SEE 5 Flashcards
___ LA’s are eliminated by plasma pseudocholinesterase except ___, which is eliminated hepatic
ester , cocaine
which LA class has greatest allergic potential
ester (from PABA)
____ is hydrolyzed much more slowly by plasma cholinesterase and is highly protein bound
tetracaine - therefore its the most toxic
what is the least potent ester
procaine
what is the max dose of cocaine
1.5mg/kg
____ LA’s are metabolized hepatic
amide
which LA causes etidocaine at a lower plasma concentration
etidocaine
what does EMLA cream contain
2.5 lido, 2.5 prilo
which LA may cause methemoglobinina
benzocaine
sensitivity testing:
SNO (sensitivity, negative, out)
SPI (Specificity, positive, in)
more soluble agents have a ____ inhalation induction
slower
less soluble agents have a ___ inhalation induction
faster
what do volatiles do to CBF and CMRO2
inc CBF, reduce CMRO2 (think they inc flow and reduce demand)
vapor pressure of a liquid is dec solely on
TEMP
which NMBs have histamine release
succs, miv, atra
roc & vec metabolism
primary biliary, secondary renal
brain uptake of anesthetics depends on what 4 things
blood solubility, CO, alveolar ventilation, inspired concentration
three ways to increase speed of equilibrium
inc inspired anesthetic concentration, second gas effect, inc alveolar ventilation
what are the two most important factors for increased alveolar partial pressure
inspired concentration and blood solubility
barbs are contraindicated in what two situations
status asthmatics and porphyria
how is propofol metabolized
liver 70%, lung 30%
what does etomidate do neuro wise
dec CBF, ICP , CMRO2
ketamine produces broncho_____
dilatoin
rank the potencies of the opiates
sufent > remifent > fent > alfent > MSO4 > meperidine
which NMB’s use hoffman elimination
cis and atra
hoffman elimination is slowed by what two things
acidosis or dec temp
4 MR’s that use renal excretion least
succs, atra, cis, miv
3 NDMR’s not sifnificantly excreted renal
atra, cisatra, miv
what augments NMB? ____mag, ____calc, ____kalemia, ___thermia
hypermag, hypocalc, hypokalemia, hyperthermia
whats the earliest sign of MH
inc ETCO2
whats the standard diagnostic test for MH
halothane-caffeine contracture test
whats the dosing of dantrolene``
2.5mg/kg followed by 1-2mg/kg boluses to a max dose of 10mg/kg
what is the cardinal sign of NMS
fever
which 2 anticholinergics cross the BBB
atropine and scop
which age group has the highest MAC
6mo-12mo
factors that dec mac: age? temp? etoh? alpha2,
old, cold, acute etoh, depressants, alpha2’s like clonidine, dec levels of CNS neurotransmitters
what does pregnancy do to MAC
dec
what 3 factors increase MAC
hyperthermia, hypernatremia, inc levels of CNS neurotransmitters
acceptable levels of N20 in the OR =
25ppm
acceptable levels of N20 + volatiles?
0.5ppm
acceptable level of volatile alone in the OR?
2ppm
n20 is metabolized to N2 in the intestine by ____
reductive anaerobic metabolism
what does n20 do to PVR
increases
what does N20 do to CBF and CMRO2
increases
what do volatiles do to the renal system
dec RBF, GFR, UO
____ is most degraded by soda lime and ____ least
sevo , des
whats the diff between competitive and non-competitive?
competitive can be overcome by increased concentrations of an agonist, while non-competitive cant be overcome by inc conc
ASA, dilantin, are examples of ___ order kinetics
zero. constant AMOUNT of a drug over time
first order kinetics : constant _____ eliminated per time
FRACTION
T/F barbiturates, opioids, benzos, amides, TCAs, antihistamines are all metabolized by CYP450
true
