pharmacology

Question 1

what is the most sensitive anesthetic end point? aka what is most likely to occur at lowest mac fraction?

Answer 1

amnesia

Question 2

MAC awake during emergence =

Answer 2

~.2 MAC

Question 3

MAC where awareness is prevented

Answer 3

.4-.5MAC

Question 4

MAC bar =

Answer 4

1.5 MAC

Question 5

which drugs undergo phase 1 hydrolysis in the plasma?

Answer 5

any drugs that are eliminated via pseudocholinesterases or non specific esterases
ex) succ, mivacurium, ester LA’s, remi

Question 6

excitatory pain modulating receptors related to substance P include

Answer 6

neurokinin 1 and 2 (NK1, NK2)

Question 7

excitatory pain modulating receptors related to glutamate include

Answer 7

NMDA, AMPA

Question 8

what is the most important factor that determines the half life of amide LA’s

Answer 8

hepatic fx

Question 9

hypobaric solutions are mixed with

Answer 9

water

Question 10

isobaric solutions are mixed with

Answer 10

saline

Question 11

which SE’s of succ are most likely to be attenuated with pre tx via non depolarizing NMB?

Answer 11

myalgia and ICP (not masseter spasm)

Question 12

factors that increase the risk of LAST (4)

Answer 12

choosing amide over ester (since ester is metabolized via pseudocholinesterases)
hyperkalemia (increases RMP to easier to stimulate level)
hypoxia/hypercarbia (increases amount of drug that gets to the brain)
high lipid solubility

Question 13

what amount of intrathecal morphine is equipotent to 5mg via epidural?

Answer 13

.3mg

Question 14

2 drugs that cause significant enzyme induction

Answer 14

carbamazepine
phenytoin

Question 15

isoflurane and neuro benefits (3)

Answer 15

isoflurane reduces resistance to reabsorption of CSF
preserves auto regulation up to 1 mac
decreased CMRO2