Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Advanced Pharmacology ANE 8433 (Spring 2023) > Exam 3 > Flashcards

Exam 3 Flashcards

(74 cards)

Start Studying
1
Q

What 3 things does diffusion depend on?

A
  • Partial pressure gradient of the gas.
  • Solubility of the gas.
  • Membrane thickness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a good indicator of anesthesia depth & recover from anesthesia?

A

Alveolar pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 partial pressure gradients?

A
  • Anesthetic machine to alveoli (Boyle).
  • Alveoli to Blood.
  • Arterial blood to brain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What affects VA uptake from alveoli to blood?

A
  • Blood: gas partition coefficient.
  • Cardiac Output.
  • A-v partial pressure difference
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What affects VA uptake from blood to brain?

A
  • Brain: blood partition coefficient.
  • Cerebral blood flow.
  • a-v partial pressure difference.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What affects VA input from machine to alveoli?

A
  • Inspired partial pressure.
  • Alveolar ventilation (RR & volume).
  • FRC.
  • Anesthetic breathing system (re-breathing)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the main concept of Pt’s going to sleep?

A

Concentration effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is over pressurization?

A

Used in emergencies to get someone to sleep fast. Crank up VA for a few breaths until asleep then dial back down.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the second gas effect?

A
  • The use of N2O with another volatile gas.
  • N2O helps create a higher concentration gradient & increases uptake of 2nd volatile gases in the alveoli leading to faster equilibrium.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When should nitrous not be used & why?

A
  • In bowel, ear, eye Sx or Pt’s with a pneumothorax.
  • N2O diffuses very fast into air-filled cavities then expands creating pressure build-up.
  • Very bad in non-compliant areas like eyes & ears.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does inhaled gases solubility look at?

A

A distribution ratio of VA between 2 compartments at equilibrium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does temperature affect solubility of VA?

A

Increased blood temp decreases solubility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If blood solubility is high, then induction is?

A

Prolonged as large amounts of the VA must be dissolved.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List the VA in order from high to low solubility.

A

Halothane,
Isoflurane,
Sevoflurane,
Desflurane,
N2O

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the Blood: Gas Partition coefficient for Halothane?

A

2.54

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the Blood: Gas Partition coefficient for Enflurane?

A

1.90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the Blood: Gas Partition coefficient for Isoflurane?

A

1.46

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the Blood: Gas Partition coefficient for Sevoflurane?

A

0.69

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the Blood: Gas Partition coefficient for Desflurane?

A

0.42

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the Blood: Gas Partition coefficient for Nitrous oxide?

A

0.46

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What 3 VA has the highest Fat: Blood coefficient?

A

Halothane
Sevoflurane
Isoflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What VA has the lowest Fat: Blood coefficient?

A

Nitrous oxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is 1.3 MAC?

A

The percentage of gas when 99% of Pt’s do not move.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is MAC awake?

A
  • 0.3-0.5 MAC, the point a Pt may open their eyes.
  • Only VA is used.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What happens in MAC bar?
No SNS response when intubating only using a VA
26
MAC is based on what 3 things?
- Age 30-55y/o - Temp of 37 degrees C. - Pressure of 1atm
27
What is the MAC of N2O?
104%
28
MAC changes how much per decade?
6%
29
MAC peaks at?
1 year old
30
What 4 things increase MAC?
- Hyperthermia. - Excess pheomelanin. - Drug-induced increases in catecholamines. - Hypernatremia
31
What decreases MAC?
- Anything that decreases metabolism - Alpha-2 agonists - Acute EtOH - Pregnancy - Lidocaine - MAP <40 mmHg - Hyponatremia - Cardiopulmonary bypass - PaO2 <38 - Post-partum <72hrs
32
How do VA affect spinal mobility?
- Depress AMPA & NMDA (glutamate receptors). - Enhance glycine. - Act on Na+ channels (block presynaptic glutamate release)
33
How do VA act on the brain?
- Inhibit GABA transmission (Especially in RAS). - Potentiate glycine activity in brainstem. - Do not affect AMPA, NMDA or kainite
34
What is vapor pressure?
The pressure at which vapor and liquid are at equilibrium
35
What does Henry’s law state?
The amount of dissolved gas in a liquid is proportional to its partial pressure above the liquid.
36
What is the vapor pressure for desflurane?
669 torr
37
What is the vapor pressure for sevoflurane?
157 torr
38
What is the vapor pressure for halothane?
243 torr
39
What is the vapor pressure for enflurane?
175 torr
40
What is the vapor pressure for isoflurane?
238 torr
41
List the VA from lowest to highest vapor pressure?
- Sevoflurane, - Enflurane, - Isoflurane, - Halothane, - Desflurane (SEIH)
42
An increased splitting ratio means?
More carrier gas is going through the vaporizer, picking up VA.
43
What is the MAC & MAC 1.3 of Halothane?
- 0.75% - 0.975%
44
What is the MAC & MAC 1.3 of Enflurane?
- 1.63% - 2.12%
45
What is the MAC & MAC 1.3 of Isoflurane?
- 1.17% - 1.52%
46
What is the MAC & MAC 1.3 of desflurane?
- 6.6% - 8.58%
47
What is the MAC & MAC 1.3 of sevoflurane?
- 1.8% - 2.34%
48
When is a priming dose given?
When intubating with Scc
49
NDMB are antagonized by?
Anticholinesterase drugs
50
Why is there fade with NDMB?
Some fibers are more susceptible to NDMB
51
What cardiac receptors are agonized by NDMBs?
- Cardiac muscarinic - nACh-r at automatic ganglia
52
Which NDMB’s ED95 is the same as the TD?
Pancuronium
53
Who is at risk for critical illness myopathy?
Pt’s with MODS, who were ventilated > 6days
54
What class of NDMB was given to someone that developed critical illness myopathy?
Aminosteroid blocker
55
Altered response with VA happens due to?
Dose dependent inhibition of nACh-r --> prolonged response @ nACh-r
56
What blocker is dosed on actual body weight?
Succinylcholine
57
How do diuretics, corticosteroids, reglan & LA affect NDMB?
- Prolong blockade. - Increase ACh release. - Depress cholinesterase activity. - Depress nerve conduction
58
How does magnesium affect NDMB?
- Enhance blockade. - Decrease presynaptic ACh release. - Decrease postsynaptic membrane sensitivity
59
Which NDMB are very sensitive to hypothermia?
Vecuronium & Pancuronium --> doubles the duration
60
How does acute hypo & hyperkalemia affect NMB?
Hypokalemia: - leads to resistance to Scc. - Increased sensitivity to NDMB. Hyperkalemia: - Increased effect of Scc. - Resistance to NDMB.
61
What is the timeframe of resistance to NDMB in burn Pt’s?
10 after burn up to 60 days.
62
How can the resistance to NMB in burn Pt’s be overcome?
Give 1.2 mg/kg of Rocuronium
63
Which NDMB is least & most likely to cause an allergic reaction?
- Least: Cisatracurium - Most: Scc
64
What is the dose, onset, duration & class for Pavulon?
- Dose: 0.1 mg/kg - Onset: 3-5mins - Duration: 60-90mins. - Aminosteroid
65
Which NDMB should not be given for renal transplant Sx?
Vecuronium(Norcuron)
66
How do acidosis & NDMB relate?
- If acidotic prior to NDMB then blockade will remain the same. - If NDMB is given and then Pt becomes acidotic then blockade is prolonged.
67
Which NDMB’s degradation is affected by pH & temp?
Nimbex (Cisatracurium) & Atracurium
68
When is a larger dose of Pancuronium dose needed?
In liver failure
69
What are the pros of N2O?
- Does not cause muscle relaxation - Does not blunt HPV - Does not cause cardiac depression / minimal arrhytmia - Slight increase in CO - No N/V with <0.5 MAC - Useful for mom’s post-delivery d/t analgesic effects without opioids
70
What are the cons of N2O?
- Do not give to pregnant ppl w/ B12 deficiency - Causes bone marrow suppression - Increase in myocardial events w. atherosclerosis - Increases PVR - Do not use in ear, eye, abdominal & pneumothorax cases
71
Who should not receive N2O?
- pregnant w/ low B12 - atherosclerosis - osteoporosis - anemic Pt's - immune suppressed - pulmonary HTN Pt’s - eye, ear or abd Sx
72
What are the pros (2) of Halothane?
- Bronchodilation - Low risk for N/V
73
What are the cons (6) of Halothane?
- Increases ICP & CBF - Decreases portal vein flow - Arrhythmias - Hepatic necrosis - Pediatric bradycardia - Decomposes into HCL acid
74
Who should not receive Halothane?
- Pt's wtih ESRD - hepatic failure - neuro Pts - Pt’s w/ arrhythmias

Advanced Pharmacology ANE 8433 (Spring 2023) (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions