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Pharmacology > Final > Flashcards

Final Flashcards

1
Q

Route of administration with most rapid onset and 100% bioavailability

A

IV

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2
Q

GABA receptors responding to all members of benzodiazepine drug class demonstrates

A

Selectivity

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3
Q

Stimulated mu opiod receptors always produce effects of analgesia and respiratory depression is an example of

A

Specificity

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4
Q

Receptor response is always the same

A

Specificity

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5
Q

Required drug concentration to elicit an effect

A

Sensitivity

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6
Q

Potency aka

A

Affinity

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7
Q

Maximum effect that a drug may produce

A

Efficacy

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8
Q

Chronic antagonist administration results in up-regulation

A

Receptor up-regulation

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9
Q

Number and sensitivity of receptors increases
Tolerance occurs
Requires larger doses of antagonists ot counteract larger numbers of receptors

A

Receptor up-regulation

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10
Q

From continued stimulation of cells by agonists

A

Receptor down regulation

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11
Q

Exposure of constant concentration of drug leads to diminished effects

A

Down regulation

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12
Q

Substance that binds to specific receptors and trigger cellular responses

A

Agonist

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13
Q

Mimics action of endogenous ligands binding to same receptors

A

Agonist

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14
Q

Drug that binds to receptors without causing conformational change

A

Antagonist

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15
Q

Bind to receptors but exert partial effects. May block effects of pure agonists

A

Agonist/antagonist

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16
Q

Stage of anesthesia: from beginning of induction of GA to loss of conciousness

A

Stage 1

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17
Q

Stage of inhalation anesthesia- from loss of consciousness to onset of automatic breathing

Excitement or delirium

A

Stage 2

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18
Q

From onset of automatic respiration to respiratory paralysis

Divided into four planes

A

Stage 3

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19
Q

Plasma concentration of drug exceeds capacity of metabolizing enzymes.

Results in a constant amount of drug metabolized per unit of time

A

Zero order kinetics

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20
Q

Constant fraction of available drug is metabolized in a given time.

Greatest amount of drug is cleared when plasma concentrations are greatest

A

First order kinetics

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21
Q

Time necessary for plasma concentration to decrease by 1/2

A

Elimination 1/2 time

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22
Q

Elimination 1/2 time is ________ r/t Vd

__________ to clearance

A

Directly released to Vd

Inversely proportional to clearance

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23
Q

Are elimination 1/2 times dependent on dose?

A

No. Independent of dose

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24
Q

The greater the inspired concentration of a volatile agent, the sooner alveolar and brain concentrations approach inspired concentrations

A

Concentration effect

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25
Q

Influences concentration of any gas given concomitantly with N2O

A

Second gas effect

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26
Q

Second gas effect- greatest kinetic advantage with ______ soluble volatile inhalation agents

A

More

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27
Q

The higher the BGPC the ______ soluble an anesthetic

A

More soluble

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28
Q 
Slow or hasten FA/FI equilibration
Second gas
Concentration effect
Decreased CO
Increased MV
Lower BGP
Decreased tissue uptake
A

Hasten FA/FI

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29
Q 
Slow or hasten FA/FI- 
Increased CO
Decreased ventilation
Higher BGP
Increased tissue uptake
A

Slow FA/FI equilibration

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30
Q

First body compartment to equilibrate with FA

A

VRG

Heart, lungs, brain, liver, kidney

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31
Q

VRG
% body mass
% CO

A

10

75

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32
Q

Muscle
% body mass
% CO

A

50

19

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33
Q

Fat
% body mass
% CO

A

20

6

34
Q

VPG
% body mass
% CO

A

20

0

35
Q

Desflurane BGPC

A

0.42

36
Q

Sevoflurane BGPC

A

0.69

37
Q

Isoflurane BGPC

A

1.46

38
Q

FA/FI approaches 1 faster with what

A

Faster with most insoluble anesthetic

39
Q

Used to compare the potencies of inhalation anesthetic to each other

A

MAC

40
Q

MAC is measured in ________

A

Alveoli

41
Q

Alveolar concentration approximates _________

A

Brain concentration

42
Q

Suppression of bucking and/or laryngospasm in 50% of patients

A

MAC tracheal stimulation

43
Q

Clinical MAC is _______ greater than MAC

A

10-30% greater than regular MAC

44
Q

Block autonomic response to surgical stimulation in 50% of patients

A

MAC BAR

45
Q

OGPC is _________ proportional to MAC

A

Inversely proportional

Higher OGP = lower the MAC

46
Q

When 50% of pt open eyes

A

MAC awake

47
Q

5 causes of Compound A formation

A 
Low FGF
High absorbent temp
High CO2 production
Greater sevo concentration
Baralyme/soda lime
48
Q

Compound A renal injury is

A

Dose and time dependent

Transient

49
Q

Desflurane and 3 causes of carbon monoxide

A

Dry CO2 absorbent
High absorbent temp
Prolonged high FGF

50
Q

Which produces more carbon monoxide iso or des?

A

Desflurane

51
Q

Contraindication of N2O administration

A

Closed gas spaces

  • bowel obstruction
  • pneumocephalus
  • Pneumothorax
  • air emboli

Severe disturbance/deficit in B12 or folic acid metabolism

52
Q

Abrupt increases in Desflurane concentration results in

Max response reached at _____%

A

SNS and renin-angiotensin activities

-transient increase in HR and BP

> 8%

53
Q

Volatile agents and ICP

Dose required to cause ICP change

A

Increase ICP

0.8-1.1 MAC

54
Q

To opposes volatile agents increase in ICP do what?

A

Hyperventilate to 30mmHg ETCO2

55
Q

Volatiles and ventilation and ventilatory response to hypoxia and CO2

A

Depress both

56
Q

To lessen ventilatory depressant effects of volatile agents

A

Substitute N2O for equal MAC fraction

57
Q

Volatile agents increase PaCO2 due to

A

Lower TV and greater deadspace

58
Q

Spontaneous breathing pattern with volatile agents

A

Increased RR

Decreased TV

59
Q

All volatile agents cause concentration related decreased in BP r/t what

A

Decreased SVR

60
Q

Response to abrupt increase in Desflurane concentration abated by

A

Fentanyl and beta blockers

61
Q

Volatile agents and NMB

A

Enhance actions

62
Q

Volatiles decrease uterine smooth muscle contractility and blood flow.

Effect minimal at _____ MAC and significant at ______ MAC

A

0.5 MAC

1 MAC

63
Q

Blunts post op tachycardia and hypersention effects in heart patients

A

Propofol

64
Q

Decreases BP greater than other induction agents

A

Propofol

65
Q

Negative inotropic effects of propofol caused by

A

Decreasing intracellular Ca levels

66
Q

Most common adverse effect of propofol

A

Pain on injection

67
Q

Frequently involuntary myoclonic movements due to impbalance of thalamocortical tract inhibitory and excitatory influences.

Blunted by what?

A

Etomidate

Blunted by opioids

68
Q

Potent direct cerebral vasoconstrictor, reduces CMRO2 by 35-45%

A

Etomidate

69
Q

Greater frequency of excitatory spikes on EEGs, may activate seizure foci, so use caution in epilepsy patients

A

Etomidate

70
Q

Higher incidence of PONV

A

Etomidate

71
Q

Causes adrenocorticoid suppression.

A

Etomidate

72
Q

Early awakening is due to

A

Redistribution

73
Q

Potent anesthetic. Racemic mix.

A

Ketamine

74
Q

Produces intense analgesia at low doses and induces anesthesia at high doses

A

Ketamine

75
Q

Anesthesia induction dose of ketamine

A

1-2 mg/kg IV

4-8 mg/kg IM

76
Q

Dose of ketamine for subanesthetic yet intense analgesic effects

A

0.2 mg/kg

77
Q

Visual, auditory, proprioceptive, confusional hallucinations, morbid dreams, cortical blindness associated with ketamine due to what

A

Depression of inferior colliculi and medial geniculate nucleus

78
Q

Not for CAD patients bc increases myocardial O2 needs and reduces filling of coronaries

A

Ketamine

79
Q

Do not use if pt has systemic HTN

Unless

A

Ketamine

Given with propofol

80
Q

1 mechanism for CV effects of ketamine

A

Greater SNS outflow

Increased plasma concentration of epi and NE in 2 minutes

81
Q

What blunts ketamine induced CV stimulation

A

Inhalation agents and benzodiazepines

Pharmacology (6 decks)

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