inhaled anesthetics

Question 1

definition of equilibration

Answer 1

when alvelor concentrations equal inspired concentrations

Question 2

when do maximum tissue concentrations exist

Answer 2

at equilibration

Question 3

factors affecting equiilibration times

Answer 3

lung function
FRC
Tissue Uptake
Solubility of drug
Pulmonary Blood Flow
Cardiac Output

Question 4

determiniants of lung uptake

Answer 4

inspired gas partial pressure
ventilation rate
FRC

Question 5

effect of increased FRC

Answer 5

slows flow of agent into the lung, therefore induction time is increased

Question 6

reason kids can get inhaled inductions rather than adults

Answer 6

kids have less FRC

Question 7

rise of concentration of a drug is slowed by

Answer 7

lung (little ) and blood (LOT) uptake

Question 8

primary determiniants of tissue uptake

Answer 8

solubility of agent
pulmonary blood flow (CO)
AV concentration gradient

Question 9

definition of drug soluability

Answer 9

relative content of a gas in w phases when the partial pressure of the gas is the 2 phases is equal

Question 10

measurement of drug soluability

Answer 10

B/G ratio, or partition coefficient

Question 11

if the B/G of a drug is .5, and you put 3% volume into the lung, what % will be in the blood and in the gas

Answer 11

1% blood, 2% Gas (.5)

Question 12

larger B/G increases ____ uptake and decreases _____ concentration

Answer 12

blood, alvelor

Question 13

effect of a large B/G on induction

Answer 13

slows

Question 14

more soluable agents _______ equilibration time

Answer 14

increase

Question 15

why do soluable agents increase time to effect?

Answer 15

drug is trapped in the blood and is not available to bind to tissue, reducing tissue concentation

Question 16

highest inhaled drug B/G coefficient

Answer 16

halothane

Question 17

lowest inhaled drug B/G coefficient

Answer 17

Defulane (N2O, and sevoflurane right there)

Question 18

order of inhaled drug B/G (high to low)

Answer 18

HISND

Question 19

low solubility agents will wear off (fast/slow)

Answer 19

fast

Question 20

increases in cardiac output have what effect on inhaled agents

Answer 20

decrease rate of alveolar concentrations and slow equilibrium time

Question 21

higher CO will do what to the flow of drug to the brain

Answer 21

increase proportionally

Question 22

higher CO will result in what changes to drug delivery

Answer 22

decreased concentrations, slower equilibration time

Question 23

in hypodynamic shock, what will the effect of a normal dose of drug give

Answer 23

higher concentrations of drug in tissue, possible OD

Question 24

factors that increase equilibration time of a drug

Answer 24

increased solubility/CO/AV concentration gradient

Question 25

targets of inhaled drugs

Answer 25

ligand-gated ion channels

Question 26

ligand-gated ion channels targeted by inhaled drugs

Answer 26

nACH, 5-HT3, GABA

Question 27

effectof GABA binding to its receptors

Answer 27

1) CL-conductace increases 2) membrane hyperpolarizes 3) neuronal exitability is reduced

Question 28

drugs enhance GABAA current by:

Answer 28

increasing burst frequency and duration

Question 29

basic MOA of inhaled anesthetics

Answer 29

GABA agonists by increasing cholride conductance

Question 30

inhaled anesthetic that contains a bromide

Answer 30

halothane

Question 31

pleasent smelling inhaled gas

Answer 31

halothane

Question 32

low boiling point inhaled gas

Answer 32

desflurane

Question 33

pungent smelling gasses

Answer 33

isoflurane and desflurane

Question 34

primary measure of inhaled drug potency

Answer 34

Minimum alveolar concentration (MAC)

Question 35

definition of MAC

Answer 35

equilbrium concentration required to prevent movement to skin incision at 1 ATM in 50% of pts

Question 36

highest potency of inhaled gas

Answer 36

N2O

Question 37

lowest potency of inhaled gas

Answer 37

halothane

Question 38

rank of inhaled gas potency (low to high)

Answer 38

HISDN

Question 39

anything physiological that increases MAC ______ anesthetic requirements

Answer 39

increases (and decrease/decrease)

Question 40

physiological states that increase MAC

Answer 40

hyperthermia, elevated CNS catecholamine anxiety), chronic EtOH/Cocaine use, nypernatriemia

Question 41

physiological states that decrease MAC

Answer 41

hypothermia, pregnancy,shock,increasing age,acute EToH ingestion, CNS depressent drugs

Question 42

general goals of anesthetisa (5)

Answer 42

hypnosis, amnesia, analgesia, inhibition of autonomic reflexes, muscle relaxation

Question 43

inhaled drugs do what to ICP

Answer 43

increase

Question 44

drug that increases ICP and cerebral drug flow the most

Answer 44

halothane

Question 45

drug that decreases cerebral O2 consumption the most

Answer 45

isoflurane

Question 46

drug that decreases CO

Answer 46

halothane

Question 47

drugs that increase HR

Answer 47

isoflurane, desflurane (more)

Question 48

drug that lowers mycardial function the most

Answer 48

halothane

Question 49

effect of N2O on the CV system

Answer 49

none

Question 50

drug that can either increase or decrease airway resistance

Answer 50

desfulrane

Question 51

effect of inhaled agents on tidal colume

Answer 51

down

Question 52

effect of inhaled agents on respiratory rate

Answer 52

sligtly higher

Question 53

effect of inhaled agants on airway resistance

Answer 53

mostly considerably lower (except desflurane)

Question 54

effectof inhaled agents on kidney/liver function

Answer 54

lower

Question 55

inhaled agent that can cause n/v

Answer 55

N2O