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Flashcards in induction agents Deck (23):
1

sedativ and hypnotic properties result from substitutions at the...

2 and 5 carbon atoms of barbaturic acid

2

branched on 5...

greater hypnotic activity than straight chain

3

phenol group on 5...

enhanced anticonvulsant activity

4

methyl radical

pro-convulsive effects

5

oxygen on 2

oxybarbituates

6

sulfur on 2

thiobarbituates, greater lipid solubility, faster onset, greater potency, shorter DOA

7

barbituric acid

malonic acid + urea

8

return of awareness after IV administration reflects...

rapid redistribution to inactive sites

9

distribution depends on...

-lipid solubility (most important)
-protein binding
-degree of ionization
-tissue blood flow

10

EEG small dose

low volt, fast wave activity (1-5 HZ), clouding of consciousness

11

EEG moderate dose

high volt, slow wave activity (<4 Hz), similar to physiologic sleep

12

EEG large dose

1-3 Hz, electrical silence

13

barbs stimulate activity of the mitochondrial enzyme...

D-aminolevulnic acid synthetase...production of heme is increased

14

porphyria exacerbated d/t inc in..

porphobilinogen deaminase....porphyrin accumulates (s/s- abdominal pian, constipation, musc weakness, seizures, severs NV)

15

Acute Intermittent Porphyria/ Variegate Porphyria Treatment

-d/c causative agent
-consult hematology
-10% glucose solution
-opioids for pain
-gabapentin for seizures

16

intra-arterial injection STP

-vasoconstriction, pain, extremity cyanosis, gangrene, limb loss

-treatment: dilution with saline, injection of lidocaine, papaverine, phenoxybenzamine, stelate ganglion block, brachial plexus block, urokinase, heparin

17

propofol solution made up of...

1% solution (2, 6- diisopropylphenol)

-10% soybean oil
-2.25% glycerol
-1.2% egg phosphatide
-0.005% disodium edetate added as microbial retardant (or metabisulfite)

18

propofol...peds require higher dose b/c...

-larger central distribution
-high clearance

(elderly- smaller central distribution, low clearance)

19

propofol (rigid, arched back, abnormal position...)

opisthotonus

20

etomidate structure

carboxylated imidazole derivative

21

isomer responsible for hypnotic effects in etomidate

D-isomer

22

etomidate metabolism

ester-hydrolysis by plasma esterase's and microsomal enzymes

23

ketamine more potent isomer

S- isomer