Anaesthetic Drugs: Induction and Intubation Facilitation

A set of vocabulary flashcards covering induction and intubation facilitation drugs, mechanisms, dosages, and complications based on the lecture notes.

Crash Airway

A clinical state involving an unresponsive patient who requires immediate airway patency and is likely not to respond to laryngoscopy, often seen in cardiac arrest or agonal respiration.

Rapid Sequence Intubation (RSI)

The simultaneous administration of a potent sedative agent and a rapid-acting muscle relaxant after preoxygenation to facilitate tracheal intubation without providing positive pressure ventilation.

Actual/Impending Airway Obstruction Indication

Conditions requiring intubation such as angioedema, foreign body, haemorrhage, secretions, or trauma.

GABA receptor activity

The inhibitory mechanism used by induction agents like benzodiazepines, barbiturates, propofol, etomidate, isofluerene, enflurane, and halothane to increase neural inhibition.

NMDA receptors

Receptors targeted by agents such as ketamine, NO, and xenon to decrease neural excitation for induction.

Etomidate

An imidazole derivative that is Primarily hypnotic with no analgetic effect; it is the most hemodynamically stable induction agent and is cerebroprotective by decreasing blood flow and brain metabolism.

Etomidate RSI Induction Dose

An initial intravenous dose of $0.3\,mg/kg$, or $0.2\,mg/kg$ in hemodynamically unstable patients.

Ketamine

A phencyclidine derivative with analgesia, anesthesia, and amnesia properties that stimulates catecholamine release and causes relaxation of bronchial smooth muscles (bronchodilation).

Ketamine RSI Induction Dose

The standard intravenous dose is $1.5\,mg/kgBB$, which has an onset of $45-60$ seconds.

Propofol

A fat-soluble alkylphenol derivative with hypnotic properties that lowers $CMRO_2$ and ICP, known to cause hypotension through vasodilation and myocardial depression.

Midazolam

The only benzodiazepine class suitable for use as an induction agent for RSI emergencies, though it is considered poor due to slow onset and hemodynamic effects.

Succinylcholine ($SCh$)

A depolarizing muscle relaxant with a structure resembling ACH that is used in emergency RSI due to its fast onset ($<1\,minute$ half-life) and short duration.

Pseudocholinesterase ($PCHE$)

An enzyme from the liver responsible for the rapid hydrolysis and metabolism of Succinylcholine ($SCh$).

Fasikulasi (Fasciculation)

Muscle twitching caused by the stimulation of ACH nicotinic receptors during the administration of Succinylcholine, which occurs alongside increased intracranial and intragastric pressure.

Malignant hyperthermia

A myopathic condition with genetic membrane abnormalities of skeletal muscles that can be triggered by halogen anesthesia or Succinylcholine.

Competitive NMBA

Neuromuscular Blocking Agents that work by competing for and blocking ACH on the motor endplate's postjunctional nicotinic receptor; includes benzylisoquinoline and aminosteroid groups.

Rocuronium

A competitive NMBA used in emergency RSI at a dose of $1.0-1.2\,mg/kg$ BB IV to achieve intubation-level paralysis in $60$ seconds.

Hoffman degradation

The excretion pathway for certain competitive NMBAs like atracium and cisatracurium.

Pancuronium

A competitive NMBA excreted mainly by the kidneys with a longer duration of action, making it the third choice for RSI.

Trismus

A side effect characterized by lockjaw that Succinylcholine can cause, especially in children.