Volatile Anesthetic

Question 1

Fi determibants

Answer 1

Fgf
Volume of breathing system
Absorption of the gas by the machine in circuit

Question 2

Fast induction

Answer 2

Dec co, dec solubility
Dec alveolar partial pressure gradient meaning dec gas in venous blood
Inc alv vent
Unc fi

Question 3

Uptake and alveolar blood flow

Answer 3

Increased alveolar blood flow decreases induction because more anesthetic is removed from the gas phase into the blood

Question 4

Alveolar venous partial pressure gradient increas

Answer 4

Signifies that anesthetic is being uptaken by tissues which dec alv conc

Question 5

Benifit of halothan

Answer 5

No decrease in svr

Question 6

Halothane negatives

Answer 6

Sensitizes heart to catechols
Depressed baroreceptors there for no compensatory tach
Apnic threshhold increases 2/2 inc co2
Hepatitis 2/2 dec in hbf. Halothane reduced in liver leads to inc ast alt

Question 7

Desflurane vp mac bg

Answer 7

Vp 666
.42
Mac 6

Question 8

Nitrous bg mac

Answer 8

.47

105%

Question 9

Isoflurane bg vp mac

Answer 9

Mac 1.2
Vp 240
Bg 1.4

Question 10

Sevo bg vp max

Answer 10

Mac 2
Vp 160
Bg .65

Question 11

Halothane mac bg vp

Answer 11

Vp 243 bg2.4 mac .75%

Question 12

Absorption

Answer 12

Amount of total drug in blood stream

Question 13

Bioavailability

Answer 13

Amount of drug thay is effective at sight of action

Question 14

Potency

Answer 14

Affect relative to dosage

Question 15

Clearence

Answer 15

Rate of elimination

Question 16

Elimination

Answer 16

Biotransformation + excretion (prom by kid)

Question 17

Bio trans
Oxidation
reduction
Hydrolysis

Answer 17

Ox remove e
Red add e
Hydrolysis add h2o

Question 18

Barbituates (pheno barb thiamyl thiopental methohexital)

Answer 18

Moa: presynaptically inhibit excitatory nt releas
Post syno inc sensativity to gaba and stimulates gaba
Low albumin and hypocolemia inc brain conc
Biotransformation: oxidation

Question 19

Benzos

Answer 19

Moa: hyperpolarize w inc cl conductance

Question 20

Etomidate inhibiton of which enzyme

Answer 20

B-11 hydroxylase

Question 21

Barbituates

Answer 21

Known to induce aminevulinic acid precipitating acute intermittent porphyria

Question 22

Diazepam, 2nd peak

Answer 22

Metabolized to glucouronide

Question 23

Alfentanil rapid onset

Answer 23

Due to high non ionzed fraction

Question 24

Opiate moa

Answer 24

Blocks presynaptic release of sub p dopamine and ach
Descending inhibitory impulses accentuated
Interruped at level of dorsal horn

Question 25

Ketamine moa

Answer 25

Works by antagonizing nmda | Dissassociates thalmus from cereberal cortex, appear conscious but cannot process inputs

Question 26

Fi

Answer 26

Inspired concentration of anesthetic

Question 27

Sux atypical pseud

Answer 27

One abnormal gene heterozygote 20-30 min 40-60% dibucaine | Two abnormal > 6hr 20%

Question 28

Right to left shunt affect on induction

Answer 28

Decreased

Question 29

Left to right shunt affect on induction

Answer 29

Stays the same

Question 30

Potentcy of inhaled anesthetic is determined by

Answer 30

Lipid solubility Potency relates conc to affect for vol anes that is mac

Question 31

Mac dec by decade

Answer 31

6% over 40

Question 32

Isoflurane mac w burst supression

Answer 32

1.5 mac

Question 33

Tachycardia w induction rapid

Answer 33

Des and iso

Question 34

Most metabolized gas

Answer 34

Halothane 20% | Sevi 2%

Question 35

Does n2o inc apnenic threshold

Answer 35

No

Question 36

O2 vs n2o for ppm anesthetic pickup

Answer 36

O2 more soluble and picks up more volatile anesthetic

Question 37

High no2

Answer 37

Causes concetrating affect and augmented tracheal inflow If there is a second volatile anesthetic then it adds second gas affect

Question 38

Second gas affect

Answer 38

Woth n20 because alveolar vole decreases

Question 39

Vapor pressure

Answer 39

Des 666 Halo iso 240 Sevo 160

Question 40

Vopor output equation

Answer 40

Carrier gaa flow x vapor pressure of anesthetic gas | / barometric pressure - vp anes

Question 41

At flows less then 250 ml/min and greater than 10 what is output in relation to the dial

Answer 41

It is less. Below 250 there is less positive pressure for anesthetic to go into carrying gas, above ten it goes to fast to saturatr