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Spring 2020 - Pharmacology 1 > Inhalation Anesthesia Part 2 - Quiz 5 > Flashcards

Inhalation Anesthesia Part 2 - Quiz 5 Flashcards

1
Q

What are the 4 Phases of Uptake & Distribution?

A
  1. Inspired Anesthetic Concentraiton
  2. Alveolar Anesthetic Concentration
  3. Blood Anesthetic Concentration
  4. Anesthetic from Blood to Tissue
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2
Q

What is “Wash In”?

A

Using high flows of O2 or O2/N2O @ 5-10L/min to control partial pressure of Anesthetic Gas

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3
Q

What is the Concentration Effect of Anesthetic Gas?

A

High Concentrations = Greater Uptake = Greater Inspired Volume

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4
Q

What factors effect the Rate of Alveolar Partial Pressure of Anesthetic?

A

Inspired Concentration

&

Alveolar Ventilation

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5
Q

When Alveolar ventilation is high, the partial pressure of the anesthetic at the alveolar ______ rapidly.

A

When Alveolar ventilation is high, the partial pressure of the anesthetic at the alveolar Increases rapidly.

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6
Q

What is the Second Gas Effect?

A

First gas (N2O) rapidly goes into blood and pulls the second gas (Sevo) along with it –>

causes rise of second gas more quickly

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7
Q

What factors determine how quickly Anesthetics go from Alveoli to Blood?

A

Solubilty of Gas

Cardiac Output - Rate of blood flow

Partial Pressure of Gases in Arterial/Venous blood

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8
Q

What is the Blood:Gas Partition Coefficient?

A

Ratio of Anesthetic Concentration in Blood to Anesthetic Concentration in Alveoli

Pa / PA

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9
Q

The more blood soluble the agent, the _____ time required for induction.

A

The more soluble the agent, the more time required for induction

(Slower Induction)

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10
Q

How does a higher blood flow affect gas delivery to the tissues?

A

Higher blood flow = more blood exposed to agent = faster pickup of agent

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11
Q

What factors contribute to the teh Partial Presure of Anesthetic in the Tissue?

A

Solubility of Gas & Tissue Blood Flow

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12
Q

What happens in Stage 1 of Anesthesia?

A

Stage of Analgesia

Decrease Dorsal Horn Activity & Synaptic Transmission

Duration: Anesthesia Administration to Loss of Consciousness

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13
Q

What happens in Stage 2 of Anesthesia

A

Stage of Delirium/Excitement

Block of Inhibitory Neurons = Enhance Synaptic Transmission

↑Muscle Tone

Irregular Breathing

Dilated Pupils

↑BP & ↑HR

Begins: Loss of Consciousness

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14
Q

What happens in Stage 3 of Anesthesia?

A

Stage of Anesthesia

Depression of Ascending Sensory Pathways

Supression of Spinal/Skeletal Activity

Regular Breathing

Centered Pupils

Absent Cough, Gag & Eyelid Reflex

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15
Q

What happens in Stage 4 of Anesthesia?

A

Stage of Depression

Depression of Medullary Centers

Profound Respiratory & Cardiac Depression

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16
Q

The lower the MAC, the ____ potent the agent and the ______ the blood:gas partition coefficent.

A

The lower the MAC, the more potent the agent and the higher the blood:gass partition coefficent

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17
Q

What are Factors that Decrease MAC?

A

Hypoxia

Anemia

Hypotension

Other Drugs

Pregnancy

Elderly

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18
Q

What are Factors that Increase MAC?

A

Infants

Hyperthermia

Chronic Drug/Alcohol Use

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19
Q

How does Hyperthermia > 42 C affect MAC?

A

Decreases MAC

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20
Q

How does Anemia w/ HCT < 10% affect MAC?

A

Decreases MAC

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21
Q

How does a PaO2 > 95 mmHg d/t decrease in pH in the CSF affect MAC?

A

Decreases MAC

22
Q

How does Hypo/Hyperthyroid affect MAC?

A

No effect

23
Q

How does Hypercalcemia & Hyponatremia affect MAC?

A

Decreases MAC

24
Q

How does Hypernatremia affect MAC?

A

Increases MAC

25
Q

What drugs increase MAC?

A

Cocaine, Ephedrine & Acute use of Amphetamine

26
Q

At what MAC will 95% of patients not move?

A

1.2 MAC

99% @ 1.3 MAC

27
Q

What is MAC-awake?

A

50% of patients will respond to “Open your eyes”

0.3 MAC = Loss of Recall

28
Q

What is MAC-BAR?

A

MAC needed to block Adrenergic Response to Skin Incision

29
Q

What is MAC intubation?

A

Same as MAC-BAR - more gas than that needed for surgical incision

30
Q

What is one thing that restricts the application of using MAC as a guideline?

A

Frequency of Muscle Relaxant Administration

31
Q

Factors that are invovled with getting Gas from Machine to Lungs

A

Inspired Partial Pressure

Alveolar Ventilation

Breathing System Properties

32
Q

Factors involved in getting Gas from Lungs to Blood

A

Solubility of Gas to Blood

Cardiac Output

Alveolar to Venous Pressure Difference

33
Q

Factors involved in getting Gas from Blood to Brain?

A

Brain:Blood Partition Coefficient

Cerebral Blood Flow

Arterial to Venous Partial Pressure Difference

34
Q

What is the MAC% for Desflurane?

A

6%

35
Q

What is the MAC% for Sevoflurane?

A

2%

36
Q

What is the MAC% for Isoflurane?

A

1.4%

37
Q

What is the λoil:gas for N2O?

A

1.4

38
Q

What is the λoil:gas for Desflurane?

A

19

39
Q

What is the λoil:gas for Sevoflurane?

A

51

40
Q

What is the λoil:gas for Isoflurane?

A

98

41
Q

What is the λblood:gas for N2O?

A

0.47

42
Q

What is the λblood:gas for Desflurane?

A

0.45

43
Q

Wht is the λblood:gas for Sevoflurane?

A

0.65

44
Q

What is the λblood:gas for Isoflurane?

A

1.4

45
Q

How does High Cardiac Output effect Gas buildup in the Alveoli?

A

High Cardiac Output slows gas buildup in the alveoli & induction because blood take up the gas too quickly

46
Q

How does Low Cardiac Output effect Gas buildup in the Alveoli?

A

Gas builds up faster in the alveoli because of less uptake by blood

47
Q

How does at Right-to-Left Cardiac Shunt effect induction?

A

Slows Induction d/t dilution of blood w/o any anesthetic

48
Q

How does Left-to-Right Cardiac Shunt effect Induction?

A

No Effect

49
Q

What is Diffusion Hypoxia?

A

When N2O is stopped abruptly and the patient is only breathing Room Air.

The N2O in the body is still diffusing into the Alveoli –> give 100% O2 for 5-10 min

50
Q

What factors influence Rate of Emergence?

A

Duration of Procedure

Temperature of Patient

Patient’s Physical Condition

Obesity

51
Q

What is the Difference between Emergence and Induction?

A

No Concentration Effect

Tissue serves as Reservoir, Not Blood

Metabolism

52
Q

What does the Elimination of Anesthetic Gas depend on?

A

Length of Administration

Solubility of Gas in Blood & Tissues

Spring 2020 - Pharmacology 1 (11 decks)

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