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pharm exam 1 > Volatile Anesthetics > Flashcards

Volatile Anesthetics Flashcards

1
Q

Characteristics of An ideal inhaled anesthetics

A 
Non-flammable
Easily vaporized at ambient temperature
Low blood solubility (rapid on & off)
Minimal metabolism
Skeletal muscle relaxation
Non-irritating to airways
Bronchodilation
Absent myocardial depression, cerebral vasodilation, hepatic and renal toxicity.
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2
Q

Ethers

A

Sevo and des

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3
Q

Alkanes

A

cyclopropane and halothane

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4
Q

N2O down side

A

PONV, poor wound healing and can also make pnx worse

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5
Q

New anesthetics charac teristics

A

non flammable and fluorinated

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6
Q

general anesthesia definition

A

It is a controlled state of unconsciousness, accompanied by partial or complete loss of protective reflexes, including the inability to independently maintain an airway or respond purposefully to verbal command

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7
Q

conscious sedation

A

It is a state of mind obtained by IV administration of combination of anxiolytics, sedatives and hypnotics &/or analgesic that render the patient relaxed, yet allows the patient to communicate, maintain patent airway and ventilate adequately.

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8
Q

deep sedation

A

It is a depressed level of consciousness with some blunting of protective reflex, although it remains possible to arouse the patient.

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9
Q

Iatro sedation

A

A general term used for any technique of anxiety reduction in which no drugs are given
Relief of anxiety through the doctor’s behavior - it is one of the form of psychosedation

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10
Q

Effects of full fluorination

A 
Low potency (low oil:gas solubility which equals a higher mac)
higher vapor pressure (lower IM attraction)
higher resistance to biotransformation (less metabolism=less TFA makes an immune mediated hepatitis less likely)
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11
Q

MAC bar

A

no autonomic nervous response

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12
Q

Meyor overton rule

A

Halothane>Iso>Sevo>Des>N2O

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13
Q

Critical Volume hypothesis

A

How anesthetics work at the receptor level and how they affect

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14
Q

Theories of anesthetic action

A

Unitary hypothesis of narcosis
Meyer-overton rule
Critical volume hypothesis

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15
Q

How can the mechanisms of action of inhalation anesthetics

A

macroscopic, microscopic, molecular

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16
Q

Synaptic

A

Gaba, glycine and NMDA

17
Q

Amnesia

A

hyppocampus and amygdala

18
Q

hypnosis/consciousness

A

RAS and thalamus

19
Q

What excitatory receptors are blocked by VA?

A

Glutamate, serotonin and nicotinic

20
Q

What inhibitory receptors are augmented by VA?

A

Gaba and glycine

21
Q

Percentage that gases are metabolized by liver

A

Sevo 2-5%
Iso 0.2%
Des 0.02%
N20 0.004%

22
Q

Fi determined by

A

FGF rate, breathing-circuit volume, circuit absorption

23
Q

Fa is determined by

A

uptake, ventilation and concentration effect.

24
Q

Fa arterial gas concentration affected by

A

ventilation/perfusion mistmatching

25
Q

Pharmacokinetics of inhaled anesthetics in the older population

A

Increased fat- give Des
Decreased hepatic function-no sevo/halothane
Decreased FRC-faster induction
Decreased CO- faster induction
Decreased albumin- affects solubility of agents so if you have less it will be less soluble in blood therefore increasing onset

26
Q

vapor pressure

A

The pressure of the vapor over the liquid at equilibrium

27
Q

Henrys law

A

states that for a given solvent at a given temperature, the amount of gas dissolved in solution is directly proportional to the pp of the gas.

28
Q

Partial pressure in Alveoli

A

Depth of anesthesia
Recovery from anesthesia
Anesthetic equal potency (MAC

29
Q

What determines alveolar partial pressure?

A

Input(delivery) and uptake (loss)

30
Q

Input

A 
Inspired PP
Alveolar minute ventilation
Characteristics of the breathing system
FRC
Anatomical dead space
31
Q

Uptake from alveoli to arterial blood

A

Blood gas partition coefficiend
Cardiac output
Alveolar to venous pp difference

32
Q

Uptake from arterial blood to brain

A

Brain blood partition coefficient

Cerebral blood flow

33
Q

Alveolar ventilation inflow factors

A

Larger the FRC = slower rise in PA

Smaller the FRC= faster rise in PA

34
Q

What is the tissue uptake dependent on?

A

tissue blood flow
blood to tissue partial pressure
blood tissue solubility coefficient

pharm exam 1 (12 decks)

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