Copyright 2017 Wolters Kluwer All Rights Reserved General Anesthetics General

Copyright 2017 wolters kluwer all rights reserved

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Copyright © 2017 Wolters Kluwer • All Rights Reserved General Anesthetics General Anesthetics Actions Depression of reticular activating system (RAS) and the cerebral cortex Indications Producing sedation, hypnosis, anesthesia, amnesia, and unconsciousness to allow performance of painful surgical procedures Adverse Reactions Circulatory depression – hypotension, shock, decreased cardiac output, arrhythmias, respiratory depression Headache, nausea, vomiting Malignant hyperthermia Contraindications Status asthmaticus Absence of suitable veins for intravenous administration
Copyright © 2017 Wolters Kluwer • All Rights Reserved General Anesthetics (cont.) General Anesthetics (cont.) Pharmacokinetics Lipid soluble and therefore are distributed widely throughout the body Metabolized in the liver Crosses the placenta Caution CVD, hypotension or shock Increased intracranial pressure and myasthenia gravis Drug-to-Drug Interactions Ketamine and halothane Barbiturate anesthetics and narcotics Midazolam and inhaled anesthetic
Copyright © 2017 Wolters Kluwer • All Rights Reserved Types of General Anesthetics agents Types of General Anesthetics agents Barbiturate and Non-Barbiturate Anesthetics Volatile Liquids Gas Anesthetics
Copyright © 2017 Wolters Kluwer • All Rights Reserved 1. Barbiturate Anesthetics 1. Barbiturate Anesthetics Thiopental ( Pentothal ) Most widely used of the intravenous anesthetics Rapid onset of action; ultra-short recovery period Methohexital ( Brevital ) Rapid onset of action Recovery period that is even more ultra-short
Copyright © 2017 Wolters Kluwer • All Rights Reserved Prototype Barbiturate Anesthetics Prototype Barbiturate Anesthetics
Copyright © 2017 Wolters Kluwer • All Rights Reserved Non-Barbiturate Anesthetics (cont.) Non-Barbiturate Anesthetics (cont.) Act in the reticular activating system and limbic system to potentiate the effects of gamma-aminobutyric acid. Ketamine (Ketalar) Rapid onset and a very slow recovery Associated with bizarre state of unconsciousness Crosses the blood brain barrier Propofol (Diprivan) Short acting with rapid onset of action Often used for short procedures Can cause bradycardia, hypotension Midazolam Rapid onset, does not peak 30-60 minutes More likely to cause nausea and vomiting Droperidol (Inapsine) Rapid onset of action and ultra-short recovery period Used with caution in patients with renal or hepatic failure Etomidate (Amidate) Ultra-short onset and a rapid recovery period Not recommended for children younger than age 10
Copyright © 2017 Wolters Kluwer • All Rights Reserved Prototype Non-Barbiturate Anesthetics Prototype Non-Barbiturate Anesthetics

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