This is a short summary of medicines used for anesthesia.
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ADDITIONAL TAGS:
Anesthesia
Drug
Administration
Mechanism of action
Advantage
Disadvantages
Etomidate
Intravenous
Bind GABA receptor, enhance effects of GABA (main inhibitory neurotransmitter)
Cardiovascular stability
Many side effects, can't use in septic shock
Ketamine
Antagonize NMDA receptor, reduce effects of glutamate (main excitatory neurotransmitter) → dissociative anesthetic
Potent without respiratory depression
Increases heart rate and cardiac output; can cause hallucinations and nightmares
Propofol
Enhance GABA
Rapid onset, rapid recovery → very widely used
Can cause respiratory depression and bradycardia
Thiopental
Enhance GABA
Can decrease intracranial pressure
Can cause respiratory depression and bradycardia
Nitrous oxide
Inhalation
Enhance GABA transmission; inhibit glutamate receptors
Causes analgesia, depersonalisation, derealisation, dizziness, euphoria
Low potency (high minimum alveolar concentration) → cannot achieve surgical anesthesia
Halothane
Low cost → widely used worldwide
Risk of arrhythmias and immune hepatitis → no longer used in US
Fluranes: desflurane, isoflurane, sevoflurane
Potent, enough for general anesthesia for surgery
Can cause malignant hyperthermia (fatal hypermetabolic dz, treat with dantrolene)
Side effects:
-CV (dec heart contraction, SVR, and BP)
-respiratory (inc rate, dec TV and CO2 response to CO2)
-renal (dec blood flow and GFR)