Anesthetics

Local Anesthetics

Sodium channel blockers that block Na entry in the axonal membrane, affecting both sensory and motor impulses.

Mechanism of Action (MOA) of Local Anesthetics

Block Na entry in the axonal membrane, leading to blocked perception of pain, then cold, warmth, touch, and deep pressure.

Role of Epinephrine in Local Anesthesia

Constricts blood vessels to keep anesthetic localized, extends duration of action, and reduces risk of toxicity.

Lidocaine

A frequently used local anesthetic and antidysrhythmic sodium channel blocker, it is administered IV, IM, or topically.

Adverse Effects (AE) of Lidocaine

CNS toxicity, excitement to altered mental status (AMS), bradycardia, and a black box warning for accidental ingestion in children.

Lipid Rescue

Lipid infusion therapy used for lidocaine toxicity by binding to the toxin and facilitating its removal from the body.

Spinal Anesthesia Complications

Includes spinal headache and urinary retention; to avoid headaches, encourage fluids and lay flat.

Balanced Anesthesia Components

Utilizes propofol, short-acting barbiturates for induction, neuromuscular blocking agents for muscle relaxation, and opioids for analgesia.

Propofol (Diprivan)

An intravenous anesthetic with rapid onset, used for induction or maintenance in general anesthesia.

Nitrous Oxide

A low-potency inhaled anesthetic with high analgesic properties, ideal for short surgical or dental procedures.

Isoflurane (Forane)

Inhaled general anesthetic that is a high-potency GABA and glutamate receptor agonist with dose-dependent respiratory depression.

Malignant Hyperthermia

A rare, life-threatening reaction to anesthesia characterized by rapid hypermetabolic response, increased heart rate, and muscle breakdown.

Dantrolene

A skeletal muscle relaxant used to treat malignant hyperthermia and as a direct acting antispasmodic.

Succinylcholine

A depolarizing neuromuscular blocker that binds to acetylcholine receptors causing paralysis.

Non-Pharmacological Treatments for Muscle Spasms

Includes immobilization, hot/cold therapies, acupuncture, physical therapy, and possibly surgery.

Adjuvants to Anesthesia

Includes anticholinergics to dry secretions, benzodiazepines to reduce anxiety, and opioids to counteract pain.

Neuromuscular Blocking Agents

Cause paralysis without affecting consciousness, sedation, analgesia, or amnesia, and require close monitoring during surgical procedures.