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Anesthesia Pharm > IA Up/Dist > Flashcards

IA Up/Dist Flashcards

1
Q

Uptake =

A

Solubility (upside down y) x Q (CO) X (A-v)

A-v= diff in partial p of alveolar and venous blood

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2
Q

If solubility, CO, or partial pressure difference is 0

A

Uptake will be 0

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3
Q

Equilibrium refers to

A

State of equal partial pressures (not concentration)

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4
Q

Blood/gas coefficients:
Des
N2O

A
  1. 42

0. 47

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5
Q

Blood/gas coefficients:
Sevo
ISO

A
  1. 69

1. 4

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6
Q

Blood/gas coefficients:
Enflurane
Halothane
Diethyl ether

A

1.8
2.4
12

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7
Q

Order of low to high solubility

A

Do not say i eat heavy dopamine

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8
Q

How hct alters blood gas coefficients

A

Lower hct= lower solubility coefficient. If anemic, alveolar buildup of gas is faster b/c fewer binding sites

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9
Q

FA reaching FI determines what

A

When equal= faster uptake into brain and induction

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10
Q

FA represents what

A

Partial p of anesthetic going into brain. No gradient between alveoli and brain bc large perfusion

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11
Q

How we control FI

A

Vaporizer setting, inspired %

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12
Q

Alveolar partial pressure used to estimate

A

Anesthetic depth, recovery, and MAC

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13
Q

PA is determined by what

A

PI (inhaled partial p), alveolar ventilation, breathing circuit, and FRC

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14
Q

Alveolar ventilation =

A

In one minute. Normal minute vent (VE) 6l - 2L (anatomical dead space)

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15
Q

Change in alveolar concentration faster when anesthetist does what

A

Hyperventilates (faster rate lower volume)

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16
Q 
FA/FI curves 
First knee- 
Second knee- 
Continues \_\_\_ \_\_ after 
\_\_ \_\_ for agents
A

Initial rapid rise
Less rapid rise
More slowly
Same shape for all agents

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17
Q

___ soluble agents have fastedt rate of alveolar gas/inspired conc over time

A

Least

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18
Q

First knee __ __ group

Second knee __ group

A

Vessel rich

Muscle

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19
Q

If uptake removes 1/2 anesthetic in lung, FA would be __ of FI

A

1/2

20
Q

If uptake removes 2/3 of anesthetic in lung, FA would be __ of FI

A

1/3

21
Q

Overpressure

A

Use of high delivered concentrations to compensate for slowness

22
Q

Impact of solubility on emergence

A

Lower the b/g solubility coefficient, shorter time emergence will take

23
Q

Emergence ___ induction with respect to solubility

A

Parallels. High solubility= takes longer to induce and emerge (more left in reservoir)

24
Q

How cardiac output affects induction

A

Dec CO- inc speed. Inc CO- dec induction speed. If CO 0= uptake = 0

25
Q

How CO effects FA/FI curve

A

Increase CO: ratio decreases, takes longer to rise

Decrease CO: inc ratio, straight up faster

26
Q

Effect of CO change greatest on FA/FI curve when what

A

Agent is more soluble (less effect on n20)

27
Q

Tissue uptake of anesthetic =

A

Same factors as lung. = tissue/blood coefficient x flow x (a-t)

28
Q

Coefficients for brain vs fat

A

Brain: 1-2
Fat: n20 (2.3) rest are higher 27-67

29
Q

Vessel rich group: components, equilibrium when

A

Brain, heart, liver, kidney. 5-15 min equilibrium w FI

30
Q

Muscle group: parts and what

A

Muscle, skin, highest % of body mass

31
Q

Vessel poor group

A

Bone, ligaments, tendons, 0% CO

32
Q 
% Body mass 
VRG 
MG 
FG
VPG
A 
% body mass 
VRG- 9%
MG- 50% 
FG- 19%
VPG- 22%
33
Q 
% of cardiac output 
VRG
MG
FG
VPG
A 
% CO
VRG- 75%
MG- 18%
FG- 7%
VPG- 0%
34
Q

What happens in FA/FI curve:
Initial steep rise
First knee

A

Initial: a-v diff= 0, no agent in alveoli, no uptake
1st: uptake by VRG balances input

35
Q

What happens in FA/FI curves
2nd rise
2nd knee

A

Rise: dec uptake by VRG, muscle group uptake
Knee: 4-8 min, uptake by MRG slows

36
Q

PA (alveoli P) of volatile determined by what

A

PI, alveolar vent, breathing circuit, and FRC

37
Q

Impact of ventilation on induction and emergence

A

Increased: both more rapid
Decreased: slower (both)

38
Q

Effect of increased ventilation on FA/FI curve

A

Increases it for a highly soluble agent. Wont inc for N20 (low solubility)

39
Q

How FRC/alveolar ventilation affects induction

A

Greater alveolar vent/FRC= faster induction. Dec FRC and inc alveolar vent= faster induction

40
Q

What happens when inc CO and ventilation

A

FA/FI increases slightly.

41
Q

V/Q abn have what effect on FA/FI

A

Rise in FA until ventil high, rise in arterial blood depressed (undervent lung not offset by inc vent lung). Dilutional effect= slower induction with LESS soluble agents

42
Q

Concentration effect is what

A

Large vol of gas abs: residual gas in lung is conc as vol decreases, ins vent increases which adds anesthetic and negative p created by uptake draws more gas into lung

43
Q

Washout
Which agents washout 1st
What happens as anes duration lengthens

A

Least soluble

Washout prolonged- more anesthetic in reservoirs

44
Q

Impact of solubility on emergence

A

Higher b/g solubility= longer emergence will take

45
Q

Slower inc in FA toward FA with ___ solubility

Washout more rapid with __ solubility

A

High

Low

Anesthesia Pharm (12 decks)

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