Inhalation Anesthesia Part 2 - Quiz 5 Flashcards Preview

Spring 2020 - Pharmacology 1 > Inhalation Anesthesia Part 2 - Quiz 5 > Flashcards

Flashcards in Inhalation Anesthesia Part 2 - Quiz 5 Deck (52)
Loading flashcards...
1

What are the 4 Phases of Uptake & Distribution?

  1. Inspired Anesthetic Concentraiton
  2. Alveolar Anesthetic Concentration
  3. Blood Anesthetic Concentration
  4. Anesthetic from Blood to Tissue

2

What is "Wash In"?

Using high flows of O2 or O2/N2O @ 5-10L/min to control partial pressure of Anesthetic Gas

3

What is the Concentration Effect of Anesthetic Gas?

High Concentrations = Greater Uptake = Greater Inspired Volume

4

What factors effect the Rate of Alveolar Partial Pressure of Anesthetic?

Inspired Concentration

&

Alveolar Ventilation

5

When Alveolar ventilation is high, the partial pressure of the anesthetic at the alveolar ______ rapidly.

When Alveolar ventilation is high, the partial pressure of the anesthetic at the alveolar Increases rapidly.

6

What is the Second Gas Effect?

First gas (N2O) rapidly goes into blood and pulls the second gas (Sevo) along with it --> 

causes rise of second gas more quickly

7

What factors determine how quickly Anesthetics go from Alveoli to Blood?

Solubilty of Gas

Cardiac Output - Rate of blood flow

Partial Pressure of Gases in Arterial/Venous blood

8

What is the Blood:Gas Partition Coefficient?

Ratio of Anesthetic Concentration in Blood to Anesthetic Concentration in Alveoli

Pa / PA

9

The more blood soluble the agent, the _____ time required for induction.

The more soluble the agent, the more time required for induction

(Slower Induction)

10

How does a higher blood flow affect gas delivery to the tissues?

Higher blood flow = more blood exposed to agent = faster pickup of agent

11

What factors contribute to the teh Partial Presure of Anesthetic in the Tissue?

Solubility of Gas & Tissue Blood Flow

12

What happens in Stage 1 of Anesthesia?

Stage of Analgesia

Decrease Dorsal Horn Activity & Synaptic Transmission

Duration: Anesthesia Administration to Loss of Consciousness

13

What happens in Stage 2 of Anesthesia

Stage of Delirium/Excitement

Block of Inhibitory Neurons = Enhance Synaptic Transmission

↑Muscle Tone

Irregular Breathing

Dilated Pupils

↑BP & ↑HR

Begins: Loss of Consciousness

14

What happens in Stage 3 of Anesthesia?

Stage of Anesthesia

Depression of Ascending Sensory Pathways

Supression of Spinal/Skeletal Activity

Regular Breathing

Centered Pupils

Absent Cough, Gag & Eyelid Reflex

15

What happens in Stage 4 of Anesthesia?

Stage of Depression

Depression of Medullary Centers

Profound Respiratory & Cardiac Depression

16

The lower the MAC, the ____ potent the agent and the ______ the blood:gas partition coefficent.

The lower the MAC, the more potent the agent and the higher the blood:gass partition coefficent

17

What are Factors that Decrease MAC?

Hypoxia

Anemia

Hypotension

Other Drugs

Pregnancy

Elderly

18

What are Factors that Increase MAC?

Infants

Hyperthermia

Chronic Drug/Alcohol Use

19

How does Hyperthermia > 42 C affect MAC?

Decreases MAC

20

How does Anemia w/ HCT < 10% affect MAC?

Decreases MAC

21

How does a PaO2 > 95 mmHg d/t decrease in pH in the CSF affect MAC?

Decreases MAC

22

How does Hypo/Hyperthyroid affect MAC?

No effect

23

How does Hypercalcemia & Hyponatremia affect MAC?

Decreases MAC

24

How does Hypernatremia affect MAC?

Increases MAC

25

What drugs increase MAC?

Cocaine, Ephedrine & Acute use of Amphetamine

26

At what MAC will 95% of patients not move?

1.2 MAC

99% @ 1.3 MAC

27

What is MAC-awake?

50% of patients will respond to "Open your eyes"

0.3 MAC = Loss of Recall

28

What is MAC-BAR?

MAC needed to block Adrenergic Response to Skin Incision

29

What is MAC intubation?

Same as MAC-BAR - more gas than that needed for surgical incision

30

What is one thing that restricts the application of using MAC as a guideline?

Frequency of Muscle Relaxant Administration