General Anesthetics Overview
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Questions and Answers

What does a lower MAC value indicate about an inhalation anesthetic?

  • It has a higher blood/gas partition coefficient.
  • It requires more concentration to induce anesthesia.
  • It causes slower induction.
  • It has higher potency. (correct)

    • Which parameter reflects the speed of induction and awakening from inhalation anesthesia?

  • Blood/gas partition coefficient. (correct)
  • Heart rate variability.
  • Neurotransmitter levels.
  • MAC value.

    • Which is not a stage of general anesthesia based on ether narcosis?

  • Recovery. (correct)
  • Immobilization.
  • Excitement.
  • Analgesia.

    • Why is immobility no longer a safe criterion for controlling the depth of anesthesia?

    <p>Muscle relaxants can cause paralysis without loss of consciousness.</p> Signup and view all the answers

    At what concentration do inhalation anesthetics primarily induce amnesia?

    <p>At low concentrations.</p> Signup and view all the answers

    What method is commonly used today to monitor the depth of anesthesia?

    <p>EEG and hemodynamic function.</p> Signup and view all the answers

    Which of the following could be a consequence of using muscle relaxants during anesthesia?

    <p>Masking the loss of consciousness.</p> Signup and view all the answers

    Modern general anesthetics may eliminate which stages of ether narcosis?

    <p>Stage 1 and 2.</p> Signup and view all the answers

    Which anesthetic is primarily used for induction anesthesia and has sedative and hypnotic effects?

    <p>Propofol</p> Signup and view all the answers

    What mechanism of action is associated with Etomidate?

    <p>GABA-A allosteric modulation</p> Signup and view all the answers

    Which anesthetic is known for causing a dissociative state and analgesia?

    <p>Ketamine</p> Signup and view all the answers

    What is the primary use of Sevoflurane in anesthesia?

    <p>Maintenance anesthesia</p> Signup and view all the answers

    Which of the following anesthetics is NOT classified as a non-inhalation anesthetic?

    <p>Sevoflurane</p> Signup and view all the answers

    What type of effect does Propofol have due to its action on GABA-A receptors?

    <p>Sedative, hypnotic</p> Signup and view all the answers

    Which anesthetic is characterized as causing a cataleptic condition where the patient remains uncommunicative but has open eyes?

    <p>Ketamine</p> Signup and view all the answers

    Which of the following anesthetics is primarily used with oxygen or nitrous oxide for maintenance anesthesia?

    <p>Sevoflurane</p> Signup and view all the answers

    What does a dark green spot indicate in the context of anesthetics?

    <p>Significant potentiation by the anesthetic</p> Signup and view all the answers

    Which of the following is a key characteristic of dexmedetomidine?

    <p>It has central α2 receptor agonist activity</p> Signup and view all the answers

    What is the purpose of premedication before general anesthesia?

    <p>To prepare the patient for general anesthesia and surgical manipulation</p> Signup and view all the answers

    Which of the following is NOT typically used as a premedication drug?

    <p>Opioids</p> Signup and view all the answers

    How does premedication affect the side effects of anesthetics or surgical manipulation?

    <p>It may reduce the side effects of anesthetics or surgical manipulation.</p> Signup and view all the answers

    Which ion is associated with NMDA receptors that anesthetics may modulate?

    <p>Calcium ion</p> Signup and view all the answers

    What characteristic of a light pink spot indicates regarding the anesthetic's effect?

    <p>Some inhibition by the anesthetic</p> Signup and view all the answers

    Which of the following sedative agents is known for reducing the need for other anesthetics such as propofol and opioids?

    <p>Dexmedetomidine</p> Signup and view all the answers

    What is the primary difference between peripheral and central action muscle relaxants?

    <p>Central action relaxants work on the brain and spinal cord.</p> Signup and view all the answers

    Which type of local anesthesia involves a drug being applied topically?

    <p>Surface or terminal anesthesia</p> Signup and view all the answers

    How does infiltration anesthesia block sensory and motor nerve receptors?

    <p>The drug diffuses from the tissue into the nerve.</p> Signup and view all the answers

    What distinguishes spinal anesthesia from analgesia?

    <p>Spinal anesthesia includes muscle relaxation effects.</p> Signup and view all the answers

    Which of the following is an example of a peripheral action muscle relaxant?

    <p>Suxamethonium</p> Signup and view all the answers

    What is the role of local anesthetics in nerve fibers?

    <p>They interrupt the conduction of excitation pulses.</p> Signup and view all the answers

    What is a common application for epidural anesthesia?

    <p>Administered in the epidural space to block nerve roots.</p> Signup and view all the answers

    What type of fibers do local anesthetics primarily affect?

    <p>Sensory fibers responsible for pain sensation.</p> Signup and view all the answers

    What are the potential systemic side effects of local anesthetics?

    <p>Cardiotoxicity and CNS toxicity</p> Signup and view all the answers

    How does liver disease affect the metabolism of amide local anesthetics?

    <p>It slows down the metabolism, potentially increasing toxicity</p> Signup and view all the answers

    Which local anesthetic is classified as a Class 1B antiarrhythmic when administered intravenously?

    <p>Lidocaine</p> Signup and view all the answers

    What is a primary disadvantage of ester local anesthetics compared to amide anesthetics?

    <p>Higher incidence of allergic complications</p> Signup and view all the answers

    What is the mechanism by which local anesthetics exert their effect?

    <p>Na+ channel blockade</p> Signup and view all the answers

    Which type of anesthesia involves administering an anesthetic agent through the epidural space?

    <p>Epidural anesthesia</p> Signup and view all the answers

    What is a common reason for the shorter duration of action seen with esters compared to amides?

    <p>Rapid metabolism by esterases</p> Signup and view all the answers

    Which of the following best describes a characteristic of amide local anesthetics?

    <p>Metabolized primarily in the liver</p> Signup and view all the answers

    What role does the non-ionized form of local anesthetics play?

    <p>It penetrates the cell membrane efficiently.</p> Signup and view all the answers

    Why does the degree of ionization of local anesthetics decrease in infected tissues?

    <p>Infected tissues have a more acidic environment.</p> Signup and view all the answers

    What is a common adverse effect associated with the vasodilatory properties of most local anesthetics?

    <p>Increased risk of systemic side effects.</p> Signup and view all the answers

    Which components make up the Na+ channels in neurons?

    <p>Three subunits: α, β1, β2.</p> Signup and view all the answers

    What is a method commonly used to counteract the vasodilatory effect of local anesthetics?

    <p>Combining it with vasoconstrictors.</p> Signup and view all the answers

    What is the effect of the ionized form of local anesthetics on Na+ channels?

    <p>It blocks the Na+ channels.</p> Signup and view all the answers

    How does tissue pH affect local anesthetics?

    <p>It alters the pKa and ionization degree.</p> Signup and view all the answers

    What is the primary property of both non-ionized and ionized forms of local anesthetics?

    <p>They both play a role in anesthesia.</p> Signup and view all the answers

    Study Notes

    General Anesthetics

    • General anesthetics induce a reversible, medically-induced state characterized by amnesia, loss of consciousness, and immobility.
    • Analgesic properties are not uniform across all general anesthetics.
    • Induction anesthesia aims to avoid excitory anesthetic stage and reduce maintenance dose.
    • Induction anesthetics may not always produce the desired depth of anesthesia for the situation.
    • Maintenance anesthesia provides the required depth of anesthesia for a given clinical setting.

    Inhalation Anesthetics

    • Inhalation anesthetics include volatile liquids (e.g., sevoflurane) and gaseous substances (e.g., nitrous oxide).
    • Sevoflurane is often used in oxygen or oxygen/nitrous oxide mixtures.
    • All flurans (including sevoflurane) have arrhythmogenic effects.
    • Malignant hyperthermia is a genetic condition triggered by certain inhalational anesthetics, often resulting in tachycardia, respiratory failure, acidosis, rigidity, and rhabdomyolysis.

    Nitrous Oxide

    • Nitrous oxide (N₂O) is a gaseous anesthetic.
    • It works as an NMDA receptor antagonist.
    • It produces a sedative and analgesic effect but does not cause muscle relaxation.
    • N₂O triggers the release of endogenous opioid peptides (endorphins) in the brain stem, contributing to its anesthetic effects.

    Non-Inhalation Anesthetics

    • Propofol, ketamine, and etomidate are non-inhalation anesthetics.
    • Propofol's mechanism involves allosteric modulation of GABA receptors.
    • Propofol exerts sedative and hypnotic effects, and is important for maintaining general anesthesia and as an induction agent.
    • Etomidate allosterically modulates GABA-A receptors to produce a sedative and hypnotic effect, and is useful for induction anesthesia.
    • Ketamine is an NMDA receptor channel blocker that produces analgesia and dissociative anesthesia.
    • Ketamine is used for maintaining general anesthesia, induction, and postoperative sedation.

    Sedative Agents

    • Dexmedetomidine is a central α2 receptor agonist.
    • It induces sedative, anxiolytic, analgesic, and sympatholytic effects.
    • Dexmedetomidine is used intravenously in intensive care units for short-term diagnostic or surgical procedures.

    Premedication Agents

    • Premedication involves administering drugs before general anesthesia to prepare the patient and reduce side effects.
    • Premedication drugs come from various classes, such as cholinolytics, anxiolytics, sedatives, beta-adrenergic blocking agents, antihistamines, and hypotensive agents.
    • Diazepam, midazolam, and atropine are examples of premedication agents.

    Myorelaxants

    • Muscle relaxants (myorelaxants) are categorized as central or peripheral acting.
    • Suxamethonium is a central acting N-cholinergic agonist.
    • Rocuronium is a peripheral acting N-cholinergic antagonist.

    Local Anesthetics

    • Local anesthetics reversibly inhibit sensory and motor function, and interrupt excitation pulse conduction in nerve fibers.
    • Lidocaine and bupivacaine are examples of aminoamide local anesthetics.
    • Benzocaine is an example of an amino ester local anesthetic.
    • Important considerations regarding local anesthetics include their degree of ionization, vasodilatory effects, and potential for systemic side effects.
    • Local anesthetics have different types based on application site and method. These include surface/terminal anesthesia, infiltration, regional (spinal and epidural), and wire anesthesia.

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    Description

    This quiz explores the fundamentals of general anesthetics, including induction and maintenance anesthesia, as well as the characteristics of inhalation anesthetics like sevoflurane and nitrous oxide. Understand the implications of their use, including potential side effects such as malignant hyperthermia. Test your knowledge on these essential concepts in anesthesiology.

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