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Board Prep > Module 14 Inhalation Agents & IV Anesthetics > Flashcards

Module 14 Inhalation Agents & IV Anesthetics Flashcards

1
Q

Potency of volatile is directly related to

A

Lipid solubility

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2
Q

N20
OGP

MAC

BGP

A

OGP 1.4

MAC 104%

BGP 0.46

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3
Q

Desflurane OGP

MAC

BGP

A

OGP 18.7

MAC 6.6%

BGP 0.42

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4
Q

Sevoflurane OGP

MAC

BGP

A

OGP 55

MAC 2

BGP 0.69

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5
Q

Isoflurane OGP

MAC

BGP

A

OGP 98

MAC 1.2%

BGP 1.46

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6
Q

Volatile that increases SVR and PVR

A

N2O

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7
Q

Volatile that can decrease CO

A

Iso

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8
Q

Volatile with no effect on HR

A

Sevo

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9
Q

MAC peaks at what age

A

6 months

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10
Q

MAC decreases by how much for each decade of life

A

4%

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11
Q

Volatile that is methyl ethyl ether

A

Iso and des

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12
Q

Volatile that is methyl isopropyl ether

A

Sevo

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13
Q

Desflurane Vapor pressure

A

669

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14
Q

Isoflurane Vapor pressure

A

240

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15
Q

Sevoflurane vapor pressure

A

170

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16
Q

How much does N20 reduce MAC of volatile

A

1% for every 1% N20 used

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17
Q

How do volatiles affect CMRO2, CBF, and ICP

A

Increase CBF and ICP

Decreased CMRO2

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18
Q

Which volatile depresses BRR most

A

Sevo

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19
Q

Which electrolyte abnormalities can effect MAC

A

Hypernatremia- increases MAC

Hyponatremia or hypercalcemia - decrease MAC

20
Q

acceptable level in ppm of volatile used alone

Volatile with N20

A

Volatile alone- 2ppm

Volatile w/ N20- 25ppm N20
0.5ppm volatile

21
Q

Which volatile is susceptible to degradation to carbon monoxide by CO2 absorbent

A

Desflurane

22
Q

What IV anesthetic in small doses my increase the reaction to painful stimuli- hyperalgesic

A

Thiopental

23
Q

What barbiturate may elicit a histamine release and is contraindicated in patients with porphyria

A

Thiopental

24
Q

Benzodiazepine MOA

A

Enhance the action of GABA

25
Most protein bound benzodiazepine
Diazepam 98-99% protein bound
26
What 3 patient categories should not receive ketamine
Cardiac- SNS increase Glaucoma patients- increased IOP Elevated ICP- cerebral vasodilator
27
Opioids cause what GI sphincter change How to treat
Sphincter of Oddi to spasm = increased biliary tract pressure Treat with glucagon 1-2 mg IM
28
Where do barbiturates work
Depress the RAS
29
Opioids produce supraspinal and spinal analgesia by working on which receptors
Spinal- Mu 2 decrease perception of pain Supraspinal- Mu 1 alter response to pain
30
Opioids work on which lamina rexed
Lamina II aka substantia gelatinosa
31
Agonist-antagonist opioids work on what receptors
Kappa and some delta Minimal mu antagonism so less respiratory depression
32
Rank opioids from most to least potent
Sufenta - remi - fentanyl - alfentanil - morphine - Demerol
33
What opioids cause histamine release
Morphine and demerol
34
How does ketamine produce dissociative anesthesia
Causes dissociation between thalocortical system and limbic system
35
Which IV sedative-hypnotic inhibits platelet aggregation
Propofol
36
Ester metabolisms
Pseudocholinesterase
37
Max doses for esters Procaine and chloroprocaine Benzocaine, cocaine, and tetracaine
Procaine and chloroprocaine- 1000mg Benzocaine, cocaine, and tetracaine- 200mg
38
Amide elimination
Liver metabolism
39
Max doses Lidocaine Mepivacaine and ropivacaine Prilocaine Bupivacaine and levobupivacaine
Lidocaine- 500 (700) Mepivacaine and ropivacaine 300 (500) Prilocaine 400 (600) Bupivacaine and levobupivacaine 175 (225)
40
4 anticholinesterase drugs that depress plasma cholinesterase activity thereby prolonging action of ester LA
Echothiopate Neostigmine Pyridostigmine Edrophonium
41
What drugs inhibit P450 thereby decreasing clearance of amides
Cimetidine Propanolol Volatiles
42
What is the primary determinant of LA potency
Lipid solubility
43
These antiemetic bind to which receptor Metoclopramide Droperidol Haloperidol
Dopamine receptors (D2)
44
These antiemetic bind to which receptor Diphenhydramine Promethazine
Histamine receptors (H1)
45
These antiemetic bind to which receptor Ondansetron
Serotonin receptors (5HT3)
46
These antiemetic bind to which receptor Aprepitatnt
Neurkinin-1 (NK1)
47
What happens to glucocorticoid (cortisol) output in pt on steroids
Depressed release of ACTH by negative feedback.. without ACTH glucocorticoid release is inadequate from the adrenal gland

Board Prep (19 decks)

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