Pharm - 2nd term to memorize

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jonas112
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275313
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Pharm - 2nd term to memorize
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2014-05-25 16:30:39
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Pharm 2nd term memorize
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Pharm - 2nd term to memorize
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Pharm - 2nd term to memorize
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  1. What are the 4 goals of general anaesthesia? What is important to realize.
    • 1) amnesia/hypnosis
    • 2) analgesia
    • 3) Akinesia (no motor movement)
    • 4) Control of physiology

    Realize that no one treatment can do this SAFELY. Need to use a combination
  2. Describe the 5 categories of systemic effects of inhalation anesthetics
    • 1) resp: decrease tidal volume, increase RR, blunt response to CO2, bronchodilation
    • 2) CV: vasodilation, decrease contractility, decrease BP
    • 3) CNS: decrease cerebral metabolic rate, cerebral vasodilation, increase cerebral blood flow
    • 4) Other organs: hepatic, renal, uterine
    • 5) malignant hyperthermia: AD metabolic disorder
  3. Describe what the minimum alveolar concentration (MAC) is. What is it analogous to? Important points (2)
    • The concentration at 1 atm produces immobility in 50% of patients exposed to skin incision. Analogous to ED50.
    • -95% are immobile at 1.3 MAC
    • -MAC values are additive for different gasses
  4. Describe the two classes of local anesthetics
    • 1) esters: cocaine, procaine, etc (no "i" in the prefix before -caine. More likely to cause hypersens reactions, rapidly broken down in the blood
    • 2) amides: lidocaine, etc (by convention have an "i" in the prefix (just like amIde)). metabolized in blood, MORE SYSTEMIC toxicity than esters
  5. What is the MOA of local anesthetics?
    • -prevent conduction of nerve impulses
    • -non-protonated form enters axon, becomes protonated and blocks the sodium channel on cytosolic side
  6. Key points on the adverse effects of local anesthetics? (5 points)
    • 1) systemic toxicity: amides>esters
    • 2) toxic range: lidocaine alone > 5mg/kg, higher with epi
    • 3) CNS: inhib neurons affected more; perioral numbness; restlessness; dizziness; seizures; coma
    • 4) CVS: myocardial depression, vasodilation, arrhythmias
    • 5) heme: methemoglobinemia
  7. Describe the progression of local anesthetic toxicity (8 steps)
    • 1) drowsiness
    • 2) perioral numbness
    • 3) auditory/visual signs
    • 4) twitching
    • 5) convulsions
    • 6) coma
    • 7) resp. arrest
    • 8) death (CV arrest)
  8. What can a sudden withdrawl of exogenous corticosteroids cause?
    addisonian crisis

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