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2024 Pharmacology > Exam 2: Module 5: Inhalational Anesthetics > Flashcards

Exam 2: Module 5: Inhalational Anesthetics Flashcards

1
Q

What does the blood-brain barrier limit?

A

Access to the brain.

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2
Q

What must anesthetics pass to work on the brain?

A

Blood-brain barrier (BBB).

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3
Q

What is the main function of the BBB?

A

Physical and metabolic barrier.

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4
Q

What regulates the BBB?

A

Astrocytes, neurons, pericytes, microglia.

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5
Q

What is the purpose of active efflux at the BBB?

A

Remove substances from the brain.

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6
Q

What happens if the brain is hypoxic?

A

Neuron function decreases.

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7
Q

What are passive transport mechanisms across the BBB?

A

Hydrophilic paracellular and lipophilic diffusion.

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8
Q

What does P-glycoprotein do in the BBB?

A

Efflux of substances from the brain.

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9
Q

What does adipose tissue do to anesthetics?

A

Reduces drug efficiency.

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10
Q

What physicochemical factor influences brain uptake?

A

Permeability coefficient.

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11
Q

What is the blood:gas partition coefficient?

A

Solubility of a compound in the bloodstream.

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12
Q

What are common inhalational anesthetics?

A

Isoflurane, sevoflurane, desflurane.

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13
Q

How are inhalational anesthetics excreted?

A

Via pulmonary exhalation.

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14
Q

What is the ideal effect of inhalational anesthetics?

A

Affect CNS only, no other organ effects.

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15
Q

What is malignant hyperthermia?

A

Dangerous increase in body temperature due to anesthetics.

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16
Q

How is clearance of inhalational anesthetics achieved?

A

Exhalation.

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17
Q

What does MAC stand for in anesthesia?

A

Minimum alveolar concentration.

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18
Q

What does MAC measure?

A

Ability to immobilize 50% of individuals with anesthetic.

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19
Q

What is the target site of MAC?

A

Cerebral cortex.

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20
Q

What does a low MAC indicate?

A

High anesthetic potency.

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21
Q

Which drug has the lowest MAC?

A

Halothane.

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22
Q

Which drug has the highest MAC?

A

Desflurane.

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23
Q

What rule does MAC follow?

A

Meyer-Overton Rule.

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24
Q

What does the Meyer-Overton Rule relate to?

A

Oil:gas partition coefficient.

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25
Q

What is balanced anesthesia?

A

Combination of neuromuscular blockade, IV anesthesia, and opioids.

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26
Q

What do alpha-2 agonists do in anesthesia?

A

Provide sedation and analgesia.

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27
Q

Where do alpha-2 agonists act in the brain?

A

Locus coeruleus and dorsal horn.

28
Q

How do alpha-2 agonists affect MAC?

A

Reduce MAC by 30-70%.

29
Q

What is a common alpha-2 agonist?

A

Xylazine.

30
Q

What neurotransmitter is modulated by benzodiazepines?

A

GABA.

31
Q

What are benzodiazepines used for in anesthesia?

A

Premedication and co-induction agent.

32
Q

What effect does propofol have?

A

Hypnotic effect through GABAA agonism.

33
Q

How is propofol metabolized?

A

Via lipophilic distribution.

34
Q

What is TIVA?

A

Total intravenous anesthesia.

35
Q

What is the effect of propofol on psychomotor recovery?

A

Rapid recovery.

36
Q

What type of receptor do alpha-2 agonists act on?

A

G-protein coupled receptors.

37
Q

What does alpha-2 agonist activation cause?

A

Hyperpolarization of neurons.

38
Q

What happens to calcium flux with alpha-2 agonists?

A

Decreases.

39
Q

What ion channel is affected by alpha-2 agonists?

A

Potassium (K+) channels.

40
Q

What does benzodiazepine modulation of GABA cause?

A

Muscle relaxation and hypnosis.

41
Q

What receptors do inhalational anesthetics primarily target?

A

NMDA and GABA receptors.

42
Q

How is anesthetic recovery achieved?

A

Pulmonary excretion of unchanged anesthetic.

43
Q

What are the pharmacokinetic properties of inhalational anesthetics?

A

Low blood:gas partition coefficient, rapid excretion.

44
Q

What effect does anesthetic have on skeletal muscles?

A

Causes relaxation.

45
Q

What anesthetic agent is used to reduce MAC?

A

Medetomidine.

46
Q

What is the effect of benzodiazepines on memory?

A

Cause amnesia.

47
Q

How do inhalational anesthetics affect the heart?

A

Minimal to no effect on coronary blood flow.

48
Q

What is the oil:gas partition coefficient?

A

Measure of solubility in fats compared to gases.

49
Q

How do inhalational anesthetics affect respiratory rate?

A

May cause respiratory depression.

50
Q

What effect does high FIO2 have with anesthetics?

A

Enhances oxygen delivery.

51
Q

What is the primary route of anesthetic elimination?

A

Lungs.

52
Q

What receptor is primarily targeted by propofol?

A

GABAA receptor.

53
Q

What is the effect of alpha-2 agonists on norepinephrine?

A

Inhibit norepinephrine release.

54
Q

What does MACBAR stand for?

A

MAC that blocks autonomic response to a noxious stimulus.

55
Q

How do benzodiazepines affect anxiety?

A

Reduce anxiety (anxiolytic effect).

56
Q

What is the effect of volatile anesthetics on CNS excitability?

A

Decrease CNS excitability.

57
Q

How do anesthetics affect the blood-brain barrier?

A

Must cross BBB to induce effects.

58
Q

What does the BBB limit in anesthesia?

A

Limits drug access to the brain.

59
Q

What effect does hypoxia have on anesthesia?

A

Decreases drug effectiveness in the brain.

60
Q

How do inhalational anesthetics impact cerebral blood flow?

A

May increase cerebral blood flow.

61
Q

Glycine receptors:

  • ionotropic or metabotropic
  • Cl- or Ca2+
A

ionotropic
Cl-

62
Q

NMDA receptors

  • ionotropic or metabotropic
  • Cl- or Ca2+
A

ionotropic
Ca2+

63
Q

Glutaminergic AMPA receptors

  • ionotropic or metabotropic
  • Cl- or Ca2+
A

ionotropic and metabotropic types

Excitability

64
Q

what should we think of when we think about potentiate

A

enhancement

65
Q

what should we think of when we think about GABA

A

inhibitory

66
Q

What should we think of when we think about Metabotropic receptors

A

2nd messenger systems

2024 Pharmacology (23 decks)

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