Pharm II (ANESTHETICS)

It is a measure of inhalational anesthetic potency.


It is defined as the minimum alveolar anesthetic concentration at which 50% of patients do not respond to a surgical stimulus.

MAC values are additive

• Safest inhalational anesthetic
• Weak but a good Analgesic
• No toxic effect

• Dental procedures
• Raplidly eliminated

Hypoxia and Megaloblastic anemia

• Potent anesthetic
• It sensitizes the heart to catecholamines
• Dilates Bronchus
• Hepatitis and malignant hyperthermia

Malignant Hyperthermia

Dantrolene: a muscle relaxant that acts by abolishing excitation-contraction coupling in muscle cells

Do not sensitizes the heart to catecholamines

Seizures occurs at deeper levels (so it is contraindicated in epileptics).

Renal failure due to fluoride.

Used with Oxygen or Nitrous oxide

Do not sensitize the heart to catecholamines


Can irritate the respiratory system.

• -popular anesthetic for day care surgery
• -recovery is fast

-irritates the air passages producing cough and laryngospasm.

-recovery is fast

-pleasant and acceptable due to lack of pungency

• -Do not cause air way irritancy.
• -Concerns about nephrotoxicity

Arrhythmia, Hepatitis, Hyperthermia

Seizures, hyperthermia

Widely used

Ideal

Cough

Anemia

Used for INduction of anesthesia

• Rapid onset of action
• Recovery is mainly by redistribution

-thiopental, midazolam propofol, etomidate, ketamine

Benzodiazapine> Phenytoin> Barbituates

- It is an ultra short acting Barbiturate.

Consciousness regained within 10-20 mins by redistribution to skeletal muscle.

Does not increase the ICT


Eliminated slowly from the body by metabolism and produce hang over.

It can be used for rapid control of seizures.

commonly used IV anesthetic for both induction and maintenance.

Recovery is rapid and clearer than thiopenthal.

Anti-emetic in action.

Suited for day care surgery

Is not an Analgesic, so give Opioids with it to alleviate pain

-Pain on injection. Mild myoclonic movements are common

• Short acting Anesthetic
• decrease the production of steroids from the adrenal gland.

• -Is a Pro-convulsant and emetic.
• -CVS stability

Dissociative anesthesia (soul from body)

-Profound analgesia, cataleptic state, immobility, amnesia with light sleep.

• - Increased HR and BP due to increased Sympathetics
• -Patients respond to commands and their eyes are open.

Burn Dressing and Trauma surgery

Emergence delirium, hallucinations and involuntary movements occur in 50% of cases.

- Dangerous Hypertension

• -It is an opioid.
• -It is the DOC for Open heart surgery due to lack of cardiac depression.

- Antagonists Nalmefene and Naloxone reverse an overdose.

Can cause respiratory Depression.

• DOC for controlling and preventing Seizures.
• -Used for induction and short procedures.
• -Flumazenil can reverse its overdose.

-Has the Fastest onset of action, greatest potency and fastest elimination.

• Causes psychic indifference and intense analgesia without total loss of consciousness
• -decreased motor functions, suppressed autonomic reflexes, cardiovascular stability with mild amnesia. Drowsy but respond to commands.
• - Used in minor opertions

-It is a combination of Fentanyl and Droperidol.

Analgesia (and Hallucinations)

Muscle relaxation (and amnesia)

Analgesia ( and respiratiory depression)