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Board Prep > Module 14 Inhalation Agents & IV Anesthetics > Flashcards

Module 14 Inhalation Agents & IV Anesthetics Flashcards

1
Q

Potency of volatile is directly related to

A

Lipid solubility

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2
Q

N20
OGP

MAC

BGP

A

OGP 1.4

MAC 104%

BGP 0.46

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3
Q

Desflurane OGP

MAC

BGP

A

OGP 18.7

MAC 6.6%

BGP 0.42

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4
Q

Sevoflurane OGP

MAC

BGP

A

OGP 55

MAC 2

BGP 0.69

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5
Q

Isoflurane OGP

MAC

BGP

A

OGP 98

MAC 1.2%

BGP 1.46

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6
Q

Volatile that increases SVR and PVR

A

N2O

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7
Q

Volatile that can decrease CO

A

Iso

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8
Q

Volatile with no effect on HR

A

Sevo

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9
Q

MAC peaks at what age

A

6 months

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10
Q

MAC decreases by how much for each decade of life

A

4%

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11
Q

Volatile that is methyl ethyl ether

A

Iso and des

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12
Q

Volatile that is methyl isopropyl ether

A

Sevo

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13
Q

Desflurane Vapor pressure

A

669

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14
Q

Isoflurane Vapor pressure

A

240

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15
Q

Sevoflurane vapor pressure

A

170

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16
Q

How much does N20 reduce MAC of volatile

A

1% for every 1% N20 used

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17
Q

How do volatiles affect CMRO2, CBF, and ICP

A

Increase CBF and ICP

Decreased CMRO2

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18
Q

Which volatile depresses BRR most

A

Sevo

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19
Q

Which electrolyte abnormalities can effect MAC

A

Hypernatremia- increases MAC

Hyponatremia or hypercalcemia - decrease MAC

20
Q

acceptable level in ppm of volatile used alone

Volatile with N20

A

Volatile alone- 2ppm

Volatile w/ N20- 25ppm N20
0.5ppm volatile

21
Q

Which volatile is susceptible to degradation to carbon monoxide by CO2 absorbent

A

Desflurane

22
Q

What IV anesthetic in small doses my increase the reaction to painful stimuli- hyperalgesic

A

Thiopental

23
Q

What barbiturate may elicit a histamine release and is contraindicated in patients with porphyria

A

Thiopental

24
Q

Benzodiazepine MOA

A

Enhance the action of GABA

25
Q

Most protein bound benzodiazepine

A

Diazepam 98-99% protein bound

26
Q

What 3 patient categories should not receive ketamine

A

Cardiac- SNS increase

Glaucoma patients- increased IOP

Elevated ICP- cerebral vasodilator

27
Q

Opioids cause what GI sphincter change

How to treat

A

Sphincter of Oddi to spasm = increased biliary tract pressure

Treat with glucagon 1-2 mg IM

28
Q

Where do barbiturates work

A

Depress the RAS

29
Q

Opioids produce supraspinal and spinal analgesia by working on which receptors

A

Spinal- Mu 2 decrease perception of pain

Supraspinal- Mu 1 alter response to pain

30
Q

Opioids work on which lamina rexed

A

Lamina II aka substantia gelatinosa

31
Q

Agonist-antagonist opioids work on what receptors

A

Kappa and some delta

Minimal mu antagonism so less respiratory depression

32
Q

Rank opioids from most to least potent

A

Sufenta - remi - fentanyl - alfentanil - morphine - Demerol

33
Q

What opioids cause histamine release

A

Morphine and demerol

34
Q

How does ketamine produce dissociative anesthesia

A

Causes dissociation between thalocortical system and limbic system

35
Q

Which IV sedative-hypnotic inhibits platelet aggregation

36
Q

Ester metabolisms

A

Pseudocholinesterase

37
Q

Max doses for esters

Procaine and chloroprocaine

Benzocaine, cocaine, and tetracaine

A

Procaine and chloroprocaine- 1000mg

Benzocaine, cocaine, and tetracaine- 200mg

38
Q

Amide elimination

A

Liver metabolism

39
Q

Max doses

Lidocaine

Mepivacaine and ropivacaine

Prilocaine

Bupivacaine and levobupivacaine

A

Lidocaine- 500 (700)

Mepivacaine and ropivacaine 300 (500)

Prilocaine 400 (600)

Bupivacaine and levobupivacaine 175 (225)

40
Q

4 anticholinesterase drugs that depress plasma cholinesterase activity thereby prolonging action of ester LA

A

Echothiopate

Neostigmine

Pyridostigmine

Edrophonium

41
Q

What drugs inhibit P450 thereby decreasing clearance of amides

A

Cimetidine

Propanolol

Volatiles

42
Q

What is the primary determinant of LA potency

A

Lipid solubility

43
Q

These antiemetic bind to which receptor

Metoclopramide
Droperidol
Haloperidol

A

Dopamine receptors (D2)

44
Q

These antiemetic bind to which receptor

Diphenhydramine
Promethazine

A

Histamine receptors (H1)

45
Q

These antiemetic bind to which receptor

Ondansetron

A

Serotonin receptors (5HT3)

46
Q

These antiemetic bind to which receptor

Aprepitatnt

A

Neurkinin-1 (NK1)

47
Q

What happens to glucocorticoid (cortisol) output in pt on steroids

A

Depressed release of ACTH by negative feedback.. without ACTH glucocorticoid release is inadequate from the adrenal gland

Board Prep (19 decks)

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