anesthesia stuff

Question 1

nitrous oxide: possible side effects

Answer 1

diffusion hypoxia: rapid diffusion into closed spaces

Question 2

sevofluorane: MAC

Answer 2

2%

Question 3

desfluorane: MAC

Answer 3

6%

Question 4

propofol: mechanism of action

Answer 4

interacts w/ GABA receptors: increases duration of Cl- channel opening –> hyperpolarizes cell

Question 5

barbiturates: mechanism of action

Answer 5

GABA-A receptor action: increases duration Cl- channels are open –> hyperpolarization

Question 6

etomidate: side effects

Answer 6

adrenal suppression

Question 7

morphine: side effects

Answer 7

• histamine release –> hypotension

Question 8

demerol side effects

Answer 8

• increases peripheral blood flow
• increases HR

Question 9

diazepam: time-based characteristics

Answer 9

takes the longest for pts to wake up, but has the shortest effect

Question 10

etomidate: time-based characteristics

Answer 10

lasts a long time, pts wake up quickly

Question 11

benzodiazepines: mechanism of action

Answer 11

facilitate GABA-A receptor action –> increase frequecy of Cl- channel opening –> hyperpolarization

Question 12

fentanyl: mechanism of action

Answer 12

agonist at mu and kappa opiate receptors –> close N-type voltage-gated Ca2+ channels –> K+ influx –> hyperpolarization

Question 13

morphine: mechanism of action

Answer 13

binds mu receptor

Question 14

succinylcholine: uses, issues

Answer 14

• used to facilitate intubation: very quick onset, doesn’t last long
• can cause malignant hyperthermia

Question 15

dantrolene: mechanism of action

Answer 15

• interferes w/ Ca2+ release from SR
• inhibits excitation-contraction
• blocks RyR

Question 15

dantrolene: use

Answer 15

malignant hyperthermia

Question 16

dantrolene: dose

Answer 16

need to give 175 mg: usually comes in 20 mg bags: prep 9 vials by diluting in 60 mL sterile water

Question 17

exparel: dose, max dose

Answer 17

dose: 133 mg (10 mL) in ankle
max dose: 266 mg (20 mL)

Question 17

amides: metabolism

Answer 17

microsomal P450 in liver

Question 18

esters: metabolism

Answer 18

plasma enzyme produced in liver

Question 19

loss of sensation: order of fibers

Answer 19

sharp pain, temperature, touch, pressure, motor

Question 20

1° determinant of local anesthetic potency

Answer 20

degree of lipid solubility
- more lipid soluble = slower onset, longer duration

Question 21

lidocaine 1% plain: dose, max dose

Answer 21

dose: 4.5 mg/kg
max dose: 300 mg

Question 22

lidocaine 1% plain + epi: dose, max dose

Answer 22

dose: 7 mg/kg
max dose: 500 mg

Question 23

mepivacaine 1%: dose, max dose

Answer 23

dose: 6 mg/kg max dose: 400 mg

Question 24

bupivacaine 0.25%: dose, max dose

Answer 24

dose: 2.5 mg/kg max dose: 175 mg

Question 25

ropivacaine 0.5%: dose, max dose

Answer 25

dose: 5 mg/kg max dose: 400 mg

Question 26

lidocaine 1% plain: duration

Answer 26

30-120 min

Question 27

lidocaine 1% plain + epi: duration

Answer 27

60-400 min

Question 28

mepivacaine 1%: duration

Answer 28

30-120 min w/o epi 60-400 min w/ epi

Question 29

bupivacaine 0.25%: duration

Answer 29

120-240 min (2-4 hrs) w/o epi 240-480 (4-8 hrs) min w/ epi

Question 30

ropivacaine 0.5%: duration

Answer 30

120-360 min (2-6 hrs)

Question 31

chloroprocaine: duration

Answer 31

30-60 min

Question 32

Aα nerve fiber: function

Answer 32

proprioception, motor

Question 33

Aβ nerve fiber: function

Answer 33

pressure, touch

Question 34

AΔ nerve fibers: function

Answer 34

touch, cold, fast pain

Question 35

Aγ nerve fibers: function

Answer 35

muscle spindles

Question 36

plavix & pradaxa: minimum time between last dose and spinal injection

Answer 36

7 days

Question 37

atrixia: minimum time between last dose and spinal injection

Answer 37

- 24-36 hours when <2.5 mg - contraindicated when full dose

Question 38

lovenox: minimum time between last dose and spinal injection

Answer 38

- 24 hours when full dose - 12 hours when prophylactic

Question 39

eliquis: minimum time between last dose and spinal injection

Answer 39

48 hours

Question 40

warfarin: minimum time between spinal injection/catheter removal and next dose

Answer 40

2 hours

Question 41

heparin: minimum time between spinal injection /catheter removal and next dose

Answer 41

1 hour

Question 42

atrixia: minimum time between spinal injection/catheter removal and next dose

Answer 42

- 6-12 hours for <2.5 mg - 24 hours for 5-10 mg

Question 43

lovenox: minimum time between spinal injection/catheter removal and next dose

Answer 43

- 24 hours when full dose - 6-8 hours when prophylactic