Lesson 6 (General Anesthetics) Part 4 – Medical English School

Pharmacology

Про урок

General Anesthetics

PART 4. What are intravenous anesthetics?

Now watch the video till the end and study the material below😉

Listening vocabulary list:

🎧Anesthesia – Анестезія
🎧Consciousness – Свідомість
🎧Invasive – Інвазивний
🎧General anesthesia – Загальна анестезія (наркоз)
🎧Local anesthesia – Місцева анестезія
🎧To numb – Знечулити
🎧Updated – Оновлений
🎧Onset – Початок
🎧Safety – Безпека
🎧Recovery – Відновлення
🎧Induction – Введення, стадія аналгезії
🎧Excitement – Збудження
🎧Involuntary – Мимовільний
🎧Surgical anesthesia – Хірургічна стадія
🎧To prevent – Запобігати
🎧Medullary paralysis – Агональна стадія
🎧Overdose – Передозування
🎧Apparent – Очевидний
🎧Immobility – Нерухомість
🎧Analgesia – Знеболення
🎧Resting potential – Потенціал спокою
🎧Excitability – Збудливість
🎧Myoclonus – Міоклонія
🎧Crucial – Вирішальний
🎧Inflow – Приплив
🎧Ultimately – Зрештою
🎧Diverse – Різноманітний
🎧Sensitive – Чутливий
🎧Renal toxicity – Нефротоксичність
🎧Dexmedetomidine – Дексмедетомідин
🎧Perception – Сприйняття
🎧Rare – Рідкісний
🎧Lightheadedness – Запаморочливість

Listening phrases list:

🔉Loss of response to pain – Втрата реакції на біль
🔉Loss of muscle tone – Втрата м’язового тонусу
🔉Adrenal suppression – Пригнічення функції наднирників
🔉Vivid dreams – Яскраві сни
🔉Terminating the propagation of pain signals – Припинення поширення больових сигналів
🔉Loss of sensation – Втрата чутливості

Intravenous nonopioid^✅ anesthetics play an essential^2✅ role in the practice of modern anesthesia. They are used to facilitate^3✅ rapid induction of anesthesia and have replaced^24☑️ inhalation as the preferred^25☑️ method of anesthesia induction^4✅ in most settings except for pediatric anesthesia. Intravenous agents are also commonly used to provide sedation^5✅ during monitored anesthesia care and for patients in ICU^6✅ settings. With the introduction of propofol, intravenous anesthesia also became a good option for the maintenance^26☑️ of anesthesia.

The intravenous anesthetics used for induction of general anesthesia^7✅ are lipophilic^8✅ and preferentially^27☑️ partition into highly perfused⁹^✅ lipophilic tissues (brain, spinal cord), which accounts for their rapid onset^28☑️ of action. Regardless of^29☑️ the extent^30☑️ and speed of their metabolism, termination^10✅ of the effect of a single bolus is determined by redistribution^11✅ of the drug into less perfused and inactive tissues such as skeletal muscle and fat^12✅.

In most countries, propofol^13✅ is the most frequently^31☑️ administered drug for induction of anesthesia, and it has largely replaced barbiturates in this setting^14✅. Because its pharmacokinetic profile allows for continuous^32☑️ infusions, propofol is a good alternative to inhaled anesthetics for maintenance of anesthesia and is a common choice for sedation in the setting of monitored anesthesia care.

Propofol is rapidly^33☑️ metabolized in the liver; the resulting water-soluble compounds^34☑️ are presumed^15✅ to be inactive and are excreted through the kidneys. Plasma clearance is high and exceeds^35☑️ hepatic blood flow^16✅, indicating the importance of extrahepatic metabolism, which presumably^36☑️ occurs in the lungs and may account^17✅ for the elimination of up to 30% of a bolus dose^18✅ of the drug. As with other intravenous agents, awakening^19✅ after an induction dose of propofol usually occurs within 8–10 minutes.

Propofol acts as hypnotic but does not have analgesic properties. Although^37☑️ the drug leads to a general suppression^38☑️ of CNS activity, excitatory^20✅ effects such as twitching^21✅ or spontaneous movement are occasionally^39☑️ observed during induction of anesthesia. Compared with other induction drugs, propofol produces the most pronounced^22✅ decrease in systemic blood pressure; this is a result of profound^23✅ vasodilation in both arterial and venous circulations leading to reductions in preload^40☑️ and afterload^41☑️. Propofol is also a potent respiratory depressant and generally produces apnea after an induction dose.

Propofol is often used for maintenance of anesthesia either as part of a balanced anesthesia regimen in combination with volatile anesthetics, nitrous oxide, sedative-hypnotics, and opioids or as part of a total^42☑️ intravenous anesthetic technique, usually in combination with opioids. Therapeutic plasma concentrations for maintenance of anesthesia normally range between 3 and 8 mcg/ml.

Here is a vocabulary for better understanding🫀

Vocabulary list:

✅Nonopioid – Неопіоїдний
✅Essential – Необхідний
✅To facilitate – Полегшувати
✅Induction – Введення
✅Sedation – Седація
✅ICU – Відділення інтенсивної терапії
✅General anesthesia – Загальне знечулення
✅Lipophilic – Ліпофільний
✅Perfused – Перфузований
✅Termination – Припинення
✅Redistribution – Перерозподіл
✅Fat – Жирова тканина
✅Propofol – Пропофол
✅Setting – Ситуація
✅Presumed – Передбачуваний
✅Hepatic blood flow – Печінковий кровотік
✅To account – Спричинювати, нести відповідальність
✅Bolus dose – Болюсна доза
✅Awakening – Пробудження
✅Excitatory – Збудливий
✅Twitching – Посмикування
✅Pronounced – Виражений
✅Profound – Глибокий
☑️To replace – Замінювати
☑️Preferred – Переважний, той, кому надається перевага
☑️Maintenance – Підтримування
☑️Preferentially – Переважно
☑️Onset – Початок
☑️Regardless of – Незалежно від
☑️Extent – Ступінь
☑️Frequently – Часто
☑️Continuous – Безперервний
☑️Rapidly – Швидко
☑️Compounds – Сполуки
☑️To exceed – Перевищувати
☑️Presumably – Імовірно
☑️Although – Хоча
☑️Suppression – Пригнічення
☑️Occasionally – Зрідка, іноді
☑️Preload – Переднавантаження
☑️Afterload – Післянавантаження
☑️Total – Загальний

Congratulations! You did a fantastic work! Now let`s complete the questions in the next folder “Lesson 6 – Part 4″🥳

https://www.ncbi.nlm.nih.gov/books/NBK554540/

https://www.ncbi.nlm.nih.gov/books/NBK537106/

https://www.sciencedirect.com/science/article/abs/pii/B978032348110600003X

https://www.youtube.com/watch?v=Xu4pVJiN0As

https://www.semanticscholar.org/paper/Inhaled-Anesthetic-Pharmacokinetics-%3A-Uptake-%2C-%2C-%2C-Forman-Ishizawa/3b152268ea57e6133a4cc9eb27c3e0491fc7a217

https://www.google.com/search?sxsrf=AB5stBiNZr-deth1cI_uzJ_FpJ61OLW7jg:1690484550148&q=anesthesia+stages&tbm=isch&source=lnms&sa=X&ved=2ahUKEwjIkPDYya-AAxUfgv0HHajiCHMQ0pQJegQIDBAB&biw=1536&bih=688&dpr=1.25#imgrc=UN1FaON1JxHQ0M&imgdii=Re0vt86g3N55JM

https://www.youtube.com/watch?v=zpu9mUpTiOM

https://www.dentistrytoday.com/patients-prefer-propofol-for-sedation/

https://www.openpr.com/news/2479109/intravenous-anesthetic-market-driving-factors-industry

https://www.grovet.com/en/thiopental-1-0-g-20-ml.html

https://puragraft.com/products/flumazenil