general anesthetics

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general anesthetics
2012-09-27 22:51:15
general anesthetics

general anesthetics
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  1. halothane
    • inhaled anesthetics
    • MOA: GABA mediated inhibition at GABA A receptor site (causes hyperpolarization and inhibition of AP)
    • USES: slow induction and recovery, increase cardiac automaticity, bronhodilation
    • AE: halothane hepatitis - rare but serious, 
    • volatile liquid at room temp
  2. isoflurane
    • inhaled anesthetic
    • MOA: GABA receptor inhibitor (increases hyperpolarization, decreasing AP)
    • USES: medium induction and recovery, partial loss of nicoceptive reflexes, good muscle relaxtion, decreases TPR, cardiac automaticity not affected
  3. sevoflurane
    • inhaled anesthetic
    • MOA: GABA receptor inhibition (increases hyperpolarization, decreases AP)
    • USES: resembles isoflurane except - rapid induction and recovery - Most frequently used, better than isoflurane
  4. nitrous oxide
    • inhaled anesthetic
    • MOA: potent selective inhibitor of NMDA activated current (inhibits glutamate)
    • USES: low potency, can't be used as an anesthetic alone, but has a very high analgesic effect which is why its used with other anesthetics
    • AE: megaloblastic anemia
  5. thiopental
    • IV anesthetics, barbituate
    • MOA: opens Cl channels, prolonging GABA effect
    • USES: unconsciousness occurs in 10-20 sec, short recovery b/c of redistribution, sole agent in case of short surgery for induction of anesthesia in combo with inhaled anesthetics
    • AE: anaphylactoid reaction
  6. propofol
    • IV anesthetics
    • MOA: opening of Cl channels prolonging GABA action
    • USES: most common parenteral anesthetic in US, pronounced antiemetic activity
    • AE: anaphylactoid reaction
  7. etomidate
    • IV anesthetic
    • MOA: inhibition of GABA receptors
    • USES: worst drug for post op N/V, not often used, anesthesia mainly in pts with serious CV diseases b/c HR and CO are well maintained
    • AE: inhibition of adrenal steroid synthesis ( can cause adrenal insufficiency)
  8. ketamine
    • IV anesthetic
    • MOA: NMDA receptor inhibitor
    • USES: immobility without loss of consciousness, dissociative anesthesia, post op hallucinations, flash-backs, achieve pronounced analgesia without resp depression
    • doesn't cause loss of consciousness