Mastering General Anesthetic Agents
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Questions and Answers

Which of the following statements about thiopentone sodium is correct?

  • Thiopentone sodium causes analgesia.
  • Thiopentone sodium has a low oil gas partition coefficient.
  • Thiopentone sodium is used as an inducing agent prior to an inhalational agent. (correct)
  • Thiopentone sodium is rapidly metabolized.

    • Which of the following statements about methohexital/methohexitone is correct?

  • Methohexital/methohexitone causes less hangover due to rapid hepatic metabolism. (correct)
  • Methohexital/methohexitone is safe for use in epilepsy patients.
  • Methohexital/methohexitone is associated with a low incidence of muscle twitching.
  • Methohexital/methohexitone is an oxybarbiturate.

    • Which of the following statements about benzodiazepines is correct?

  • Diazepam and lorazepam are dissolved in propylene glycol, which is not irritant to the vasculature.
  • Midazolam, diazepam, and lorazepam are not used in anesthesia.
  • Midazolam is the most popular benzodiazepine for induction of anesthesia. (correct)
  • IV administration of benzodiazepines provides analgesia and adequate skeletal muscle relaxation.

    • Which of the following statements about etomidate is correct?

    <p>Etomidate preserves cardiovascular and respiratory stability.</p> Signup and view all the answers

    Which of the following statements about propofol is correct?

    <p>Propofol possesses antiemetic properties.</p> Signup and view all the answers

    Which of the following statements about opioid agonists is correct?

    <p>Fentanyl is less likely to cause skeletal muscle rigidity than relaxation.</p> Signup and view all the answers

    Which of the following statements about ketamine is correct?

    <p>Ketamine produces more sensory distortion and euphoria than PCP.</p> Signup and view all the answers

    Which of the following is NOT a desirable criterion for a good general anesthetic?

    <p>Rapid induction</p> Signup and view all the answers

    Which site is NOT one of the important sites at which anesthetics act?

    <p>Cerebral cortex</p> Signup and view all the answers

    Which of the following is an advantage of nitrous oxide as an anesthetic?

    <p>Minimal effect on CVS</p> Signup and view all the answers

    Which of the following is NOT an advantage of diethyl ether as an anesthetic?

    <p>Non-toxic to liver &amp; kidney</p> Signup and view all the answers

    Which of the following is NOT a disadvantage of halothane as an anesthetic?

    <p>Sensitizes the myocardium to catecholamines</p> Signup and view all the answers

    Which of the following is NOT an advantage of enflurane as an anesthetic?

    <p>Does not cause hepatic damage</p> Signup and view all the answers

    Which of the following is a disadvantage of isoflurane as an anesthetic?

    <p>Increases heart rate</p> Signup and view all the answers

    Which of the following is NOT an intravenous anesthetic?

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

    Which of the following is NOT an advantage of thiopentone sodium as an anesthetic?

    <p>Safe with a wide therapeutic index</p> Signup and view all the answers

    Which of the following is NOT a characteristic of diethyl ether as an anesthetic?

    <p>Non-irritant to respiratory tract</p> Signup and view all the answers

    Which route is commonly followed for the administration of general anesthetic agents?

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

    What are the major clinical characteristics of nitrous oxide, halothane, desflurane, sevoflurane, isoflurane, and enflurane?

    <p>They are all inhalational anesthetics</p> Signup and view all the answers

    What is the mechanism of action of inhalational anesthetic agents?

    <p>They block NMDA receptors</p> Signup and view all the answers

    Which of the following anesthetics is associated with major toxicities, including hepatotoxicity?

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

    Which of the following is not an intravenous anesthetic?

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

    What is the major indication for the use of benzodiazepines as intravenous anesthetics?

    <p>Induction of anesthesia</p> Signup and view all the answers

    Which of the following is a major clinical characteristic of general anesthesia?

    <p>Responsiveness to painful stimuli</p> Signup and view all the answers

    What is the main effect of general anesthesia on the central nervous system?

    <p>Induction of unconsciousness</p> Signup and view all the answers

    Which of the following routes of administration is NOT commonly used for general anesthetic agents?

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

    What is the purpose of administering general anesthetic agents systemically?

    <p>To induce unconsciousness</p> Signup and view all the answers

    Which of the following is NOT a main inhalational anesthetic agent?

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

    What are the major toxicities associated with nitrous oxide and the halogenated anesthetics?

    <p>Methemoglobinemia and malignant hyperthermia</p> Signup and view all the answers

    Which of the following is a major indication for the use of intravenous anesthetics?

    <p>Inducing amnesia</p> Signup and view all the answers

    Which of the following is NOT a major clinical characteristic of general anesthesia?

    <p>Increased heart rate</p> Signup and view all the answers

    Which of the following is NOT a disadvantage of halothane as an anesthetic?

    <p>Respiratory depression</p> Signup and view all the answers

    Which of the following is an advantage of nitrous oxide as an anesthetic?

    <p>Minimal metabolism</p> Signup and view all the answers

    Which of the following is NOT a major indication for the use of barbiturates as intravenous anesthetics?

    <p>Providing analgesia</p> Signup and view all the answers

    Which of the following is NOT a major indication for the use of opioids as intravenous anesthetics?

    <p>Providing muscle relaxation</p> Signup and view all the answers

    Which of the following is NOT a major indication for the use of propofol as an intravenous anesthetic?

    <p>Providing analgesia</p> Signup and view all the answers

    Which of the following is NOT a major indication for the use of etomidate as an intravenous anesthetic?

    <p>Providing analgesia</p> Signup and view all the answers

    Which of the following is NOT an advantage of nitrous oxide as an anesthetic?

    <p>It provides good analgesia without loss of consciousness</p> Signup and view all the answers

    Which of the following is NOT a disadvantage of halothane as an anesthetic?

    <p>Poor analgesic properties</p> Signup and view all the answers

    Which of the following is NOT a disadvantage of enflurane as an anesthetic?

    <p>Non-irritant to the respiratory tract</p> Signup and view all the answers

    What is the major indication for the use of benzodiazepines as intravenous anesthetics?

    <p>Induction of anesthesia</p> Signup and view all the answers

    Which of the following is NOT a disadvantage of isoflurane as an anesthetic?

    <p>Increased heart rate</p> Signup and view all the answers

    Which of the following is NOT an advantage of thiopentone sodium as an anesthetic?

    <p>Non-toxic to the liver and kidneys</p> Signup and view all the answers

    Which of the following statements about thiopentone sodium is correct?

    <p>It is a highly lipid-soluble barbiturate</p> Signup and view all the answers

    Which of the following is NOT an advantage of diethyl ether as an anesthetic?

    <p>Potent analgesic</p> Signup and view all the answers

    Which of the following is a major clinical characteristic of general anesthesia?

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

    Which of the following statements about ketamine is correct?

    <p>It increases the threshold for firing of CNS neurons</p> Signup and view all the answers

    Which of the following statements about thiopentone sodium is correct?

    <p>Thiopentone sodium is used as an inducing agent prior to an inhalational agent.</p> Signup and view all the answers

    Which of the following statements about methohexital/methohexitone is correct?

    <p>Methohexital/methohexitone causes less hangover due to rapid hepatic metabolism.</p> Signup and view all the answers

    Which of the following statements about benzodiazepines is correct?

    <p>Benzodiazepines are derivatives used in anesthesia.</p> Signup and view all the answers

    Which of the following statements about etomidate is correct?

    <p>Etomidate preserves cardiovascular and respiratory stability.</p> Signup and view all the answers

    Which of the following statements about propofol is correct?

    <p>Propofol is administered via continuous infusion for conscious sedation.</p> Signup and view all the answers

    Which of the following statements about opioid agonists is correct?

    <p>Fentanyl is more likely to cause skeletal muscle rigidity than relaxation.</p> Signup and view all the answers

    Which of the following statements about ketamine is correct?

    <p>Ketamine is chemically related to phencyclidine (PCP).</p> Signup and view all the answers

    Which of the following statements about intravenous anesthetics is correct?

    <p>Intravenous anesthetics cause rapid recovery.</p> Signup and view all the answers

    Which of the following statements about general anesthesia is correct?

    <p>General anesthesia causes respiratory and cardiovascular depression.</p> Signup and view all the answers

    Which of the following statements about nitrous oxide is correct?

    <p>Nitrous oxide possesses antiemetic properties.</p> Signup and view all the answers

    Study Notes

    Thiopentone Sodium

    • A barbiturate that is used as an intravenous anesthetic.
    • It is a potent hypnotic agent that produces a rapid onset of anesthesia.
    • Thiopentone sodium is metabolized in the liver and has a short duration of action.
    • It is commonly used for induction of anesthesia and as a sedative for short procedures.

    Methohexital/Methohexitone

    • This drug is a barbiturate used for intravenous anesthesia.
    • It is a short-acting anesthetic that produces a rapid onset of anesthesia.
    • Methohexital is metabolized in the liver.
    • It is commonly used for induction of anesthesia for short procedures.

    Benzodiazepines

    • This class of drug is used as intravenous anesthetics.
    • They are used primarily for sedation and amnesia.
    • Benzodiazepines have a slower onset of action than barbiturates.
    • They are metabolized in the liver.
    • Common examples are midazolam and diazepam.

    Etomidate

    • An anesthetic used intravenously.
    • It produces rapid onset of anesthesia.
    • Etomidate is metabolized in the liver.
    • It is often used for induction of anesthesia in patients with cardiovascular disease.

    Propofol

    • A hypnotic agent used as an intravenous anesthetic.
    • It has a rapid onset and short duration of action.
    • Propofol is metabolized in the liver.
    • It is commonly used for induction and maintenance of anesthesia.

    Opioid Agonists

    • These drugs are used intravenously as anesthetics.
    • Their primary use is to provide analgesia during anesthesia.
    • Opioid agonists are used in combination with other anesthetic agents.
    • Examples include fentanyl, sufentanil, and remifentanil.

    Ketamine

    • An intravenous anesthetic that has dissociative properties.
    • Ketamine can be used as an induction agent or as a maintenance anesthetic for short procedures.
    • It is metabolized in the liver.
    • It is particularly useful in situations where it is important to maintain airway reflexes.

    Desirable Criteria for General Anesthetics

    • A good general anesthetic should have a rapid onset of action.
    • It should be potent and have a short duration of action.
    • The anesthetic should be safe and have minimal side effects.

    Important Sites of Action for Anesthetics

    • Central Nervous System (CNS)
    • Peripheral Nervous System (PNS)
    • Spinal Cord

    Nitrous Oxide

    • It has analgesic and amnesic properties.
    • It is a weak general anesthetic that can be used in combination with other agents.
    • Nitrous oxide is easily administered by inhalation.

    Diethyl Ether

    • It has been used as a general anesthetic for many years.
    • Diethyl ether has several disadvantages, which include its flammable nature.
    • It has a pungent odor, and it can cause a prolonged recovery period.

    Halothane

    • Commonly used anesthetic agent that is administered by inhalation.
    • Halothane has some disadvantages, such as its hepatotoxicity.
    • It can cause cardiac arrhythmias.

    Enflurane

    • An inhaled general anesthetic.
    • It is commonly used for induction and maintenance of anesthesia.
    • Enflurane is non-flammable, but it has a disadvantage of being a potent trigger for seizures.

    Isoflurane

    • Another inhaled general anesthetic.
    • Isoflurane is non-flammable.
    • The disadvantage is that it may cause hypotension and tachycardia. It is also a potent trigger for malignant hyperthermia.

    Intravenous Anesthetics

    • These anesthetics are rapidly injected into the bloodstream.
    • They are often used to induce anesthesia, especially in situations where rapid onset is required.

    Thiopentone Sodium

    • It can produce a quick onset of anesthesia.
    • The disadvantage is that it has a short duration of action.

    Diethyl Ether

    • It has a prolonged recovery time.
    • It has a pungent odor and can cause nausea and vomiting.

    Administration of General Anesthetic Agents

    • General anesthetic agents are administered by inhalation or intravenously.

    Clinical Characteristics of General Anesthetics

    • Nitrous Oxide: Anesthetic; analgesic properties
    • Halothane: Anesthetic; potent, metabolized in the liver
    • Desflurane: Anesthetic; rapid onset, short duration, low blood solubility, non-flammable
    • Sevoflurane: Anesthetic; non-flammable, rapid onset, short duration
    • Isoflurane: Anesthetic; potent, non-flammable, metabolized in the liver
    • Enflurane: Anesthetic; potent, non-flammable, metabolized in the liver

    Mechanism of Action of Anesthetics

    • General anesthetic agents inhibit neurotransmission by increasing the inhibitory effects (GABA) in the central nervous system (CNS).

    Anesthetic Associated with Major Toxicity

    • Halothane can cause hepatotoxicity.

    Intravenous Anesthetics

    • Thiopentone sodium is a barbiturate intravenous anesthetic.

    Major Indication for the Use of Benzodiazepines

    • Sedation, amnesia, and anxiety relief before surgery

    Major Clinical Characteristic of General Anesthesia

    • General anesthesia is a reversible loss of consciousness and responsiveness.

    Main Effect of General Anesthesia on the CNS

    • General anesthetics act on the brain to reduce neuronal activity and cause unconsciousness.

    Routes of Administration for General Anesthetics

    • Inhalation
    • Intravenous

    Purpose of General Anesthetic Agents

    • To produce a loss of consciousness, analgesia, and muscle relaxation for surgery.

    Inhalational Anesthetic Agents

    • Halothane
    • Enflurane
    • Isoflurane
    • Desflurane
    • Sevoflurane

    Toxicities associated with Nitrous Oxide and Halogenated Anesthetics

    • Nitrous Oxide: Bone marrow suppression and megaloblastic anemia
    • Halogenated Anesthetics: Hepatotoxicity, cardiac arrhythmias, renal toxicity, and neurotoxicity

    Major Indication for the Use of Intravenous Anesthetics

    • Induction and maintenance of general anesthesia.

    Major Clinical Characteristics of General Anesthesia

    • Loss of consciousness
    • Analgesia
    • Muscle relaxation
    • Amnesia

    Disadvantage of Halothane

    • It can cause hepatotoxicity

    Advantage of Nitrous Oxide

    • It is a weak general anesthetic that has analgesic and amnesic properties.

    Major Indication for the Use of Barbiturates as Intravenous Anesthetics

    • Induction of anesthesia The barbiturate drugs used include thiopentone sodium and methohexital/methohexitone.

    Major Indication for the Use of Opioids as Intravenous Anesthetics

    • Analgesia

    Major Indication for the Use of Propofol as an Intravenous Anesthetic

    • Induction and maintenance of anesthesia
    • Sedation

    Major Indication for the Use of Etomidate as an Intravenous Anesthetic

    • Induction of anesthesia in patients with cardiovascular disease.

    Advantage of Nitrous Oxide

    • It is a weak general anesthetic that has analgesic and amnesic properties.
    • It is also relatively safe and has a rapid onset and offset.

    Disadvantage of Halothane

    • It can cause hepatotoxicity
    • It has a slow onset and offset.
    • It can also cause cardiac arrhythmias.

    Disadvantage of Enflurane

    • It can cause seizures and malignant hyperthermia.

    Major Indication for the Use of Benzodiazepines as Intravenous Anesthetics

    • Sedation, amnesia, and anxiety relief before surgery.

    Disadvantage of Isoflurane

    • It can cause hypotension and tachycardia.
    • It can trigger malignant hyperthermia.

    Advantage of Thiopentone Sodium

    • It has a rapid onset of action.
    • It is a potent hypnotic agent.

    Thiopentone Sodium

    • It can cause respiratory depression.
    • It has a short duration of action.

    Advantage of Diethyl Ether

    • It is a potent anesthetic.

    Major Clinical Characteristic of General Anesthesia

    • Loss of consciousness

    Ketamine

    • Ketamine is not a barbiturate. It is a dissociative anesthetic.
    • It is used to induce and maintain anesthesia.
    • It is not metabolized in the liver.

    Thiopentone Sodium

    • Thiopentone sodium is a barbiturate.

    Methohexital/methohexitone

    • Methohexital/methohexitone is a short-acting barbiturate. It is used for induction of anesthesia.

    Benzodiazepines

    • Benzodiazepines are a class of drugs that are used as sedatives, hypnotics, and anxiolytics.

    Etomidate

    • It has a very short duration of action. It is an effective induction agent.

    Propofol

    • It is a very potent and rapid-acting hypnotic agent.
    • It is used for induction and maintenance of anesthesia.
    • it can cause hypotension.

    Opioid Agonists

    • They produce analgesia and sedation.
    • Opioid agonists can cause respiratory depression.

    Ketamine

    • Ketamine is a dissociative anesthetic that produces a unique state of anesthesia.
    • It is used for induction of anesthesia.
    • It is metabolized in the liver.

    Intravenous Anesthetics

    • They can cause a rapid onset of anesthesia.
    • They are used for induction and maintenance of anesthesia.
    • Some IV anesthetics are short-acting and have minimal side effects.

    General Anesthesia

    • It is a reversible loss of consciousness achieved by using anesthetic drugs that suppress neurotransmission in the brain.
    • It is used to perform surgery and other medical procedures without pain and discomfort.

    Nitrous Oxide

    • It has analgesic and amnesic properties.
    • It is a weak general anesthetic.
    • It is metabolized in the liver.

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