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CNS I > inhaled anesthetics > Flashcards

inhaled anesthetics Flashcards

Define 6 factors affecting equilibration (onset) times of inhaled anesthetics. Define the mechanism of action of inhaled anesthetics. Distinguish inhaled anesthetics based on physicochemical properties. Define potency (minimal alveolar concentrations) of inhaled anesthetics. Describe the clinical effects of inhaled anesthetics.

1
Q

definition of equilibration

A

when alvelor concentrations equal inspired concentrations

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2
Q

when do maximum tissue concentrations exist

A

at equilibration

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3
Q

factors affecting equiilibration times

A 
lung function
FRC
Tissue Uptake
Solubility of drug
Pulmonary Blood Flow
Cardiac Output
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4
Q

determiniants of lung uptake

A

inspired gas partial pressure
ventilation rate
FRC

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5
Q

effect of increased FRC

A

slows flow of agent into the lung, therefore induction time is increased

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6
Q

reason kids can get inhaled inductions rather than adults

A

kids have less FRC

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7
Q

rise of concentration of a drug is slowed by

A

lung (little ) and blood (LOT) uptake

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8
Q

primary determiniants of tissue uptake

A

solubility of agent
pulmonary blood flow (CO)
AV concentration gradient

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9
Q

definition of drug soluability

A

relative content of a gas in w phases when the partial pressure of the gas is the 2 phases is equal

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10
Q

measurement of drug soluability

A

B/G ratio, or partition coefficient

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11
Q

if the B/G of a drug is .5, and you put 3% volume into the lung, what % will be in the blood and in the gas

A

1% blood, 2% Gas (.5)

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12
Q

larger B/G increases ____ uptake and decreases _____ concentration

A

blood, alvelor

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13
Q

effect of a large B/G on induction

A

slows

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14
Q

more soluable agents _______ equilibration time

A

increase

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15
Q

why do soluable agents increase time to effect?

A

drug is trapped in the blood and is not available to bind to tissue, reducing tissue concentation

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16
Q

highest inhaled drug B/G coefficient

A

halothane

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17
Q

lowest inhaled drug B/G coefficient

A

Defulane (N2O, and sevoflurane right there)

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18
Q

order of inhaled drug B/G (high to low)

A

HISND

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19
Q

low solubility agents will wear off (fast/slow)

A

fast

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20
Q

increases in cardiac output have what effect on inhaled agents

A

decrease rate of alveolar concentrations and slow equilibrium time

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21
Q

higher CO will do what to the flow of drug to the brain

A

increase proportionally

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22
Q

higher CO will result in what changes to drug delivery

A

decreased concentrations, slower equilibration time

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23
Q

in hypodynamic shock, what will the effect of a normal dose of drug give

A

higher concentrations of drug in tissue, possible OD

24
Q

factors that increase equilibration time of a drug

A

increased solubility/CO/AV concentration gradient

25
Q

targets of inhaled drugs

A

ligand-gated ion channels

26
Q

ligand-gated ion channels targeted by inhaled drugs

A

nACH, 5-HT3, GABA

27
Q

effectof GABA binding to its receptors

A

1) CL-conductace increases
2) membrane hyperpolarizes
3) neuronal exitability is reduced

28
Q

drugs enhance GABAA current by:

A

increasing burst frequency and duration

29
Q

basic MOA of inhaled anesthetics

A

GABA agonists by increasing cholride conductance

30
Q

inhaled anesthetic that contains a bromide

A

halothane

31
Q

pleasent smelling inhaled gas

A

halothane

32
Q

low boiling point inhaled gas

A

desflurane

33
Q

pungent smelling gasses

A

isoflurane and desflurane

34
Q

primary measure of inhaled drug potency

A

Minimum alveolar concentration (MAC)

35
Q

definition of MAC

A

equilbrium concentration required to prevent movement to skin incision at 1 ATM in 50% of pts

36
Q

highest potency of inhaled gas

A

N2O

37
Q

lowest potency of inhaled gas

A

halothane

38
Q

rank of inhaled gas potency (low to high)

A

HISDN

39
Q

anything physiological that increases MAC ______ anesthetic requirements

A

increases (and decrease/decrease)

40
Q

physiological states that increase MAC

A

hyperthermia, elevated CNS catecholamine anxiety), chronic EtOH/Cocaine use, nypernatriemia

41
Q

physiological states that decrease MAC

A

hypothermia, pregnancy,shock,increasing age,acute EToH ingestion, CNS depressent drugs

42
Q

general goals of anesthetisa (5)

A

hypnosis, amnesia, analgesia, inhibition of autonomic reflexes, muscle relaxation

43
Q

inhaled drugs do what to ICP

A

increase

44
Q

drug that increases ICP and cerebral drug flow the most

A

halothane

45
Q

drug that decreases cerebral O2 consumption the most

A

isoflurane

46
Q

drug that decreases CO

A

halothane

47
Q

drugs that increase HR

A

isoflurane, desflurane (more)

48
Q

drug that lowers mycardial function the most

A

halothane

49
Q

effect of N2O on the CV system

A

none

50
Q

drug that can either increase or decrease airway resistance

A

desfulrane

51
Q

effect of inhaled agents on tidal colume

A

down

52
Q

effect of inhaled agents on respiratory rate

A

sligtly higher

53
Q

effect of inhaled agants on airway resistance

A

mostly considerably lower (except desflurane)

54
Q

effectof inhaled agents on kidney/liver function

A

lower

55
Q

inhaled agent that can cause n/v

A

N2O

CNS I (36 decks)

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