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Anesthetics (Pharmacology) - Coggle Diagram

- - - - Drugs
        
        Ketamine
      - Possible Mechanism
        
        Blocks excitation by glutamate at NMDA receptors
      - Pharmacologic Effects
        
        Analgesia, amnesia
        and catatonia but consciousness retained, cardiovascular (CV)
        stimulation!
      - Pharmacokinetics
        
        Moderate duration of action-hepatic metabolism
      - Toxicities and Interactions
        
        Increased intracranial pressure,
        emergence reactions
    - - Possible Mechanism
        
        -
      - Pharmacologic Effects
        
        Minimal effects on CV and respiratory functions
      - Drugs
        
        Etomidate
      - Pharmacokinetics
        
        Short duration due to redistribution
      - Toxicities and Interactions
        
        No analgesia, pain on injection (may need opioid), myoclonus,nausea, and vomiting
    - - Pharmacologic Effects
        
        Less depressant than barbiturates Slower onset, but longer duration than barbiturates
      - Pharmacokinetics
        
        Slower onset, but longer duration than barbiturates
      - Possible Mechanism
        
        -
      - Toxicities and Interactions
        
        Postoperative respiratory depression reversed by flumazenil
      - Drugs
        
        Midazolam
    - - Pharmacologic Effects
        
        Marked analgesia,respiratory depression
      - Pharmacokinetics
        
        Alfentanil and remifentanil fast onset (induction)
      - Possible Mechanism
        
        Interact with µ, κ, and δ opioid receptors
      - Toxicities and Interactions
        
        Respiratory depression reversed by naloxone
      - Drugs
        
        Fentanyl
        
        Alfentanil
        
        Remifentanil
        
        Morphine
    - - Pharmacologic Effects
        
        Circulatory and respiratory depression decrease intracranial pressure
      - Pharmacokinetics
        
        High lipid solubility-fast onset and short duration due to redistribution
      - Possible Mechanism
        
        Barbiturates, benzodiazepines, etomidate, and propofol facilitate GABA mediated inhibition at GABAA receptors
      - Toxicities and Interactions
        
        Extensions of CNS depressant actions additive CNS depression with many drugs.
      - Drugs
        
        Thiopental
        
        Thioamylal
        
        Methohexita
    - - Pharmacologic Effects
        
        Vasodilation and hypotension,negative
        inotropy.Fospropofol
        water-soluble
      - Pharmacokinetics
        
        Fast onset and fast recovery due to inactivation
      - Possible Mechanism
        
        Uncertain
      - Toxicities and Interactions
        
        Hypotension (during
        induction),cardiovascular
        depression
      - Drugs
        
        Propofol
        
        ,Fospropofol
  - - - Increase cerebral blood
        flow enflurane and halothane decrease cardiac
        output. Others cause vasodilation all decrease
        respiratory functions lung irritation (desflurane)
    - - Rate of onset and recovery vary by blood:gas partition coefficient
        recovery mainly due to redistribution from brain
        to other tissues
    - - Facilitate GABA-mediated inhibition block brain NMDA and
        ACh-N receptors
    - - Toxicity: extensions of effects
        on brain, heart/vasculature, lungs
        Drug interactions: additive
        CNS depression with many agents, especially opioids and
        sedative-hypnotics
    - - Desflurane
        
        Enflurane
        
        Halothane
        
        Isoflurane
        
        Sevoflurane
        
        Nitrous oxide
- - - - Hepatic metabolism via
        CYP450 in part ,Half lives ; Lidocaine ,Prilocaine < 2 hr, others 3-4 hrs
    - - Analgesia via topical use,or injection (perineural, epidural, subarachnoid)
    - - Blockade of Na+ channels slows,then prevents actionpotential propagation
    - - CNS: excitation, seizure CV: vasodilation,hypotension, arrhythmias(bupivacaine)
    - - Articaine
        
        Bupivacaine
        
        Levobupivacaine
        
        Lidocainea
        
        Mepivacaine
        
        Prilocaine
        
        Ropivacaine
  - - - Rapid metabolism via plasma esterases. short half-lives
    - - Analgesia, topical only for cocaine and benzocaine
    - - As above, plus cocaine has intrinsic sympathomimetic actions
    - - As above re CNS actions
        Cocaine vasoconstrictsAnalgesia, topical only for
        cocaine and benzocaine
        When abused cocaine has caused hypertension,seizures, and cardiac arrhythmias
    - - Benzocaine a
        
        Cocaine a
        
        Procaine
        
        Tetracaine a