Pharm Part 4 & 5

Parts 4.1, 4.2, 5.1, 5.2

general anesthesia

the goal of _________________ is the absence of all perceived sensations with the purpose of allowing detailed surgical procedures with minimal harm to the patient

before

for anesthesia (after/before) 1846, people were knocked out with a blow to the head, given alcohol or opium, or physically restrained

after

for anesthesia (after/before) 1846, ether was used to make people pass out

requirements

the ____________ for general anesthesia are loss of consciousness, perceived sensations, amnesia, inhibition of reflexes, skeletal muscle relaxation, safe, transient/temporary, and predictable

stages

the ______________ for general anesthesia are analgesia, excitement/delirium, surgical anesthesia, medullary paralysis

inhalation, IV

two types of general anesthetics are ______________ agents and _________ agents

injected

_____________ anesthetics take effect quickly, but more difficult to control level of anesthesia after injection

inhaled

___________ anesthetics take effect more slowly, but easier to control level of anesthesia

begin

it is best to _________ general anesthesia with injected agents

maintain

it is best to _________ general anesthesia with inhaled agents

increase, decrease

general anesthetics __________ inhibition or ___________ excitation through the CNS by having a direct effect on neuronal receptors

adjuvants

anesthetic ____________ are drugs that can be given pre-op or post-op to reduce side effects of anesthesia

nmj blockers

________________ are used to “paralyze” skeletal muscles to facilitate positioning on table, prevent spasms, and allow easier mechanical ventilation

short

njm blockers have a (long/short) duration of action

reversed

effects of nmj blockers can be _________ by cholinesterase inhibitors or sugammadex

dissociation

_______________ is when patients may remain conscious but indifferent to surroundings

ketamine

dissociative anesthesia is achieved by the use of ___________

confusion, lethargy

cognitive effects like short-term ___________ and __________ are quite common due to redistribution of anesthesia combined with pain meds

long

possible (long/short)-term effects on cognition/intellect can happen especially in older adults or patients with comorbidities

residual effects

patients recovering from general anesthesia may experience _________________ such as muscle soreness and cognitive deficits when they are seen in PT

local anesthesia

the goal of _________________ is to interrupt nerve conduction at the site of application with the purpose of preventing or relieving pain without the loss of consciousness or systemic effects

caine

typical local anesthetics have the ending “-________”

sodium

the mechanism for local anesthetics involves binding to ________ channels in the nerve membrane that inactive the channel and prevent action potential conduction

topical

_________ anesthetics are applied to the surface of the skin for pain relief of minor burns and abrasions, also used prior to injections or IV insertions

transdermal

___________ anesthetics on a patch move through skin enhanced by electricity, ultrasound, or other chemicals

lidocaine patch

an example of a transdermal anesthetic is a _____________________

should not

heat (should/should not) be applied over lidocaine patches

infiltration

____________ anesthesia is injected subcutaneously in a wound and allowed to penetrate into the selected area, often used before suturing wounds

peripheral nerve blocks

______________ are injected close to nerves or nerve plexuses, and are commonly used for dental procedures or other minor surgeries

spinal

a _________ block is administered into the subarachnoid space

epidural

a _________ block is administered outside of the dura

sympathetic

a _________ block decreases output from the SNS to a specific part of the body

bier

a __________ block is intravenous regional anesthesia injected into the affected arm or leg with a tourniquet placed proximally to keep the drug in the limb

continuous nerve

a _____________block is a small catheter implanted near a peripheral nerve and local anesthetic is constantly dripped onto the nerve

differential nerve

a __________________ block affects the smallest, unmyelinated fibers first, and the largest myelinated fibers last

local anesthetic systemic toxicity LAST

__________________________ is characterized by cardiac and CNS symptoms that can be serious or even fatal

cardiac

_________ toxicity symptoms of LAST are changes in HR, other ecg abnormalities, clinical signs of cardiac depression, or cardiac arrest

CNS

_________ toxicity symptoms of LAST are ringing/buzzing in the ears, agitation, restlessness, seizures, decreased sensation in mouth area, depression