Created by Bhavi Mistry
over 11 years ago
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Question | Answer |
Thiopentone | Short acting barbituate anaesthetic (positive GABAa allosteric modulation at the B subunit) |
Why is thiopentone replaced by propofol? | Repeated dose of thiopentane saturates tissue stores, so it sits around in the blood, and can therefore not maintain a constant infusion |
Propofol | Rapid metabolism and non-accumulative (no storage in fat/muscle) |
tiletamine (phencyclidine) | NMDA channel - |
midazolam | Benzodiazepine amnesia used in endoscopy when full analgesia is not needed |
Advantages of injectable anaesthetics | High therapeutic index No CV/Resp depression Non-cumulative Analgesic |
Disadvantages of injectable anaesthetics | Psychic disturbance Involuntary movement |
Halothane | Toxic metabolite (inhalation anaesthetics) |
Enflurane | Convulsions |
Des/Sevoflurane | Rapid induction |
Advantages of inhalation anaesthetics | Maintenance of stage III (surgical anaesthaesia) Small lipid soluble molecules cross the alveolar membrane easily |
Disadvantages of inhalation anaesthetics | Problem if lungs are damaged Toxicity is associated with their metabolism |
Review | Stages of anaesthaesia Effects on the CNS Effects on other channels |
Unitary theory | No obvious structure-activity relationship |
Lipid theory | Membrane expansion leads to disruption of function |
Meyer+overton | The potency of a drug is proportional to its lipid solubility |
Protein theory | Binding to hydrophobic regions (true, but not always in the same way) |
Etomidate | Enhancement of GABAaR function |
Volatile anaesthetics | Bind between alpha and beta subunits |
IV anaesthetics | Bind to beta subunits |
N2O | (-) NMDA Rs |
Xenon | (-)NMDA Rs |
Ketamine | (-) NMDA R |
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