Inhaled anesthetics 1: pharmacokinetics 2 Flashcards
_______ is the tendency of a solute to dissolve in a solvent
Solubility
In the case of inhalation anesthetics, solubility is the ability of the
anesthetic agent to dissolve into the blood and tissues
___________ describes the relative solubility of an inhalation anesthetic in the blood vs. in the alveolar gas when the partial pressures between the two compartments are equal.
The blood:gas partition coefficient
Blood: gas coefficient for sevoflurane.
0.65
Blood: gas coefficient for isoflurane.
1.46
Blood gas coefficient for desflurane.
0.42
Blood gas coefficient for nitrous oxide is
0.46
How easily a solute will dissolve into a solvent depends on the
physiochemical characteristics of both compounds- “like dissolves like”
A polar solute will be more soluble in a
hydrophilic solvent
A nonpolar solute will be more soluble in a
liphophilic solvent
An anesthetic gas with low blood:gas solubility is
less likely to be taken up into the blood
as a result, more of the agent is available to exert a partial pressure in the alveoli and brain
An anesthetic gas with high blood: gas solubility is
more likely to be taken up into the blood;
as a result, less of the agent is available to exert a partial pressure in the alveoli and brain
While administering a volatile anesthetic, we produce a state of anesthesia by
building up a partial pressure of anesthetic agent inside the patient’s brain and spinal cord
These three factors determine anesthetic uptake into the blood:
agent solubility
partial pressure difference between the alveoli and the blood
cardiac output
The amount of anesthetic agent inside the alveoli is a balance between
input (the setting on the vaporizer) and uptake into the blood
The Fa/Fi curve helps us appreciate the speed at which
FA equilibrates with Fi (speed of induction)
The concentration of an agent inside the alveoli is proportional to its
concentration inside the brain
for this reason, we use alveolar partial pressure (FA) as a surrogate for the brain partial pressure