Bind to GABAA receptor subunits facilitating Cl- channel opening; sedation and relief of anxiety

↓ BP, SV, CO

↓ CNS metabolism, O2 utilization,

cerebral blood flow

↓ Sensitivity of medullary respiratory center to CO2 (respiratory depressant)

Exacerbate porphyria

Respiratory depression,

Induces P450

Patients with cerebral swelling – head trauma, brain tumors (intracranial pressure not ↑)

Depression of central ventilator drive, transient  apnea, ↓ BP, negative ionotropic effects

Prolonged administration can ↑ serum lipid levels; severe acidosis in presence of resp infections and possible neurologic sequelae upon withdrawal (in children);

pain at injection site, hypotonus, rarely tremors

Most popular IV anesthetic
more rapid recovery, ↓ postop nausea and vomiting

Induction and maintenance of anesthesia, and prolonged sedation

Minimal cardiovascular and respiratory depression; rapid loss of consciousness with minimal hypotension, unchanged HR, low incidence of apnea

High incidence of pain on injection, myoclonic activity, postop nausea and vomiting, adrenocortical suppression

Induction of anesthesia in patients with limited cardiovascular reserve

No analgesic effects (administer with opioids)

Blocks glutamate’s effects at the

NMDA receptor

Stimulates the CNS

Inhibits norepi reuptake

Anesthetic & analgesic with cardiovascular stimulation;

↑ HR, BP, CO, cerebral blood flow, O2 consumption, intracranial pressure

High incidence of post-op psychic phenomena: disorientation,

sensory & perceptual illusions, vivid dreams

Psychosis

High-risk patients in

cardiogenic or septic shock

(due to cardio-stimulatory

properties)

Produces a dissociative

anesthetic state

Strong analgesia, cannot produce full anesthesia

Megaloblastic anemia

Inhaled anesthetics target the GABA_A receptor Cl^- channel, which is a major mediator of

inhibitory synaptic transmission. The anesthetics facilitate GABA-mediated inhibition, increasing the

sensitivity of the GABA_A receptor for GABA.

Other sites of action include stimulation of inhibitory glycine receptors in the spinal cord and

inhibition of nicotinic receptors in the peripheral nervous system.

Acute Toxicity:

Malignant hyperthermia

Chronic Toxicity:

Prolonged exposure to most anesthetics can lead to renal insufficiency, mutagenicity,

carcinogenicity, hematotoxicity, and a higher incidence of miscarriages

Strong anesthetic; minor analgesia

Cardiac arrhythmias, severe Hepatic toxicity

Inhaled anesthetics target the GABA_A receptor Cl^- channel, which is a major mediator of

inhibitory synaptic transmission. The anesthetics facilitate GABA-mediated inhibition, increasing the

sensitivity of the GABA_A receptor for GABA.

Other sites of action include stimulation of inhibitory glycine receptors in the spinal cord and

inhibition of nicotinic receptors in the peripheral nervous system.

Acute Toxicity:

Malignant hyperthermia

Chronic Toxicity:

Prolonged exposure to most anesthetics can lead to renal insufficiency, mutagenicity,

carcinogenicity, hematotoxicity, and a higher incidence of miscarriages

Inhaled anesthetics target the GABA_A receptor Cl^- channel, which is a major mediator of

inhibitory synaptic transmission. The anesthetics facilitate GABA-mediated inhibition, increasing the

sensitivity of the GABA_A receptor for GABA.

Other sites of action include stimulation of inhibitory glycine receptors in the spinal cord and

inhibition of nicotinic receptors in the peripheral nervous system.

Acute Toxicity:

Malignant hyperthermia

Chronic Toxicity:

Prolonged exposure to most anesthetics can lead to renal insufficiency, mutagenicity,

carcinogenicity, hematotoxicity, and a higher incidence of miscarriages

Droperidol (a butyrophenone) and fentanyl administered together produce analgesia and amnesia and combinedwith nitrous oxide provide a state referred to as neuroleptanesthesia

Neuroleptanesthesia

High doses used with benzodiazepines to achieve anesthetic state

Awareness during anesthesia and postop recall may occur; chest wall rigidity; ↑ postop opioid requirements due to tolerance

Cardiac or other major surgery when patient’s circulatory reserve is limited

Bind to GABA_A receptor subunits facilitating Cl^- channel opening; sedation and relief of anxiety

Large doses prolong recovery period and can produce anterograde amnesia

Premedication – sedative-anxiolytic with high incidence of amnesia