Podcast
Questions and Answers
What is the primary aim of Phase 2 metabolism in drug processing?
What is the primary aim of Phase 2 metabolism in drug processing?
- To increase the solubility of the metabolized drug (correct)
- To excrete drugs unchanged from the body
- To convert drugs into their active forms
- To decrease the solubility of the metabolized drug
Which combination of gases is primarily used for analgesia during procedures?
Which combination of gases is primarily used for analgesia during procedures?
- 25% nitrous oxide and 75% oxygen
- 100% oxygen mixed with nitrous oxide
- 70% oxygen and 30% nitrous oxide
- 50% nitrous oxide and 50% oxygen (correct)
What are common adverse effects of prolonged administration of certain anesthetics?
What are common adverse effects of prolonged administration of certain anesthetics?
- Diarrhea and renal failure
- Megaloblastic anemia and nausea (correct)
- Cardiovascular disease and headache
- Respiratory depression and convulsions
Which of the following is NOT a contraindication for the use of nitrous oxide?
Which of the following is NOT a contraindication for the use of nitrous oxide?
What is the acceptable concentration of oxygen in inspired anesthetic gases?
What is the acceptable concentration of oxygen in inspired anesthetic gases?
What potential effect does administering oxygen above 80% have?
What potential effect does administering oxygen above 80% have?
What is the recommended dosage of premedication for adults before surgery via subcutaneous or intramuscular injection?
What is the recommended dosage of premedication for adults before surgery via subcutaneous or intramuscular injection?
Which of the following may result from inhalational anesthetic practice?
Which of the following may result from inhalational anesthetic practice?
What is the first step in the WHO recommendations for hand hygiene during patient care?
What is the first step in the WHO recommendations for hand hygiene during patient care?
Which of the following is NOT included in the protocols to minimize infection risk associated with invasive devices?
Which of the following is NOT included in the protocols to minimize infection risk associated with invasive devices?
What is the recommended intubating dose of pancuronium?
What is the recommended intubating dose of pancuronium?
Which muscle relaxant has a faster onset for rapid sequence intubation?
Which muscle relaxant has a faster onset for rapid sequence intubation?
What should be done after body fluid exposure or risk according to the hand hygiene recommendations?
What should be done after body fluid exposure or risk according to the hand hygiene recommendations?
What is a common adverse effect associated with atracurium use?
What is a common adverse effect associated with atracurium use?
Which of the following techniques is suggested for reprocessing single-use equipment?
Which of the following techniques is suggested for reprocessing single-use equipment?
Which of the following is a contraindication for the use of rocuronium?
Which of the following is a contraindication for the use of rocuronium?
When should clean/aseptic procedures be conducted during patient care?
When should clean/aseptic procedures be conducted during patient care?
Which step in proper hand hygiene involves rubbing fingers in a circular motion?
Which step in proper hand hygiene involves rubbing fingers in a circular motion?
What precaution should be taken when administering cisatracurium?
What precaution should be taken when administering cisatracurium?
After interacting with which of the following should hands be washed?
After interacting with which of the following should hands be washed?
What is the maintenance dose for rocuronium?
What is the maintenance dose for rocuronium?
What class of muscle relaxant is cisatracurium considered?
What class of muscle relaxant is cisatracurium considered?
What should be the frequency of reviewing the condition of an indwelling invasive device?
What should be the frequency of reviewing the condition of an indwelling invasive device?
Which of the following doses is appropriate for intubation using cisatracurium?
Which of the following doses is appropriate for intubation using cisatracurium?
What characteristic distinguishes biphasic defibrillation from monophasic defibrillation?
What characteristic distinguishes biphasic defibrillation from monophasic defibrillation?
Which of the following is a potential complication during intubation?
Which of the following is a potential complication during intubation?
Why is a biphasic defibrillator considered more practical than a monophasic one?
Why is a biphasic defibrillator considered more practical than a monophasic one?
What can be a consequence of inadequate anaesthesia during intubation?
What can be a consequence of inadequate anaesthesia during intubation?
What is the purpose of using high flow nasal oxygen (HFNO) during intubation?
What is the purpose of using high flow nasal oxygen (HFNO) during intubation?
Which feature of new intubation devices enhances the process of visualization?
Which feature of new intubation devices enhances the process of visualization?
What is one of the main benefits of the integrated high-resolution monitor in new intubation devices?
What is one of the main benefits of the integrated high-resolution monitor in new intubation devices?
What is a disadvantage of using a scope during a bronchoscopy procedure?
What is a disadvantage of using a scope during a bronchoscopy procedure?
What is the recommended temperature range for wetting hands during handwashing?
What is the recommended temperature range for wetting hands during handwashing?
How long should the duration be for handwashing with plain soap according to JCI recommendations?
How long should the duration be for handwashing with plain soap according to JCI recommendations?
What is advised regarding the handling of gloves during hand hygiene practices?
What is advised regarding the handling of gloves during hand hygiene practices?
Which of the following is NOT part of the maximal sterile barrier recommended for the anesthesia provider?
Which of the following is NOT part of the maximal sterile barrier recommended for the anesthesia provider?
When should the operation theatre be cleaned according to local protocols?
When should the operation theatre be cleaned according to local protocols?
What is a misconception about gloved hands during procedures?
What is a misconception about gloved hands during procedures?
What is the recommended duration for hand rub with alcohol-based hand rub (ABHR)?
What is the recommended duration for hand rub with alcohol-based hand rub (ABHR)?
Which procedure must always be followed when placing peripheral arterial lines?
Which procedure must always be followed when placing peripheral arterial lines?
What is the primary purpose of weekly maintenance checks for anesthesia equipment?
What is the primary purpose of weekly maintenance checks for anesthesia equipment?
Which system is classified as a semi-open breathing system?
Which system is classified as a semi-open breathing system?
What is a significant risk associated with improper handling of oxygen cylinders?
What is a significant risk associated with improper handling of oxygen cylinders?
How often should connections to oxygen delivery devices be checked for leakage?
How often should connections to oxygen delivery devices be checked for leakage?
Which of the following is NOT a characteristic of open systems in anesthesia?
Which of the following is NOT a characteristic of open systems in anesthesia?
What is a disadvantage of semi-closed breathing systems?
What is a disadvantage of semi-closed breathing systems?
Which of the following actions is included in the pre-anesthetic checkout procedure as per the American Society of Anesthesiologists?
Which of the following actions is included in the pre-anesthetic checkout procedure as per the American Society of Anesthesiologists?
What characteristic distinguishes semi-closed breathing systems from open systems?
What characteristic distinguishes semi-closed breathing systems from open systems?
Flashcards
Phase 2 metabolism (Synthetic Phase)
Phase 2 metabolism (Synthetic Phase)
Phase of drug metabolism where the drug is modified by the body, usually making it easier to excrete.
Intravenous (IV) administration
Intravenous (IV) administration
A common method of drug administration that involves injecting medication into a vein.
Intramuscular (IM) administration
Intramuscular (IM) administration
A common method of drug administration that involves injecting medication into a muscle.
Anesthesia
Anesthesia
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Analgesic
Analgesic
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Nitrous oxide
Nitrous oxide
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Nausea and vomiting
Nausea and vomiting
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Morphine
Morphine
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Pancuronium
Pancuronium
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Cisatracurium
Cisatracurium
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Rocuronium
Rocuronium
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Reversal of Neuromuscular Blockade
Reversal of Neuromuscular Blockade
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Adverse effects of Pancuronium
Adverse effects of Pancuronium
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Adverse effects of Atracurium/Cisatracurium
Adverse effects of Atracurium/Cisatracurium
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Rapid sequence intubation (RSI)
Rapid sequence intubation (RSI)
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Tracheal intubation
Tracheal intubation
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Infection Prevention
Infection Prevention
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Hand Hygiene
Hand Hygiene
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WHO's 5 Moments for Hand Hygiene
WHO's 5 Moments for Hand Hygiene
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Moment 1: Before Touching a Patient
Moment 1: Before Touching a Patient
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Moment 2: Before a Clean/Aseptic Procedure
Moment 2: Before a Clean/Aseptic Procedure
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Moment 3: After a Procedure or Body Fluid Exposure Risk
Moment 3: After a Procedure or Body Fluid Exposure Risk
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Moment 4: After Touching a Patient
Moment 4: After Touching a Patient
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Moment 5: After Touching a Patient's Surroundings
Moment 5: After Touching a Patient's Surroundings
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Biphasic defibrillation
Biphasic defibrillation
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Monophasic defibrillation
Monophasic defibrillation
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Video Laryngoscope
Video Laryngoscope
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Airway trauma
Airway trauma
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Bronchoscope damage
Bronchoscope damage
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High-flow Nasal Oxygen
High-flow Nasal Oxygen
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Double Lumen Tube (DLT) placement
Double Lumen Tube (DLT) placement
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Bronchoscopy
Bronchoscopy
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Handwashing
Handwashing
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Alcohol-based hand rub (ABHR)
Alcohol-based hand rub (ABHR)
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Recommended Handwashing Duration with Soap
Recommended Handwashing Duration with Soap
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Recommended Hand Rub Duration with ABHR
Recommended Hand Rub Duration with ABHR
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Gloves Removal Before HH
Gloves Removal Before HH
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Cleaning of the Operating Theatre
Cleaning of the Operating Theatre
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Full Maximal Sterile Barrier
Full Maximal Sterile Barrier
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Central Intravenous Catheter (CVC)
Central Intravenous Catheter (CVC)
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Weekly Anesthesia Equipment Maintenance
Weekly Anesthesia Equipment Maintenance
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Daily Anesthesia Equipment Checks
Daily Anesthesia Equipment Checks
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Pre-Anesthetic Checkout Procedure
Pre-Anesthetic Checkout Procedure
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Breathing System Pressure & Leak Testing
Breathing System Pressure & Leak Testing
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Breathing Circuit Gas Flow Verification
Breathing Circuit Gas Flow Verification
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Checking the Oxygen Cylinder
Checking the Oxygen Cylinder
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Semi-Closed Breathing System
Semi-Closed Breathing System
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ANESTHESIA Time Out
ANESTHESIA Time Out
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Study Notes
Pharmacology of Anesthesia Types
- General anesthesia (GA) is suitable for most major surgeries
- Goals of Stage III surgical anesthesia: hypnosis/unconsciousness, amnesia, analgesia, muscle relaxation, and autonomic/sensory blockade
General Anesthesia Stages
- Stage I (Analgesia): Pain loss, patient remains conscious and can converse.
- Stage II (Excitement): Delirium, violence, decreased blood pressure, increased respiratory rate. Barbiturates often bypass this stage.
- Stage III (Surgical Anesthesia): Skeletal muscle relaxation, regular breathing, slow/stopped eye movements. Surgery can begin at this stage.
- Stage IV (Medullary Paralysis): Death can result if not revived; careful control of anesthetic amounts is crucial.
Induction
- Induction may involve intravenous and/or inhalation agents.
- Intravenous agents include sedative-hypnotics (e.g., Propofol, Etomidate, Ketamine) accompanied by adjuvant agents (e.g. opioids, benzodiazepines like Midazolam)) and a neuromuscular blocking agent (NMBA) for endotracheal intubation.
Maintenance
- Total Intravenous Anesthesia (TIVA) or inhalation/IV combinations are used to sustain GA.
- The aim is to reduce the total dose of any single agent.
- NMBA (neuromuscular blocking agents) are used if complete muscle relaxation is required.
Emergence
- GA emergence is the return to consciousness and movement after the surgery.
- Residual NMBA effects are reversed.
- Spontaneous ventilation usually enables extubation without assistance.
Main Types of Medication in Anesthesia
- Induction agents (IV and volatile) to induce and maintain unconsciousness
- Analgesics for pain relief
- Muscle relaxants to induce muscle relaxation
- Other medications frequently used in anesthesia include those that reduce memory loss/amnesia and vomiting, counteracting (antagonists) and stimulating sympathetic/parasympathetic responses
Essential Introduction to Pharmacology
- Pharmacokinetics (PK) studies how the body affects a drug (absorption, distribution, metabolism, excretion).
- Pharmacodynamics (PD) studies the effect of a drug on the body. This includes drug action in terms of physiochemical characteristics, receptor binding, and enzyme binding to inhibit or decrease activity.
Induction Medications
- Generally, induction is done with intravenous agents or inhalation.
- Intravenous induction medications include medications like thiopentone and propofol.
Intravenous Anesthetics
- Thiopental sodium: Powder for solution injection, for induction and short duration anesthesia.
Metabolism
- Drugs are metabolized through phases: Phase 1 (non-synthetic) involves processes like oxidation, reduction, and hydrolysis; phase 2 (synthetic) includes glucuronidation, sulfation, acetylation, methylation, and glycination. Metabolic processes aim to increase the solubility of drugs for excretion.
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