Atomic Anesthesia

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Want more content like this? Become a member of our learning platform.

Valvular heart disease feels like a memorization topic, but the table of arrows in every review book isn't random. In Week 2 of our 12-week SEE/NCE series, we show you how two questions (pressure or volume problem, systole or diastole) let you rebuild the hemodynamic goals for every valve lesion in the middle of your exam.

In this episode:

• The shortcut: stenosis is full, slow and tight; regurgitation is full, fast and forward
• Aortic stenosis: severe AS numbers, the atrial kick, why phenylephrine is the go-to and why CPR rarely works
• Aortic regurgitation: acute vs chronic, why neuraxial is well tolerated, and the balloon pump contraindication
• Mitral stenosis: protecting the right heart, avoiding PVR triggers, and why wedge pressure overestimates LVEDP
• Mitral regurgitation: the large v wave and why phenylephrine can worsen the leak
• A rapid-fire board review of every lesion, plus how to handle mixed valve disease

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards
• Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page
• GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

In this premium episode, we’re breaking down pharmacokinetics, the concepts that explain what happens to a drug after it enters the body. From distribution and protein binding to metabolism, clearance, and context-sensitive half-time, we’ll connect the equations and terminology to how anesthetic drugs actually behave in the OR and focus on the high-yield concepts you need to know for the SEE/NCE.

In this episode:

• Volume of distribution, protein binding, and drug distribution
• Clearance, elimination, and half-life
• First-order vs. zero-order kinetics
• Hepatic extraction ratio and factors that affect drug metabolism
• Context-sensitive half-time and continuous infusions
• High-yield pharmacokinetic concepts for the SEE/NCE

This episode is part of our 12-week SEE/NCE podcast series, designed to follow the Atomic Anesthesia SEE/NCE Study Plan week by week.

Want to study along with the episode? Join the Atomic Anesthesia learning platform to get the accompanying worksheet, plus access to our members-only podcast episodes and additional SEE/NCE study resources.

FREE RESOURCE FOR THIS EPISODE:

SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards. Head to atomicanesthesia.com/freebies/see-nce-study-plan to grab it free.

WANT THE FULL PLATFORM?

Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs: 800 lessons, 10,000 quiz questions, flashcards, and interactive features. Join at atomicanesthesia.com.

In this episode, we’re covering barbiturates and benzodiazepines, two drug classes that both act at the GABA-A receptor but have important differences in their pharmacology, clinical effects, and reversal.

In this episode:

• How barbiturates and benzodiazepines modify the GABA-A receptor
• Why barbiturates increase chlo ride channel duration while benzodiazepines increase frequency
• Methohexital, thiopental, midazolam, diazepam, and lorazepam
• Key pharmacokinetic and clinical differences between the major drugs
• Flumazenil reversal and the board-relevant risks you need to remember

This episode is part of our 12-week SEE/NCE podcast series, designed to follow the Atomic Anesthesia SEE/NCE Study Plan week by week.

Want to study along with the episode? Join the Atomic Anesthesia learning platform to get the accompanying worksheet, plus access to our members-only podcast episodes and additional SEE/NCE study resources.

FREE RESOURCE FOR THIS EPISODE:

SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards. Head to atomicanesthesia.com/freebies/see-nce-study-plan to grab it free.

WANT THE FULL PLATFORM?

Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs: 800 lessons, 10,000 quiz questions, flashcards, and interactive features. Join at atomicanesthesia.com.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

Neuromuscular blockers are packed with high-yield SEE/NCE material and knowing the drug names isn’t enough. In this episode, we break down the pharmacology you need to understand so you can apply it to board-style questions and clinical scenarios.

In this episode:

• Depolarizing vs nondepolarizing neuromuscular blockade
• Succinylcholine pharmacology, contraindications & major complications
• Rocuronium, vecuronium & cisatracurium
• Pseudocholinesterase deficiency & the dibucaine number
• Factors that potentiate or cause resistance to neuromuscular blockade
• Reversal, residual blockade & high-yield board pearls

This episode is part of our 12-week SEE/NCE podcast series, designed to follow the Atomic Anesthesia SEE/NCE Study Plan week by week.

Want to study along with the episode? Join the Atomic Anesthesia learning platform to get the accompanying worksheet, plus access to our members-only podcast episodes and additional SEE/NCE study resources.

FREE RESOURCE FOR THIS EPISODE:

SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards. Head to atomicanesthesia.com/freebies/see-nce-study-plan to grab it free.

WANT THE FULL PLATFORM?

Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs: 800 lessons, 10,000 quiz questions, flashcards, and interactive features. Join at atomicanesthesia.com.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

Carotid endarterectomy is a critical procedure requiring careful management to protect cerebral perfusion, especially during cross-clamping. This episode delves into essential intraoperative considerations, particularly mean arterial pressure (MAP) targets, and strategies to maintain cerebral blood flow through monitoring and potential shunting.

• Preoperative assessment and baseline establishment
• Intraoperative monitoring techniques and A-line importance
• MAP target calculation and cerebral autoregulation adjustments
• Induction and maintenance anesthesia specifics
• Strategies for smooth emergence and minimizing complications

FREE RESOURCE FOR THIS EPISODE:

SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards. Head to atomicanesthesia.com/freebies/see-nce-study-plan to grab it free.

MORE FREE STUDY RESOURCES:

Non-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one page

GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia

Malignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page reference

WANT THE FULL PLATFORM?

Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs — lessons, quizzes, flashcards, and more. Join at atomicanesthesia.com.

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Want more content like this? Become a member of our learning platform: http://atomicanesthesia.com

In this episode:

• Train-of-four basics, including what the twitches actually represent and how to interpret your TOF count
• TOF count vs TOF ratio, understanding fade, and why four twitches does not necessarily mean full recovery
• Post-tetanic count, depth of neuromuscular blockade, and when to use different stimulation patterns
• Ulnar vs facial nerve monitoring, Phase I vs Phase II succinylcholine blockade, and qualitative vs quantitative monitoring
• Using TOF to guide neostigmine and sugammadex reversal, plus high-yield SEE/NCE concepts and practice board questions

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• GPCR Cheat Sheet — The G-protein coupled receptor mechanisms behind the alpha antagonists, beta blockers, and signaling pathways that show up in every OR vasodilator conversation.
• SEE/NCE Study Plan — A structured plan to help you prepare for the SEE and NCE without burning out — hypertension treatment is a high-yield topic.
• Non-Opioid Pharmacology Cheat Sheet — Propofol, ketamine, dexmedetomidine, and the rest of the non-opioid sedation toolkit on one page.

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea & Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Want more content like this? Become a member of our learning platform: http://atomicanesthesia.com

In this episode:

• The three mechanism buckets every OR vasodilator falls into — nitric oxide donors, calcium channel blockers, alpha antagonists — and why the bucket tells you the side effect profile before you ever look up the drug
• The full NO → cGMP → PKG → smooth muscle relaxation cascade behind nitroglycerin and nitroprusside, and why one drops preload while the other balanced-dilates
• Cyanide toxicity and coronary steal with nitroprusside — when to use it, when to cap it, and when to pick something else
• Clevidipine vs nicardipine vs hydralazine — which drug fits which case, and why hydralazine is falling out of favor for tight OR control
• Controlled hypotension for neuro cases, afterload management in cardiac surgery, and hypertensive emergencies including aortic dissection and pheochromocytoma

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• GPCR Cheat Sheet — The G-protein coupled receptor mechanisms behind the alpha antagonists, beta blockers, and signaling pathways that show up in every OR vasodilator conversation.
• SEE/NCE Study Plan — A structured plan to help you prepare for the SEE and NCE without burning out — hypertension treatment is a high-yield topic.
• Non-Opioid Pharmacology Cheat Sheet — Propofol, ketamine, dexmedetomidine, and the rest of the non-opioid sedation toolkit on one page.

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Dr. Temmermand at [email protected], follow us on social media, and sign up for our newsletter.

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

You work hard caring for others—let us take care of you. Whether you're a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That's where we step in.

Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we're a partner you can rely on, today and in the future.

We evaluate all available options and resources in the market to protect our clients, so contact us, and we'll get started! — Jake Bevilacqua, CRNA ([email protected])

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Want more content like this? Become a member of our learning platform: http://atomicanesthesia.com

In this episode:

• Exactly how PONV happens in the brain, no vague "vomiting center" hand waving
• All 5 real mechanisms behind how dexamethasone actually stops nausea and vomiting
• The practical dosing, timing, and combination strategy that gets the best PONV prevention

References:

• Chu CC, Hsing CH, Shieh JP, Chien CC, Ho CM, Wang JJ. The cellular mechanisms of the antiemetic action of dexamethasone and related glucocorticoids against vomiting. Eur J Pharmacol. 2014;722:48-54.
• Horn CC, Wallisch WJ, Homanics GE, Williams JP. Pathophysiological and neurochemical mechanisms of postoperative nausea and vomiting. Eur J Pharmacol. 2014;722:55-66.
• Ho CM, Wu HL, Ho ST, Wang JJ. Dexamethasone prevents postoperative nausea and vomiting: benefit versus risk. Acta Anaesthesiol Taiwan. 2011;49(3):100-104.

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards
• Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page
• GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Want more content like this? Become a member of our learning platform: http://atomicanesthesia.com

In this episode:

• The three decisions that shape every airway plan: awake or asleep, noninvasive or invasive, and preserve or ablate spontaneous ventilation
• The most important fork in the algorithm, can you oxygenate or not, and how it sends you down the non-emergency pathway or the emergency pathway
• Managing the cannot intubate, cannot oxygenate crisis, including front-of-neck access and the scalpel-bougie-tube technique

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards
• Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page
• GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.

Want more content like this? Become a member of our learning platform: http://atomicanesthesia.com

In this episode:

• Ten challenging SEE/NCE board questions, one from every corner of the NBCRNA blueprint, each read in full board style with a breakdown of why the right answer wins and why every distractor was built to fool you
• High-yield pharmacology and physiology traps, including Hofmann elimination for the organ-failure patient, shifting the oxyhemoglobin dissociation curve, and the MAC family from MAC-awake to MAC-BAR
• The clinical-reasoning questions that show up at the bedside, from autonomic hyperreflexia and infant bradycardia to coronary perfusion pressure and reading the capnograph waveform
• A local anesthetic maximum-dose calculation and a full walk-through of recognizing and treating local anesthetic systemic toxicity

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.

• SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards
• Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page
• GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at [email protected], follow us on social media, and sign up for our newsletter.

Mentioned in this episode:

💜 PARTNERS: The Incomologists®

https://theincomologists.com/