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Pharmacology > Inhaled Agents > Flashcards

Inhaled Agents Flashcards

1
Q

What were some of the early anesthetic agents?

A

N2O - 1844
Ether - 1846
Chloroform - 1847

Other agents emerged about 100 years later

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2
Q

What are three types of covalent bonds?

A
  • Alkane: 1 bond between atoms
  • Alkene: 2 bonds between atoms
  • Alkyne: 3 bonds between atoms

*covalent bonds share electron pairs

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3
Q

All commonly used inhalation ages agents are _____ or ______ and have no more than ______ carbon atoms

A

Ethers
Aliphatic hydrocarbons
4

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4
Q

Anesthetics are what kind of hydrocarbons (except N2O)

A

Halogenated

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5
Q

Halogenation influences what properties of anesthetic gases?

A

Potency

Arrhythmogenic properties

Flammability

Chemical stability

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6
Q

What chain is found on ethers?

A

C-O-C

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7
Q

What is found on methyl groups?

A

CH3

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8
Q

What is found on Ethyl groups?

A

CH2, CH3

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9
Q

What is the molecular shape of anesthetic agents?

A

Spherical/cylindrical with a length less than 1.5 times the diameter

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10
Q 
F      H   F
     |       |    |
H-C-O-C-C-F
|        |   |
F      Cl  F
A

Isoflurane

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11
Q

F H F
H-C-O-C-C-F
F F F

A

Desflurane

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12
Q 
F      H   F
     |        |   |
H-C-O-C-C-F
     |        |   |
    H       |   F
         F-C-F
              |
              F
A

Sevoflurane

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13
Q

How does halogenation affect potency?

A
  • increases when the lower atomic mass is replaced by a heavier halogen.
  • direct relationship with weight. As weight goes up, potency you goes up
  • there is a ceiling affect to potency
  • correlates to lipid solubility. A decline in potently means an increase in MAC.
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14
Q

How does halogenation affect arrhythmogenic properties?

A

Causes more arrhythmias

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15
Q

How does halogenation affect flammability?

A

The more halogenated the less flammable (bc H is flammable so more you take off the less flammable)

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16
Q

How does halogenation affect chemical stability?

A

A compound that contains flurane as its only halogen is strongly resistant to biodegradation (des is best example)

-stability is increased with halogenation. If has same halogen, more stable than one that has multiple

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17
Q

Names for the pharmacodynamics of anesthetic agents

A

Absorption phase —>uptake
Metabolic phase—>bio transformation
Excretion phase—>elimination

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18
Q

What are some unique features of inhaled anesthetics?

A
  • most rapidly acting drugs in existence
  • must behave in accordance with the ideal gas laws
  • all are non-ionized
  • all have low molecular weight
  • deliver to blood directly via lungs
19
Q

Of the anesthetic agents, which are true gases?

A
  • oxygen and nitrous oxide

- all inhaled anesthetics are in the gas phase during administration

20
Q

What is the goal of anesthesia?

A

Unconsciousness
Amnesia
Analgesia
Immobility

21
Q

How does body temperature affect anesthetic requirements?

A
  • lower body temperature reduces anesthetic requirement b/c metabolism is slowed
  • higher body temperature increases anesthetic requirement
22
Q

What is the Meyer-Overton rule?

A

Lipid solubility is directly proportional to potency

23
Q

Reversal is achieved by the application of _______________

A

Pressure

24
Q

Anesthesia affects the ______ _______ and ________ _______ to produce immobility

A

Dorsal Horne
Spinal cord

*immobility is measurable: MAC

25
Q

Anesthesia is “probably” produced by _______ the function of inhibitory ion channels and by ________ the function of excitatory ion channels

A

Enhancing

Blocking

26
Q

These are the “highly probable”targets for amnesia during anesthesia

A

Supraspinal structures such as the amygdala, hippocampus, and cortex

*amnesia has no reliable measure

27
Q

Analgesia is reached through

A

Spinothalamic tract

*cannot be measured in immobile/unconscious pts. Increased HR, BP suggestive of pain

28
Q

Unconsciousness is obtained via

A

Cortex, thalamus, brainstem

29
Q

Enhancement of inhibitory channels occurs how?

A

(Hyperpolarization of neuron)

  • Cl enters through GABA or glycine, slows down transmission
  • Efflux of K+ out of neurons
30
Q

Blocking of excitatory channels occurs how?

A

(Depolarization of neuron)

-blockage of glutamate and NMDA

31
Q

What is equilibrium?

A

CNS partial pressure will equal blood partial pressure, which in turn will equals alveolar partial pressure

32
Q

Equilibrium is a result of 3 factors:

A
  1. Inhaled agent: differ even if partial pressures will attempt to balance
  2. Gas fulls up designated space in blood
  3. Metabolism, excretion, and redistribution minimal relative to rate of deliver to and removal from lungs ** this allows for quick changes when altering amount of drug administered**
33
Q

Characteristics of potent volatile anesthetics

A
  • liquids at ambient temp/pressure
  • in closed container, molecules will equilibrate between gas/liquid phase
  • in closed container, vapor pressure is independent of the volume of liquid
  • vapor pressure proportional to temp (as temp increases, pressure increases)
34
Q

Dalton’s Law

A

The sum of the partial pressures of each gas in a mixture of gases equals the total pressure of the entire mixture

35
Q

What determines the partial pressure of a gas?

A

It’s determined from the portion of volatile agent in the gas phase

36
Q

How is the amount of gas measured in a liquid/solution?

A

It’s measured as a concentration

37
Q

What does the partial pressure of a gas in solution refer to?

A

It refers to the partial pressures of the gas in the gas phase (if it were present) in equilibrium with the liquid

38
Q

Gasses equilibrate (in delivery of anesthesia) based on _____ _______, not on ____________.

A

Partial pressures

Concentration

39
Q

Henry’s Law

A

The relationship of concentration of a gas in solution to the partial pressure of the gas with which the solution is in equilibrium

40
Q

This is term used to describe the tendency of a gas to equilibrate with a solution

A

Solubility

41
Q

Solubility coefficient

A

For any gas in equilibrium with a liquid, a certain volume of that gas dissolves in a given volume of liquid

V dissolved/V liquid at 37 degrees C

42
Q

Mixture of a gas in solution will behave according to the sum of these principles:

A
  • its partial pressure in the gas phase in equilibrium with the solution
  • solubility within that solution
43
Q

Describe how anesthetic gas gets to the brain

A
  • anesthetic gases are administered to the lungs
  • anesthetic gases diffuse from the lungs into he blood until the partial pressures in alveoli and blood are equal (depends on blood:gas solubility)
  • anesthetic from blood to target tissues towards equalizing partial pressures
44
Q

What providers an index of the anesthetic gas’s effects on the brain?

A

MAC

Pharmacology (4 decks)

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