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

Inhalation Anesthesia Part 2 - Quiz 5 Flashcards

1
Q

What are the 4 Phases of Uptake & Distribution?

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

What is “Wash In”?

A

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

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3
Q

What is the Concentration Effect of Anesthetic Gas?

A

High Concentrations = Greater Uptake = Greater Inspired Volume

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4
Q

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

A

Inspired Concentration

&

Alveolar Ventilation

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5
Q

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

A

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

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6
Q

What is the Second Gas Effect?

A

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

causes rise of second gas more quickly

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7
Q

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

A

Solubilty of Gas

Cardiac Output - Rate of blood flow

Partial Pressure of Gases in Arterial/Venous blood

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8
Q

What is the Blood:Gas Partition Coefficient?

A

Ratio of Anesthetic Concentration in Blood to Anesthetic Concentration in Alveoli

Pa / PA

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9
Q

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

A

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

(Slower Induction)

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10
Q

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

A

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

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11
Q

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

A

Solubility of Gas & Tissue Blood Flow

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12
Q

What happens in Stage 1 of Anesthesia?

A

Stage of Analgesia

Decrease Dorsal Horn Activity & Synaptic Transmission

Duration: Anesthesia Administration to Loss of Consciousness

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13
Q

What happens in Stage 2 of Anesthesia

A

Stage of Delirium/Excitement

Block of Inhibitory Neurons = Enhance Synaptic Transmission

↑Muscle Tone

Irregular Breathing

Dilated Pupils

↑BP & ↑HR

Begins: Loss of Consciousness

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14
Q

What happens in Stage 3 of Anesthesia?

A

Stage of Anesthesia

Depression of Ascending Sensory Pathways

Supression of Spinal/Skeletal Activity

Regular Breathing

Centered Pupils

Absent Cough, Gag & Eyelid Reflex

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15
Q

What happens in Stage 4 of Anesthesia?

A

Stage of Depression

Depression of Medullary Centers

Profound Respiratory & Cardiac Depression

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16
Q

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

A

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

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17
Q

What are Factors that Decrease MAC?

A

Hypoxia

Anemia

Hypotension

Other Drugs

Pregnancy

Elderly

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18
Q

What are Factors that Increase MAC?

A

Infants

Hyperthermia

Chronic Drug/Alcohol Use

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19
Q

How does Hyperthermia > 42 C affect MAC?

A

Decreases MAC

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20
Q

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

A

Decreases MAC

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21
Q

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

A

Decreases MAC

22
Q

How does Hypo/Hyperthyroid affect MAC?

23
Q

How does Hypercalcemia & Hyponatremia affect MAC?

A

Decreases MAC

24
Q

How does Hypernatremia affect MAC?

A

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
31
Factors that are invovled with getting Gas from Machine to Lungs
Inspired Partial Pressure Alveolar Ventilation Breathing System Properties
32
Factors involved in getting Gas from Lungs to Blood
Solubility of Gas to Blood Cardiac Output Alveolar to Venous Pressure Difference
33
Factors involved in getting Gas from Blood to Brain?
Brain:Blood Partition Coefficient Cerebral Blood Flow Arterial to Venous Partial Pressure Difference
34
What is the MAC% for Desflurane?
6%
35
What is the MAC% for Sevoflurane?
2%
36
What is the MAC% for Isoflurane?
1.4%
37
What is the λoil:gas for N2O?
1.4
38
What is the λoil:gas for Desflurane?
19
39
What is the λoil:gas for Sevoflurane?
51
40
What is the λoil:gas for Isoflurane?
98
41
What is the λblood:gas for N2O?
0.47
42
What is the λblood:gas for Desflurane?
0.45
43
Wht is the λblood:gas for Sevoflurane?
0.65
44
What is the λblood:gas for Isoflurane?
1.4
45
How does High Cardiac Output effect Gas buildup in the Alveoli?
High Cardiac Output **slows** gas buildup in the alveoli & induction because blood take up the gas too quickly
46
How does Low Cardiac Output effect Gas buildup in the Alveoli?
Gas builds up **faster** in the alveoli because of less uptake by blood
47
How does at Right-to-Left Cardiac Shunt effect induction?
**Slows** Induction d/t dilution of blood w/o any anesthetic
48
How does Left-to-Right Cardiac Shunt effect Induction?
No Effect
49
What is Diffusion Hypoxia?
When N2O is stopped abruptly and the patient is only breathing Room Air. The N2O in the body is still diffusing into the Alveoli --\> give 100% O2 for 5-10 min
50
What factors influence Rate of Emergence?
Duration of Procedure Temperature of Patient Patient's Physical Condition Obesity
51
What is the Difference between Emergence and Induction?
No Concentration Effect Tissue serves as Reservoir, Not Blood Metabolism
52
What does the Elimination of Anesthetic Gas depend on?
Length of Administration Solubility of Gas in Blood & Tissues

Spring 2020 - Pharmacology 1 (11 decks)

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