Unit 4 Assignment

Pharmacology 1273 with Espinoza at Austin Community College

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By: M. P.
Created: 2011-11-03
Size: 18 flashcards
Views: 14

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Anesthesia –

medication given that causes a loss of sensation.

Local anesthesia

when a client or patient loses sensation to a limited part of their body (i.e. mouth, arm) without losing consciousness.

Used when brief dental or medical procedures are performed.

Five major routes are used for applying local anesthetics:

Topical (surface) anesthesia

Infiltration anesthesia

Nerve Block anesthesia

Spinal anesthesia

Epidural anesthesia

Topical (surface) anesthesia (Local anesthesia)

applied to mucous membrane (+ eyes, lips, gums, throat, nasal membranes)

Infiltration anesthesia (Local anesthesia)

direct injection into tissue to block a specific group of nerves near to the surgical site.

Nerve block anesthesia (Local anesthesia)

direct injection into tissue that affects the bundle of nerves that may be distant from the operation site. Used to block sensation in a limb

Spinal anesthesia (Local anesthesia)

injection into the cerebral spinal fluid (CSF). Affects large regional areas.

Epidural anesthesia (local anesthesia)

injection into the epidural space of spinal cord. Mainly used in obstetrics during labor and delivery.

Local anesthesia – sodium channel blockers

MOA: prevent entry of Na+ ions into cells of the nervous system, thus producing a numbing effect, diminish sensation and muscle activity in that area.

FYI: Adding small amounts of Epinephrine to the anesthetic solution extends the DOA of injectable local anesthetics. It causes a Vasoconstriction effect, allowing the anesthetic to stay there longer

Local anesthesia - Esters - short or moderate duration of action (DOA) "AINE"

a. cocaine

b. Procaine (Novocain®)

c. Benzocaine (Solarcaine®)

Local anesthesia - Amides - longer DOA "AINE"

a. Lidocaine (Xylocaine®) Lidocaine + Epi extends time 15-20 minutes ® 45-60 minute

Bacteria can acidify infected site, therefore, adding sodium hydroxide or sodium

bicarbonate (alkaline substance) will neutralize the region for a basic environment

b. Prilocaine (Citanest®)

c. Mepivacaine (Carbocaine®)

d. Etidocaine (Duranest®)

e. Bupivacaine (Marcaine®)

Local anesthesia - Adverse effects/ Side effects of Esters/Amides

Early Effects

CNS

Restlessness

Anxiety

Later Effects

Drowsiness

Unresponsiveness

Others

Hypotension

Dysrhythmias

NOTE: These side effects are lessened with Amides

General anesthesia

medication that causes loss of sensation to entire body, usually results in a loss of consciousness.

- Provides a rapid and complete loss of sensation for a long period of time.

- Signs include loss of pain, consciousness, memory, and body movement.

- G. A. depresses all nervous activity in the brain.

General anesthesia - Stages

Stage 1: loss of pain. proceeds until the patient loses consciousness.

Stage 2: calming agents stage. Excitement & hyperactivity, increased HR, breathing, BP

Stage 3: surgery stage. Surgical Anethesia, skeletal muscles become relaxed. Eye movement slows down,patient becomes very still

Stage 4: paralysis of the medulla region in the brain, death could result, should be avoided, administered as IV or inhaled (gases or volatile agents)

General anesthesia - Long Procedures

1. IV agents administered

2. After patient loses consciousness, inhaled agents are given to maintain anesthesia.

Concurrent administration of IV and inhaled drugs allows the dose of inhaled anesthetics to be reduced, thus decreasing side effects.

General anesthesia - Short Procedures

1. IV agents only used

MOA: proposed, not known

· Prevents the flow of sodium into neurons

· GABA Receptors become activated to receive NT

· No receptor binding

· No effect on neurotransmitter release.

General anesthesia - IV anesthetics

also used to relax muscles and reduce pain (analgesic)

Barbituarates

Opioids

Benzodiazepines

Fentanyl (Sublimaze®)

Diazepam (Valium®)

Midazolam (Versed®)

Thiopental sodium (Pentothal®): reduces HR

General anesthesia - Inhaled anesthetics "ANE"

Nitrous oxide – gases (laughing gas)

- anxiety

- excitement

- when exhaling ® patient may experience difficulty breathing

- nausea/vomiting

- abused by HCW due to relax sedated stateHalothane (Fluothane®) – volatile agent

- cardiac dysrhythmia (bradycardia)

- reduces blood pressure

- reduces respiratory rate

- Hepatotoxicity

Insoflurane (Forane®)*most used due to less side effectsy

Anesthetics - Adjuncts to Surgery

PRE-OP:

-Atropine, anti-cholinergics are used to reverse bradycardia caused by some anesthetics.

POST-OP:

-analgesics

-anit-emetic- Promethazine (Phenergan)

-Bethanocal (Urecholine)

About this deck

By: M. P.
Created: 2011-11-03
Size: 18 flashcards
Views: 14

About StudyBlue

“I have been getting MUCH better grades on all my tests for school. Flash cards, notes, and quizzes are great on here. Thanks!”
Kathy