Pharmacology

Question 1

Nitric Oxide inhaled

Answer 1

Delivered to areas of the lung that are well-ventilated, leading to vasodilation in these areas.
Results in increased perfusion to well-ventilated areas of the lung.

Question 2

Helium

Answer 2

Low density, low solubility, high thermal conductivity

• Pulmonary function testing (highly diffusible gas that is insoluble- thus won’t leave the lung via the bloodstream) - lung volume can be measured
• High thermal conductivity- can prolong time to ignition of flammable materials such as O2
• Also used as an inhalation contrast agent for pulmonary MRI

Question 3

Hydrogen Sulfide

Answer 3

Limit mitochondrial respiration by inhibition of cytochrome C oxidase
Limit some forms of cellular injury
-Signaling mediated through chelation of metallo-proteins, direct covalent modification of proteins, redox reactions such as reduction of disulfide bonds and reaction with free radical molecules.

Question 4

Components of the anesthetic state.

Answer 4

1. amnesia
2. immobility in response to noxious stimulation
3. attenuation of autonomic responses to noxious stimulation
4. analgesia
5. unconsciousness

Question 5

Potency of inhaled general anethetics are usually defined as

Answer 5

Minimum alveolar concentration (MAC) that prevents movement in 50% of patients in response to a surgical incision.

• Represents ED50 for inhaled anesthetics
• Lower MAC = more potent anesthetic

Question 6

MAC decreases with?

Answer 6

Age
Body temperature
During pregnancy

Question 7

Anesthetic partition coefficients

Answer 7

Ratio of anesthetic concentration in two tissues when the partial pressures of anesthetic are equal

Question 8

Concentration effect

Answer 8

While the rate of increase of Fa will be slower for highly soluble anesthetics such as haloethane, their speed of induction can be increased by delivering higher inspired partial pressures.

Question 9

Effects of inhalational anesthetics on:
Blood pressure
Cardiac Output
Respiration

Answer 9

BP: reduce systemic BP
CO: reduce, except for isoflurane and desflurane which maintain CO
Respiration: reduce spontaneous minute ventilation

Question 10

Xenon

Answer 10

Close to being an ideal anesthetic:

• low blood and tissue solubility
• potent
• not metabolized by the body
• nonflammable
• has minimal side effects

Question 11

Physiological effects of glucocorticoids

Answer 11

Regulation of carbohydrate, protein and lipid metabolism
Maintenance of fluid and electrolyte balance
Preservation of normal function of the cardiovascular system, the immune system, the kidney, skeletal muscle, the endocrine system and the nervous system
Preservation of organismal homeostasis