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Pharm Cards- UNIT 2
Pharm
10
Other
Professional
11/08/2008
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Term

NITROUS OXIDE

 

 Definition
  • ONLY ANESTHETIC GAS IN USE
  • RAPID INDUCTION AND RECOVERY(LOW BLOOD AND TISSUE SOLUBILITY)
  • LOW ANESTHETIC POTENTCY ( MUST BE COMBINED WITH OTHER AGENTS)
  • ALL ELIM. BY LUNGS
  • NO MALIGNANT HYPERTHERMIA
  • NO NEPHROTOXIC OR HEPATOTOXIC
  • DEGRADED BY INTERACTION WITH B12 IN INTESTINAL BACTERIA --> INACTIVATION OF METH. SYNTH.--> MEGALOBLASTIC ANEMIA AND PERIPHERAL NEUROPATHY 
Term
HALOTHANE (FLUTHANE)
 Definition
  • Halogenated general anesthetic
  • the most commonly used inhalation anesthetic in all patients worldwide (NOT US)
  • volatile liquid
  • high blood:gas coefficient
  • high fat:blood coefficient = slow induction
  • accumulates in fat and tissue= slower recovery
  • reduce arterial blood pressure
  • myocardial depression and reduce cardiac output
  • significant effects on cardiac rhythm (sinus brady)
  • dilates cerebral vasculature, increasin blood blow ; increase ICP
  • skeletal and smooth muscle relaxation, inhibits uterine contraction
  • trigger malignant hyperthermia
  • 80% elim. by lungs; liver --> TFA --> heptatic necrosis
  • hepatic necrosis and hepatotoxicity; not used in US much now, only in children
Term
ENFLURANE
 Definition
  • halogenated general anesthetic
  • volatile liquid
  • high blood:gas coefficient = slow induction and recovery
  • primarily used for maintenence
  • 2-8% by liver, fluoride ion byproduct
  • decrease in arterial bp
  • minimal effects on heart
  • cerebral vasodilationn
  • significant skeletal muslce relaxation
  • electrical seizure activity
Term
ISOFLURANE
 Definition
  • halogenated general anesthetic
  • volatile liquid
  • used for maintenence (pungent odor)
  • excreted by lungs only
  • decrease arterial bp
  • cardiac output maintained b/c decrease in vasc. resistance
  • potent coronary vasodilator= safe for patients with ischemic heart disease
  • markedly increases cerebral blood flow
  • depression of ventilation
  • may trigger malignant hyperthermia
  • not know about breast milk
Term
SEVOFLURANE
 Definition
  • halogenated general anesthetic
  • volatile liquid
  • undergoes exothermic reaction with CO2 absorbent=rare causes of extreme heat, smoke or spontaneous fire in the anesthesia breathing circuit
  • rapid rate of induction and recovery (outpatient surgery)
  • 3% liver
  • cardiac depressant
  • decrease BP
  • potent bronchodilator
  • skeletal muscle relaxation
  • potential nephrotoxicity
  • seizures
  • can cause malignant hyperthermia
  • rare cases of mild, moderate, and severe hepatic disfxn.  or hepatitis with or without jaundice
Term
SODIUM THIOPENTAL (barbiturate)
 Definition
  • intravenous anesthetic
  • high lipid solubility; rapid entry into brain
  • used for "induction" and minor procedures
  • rapid action due to high transfer across BBB
  • short duration of action(5-8min)
  • repeated IV use leads to prolonged anesthesia b/c fatty tissues act as a reservoir
  • slow injection is recco. to minimize respiratory depression
  • narrow margin between anesthetic dose and dose causing cardiovascular effect
  • no analgesic effect
  • slowly metabolized and accumulate in body fat="hang over" effect
  • largely degraded in liver; metabolites are inactive
  • crosses placenta and breast milk
Term
IMIDAZOLE: ETOMIDATE
 Definition
  • intravenous general anesthetic
  • similar to thiopental but more quickly metabolized
  • no significant cardiovasc or resp. depression
  • involuntary movements during induction
  • slightly lowers intracranial pressure and causes a moderate decrease in intraocular pressure
  • reduce plasma cortisol
  • not known about breast milk
Term
PHENOLS; PROPOFOL
 Definition
  • intravenous general anesthetic
  • IV sedative-hypnotic agent that can be used for induction and maintenence
  • rapidly acting;
  • slow infusion is preferred
  • induction often associated with apnea
  • rapidly metabolized; no "hangover effect"
  • very rapid recovery, no cumulative effect
  • no malignant hyperthermia
  • not reccomended for obstetrics b/c crosses placenta
  • not reccomended for nursing mothers because in breast milk
  • risk of seizure
Term
DISSOCIATIVE AGENT; KETAMINE
 Definition
  • intravenous anesthetic
  • analog of PCP; can cause hallucinations or irrational behavior
  • induction and maintenence
  • rapid acting
  • catatonia
  • amnesia
  • analgesia
  • w/ or w/o loss of consciousness
  • noncomp. antagonist of the NMDA receptor and produces "dissociative anesthesia"
  • well documented neuroprotective effect against ischemic brain injury and glutamate induced brain injury
  • wide margin of safety
  • not recco with pregnancy
Term

OPIOIDS; FENTANYL

 

 Definition
  • intravenous general anesthetic
  • used to treat moderate to severe pain; potent analgesic
  • 30-60 min duration
  • alterations in resp. rate and alveolar ventilation may last longer than analgesic effect (slows resp rate and duration)
  • muscle rigidity
  • bradycardia
  • not recco for preg, children b/c insufficient data
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