General anaesthetics

?
Ideal general aesthetic agents provide (3)
a temporary loss of conciousness/sensation
analgesia
muscle relaxation
1 of 42
stage 1 of general aesthetics
Drowsiness, disorders of perception
Analgesia with some, but not all, anaesthetic agents
2 of 42
stage 2 of general aesthetics
Hyperexcitability, delirium
Loss of consciousness
3 of 42
stage 3 of general aesthetics
Surgical anesthesia
Progressive loss of reflexes
4 of 42
stage 4 of general aesthetics
Medullary paralysis
Loss of control of cardiovascular and/or respiratory systems
5 of 42
what's the lipid theory MOA for general aesthetics
Greater the lipid solubility, the greater the anaesthetic potency. by changing the function of the lipid bi-layer of neuronal cell membranes
6 of 42
Probably a combination of binding to lipid bi-layer of the cell membrane but specifically to what achored in the cell membrane e.g. neurotransmitter receptors.
distinct proteins
7 of 42
Many anaesthetics can affect neurotransmitter receptors which signal through what
ligand-gated channels
8 of 42
within the effects of MOA of ion channels, rather than action potential propogation, The predominant effect is on ,
synaptic transmission
9 of 42
Excitatory synaptic transmission: Anaesthetic are thought to block excitatory receptors such as
Glutamatergic; Cholinergic and Serotonergic (5HT)
10 of 42
Inhibitory synaptic transmission:Generally enhance the function of inhibitory synaptic receptors such as
GABA-A receptors; TREK potassium channels
11 of 42
effect on CV and resp system, nitrous oxide typically causes what
increased HR and BP
12 of 42
effect on CV and resp system, halothane typically causes what
irregular heartbeats
13 of 42
3 different phases for administering general anaesthesia
premedication, induction, maintenance
14 of 42
premedication uses include (3)
reduce anxiety, prevent parasympathomimetric effects of anaesthesia, reduce involuntary muscle contractions
15 of 42
as well as antihistamines and barbiturates, give the MAIN an example of a premedication Sedative/hypnotic and Anti-anxiety agents, general anaesthetic
Benzodiazepines
16 of 42
what might be given to prevent analgesia
opioids such as morphine or fentanyl
17 of 42
what muscarinic antagonists might be administered to prevent excessive cholinergic effects such as salivation and bronchial secretions. Also protect the heart from arrhythmias caused by some anaesthetics (3)
halothane atropine or hyoscine
18 of 42
what antiemetic drug/ antagonists at dopamine receptors are used to prevent post operative vommiting
Metoclopramide and prochlorperazine
19 of 42
what is the name for drugs that cause skeletal muscle blockade i.e. Prevention of reflex-induced muscle contractions for abdominal/thoracic surgery
neuromuscular blockers
20 of 42
name the 2 classes of neuromuscular blockers
depolarising and non-depolarising
21 of 42
how do non-depolarising neuromuscular blockers act?
act by blocking nACh receptors directly (antagonists)
22 of 42
how do depolarising neuromuscular blockers act?
act as agonists at nACh receptors.
23 of 42
example of non-depolarising muscular blocker
Pancuronium; vercuronium; atracuronium
24 of 42
Initial effect is depolarisation (muscle fasciculation) then what
nerve block due to its sustained presence (not broken down by AChE) and activation of the receptor.
25 of 42
example of depolarising muscular blocker
succinylcholine
26 of 42
2 classes of general anaesthetics
intravenous and inhalation
27 of 42
intravenous agents usually used for what and why
induction - less traumatic, rapid acting, short duration of action (no maintenance)
28 of 42
name 4 intravenous drugs
thiopental, propofol, etomidate, ketamine
29 of 42
advantage of propofol?
quick onset of action, quickly metabolised (so induction and partial maintenance)
30 of 42
what receptors does etomidate target? (Short acting => rapid induction and recovery)
on GABA-A receptors containing the beta3 subunit
31 of 42
why is ketamine not used anymore
psychoactive properties. can cause schizophrenia
32 of 42
advantage of inhalation that intravenous can't, No need for metabolism before elimination by lungs => preferred for maintaining anaesthesia
,mimtainence, At steady state, gas concentration in lung correlates with brain concentration => monitor end-expiratory gas concentration to monitor brain concentration. Not possible with intravenous anaesthetics
33 of 42
in the past, ether, halothane, and nitrous oxide used, however which 3 fluranes are commonly used?
sevoflurane, isoflurane, desflurane
34 of 42
what receptors does isoflurane bind to?
GABA, Glutamate receptors. Also affects potassium channels
35 of 42
premedication drugs of note, start or stop or cont? Antibiotics--prevent wound infection
start
36 of 42
premedication drugs of note, start or stop or cont? Oral hypoglycaemic-- avoid hypoglycaemia
STOP
37 of 42
premedication drugs of note, start or stop or cont? Warfarin-- avoid excessive bleeding
STOP
38 of 42
premedication drugs of note, start or stop or cont ? Diuretics--avoid hypovolemia
STOP
39 of 42
premedication drugs of note, start or stop or cont? Anticonvulsants-- avoid seizure
CONTINUE
40 of 42
premedication drugs of note, start or stop or cont? Bronchodilators--avoid bronchoconstriction
continue
41 of 42
premedication drugs of note, start or stop or cont? Antihypertensives/cardiac drugs--avoid hypertension/cardiac related complications
CONTINUE
42 of 42

Other cards in this set

Card 2

Front

stage 1 of general aesthetics

Back

Drowsiness, disorders of perception
Analgesia with some, but not all, anaesthetic agents

Card 3

Front

stage 2 of general aesthetics

Back

Preview of the front of card 3

Card 4

Front

stage 3 of general aesthetics

Back

Preview of the front of card 4

Card 5

Front

stage 4 of general aesthetics

Back

Preview of the front of card 5
View more cards

Comments

No comments have yet been made

Similar Biology resources:

See all Biology resources »See all general aesthetics resources »