Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology I _ Exam 2 Material > Lecture 05_Fall > Flashcards

Lecture 05_Fall Flashcards

1
Q

Indicate whether the following is a factor that increases or decreases MAC:

use of premedication

A

decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Indicate whether the following is a factor that increases or decreases MAC:

younger age

A

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Indicate whether the following is a factor that increases or decreases MAC:

older age

A

decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Indicate whether the following is a factor that increases or decreases MAC:

anxiety

A

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Indicate whether the following is a factor that increases or decreases MAC:

Chronic EtOH

A

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Indicate whether the following is a factor that increases or decreases MAC:

Acute EtOH

A

decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Indicate whether the following is a factor that increases or decreases MAC:

hyperthermia

A

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Indicate whether the following is a factor that increases or decreases MAC:

pregnancy

A

decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Indicate whether the following is a factor that increases or decreases MAC:

hypothermia

A

decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Indicate whether the following is a factor that increases or decreases MAC:

acute use of cocaine or other sympathetic stimulant

A

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does MAC stand for and what is the definition?

A

Minimal Alveolar Concentration - alveolar concentration of anesthetic gas that prevents movement in 50% of patients in response to surgical stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is MAC awake?

A

0.1 x MAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is MAC recall?

A

0.3-0.5 x MAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is MAC BAR and what does the BAR stand for?

A

1.7-2.0 x MAC Blocked Autonomic Response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MAC of Iso = ____%

A

1.2% (1.2 kind of looks like Is for Iso)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MAC of Sevo = ____%

A

2.0 % (2 kind of looks like the S of Sevo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MAC of Des = ____%

A

6.00%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MAC of N2O = ____%

A

105%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

MAC of Halothane = ____%

A

0.75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

The vapor pressure of halothane is closest to the vapor pressure of which other inhalational anesthetic?

A

Isoflurane 240mmHg compared to halothane at 243mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the blood gas partition coefficient for Sevoflurane?

A

0.65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the blood gas partition coefficient for N2O?

A

0.47

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the blood gas partition coefficient for Isoflurane?

A

1.4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the blood gas partition coefficient for Desflurane?

A

0.42

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the blood gas partition coefficient for Halothane?

A

2.4

27
Q

Is induction with halothane fast or slow? Why?

A

Slow. Because it is so soluble, it has greater uptake and it takes longer for for the CNS to become saturated since it takes longer to reach EQ (Palveoli=Pblood=Pcns).(from lecture #4)

28
Q

What does a blood gas partition coefficient of 2.4 for halothane mean?

A

that there is 2.4 times as much halothane dissolved in the blood than in the air. blood can dissolve halothane 2.4 x better than air(from lecture #4)

29
Q

Which inhalational anesthetic does not trigger MH?

A

N20

30
Q

What does the term “Halothane Hepatitis” mean?

A

Halothane is commonly associated with liver toxicity (hepatotoxicity). 1 in 5 adults develop mild hepatotoxicity. This is likely because it causes decreased hepatic blood flow .

Less commonly, massive hepatic necrosis/death is seen (Halothane Hepatitis). 20% of halothane (sevo is only 5%) is metabolzed in the liver to TFA (trifluoroacetic acid) and the increased fluoride levels are associated with hepatotoxicity

31
Q

What does the term “Halothane Hepatitis” mean?

A

Halothane is commonly associated with liver toxicity (hepatotoxicity). 1 in 5 adults develop mild hepatotoxicity. This is likely because it causes decreased renal blood flow .

Less commonly, massive hepatic necrosis/death is seen (Halothane Hepatitis). 20% of halothane (sevo is only 5%) is metabolzed in the liver to TFA (trifluoroacetic acid) and the increased fluoride levels are associated with hepatotoxicity

32
Q

Which inhlational anesthetic is sensitive to catecholamines?

A

Halothane.

Why do you care about this? In another lecture you will have to remember that Epi when used with Halothane can cause ventricular dysrhythmias - so remember this!

33
Q

Compound A is associated with which inhlational anesthetic? What is required to prevent formation of this?

A

Sevoflurane

Keeping your fresh gas flows at least 2L/min/MAC helps to prevent formation of compound A (but no data to support this??)Just remember - S of sevo looks like a 2 - MAC is 2.0 and you need 2L FGF

34
Q

Which inhalational anesthetic is used for inhalational induction for pediatrics? Why?

A

Sevoflurane b/c it is non-pungent, so it is not irritating to the airway, and it has bronchdilator properties

35
Q

Which 2 inhlational anesthetics are good bronchodilators but are irritating the the airway (pungent) and lead to salivation, coughing, breath holding and worst of all - laryngospasm?

A

Desflurane and Isoflurane

36
Q

T or F? N2O is contraindicated in a young female patient complains of severe PONV.

A

True.

37
Q

Tor F. All inhlational anesthetics cause muscle relaxation?

A

False. N2O does not (it also does not trigger MH)

38
Q

Which inhlational anesthetic oxidizes the Co atom in B12?

A

N20

39
Q

Which inhlational anesthetic causes significant myocardial depression leading to up to a 50% decrease in BP and CO?

A

halothane

40
Q

Which inhlational anesthetic inhibits methionine synthetase?How does it cause this and why does this matter?

A

N20. It matters because it effects the formation of the myelin sheath that protects neurons - this causes peripheral neuropathies and neurotoxicity.It causes this b/c it oxidizes the Co atom in B12 which inactivates methionine synthetase .You should probably remember this - esp the B12 part

41
Q

Which inhalational anesthetic is associated with toxicity secondary to a desiccated CO2 absorbent leading to the increased production of carbon monoxide?

A

desflurane

42
Q

T or F. N2O is flammable and supports combustion.

A

False. It does support combustion like O2 but it is not flammable

43
Q

Which inhalational anesthetic increase HR?

A

Des and Iso

44
Q

What is significant about Desfluranes vapor pressure?

A

the vapor pressure is very high (681 mmHg) and can actually boil at normal OR temps.Because it vaporizes so easily, it makes it hard to control how much we deliver - this is why they use a heated vaporizer - it allows to control the concentration of the gas we deliver to the patient(remember..High VP = high volatility = low BP)

45
Q

T or F. Sevo provides enough muscle relaxation for intubating kids?

A

TRUE

46
Q

Which inhalational anesthetics have a sweet non-pungent odor?

A

Halothane and Nitrous

47
Q

Why is N2O contraindicated in the 1st trimester of pregnancy?

A

It is a teratogen that can cause birth defects, especially in the first trimester.

48
Q

T or F. A person who has had multiple surgeries in the past with no malignant hypethermia related complications has no risk of an MH reaction with anesthesia.

A

False. MH related deaths have occurred even though patients have undergone multiple prior uneventful surgeries.

49
Q

Why is N2O contraindicated in patients with a small bowl obstruction, PTX, or acute venous air embolism?

A

Nitrous is 35x more soluble in blood than nitrogen is and it diffuses out of blood into closed air spaces faster than air diffuses into blood - when a pt’s inspired gas mixture is switched from air (containing about 78% nitrogen) to an anesthetic mixture containing 70% N2O, the N2O will enter gas filled spaces 35x faster than nitrogen can exit - as a result, the volume and pressure within the space will increaseAlso be aware of procedures that increase chances of N2O affecting pressures in the ear, eyes, and cranium

50
Q

What is the Gold Standard for a definitive diagnosis of MH?

A

Caffeine-halothane contracture test - requires muscle biopsy at a specialized biopsy center

51
Q

What anesthetic agents can trigger MH?

A

All volatile anesthetic agents & Sux

remember..N2O is NOT a volatile gas

52
Q

T or F. Genetic testing can definitively rule out MH, so if someone in your family has MH you should get tested.

A

False. Genetic testing cannot definitively rule out MH due to heterogeneity of mutations

53
Q

What is used to treat MH and what is the dose?

A

Dantrolene 2.5mg/kg IV

This is after you stop the triggering agent!

Also want to have high O2 flows, active cooling, and treat acidosis and electrolyte imbalance

54
Q

T or F. MH presents as sustained muscle contractions, including masseter muscle rigidity, that is not relieved with additional Sux or non-depolarizing NMBs.

A

True. There is an abnormal release of Ca within the skeletal muscles

55
Q

T or F. If a patient has masseter muscle and peripheral muscle rigidity, you should assume it is MH and begin treatment.

A

True

56
Q

T or F. Mild/transient masseter muscle rigidity is a normal response following administration of sux.

A

True

57
Q

Describe the hypermetabolic state associated with MH.

A

Uncontrolled calcium release from the sarcoplasmic reticulum -> sustained myofibril contraction -> cells run out of ATP -> cell death

Inc EtCO2 despite hyperventilation

Heat production - temp will rise 1-2 degress q5min

Tachycardia, hypoxemia, acidosis, cardiac dysrythmias

*this is from a lecture from another class but I thought it was helpful in understanding why MH causes death

58
Q

T or F. MH should be suspected if you have elevated EtCo2 despite hyperventilation?

A

True

59
Q

T or F. The primary reason the use of sux is avoided in children is because of potential for undiagnosed MH.

A

False. It is because of the risk of undiagnosed muscular dystrophy (not true MH)

60
Q

T or F. Neuroleptic Malignant Syndrome is triggered by sux and inhalational anestheic agents.

A

False. It is related to the administration of antipsychotic drugs

61
Q

What is rhabdomyolysis?

A

condition in which damaged skeletal muscle tissue breaks down rapidly. Breakdown products of damaged muscle cells are released into the bloodstream; some of these, such as the protein myoglobin, are harmful to the kidneys and may lead to kidney failure.

62
Q

T or F. There is a strong correlation between patients who have experienced heat stroke and susceptibility for MH.

A

False. There is a small association between the two.

Pharmacology I _ Exam 2 Material (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions