Inhalationsal anesthetics

• Gas

• Volatile liquids

Two types of inhalational anesthetics

Nitrous oxide

• Halothane

• Enflurane

• Isoflurane

• Desflurane

• Sevoflurane

• Methoxyflurane

What are the volatile general anesthetics

Halothane

What is the most hepatotoxic general anesthetic

Methoxyflurane

• Barbiturates

• Benzodiazepines

• Opioids

• Propofol

• Ketamine

• Misc (droperidol, etomidate, dexmedetomidine)

Intravenous anesthetics

• Topical

• Infiltration

• Field block

• Nerve block

• IV regional

Routes of local anesthetics

Infiltration

Local anesthetic route directly targeted to target area

Field block

Local anesthetics route administered around the target area

• Ex: tooth extraction

Nerve black

Local anesthetics route administered to nerve connected to target area

Ester

Anesthetic class

• One I

• Short acting

Amide

Anesthetic class

• Two I

• Long acting

Bupivacaine

Most cardiotoxic local anesthetic

• Lidocaine

• Chloroprocaine

Most neurotoxic local anesthetic

• Prilocaine

• O-toluidine

Identify the ff:

• Local anesthetic that causes hemolytic anemia

• What metabolite is responsible?

Cocaine

1st local anesthetic discovered by koller with limited use

• Benoiz acid esters

• Amino benzoic acid esters

• Para ethoxy benzoic acid

• Carbamic acid esters

• Comple synthetics

Local anesthetic ester sub classes

• Cocaine

• Piperocaine

Benzoic acid esters

• Soluble: Procaine, Chloroprocaine, Tetracaine

• Limited solubility: Benzocaine

Amino benzoic acid esters (PABA Derivatives)

Intracaine

Para ethoxy benzoic acid

Diathane

Carbamic acid esters

• Straight chain acid derivative of xylidide

• Pipecolic acid derivatives of xylidide

• Oxycinchoninic acid derivative

Local anesthetics amide classifications

• Acetic acid: Xylocaine

• Propionic acid: propitocaine

Straight chain acid derivatives of xylidide

• Mepivacaine

• Bupivacaine

Pipecolic derivatives of xylidide

Dibucaine

Oxycinchoninic acid derivative

Friedrich seturner

Who discovered morphine

Morphine

• Prototype opioid

• is the golden standard among opioid analgesics to which the structure and strengths of all other drugs are compared

• Anesthesia

• Analgesia

• Amnesia

What are the three A’s of anesthetics

• Analgesia

• Anti diarrheal

• Anti tussive

What are the three A’s of opioids

• Diacetylmorphine

• Diamorphine

What is the chemical name of heroin

Methylmorphine

What is the chemical name of codeine

Codeine

Opiod primarily used as an anti tussive; discovered by Robiquet

Dextromethorphan

What is the dextro of codeine that is less potent therefore requiring a higher dose?

Fentanyl

• 100x more potent than morphine

• Given to children with chemo as a lollipop

Diphenoxylate

Opioid mainly used as an anti diarrheal

• Morphine

• Heroin

• Methadone

• Meperidine (Pethidine)

• Fentanyl

• Codeine

• Tramadol

• Diphenoxylate

Enumerate opioids

Meperidine (Pethidine)

Opioid that has the shortest DOA

• Naloxone

• Naltrexone

• Nalmefene

Enumerate opioids antagonists