Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Fall'20 Pharmacology III > Pharm Acid/Base > Flashcards

Pharm Acid/Base Flashcards

(85 cards)

Start Studying
1
Q

Acidity of solution reflects its

A

hydrogen ion content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

PH stands for

A

Potential of hydrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

causes for metabolic alkalosis

loss of acid from extracellular space examples

A

loss of gastric fluid- vomiting, NG drainage

loss of acid into urine- diuretic administration, hyperaldosteronism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

causes for metabolic alkalosis

excessive HC03 loads

A

NaHCO3 administration
Lactate, acetate, citrate administration
Alkali administration to patients with renal failure
Abrupt correction of chronic hypercapnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

respiratory alkalosis

A

Hyperventilation-Increase in minute ventilation to level greater than that required to excrete the metabolic production of CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

respiratory acidosis

A

Hypoventilation-Occurs when minute ventilation is insufficient to eliminate CO2 production without an increased capillary-alveolar CO2 gradient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

metabolic acidosis is normally accompanied by compensatory

A

hyperventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

in metabolic acidosis the significant reduction of PH

A

increased PVR
reduced myocardial contractility
decreased SVR
impaired response to CV system to endogenous or exogenous catecholamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what compensatory mechanism is immediate

A

buffer system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

the buffer system is followed by

A

respiratory

renal system- renal is slow and more effective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when the patient is acidosis- what happens to opioids, sedatives and anesthetic agents

A

sedatives and anesthetic agents on the CNS are potentiated

nonionized form of opioids increases and more penetrates the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what neuromuscular blocker do we avoid in the acidotic patient

A

succinylcholine in the acidotic patient with hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

respiratory or metabolic acidosis augments nondepolarizing NMB agents?

A

respiratory acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the circulatory depressant effects of volatile and IV anesthetics for the acidotic patient

A

exaggerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what acid-base imbalance prolongs the duration of opioid induced respiratory depression

A

respiratory alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what electrolyte abnormality may precipitate severe arrhythmias in alkalemia

A

hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

especially during hypotension cerebral ischemia can occur from marked reduction in cerebral blood flow- what acid base imbalance is this

A

alkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

normal clearance maintains serum concentrations of lactate at

A

0.5-1mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

where is most lactate cleared

A

by the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

in the liver what three things does lactate undergo

A

oxidation
gluconeogenesis
eventual conversion to bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

lactate undergoes both passive diffusion and active transport into the liver via

A

monocarboxylate transporter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

active transport becomes saturated as serum lactate concentrations >

A

2.5mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

severe reduction in hepatic blood flow will do what to hepatic lactate clearance

A

decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

lactate acid is a strong acid and therefore dissociates almost completely under physiologic conditions into the

A

lactate anion

and

hydrogen ion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
when does lactate accumulation occur
mainly during anaerobic glycolysis generated under normoxic conditions
26
in the critically ill patient lactate production may increase while lactate clearance is impaired- meaning...
lactic acidosis may occur
27
a serum lactate ___ upon admission is an independent predictor of mortality in critically ill patients
>1.5mmol/L
28
failure to decrease lactate concentration to less than or equal to ___24 hours after admission is also associated with significant mortality
1.0mmol/L
29
this investigational drug decreases concentration of lactate
dichloroacetate (DCA)
30
dichloroacetate decreases concentration of lactate in what 4 situations
malaria DKA burns cardiogenic shock
31
DCA activates
activates the mitochondrial pyruvate dehydrogenase complex, thus accelerating the irreversible oxidation of lactate via pyruvate to acetyl CoA which then enters the Krebs cycle
32
The buffer:
tris (hydroxymethyl) aminomethane or THAM can be used to treat metabolic acidosis and does not generate carbon dioxide
33
Lactic Acidosis
It may be useful as an alternative to sodium bicarbonate to treat metabolic acidosis in pts who are hypernatremic
34
When cause of metabolic acidosis is unclear measure:
Serum lactate BUN, Creatinine Glucose
35
If this does not identify the etiology then: | Send serum for toxicology to measure:
Salicylates Methanol Ethylene glycol
36
large volume infusion of isotonic saline may result in
hyperchoremic metabolic acidosis
37
Dilutional acidosis also occurs when the plasma pH is decreased by extracellular volume expansion with chloride-containing solution such as NS
Dilutional acidosis also occurs when the plasma pH is decreased by extracellular volume expansion with chloride-containing solution such as NS
38
ph of water at 37 degrees celsius is 6.8- what does this mean
any increase in the free water volume of the body will contribute to acidosis.
39
normal saline is commonly thought of as physiologic. why
because it has an osmolarity close to that of plasma and does not lyse RBC
40
what is the PH of normal saline? as it contains more chloride and slightly more sodium
5.7
41
infusion of a large volume of NS will increase ___
plasma chloride concentrations to a relatively greater degree than sodium concentrations
42
chloride is a
strong acid (proton donor)
43
sodium is a
strong base (hydroxyl donor)
44
BE is a calculation (not measured) from an algorithm baed on measured
bicarb and PH
45
does base excess distinguish among the possible causes of metabolic acidosis
no
46
anion gap normal
6-10 mEq/L
47
acute respiratory acidosis or alkalosis what happens to BE
it does not change.
48
respiratory acidosis in the presence of metabolic acidosis the BE is
<0
49
if underlying issues was metabolic alkalosis BE=
BE>0
50
mixed respiratory and metabolic acidosis is a common clinical problem - how do we guide treatment
BE can be a guide to treatment
51
does base excess distinguish among the possible causes of metabolic acidosis
no
52
major extracellular anions (-)
chloride and bicarbonate
53
the major extracellular cation is
sodium
54
is potassium measured in its anion gap
calculation varies from institution
55
k -ca- mg is grouped into
unmeasured cations
56
anion gap refers solely to the differences in concentrations between
anions and cations
57
electroneutrality occurs when
the concentrations of the combined unmeasured anions exceed that of the unmeasured cations by the same amount
58
Anion Gap
“Anion Gap” refers solely to the differences in concentration between the traditionally measured anions and cations.
59
Strong Ion Gap (SIG): | strong cations
compares excess measured serum concentrations of strong cations (NA+, K+, Mg++, Ca++)
60
Strong Ion Gap (SIG): strong anions
(Cl-, HCO3-, albumin, phosphate).
61
what can strong ion gap do
differentiate between dilution acidosis to acidosis due to tissue hypo perfusion
62
normal anion gap metabolic acidosis
diarrhea pancreatic fistula renal tubular acidosis intoxication ammonium chloride, acetazolamide, toluene. hyperchoremic acidosis (excess saline administration)
63
increased anion gap
lactic acidosis ketoacidosis chronic renal failure accumulation of sulfates, phosphates, urea. intoxication organic acids (salicylate, ethanol, methanol, formaldehyde, ethylene glycol, paraldehyde) INH, sulfates, metofrmin massive rhabdomyolysis
64
metabolic alkalosis is commonly
iatrogenic
65
causes of metabolic alkalosis
``` vomiting with excess hydrochloride acid ng suction chronic administration of diuretics hypoalbuminemia excess secretion of aldosterone ```
66
a loss of free water (PH 6.8) will cause a
volume contraction alkalosis
67
treatment of metabolic alkalosis
treat underlying cause
68
hospital cause of metabolic alkalosis
excess administration of sodium bicarbonate
69
when is respiratory acidosis compensated- how does respiratory compensation occurs
within 6-12 hours increased secretion of hydrogen ions with a resulting increase in the plasma bicarbonate concentration.
70
correction of chronic respiratory acidosis is
iatrogenic hyperventilation. | acute metabolic alkalosis. because increased plasma bicarbonate is not promptly eliminated by the kidneys
71
compensation of respiratory alkalosis
decreased reabsorption of bicarbonate ion from renal tubules.
72
compensation for metabolic acidosis
stimulates alveolar ventilation, which causes rapid removal of carbon dioxide
73
the respiratory compensation for metabolic acidosis is only partial - what does the PH do
Ph remains somewhat below normal
74
metabolic alkalosis compensation
diminishes alveolar ventilation
75
metabolic alkalosis and metabolic acidosis- the respiratory compensation is only ever
partial
76
during cardiopulmonary bypass- what happens to c02 and ph
ph will increase to 7.6 and c02 becomes more soluble.
77
in PH stat we give c02 via
the oxygenator
78
who do we give co2 in PH stat
in pediatric cardiac surgeries
79
what is a negative outcomes oh PH state
microemboli
80
what is the Main goal of PH stat
to provide co2 for cerebral vasodilation to combat the leftward shift of the oxyhemoglobin during hypocarbia and hypothermia and alkalosis. so the addition of the PH stat strategy will help the oxygen unload the hemoglobin
81
who do we use alpha stat on
adult cardiopulmonary bypass
82
does alpha stat have microemboli
no because supplemental carbon dioxide is not administered
83
does alpha stat have temperature correction
no
84
what is the alpha stat strategy
seek to optimize enzyme function during hypothermia.
85
the objective of alpha stat is to
maintain biologic neutrality by preserving the alpha imidazole and protein charge state OH/H ratio.

Fall'20 Pharmacology III (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions