Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm Fall 2019 > Ex2 IA System Effects > Flashcards

Ex2 IA System Effects Flashcards

1
Q

Effect on MAP

A

IAs:
Dose-dependent decrease (increasing concentrations)
N2O: no change or increase
N2O + Iso = less of a decrease in BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Effect on HR

A

Iso/Des: dose dependent increase

Sevo at <1.5 MAC: decrease; >2 = normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Effect on rhythm

A

Prolonged QT

Sevo should be avoided in prolonged QT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Effect on ventilation

A

Dose dependent depression of ventilation (Dec. response to increased CO2/decreasedO2)
Shallow breathing, increased rate, Bronchodilation
Inhibit HPV (esp > 1-2 MAC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

HPV

A

Hypoxic Pulmonary Vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Effect on chest wall

A

Decreased FRC, atelectasis in dependent areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Effect on CNS

A

N2O: increased CBF, modest increase in CMRO2
IAs: decreased CMRO2, increased CBF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

All volatiles cause a cerebral ______ in a dose dependent manner

A

dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

All volatiles _______ ICP at concentrations exceeding _____ MAC

A

increase; 1 MAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is impaired at concentrations > 1 MAC?

A

Autoregulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cerebrovascular response to ______ is maintained

A

PaCO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which type of procedure would avoid IAs?

A

Spinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CNS Effects

A

Dose dependent depression of amplitude/increase latency of SSEPs (& AEPs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

EPs may be abolished at _____ MAC

A

1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

At what concentration do volatiles reduce the reliability of MEPs?

A

Low concentrations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Effect on EEG

A

Increased amplitude, burst suppression > MAC 1.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which IAs are epileptogenic?

A

Enf > Sevo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Volatiles ____ NDMRs (and DMR)

A

potentiate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which volatiles trigger MH?

A

All

NOT N2O

20
Q

Effect on Liver

A

Dose dependent reductions in hepatic blood flow, mild LFT elevations

21
Q

Severe liver injury may occur with _____

A

Iso, Des

22
Q

Effect of VAs on CO result in

A

Positive feedback —> VAs depress CO, decreased CO = more Pa; excessive depth of anesthesia may occur

23
Q

Anesthetic preconditioning

A

All VAs produce biphasic preconditioning on myocardium that rivals ischemic preconditioning (myocardial injury is limited after insult, fxn is preserved)

23
Q

Which IAs are pungent?

A

ISO, Des

24
Q

Pungency of an IA causes

A

Bronchoconstriction, airway irritation

25
Q

How to avoid effects of pungency

A

Small doses of opioids attenuate this effect

26
Q

Which VA potentiates roc most?

A

Des

27
Q

Liver effect from VAs is a result of

A

CYP450 metabolism results in trifluoroacetate — binds covalently to hepatocytes which triggers an immune response
hepatic necrosis*

28
Q

Do VAs effect the renal system?

A

Yes - Dose dependent decrease in renal blood flow, GFR, UO

d/t dec. BP/CO

29
Q

Nephrotoxicity is characterized by

A

Polyuria, hypernatremia, hyperosmolality, increased serum creat., poorly concentrated urine

30
Q

Renal Toxin _____ at levels _____

A

Inorganic F > 50 mmol/L

31
Q

Which VA may concern anesthetist with renal toxicity?

A

Sevo — metabolized to inorganic F

32
Q

Prolonged Sevo anesthesia ______ impair renal function

A

Does not

33
Q

How is compound A formed?

A

CO2 absorbents (K/Na hydroxide) react with Sevo

34
Q

Compound A

A

Nephrotoxin — proximal renal tubular injury

35
Q

Dose at which Compound A causes nephrotoxicity

A

50 ppm

36
Q

How do VAs effect skeletal muscles

A

Relaxation

N2O = rigidity at high concentration s

37
Q

When does MH manifest?

A

Not always immediate - Des: 3 hours post VA

38
Q

Effect of VAs on OB

A

Dose dependent decrease in uterine contractility/blood flow

39
Q

Effect of VAs on OB - modest vs substantial

A

Modest: 0.5 MAC
Substantial: >1 MAC

40
Q

Effect of VAs on Immune system

A 
Depressed 
PMLs inhibited (inflammation)
41
Q

N2O effect on genetics

A

Teratogenic d/t inhibition of DNA synthesis (avoid in pregnancy; esp 1st trimester)

42
Q

Effects on Bone marrow function

A

N2O causes megaloblastic changes/agranulocytosis

D/t effects on Vit B — production of DNA/erythrocytes

43
Q

Chronic administration of N2O can lead to

A

Peripheral neuropathy - d/t vitamin B12 enzyme dysfunction, peripheral/spinal cord nerve degeneration (prolonged administration 15 days); and symptoms of pernicious anemia

44
Q

Effects of IAs on systemic O2 requirements

A

Decreased

45
Q

Des > ISO produces?

A

Carbon monoxide from degradation by CO2 absorbants

46
Q

Cost considerations of IAs

A
  • vapor pressure (mL vapor from each mL fluid)
  • potency
  • solubility
  • FGF (open or closed)

Pharm Fall 2019 (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions