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Pharmacology > Exam 4- Inhalation > Flashcards

Exam 4- Inhalation Flashcards

1
Q

T or F: All modern volatile agents are ether hydrocarbons with no more than 4 carbons

A

True

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2
Q

What are the 4 potential elements for halogenation?

A

F, Cl, Br, Iodine

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3
Q

The heavier the AMU, the (more/less?) potent the compound?

A

more potent

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4
Q

Continuum of adding F atoms to an ether…

A

more potent–>convulsant–>inert

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5
Q

Metabolism values (sevo, iso, des)

A

sevo: 1-5% iso 0.2% des 0.02%

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6
Q

Diffusion order:

A

D, I, A, a, Br, M, F, Venous

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7
Q

Factors that affect uptake (from diffusion order)

A

PA–>PV

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8
Q

Determinants of alveolar concentration (3) or (4)

A

PI, alveolar ventilation, characteristics of breathing system
(Delivery… PD)

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9
Q

Amount of uptake depends on: (3)

A

Solubility, CO, A-vD

alveolar to venous partial pressure difference

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10
Q

Reflects tissue uptake of anesthetic

A

A-vD

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11
Q

MAC value: N20

A

104%

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12
Q

MAC value: Des

A

6.6%

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13
Q

MAC value: Sevo

A

1.8%

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14
Q

MAC value: Iso

A

1.15%

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15
Q

Loss of memory at what MAC?

A

0.5-0.7 MAC

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16
Q

95% hold still at what MAC?

A

1.3

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17
Q

99% hold still at what MAC?

A

1.6

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18
Q

Blood: gas (N20)

A

.46

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19
Q

Blood:gas (Des)

A

.45

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20
Q

Blood:gas (Sevo)

A

.65

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21
Q

Blood:gas (Iso)

A

1.4

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22
Q

Oil:gas (N20)

A

2.39

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23
Q

Oil:gas (Des)

A

29

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24
Q

Oil:gas (Sevo)

A

54

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25
Q

Oil:gas (Iso)

A

50

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26
Q

A major site for integration, storage, and retrieval of information (memory)

A

cerebral cortex

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27
Q

Which are more sensitive to inhibition by inhaled agents: synaptic events or axonal conduction?

A

synaptic events x5

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28
Q

True or False: GABA is an inhibitory NT

A

True

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29
Q

Postsynaptic: More consistent response to inhibitory or excitatory NTs?

A

Inhibitory …. (response is enhancement)

30
Q

An organic molecule that donates electrons to form covalent bonds
A molecule that reacts to form a complex

A

Ligand

31
Q

At least how much MAC needs to come from potent agent to insure amnesia?

A

0.7

32
Q

Hyperthermia, hypernatremia, chronic ETOH, increased central NT levels
effect on MAC?

A

Increase MAC

33
Q

Age, met acid, drunk/trauma, hypoxia, lithium, lido, preg PP, cold, hyponatremia, hypotension
effect on MAC?

A

Decrease MAC

34
Q

Do Mag/K+ affect MAC? Na+?

A

No.

Yes (sodium)

35
Q

Does hypo/hyper carbia affect MAC?

A

No.

36
Q

Does thyroid affect MAC?

A

No.

37
Q

MAC awake (characteristic and level)

A

Min conc for an anes pt to respond to commands

0.33 MAC

38
Q

MAC-BAR (characteristic and level)

A

Min conc to ablate tachycardia/HTN response

1.7 MAC

39
Q

MAC for tracheal intubation (mostly for peds)

A

1.5 MAC

40
Q

ADME is PK or PD?

A

Pharmacokinetics

41
Q

ETC02 is which partial pressure?

A

Alveolar

42
Q

What is the best indicator of PaPr of anesthetic in all body tissue

A

Alveolar partial pressure (ETC02)

43
Q

Level of anesthesia determined by partial pressure of agent in

A

brain

44
Q

We make the assumption that PA is = to

at equilibrium

A

Pbrain

45
Q

2 components of 2nd gas effect

A

Increased alveolar ventilation

Concentration effect

46
Q

**Net effect of 2nd gas effect….

A

more rapid rise in PA to PI and more uptake of the 2nd gas

47
Q

**2nd gas effect…

A

Uptake of N20 reduces the volume but increases the % of sevo

When sevo’s % increases, uptake of sevo is accelerated

48
Q

High blood:gas coefficient (fast or slow equil?)

A

slower

49
Q

The greater the alveolar ventilation to FRC ratio, (rapid or slow) rise in PA?

A

Rapid

50
Q

Blood:gas coefficients can be altered by

A

Hct (proportional), fatty meal (increase solubility)

51
Q

Oil:Gas MAC calculation

A

MAC = 150/#

52
Q

Tissue:blood coefficient = determine uptake into tissues and time needed for equilibration of ____ and ____

A

tissues and Pa

53
Q

Equilibrium b/w Pa and Pbr depends on the drugs blood solubility and requires how many min/how many time constants

A

5-15 min

3 time constants

54
Q

Increased CO… PA rise (slower or faster)

A

slower

55
Q

right to left shunt: (fast or slow) onset

A

slowed onset d/t decrease Pa (diluted)

56
Q

FA/FI graph (top to bottom)

A

N20, Des, Sevo, Iso, Halothane

57
Q

1st phase of elimination is a reflection of

A

alveolar ventilation

58
Q

The major difference in elimination rates occurs in the final ____ % ( b/w sevo/des and iso)

A

final 20%

59
Q

Stage 1 extubation at what MAC?

A

0.1

60
Q

Stage 3 extubation at what MAC?

A

1.1-1.3

61
Q

MAC awake with balanced techinque

A

0.11 MAC

62
Q

Diffusion hypoxia- N20 going from where to where?

A

N20 leaves blood to enter alveoli

Dilute PA02, Pa02 decreases, –>hypoxia

63
Q

halogenated methyl ethyl ether

A

isoflurane

64
Q

“Time-proven agent”

cerebral protective/luxury perfusion

A

isoflurane

65
Q

fluorinated methyl ethyl ether

A

Desflurane

66
Q

fluorinated methyl isopropyl ether

A

sevoflurane

67
Q

Production of CO in absorbers: Order of most occurence

A

Des>Iso>Sevo

68
Q

Major metabolites of iso and des

A

TFA and Fluoride ions

69
Q

low potency, low solublility (2 agents)

A

N20, Des

70
Q

High potency, high solubility gas

A

iso

71
Q

high potency, low solubility gas

A

sevo

Pharmacology (3 decks)

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