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Pharm/ anesth test 2
Anesthesia, analgesic, CNS
| Question | Answer |
|---|---|
| What is Analgesia? | Loss of sensibility to pain, with no loss of consciousness. |
| What is anesthesia? | Loss of pain & loss of all other sensations as well, loss of consciousness. |
| Ester | Procaine (Novocain), Cocaine (vasoconstrictors used to decrease bleeding) |
| Amides | Lidocaine, Viscous lidocaine(Xylocaine): can interfere with gag/swallowing-wait 1 hr before eating or drinking with application. |
| List ways to administer local anesthetics? | Topically (transdermally):for surface anesthesia, itching, & soreness, can be absorbed & cause system toxicity. |
| How are local anesthetic administered? | Injection- risk for toxicity, infiltration, nerve block, (peripheral & central) IV regional, epidural, & spinal. |
| Explain Vasoconsctrictors: | (Usually epinephrine) commonly used in conjunction with local anesthetics. |
| What happens when epinephrine is added to local anesthetics? | It prolongs the anesthetic action, while shortening the onset of action & reducing blood to the injection site. |
| List & describe Epidural anesthesia: | Lidocaine & bupicacaine- (Marcaine)- it blocks the nerve root conduction in the spinal cord. It can reach systemic circulation in significant amounts and may cause neonatal depression. |
| Which epidural anesthesia is most commonly used? | Bupivacaine is the most commonly used epidural anesthesia is not used in the OB setting because of the risk of cardiac arrest. |
| List the rapid uptake local anesthesia medications? | Topical, interpleural, intercoastal, subcutaneous, caudal, lumbar epidural, brachial plexus, spinal -subarachnoid, Topical (transdermal) |
| How does the absorption rate effect the uptake of the anesthesia? | The faster the uptake the shorter it the drug lasts. |
| What are some factors when choosing anesthesia? | The time to take effect and any possible adverse effects. |
| What is nitrous oxide? | also known as laughing gas, almost all pt.'s receive it to supplement analgesic effect. |
| What type of gas can produce pain relief close to that of morphine? | Laughing gas or nitrous oxide, when 20% is inhaled. |
| When is nitrous oxide commonly used? | During dental procedures and for analgesia during surgery. |
| Name two benzodiazepines: | Valium (Diazepam)& Versed (Midazolam) |
| Describe Valium (Diazepam)when used as IV anesthesia: | unconscious in about 1 minute. Very little muscle relaxation, no anesthesia, cardio & respiratory depression usually moderate, have support available immediately. |
| Describe the Benzodiazepine Propofol(Diprivan): | It is used as an IV Sedative-hypnotic for induction & maintenance of Anesthesia. |
| What are some of the adverse effects of Propofol(Diprivan)? | It can cause profound respiratory Depression (including apnea & hypotension). |
| Who should be given Propofol (Diprivan) with caution? | Elderly pt.'s, hypovolemic, and anyone with a compromised cardiac function. |
| What should be kept readily available when used Propofol (Diprivan) for sedation? | Respiratory Support! |
| Why is there an increased risk for bacterial infection when using Propofol (Diprivan)? | B/C propofol (Diprivan) is supplied in a mixture of soybean oil, glycerol, egg lecithin. |
| What is Ketamine(Ketalar)& when is it used? | A sedation benzodiazepine which causes the pt. to be in a state of dissociative anesthesia. |
| Describe Ketamine(Ketalar): | It is used a lot with children and causes a disconnect from one's environment. It also is known to cause unpleasant reactions during recovery. For ex: hallucinations, disturbing dreams, & delirium. |
| When is Ketamine (Ketalar) most often used and who should not have it? | It is used with children having minor sx, changing burn dressings, & diagnostic procedures. Anyone with a Hx of psychiatric illness. |
| What are some important implications concerning Ketamine(Ketalar)? | In an effort to decrease psychological reactions to the medication in recovery, the pt. should be kept in a calm, low stimulus environment until the recovery is complete. |
| What is the difference between Analgesics & Anesthesia? | Analgesics result in a reduction to sensitivity to pain and Anesthesia causes unconsciousness & reduction to pain stimuli. |
| What are some important nursing interventions after surgery (anesthesia & analgesia)? | Monitor for N&V, watch for risk of aspiration, bowel sounds, urinary retention, & post operative pain. |
| What do anesthetics do to the urinary tract function? | They can decrease the urine function by reducing the renal blood flow.If the pt. does not void, follow hospital protocol(possible cath). Be sure to monitor urine output! |
| What should be monitored following sx in the recovery room after anesthesia? | VS until there is a baseline, be alert for reductions in blood pressure, altered cardiac rhythm, shallow, slow, or noisy breathing. |
| What is pain tolerance? | Amount of pain pone can withstand before he/she has an emotional or physical breakdown. |
| What was the first local anesthetic? | Cocaine, founded in 1884 by Sigmund Freud and Karl Koller. |
| When is cocaine used and how is it administered? | Topically, used fro ear, nose and throat procedures. Te anesthesia is rapid and lasts for about an hour. |
| How is cocaine unlike other local anesthetics? | It causes intense vasoconstriction by blocking the nor epinephrine uptake at the sympathetic nerve terminals on blood vessels. |
| List & describe the epidural anesthesia: | Lidocaine & Marcaine ( bupicacaine), it blocks the nerve root conduction in the spinal cord. Can reach systemic circulation in significant amounts. |
| What are some harmful effects of epidural anesthesia? | May cause neonatal depression. |
| What are the properties of an ideal analgesic? | Should be potent for maximum relief,not cause dependency, minimum side effects, not cause tolerance, act promptly, over a long period of time, with minimum sedation, pt. should remain conscious & responsive. Should be inexpensive. |
| How are analgesics classified? | Potency, origin, & addictive properties. |
| List the types of analgesics(origin): | Opium, semi-synthetic, coal-tar derivatives. |
| What are the additive properties of analgesics? | Narcotic, opioid derivative, capable of causing physical dependence) & non-narcotic. |
| What is the pathway of pain in the CNS? | From the site of injury to the brain, processing & reflexive action. Stimulation of receptors- nerve endings in skin |
Created by:
ndthompson
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