Term
| What type of anesthesia offers anxiolysis (decrease anxiety) and can be moderate or deep? |
|
Definition
|
|
Term
| What type of anesthesia is it when you can't recall anything going on around you; in a state of artificially induced coma? |
|
Definition
|
|
Term
| What are local anesthesia, regional anesthesia, and neuraxial anesthesia all considered? |
|
Definition
Nerve blockade
Regional anesthesia (nerve or plexus blocks)
Neuraxial anesthesia (spinal or epidural) |
|
|
Term
| What are the 3 goals of anesthesia |
|
Definition
Amnesia (can't recall anything)
Analgesia (pain relief-important)
Neuromuscular blockade (paralysis) |
|
|
Term
| What are the different roles of the anesthesiologist? |
|
Definition
• Preoperative Risk Assessment
• Intraoperative Care
• Anesthesia Recovery / Postoperative Care
• Critical Care Medicine
• Pain Medicine
• Anesthesia for Labor and Delivery
• Medical Emergency Services (MET Team) |
|
|
Term
| What intravenous anesthetic helps with sleep and anxiety (anxiolysis) |
|
Definition
|
|
Term
What intravenous anesthetic can be used for long cases, cheap, and always of shortage because it's rarely produced?
Which is the more expensive drug, better recovery, and shorter effect? |
|
Definition
|
|
Term
| What intravenous anesthetic is used for patients with cardiac problems because it depresses the vasculature less |
|
Definition
|
|
Term
| What intravenous anesthetic is raises the heart rate and blood pressure? |
|
Definition
|
|
Term
| What inhalational anesthetics is used to maintain anesthesia, put in vaporizers |
|
Definition
| volatile anesthetics (contains nitrous oxide, xenon) |
|
|
Term
| What is used for pain relief? |
|
Definition
|
|
Term
| What intravenous opioid is potent but doesn't cause much effect on alertness so is useful for procedures that you expect a lot of pain but want them awake in the end? |
|
Definition
|
|
Term
| What intravenous opioid is longer acting and used for postoperative pain relief? |
|
Definition
|
|
Term
| What intravenous opioid is short acting? |
|
Definition
|
|
Term
| What intravenous opioid is frequently used, even seen in dental procedure? |
|
Definition
|
|
Term
| What intravenous opioid is potent, doesn't have short elimination half-life, broken down by plasma esterases into non-active metabolites quickly. It is very predictable and short time of acting, given as infusion and effect goes away in 5 minutes when stop infusion |
|
Definition
|
|
Term
| What intravenous opioid has a metabolite that when given a lot and repeatedly it can cause seizure but is good for bowel surgery? |
|
Definition
|
|
Term
Identify whether the following muscle relaxants is short, intermediate, long acting
Atracurium
Pancuronium
Mivacuirium
Rapacuronium
Cisatracurium
Rocuronium |
|
Definition
Atracurium - intermediate
Pancuronium - long
Mivacuirium - short
Rapacuronium - short
Cisatracurium - intermediate (not renally excreted)
Rocuronium - intermediate (used mostly) |
|
|
Term
| What drug is used as muscle relaxant because it depolarizes the muscle and causes paralysis because it depletes all of the acetylcholine? |
|
Definition
|
|
Term
| What is a state resembling sleep marked by a level of awareness other than the conscious state? |
|
Definition
|
|
Term
| What is the condition that involves complete or near-complete lack of responsiveness to people and other environmental stimuli? |
|
Definition
| unconsciousness (condition of being not conscious) |
|
|
Term
| What is a state of unconsciousness lasting more than 6 hours, in which a person cannot be awakened, fails to respond normally to painful stimuli, light or sound, lacks a normal sleep wake cycle and does not initiate voluntary actions |
|
Definition
|
|
Term
| Some people consider anesthesia as a drug induced _____. |
|
Definition
|
|
Term
| What do people test in order measure how deep anesthesia is? |
|
Definition
| they try to elicit recall (by playing words during anesthesia) |
|
|
Term
| What is the test used in animal literature for consciousness? |
|
Definition
| mirror test (dot placed on forehead to see if animal tries to remove the dot) |
|
|
Term
| In this theory, conscious depend on? |
|
Definition
| patterns of coherent neuronal activity in the thalamus, which in turn are modulated by the ascending arousal system |
|
|
Term
| When monitoring conscious, if the EEG frequency faster or slower when you're awake versus when you are in deep sedation? |
|
Definition
| EEG frequency is faster when you're awake (smaller waves) and slower when you're asleep (large waves; larger waves when in deep sedation) |
|
|
Term
| In PET imaging, do you see more or less cortical activity when you are awake? |
|
Definition
| more cortical activity when awake |
|
|
Term
| What are the 2 proposed mechanism of actions for inhaled anesthetics and which one is more specific? |
|
Definition
Lipid theory (Anesthetics bind to lipids in
the membrane of neurons and disrupt
neurotransmission - global shut down)
Ion channel specific effects (drug binds to channels - more specific) |
|
|
Term
What drug prolongs channel opening and
increases postsynaptic inhibition |
|
Definition
|
|
Term
| What drug(s) opens the GABA receptor chloride channels? |
|
Definition
|
|
Term
| What drug enhances GABA receptor action primarily through effects on the alpha subunit? |
|
Definition
|
|
Term
*what is is a concept used to compare the strengths, or
potency, of volatile anesthetics.
It is the concentration in the lungs that is needed to prevent movement (motor response) in 50% of subjects in response to surgical (pain) stimulus |
|
Definition
| Minimum alveolar concentration (MAC) - we want to be above MAC |
|
|
Term
| Why is it that patients may go back to sleep after they have awoken? |
|
Definition
We have different profusion of tissue (slowest is fatty tissue)
The anesthesia may still be in their tissues (muscles) that can come out later |
|
|
Term
| Do barbiturates decrease or enhance pain? |
|
Definition
|
|
Term
| In the study involving pain with heat, cold, and electrical, which did propofol increase pain in? |
|
Definition
| increased heat pain (reduced cold and electrical pain) |
|
|
Term
Of the following local anesthesias, which was the first local anesthetic, which was then invented that had a longer duration of action/more potent, and which was then invented that was similar but less toxic?
bupivacaine
lidocaine
ropivacaine |
|
Definition
• Lidocaine 1943
– first synthetic local anesthetic.
• Bupivacaine 1957
– duration of action
• Ropivacaine 1996
-less toxic |
|
|
Term
| What is the mechanism of action of local anesthetics? |
|
Definition
| They work through a sodium channel, so they block sodium channels and thereby decrease nerve conduction |
|
|
Term
| What are the 2 classes of local anesthetics and which one is more used? |
|
Definition
Ester (hydrolyzed)
Amides (more used) |
|
|
Term
Identify if the follow local anesthetic is an ester or amide
Benzocaine
Procaine
Bupivacaine
Lidocaine
Ropivacaine
Tetracaine
Mepivacaine
Cocaine
Chloroprocaine |
|
Definition
Benzocaine - ester
Procaine - ester
Bupivacaine -amide (longer lasting bc protein bound)
Lidocaine -amide
Ropivacaine-amide
Tetracaine-ester
Mepivacaine-amide
Cocaine-ester
Chloroprocaine-ester (very safe) |
|
|
Term
what appears to be the most significant
property of local anesthetic molecules in determining
anesthetic potency |
|
Definition
|
|
Term
| What determines the duration of conduction block of a local anesthetic? |
|
Definition
|
|
Term
| *Allergic reactions from local anesthesia is due to what? |
|
Definition
| metabolites of ester-linked local anesthesia (namely PABA or compounds similar to PABA used as preservatives) |
|
|
Term
| *Tachycardia from local anesthesia is due to what? |
|
Definition
| epinephrine containing solutions |
|
|
Term
| If a patient has ringing in their ears or a funny taste in their mouth after receiving lidocaine than what is that a sign of? |
|
Definition
|
|
Term
| Which comes first: CNS or cardiac toxicity? |
|
Definition
| CNS toxicity occurs at lower concentration than cardiac toxicity |
|
|
Term
Benzocaine and a metabolite of prilocaine can
cause clinically significant____________ |
|
Definition
| methemoglobinemia (treat with methylene blue) |
|
|
Term
The muscle relaxant Mivacurium is (short or long acting)?
Pancuronium?
What is the biggest danger with muscle relaxants? |
|
Definition
mivacaurium (short)
pancuronium (long)
being unable to intubate or ventilate the patient |
|
|
