly frequently into a low running IV
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Incremental Boluses
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Infusion pumps provide a
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Continuous infusion
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What type of medications are anti-nausea medications?
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Antiemetic's
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Barbiturate intravenous anesthetics and propofol are all what kind of depressants?
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Respiratory
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Absence of breathing
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Apnea
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What causes an increase of carbon dioxide (Hypercarbia)
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Apnea
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A distant or wandering gaze
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Nystagmic
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This drug is highly lipid-soluble and reaches its peak in 1 minute. Patients become fully oriented within 15-30 minutes
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Ketamine
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What is the half life of Ketmaine
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Half of the drug is out of the system in 2.5-3 hours.
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This medication is highly bound to fat and is only stable for 24-48 hours and can cause and anesthetic hangover.
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Thiopental sodium (Pentothal)
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Short acting barbiturate, not highly bound to fat. This drug can cause bronchospasms, laryngospasms, hypotension, and hiccupps. This drug should be used in caution with patients with asthma or seizure disorders.
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Brevital/Methohexital
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Chemical structure derived from ammonia used for Lidocaine, mepivacaine, prilocaine, bupivacaine.
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Amide
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A chemical structure by the combination of an acid with an alcohol such as procaine and cocaine.
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Ester
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Having activity that mimics the effects of the sympathetic nervous system eg. epinephrine
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Sympathomimetic
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A topical anesthetic prior to venipuncture
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Vapocoolant
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What does anxiolytic mean?
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Dissolving anxiety
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What is the opposite of the intended effect
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Paradoxical effect
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Inflammation of a blood vessel in response to an irritating intravenously administer substance.
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Phlebitis
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Formation of a blood clot in a blood vessel, usually a vein
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Thrombosis
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Unpleasant feeling on emerging from anesthesia
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Dysphoria
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Another name for the reversal drug Romazicon
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Flumazenil
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Another name for the reversal drug Naloxone
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Narcan
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These drugs can be given by themselves have therapeutic effects if given with a narcotic it can reverse the effects of the narcotic.
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Narcotic Agonist-antagonists
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Drug that counteracts the action of acetylcholine which hereby blocks that action of the parasympathetic nerves
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Anticholinergic
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A drug that counteracts the production of saliva
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Antisialagogue
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To make stronger or enhance the effect of a drug or anesthetic agent
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Potentiate
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Where is the vomiting center located
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Center of the brainstem
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What does the chemoreceptor trigger zone or the CMTZ do?
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It activates the vomiting center
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What do muscle relaxers block?
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Nerve impulses at the neuromuscular junction where the nerve stimulation causes muscles to contract, thereby paralyzing the patient.
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What is the only depolarizing medication used in the clinical setting and why.
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Succinylcholine (Anectine) is used to relax the vocal chords in the case of laryngospasm.
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Sustained twitching of all the muscles of the body
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Fasciculation
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A type of enzyme found in the blood that is responsible for the metabolic breakdown of the muscle relaxant succinylcholine
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Pseudocholinesterase
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Effects of nonpolarizing agents can be reversed by what
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Anticholinesterase
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What is Rocuronium and what is it used for?
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Steroid based short acting muscle relaxant used for intubation and laryngospasms
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Inhalation agents are classified as what?
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Halogenated Hydrocarbons
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What are 4 Inhalation agents used in anesthesia?
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Sevoflurane, Desflurane, Isoflurane, Halothane
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What is the main stem of the bronchi
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Carnia
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What is the monitoring of carbon dioxide in expired air called? This is required in endotracheal intubation use.
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Capnography
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The reason that methohexital (Brevital) is considered to be ultra short acting is because
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It is not as highly bound to fat as thiopental (Pentothal)
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What is the advantage of using Propofol over Brevital?
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Lower incidence of nausea and a shorter duration
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Describe the 4 Classes of Malampatti
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Class I: Soft palate, fauces, uvula, pillars visible Class II: Soft palate, fauces, uvula visible Class III: Soft palate, base of uvula visible Class IV: Soft palate not visible at all
