General Anaesthetics Part 1 - Steve Fitzjohn

What is general anaesthesia?

Which reflex is lost with an overdose of general anaesthetics? What does this lead to ?

What are the four stage of general anaesthetic?

What happens at the ? stage:
Analgesia

Excitment

Surgical Anaesthesia

Medullary Paralysis

When was N20 discovered?

Name two other analgesic gases

When was cocaine first used as an anaesthetic?

When was a tube first used in a trachea to control breathing etc?

What can curare be used as?

When was halothane introduced and what was it used for? Side effect?

What are the two groups of general anaesthetics?

What does MAC stand for? What does it mean?

How does MAC correlate with the oil:gas coefficient of the anaesthetic?

What is the lipid theory of general anaesthetic?

What are the three main problems with lipid theory? 1

2.

3.

What is the Modern Lipid Theory

What is the protein theory?

What is one explanation for why the potency of anaesthetics increases with lipid soluble?

What are the four things that need to be shown when testing the protein theory?

Where do volatile anaesthetics (halothane, isoflurane) bind on the GABAa subunit.

Where does ethanol bind on the GABAa receptor bind?

What type of potassium channel is an important target for GA? Give an example

What effect does chloroform have on a two-pore potassium channel? What slope of the IV graph dependent on?

Which other drug has this effect on the two-pore potassium channel?

Which type of anaesthetics bind to the GABAa receptor and where?

Which volatile gases have no effect on GABAa receptor?

Which type of anaesthetics affect the two-pore K+ channels?

Which anaesthetics (actual drugs) block NMDA receptors? What is the point of this?

What are the other potential targets for general anaesthetics?

What are the two main actions of injectable drugs?
(Propofol, etomidate, barbituates and neurosteroids)

What do the volatile anaesthetics mainly potentiate?

What is the main effect of ketamine?

What are the main effects of xenon and N20?

What do you want to do in terms of glutamatergic transmission and how do you target this?

What do you want to do to GABAergic or Glycinergic transmission?

Where do General Anaesthetics act?

Which inhibitory neurotransmitter is most important in the spinal cord?

Why is targeting the spinal cord so important?

Why is targeting the brainstem, hypothalamus and thalamus (arousal areas) important?

What does targeting the cerebral cortex do?