Uptake/Distribution of INH agents

Question 1

Uptake of the volatile anesthetic into the blood is determined by what 3 things?

Answer 1

Solubility of the agent
CO
A-v pressure differences

Question 2

________ determines how the anesthetic will partition itself b/t the blood and air phases when equilibrium is reached.

Answer 2

Solubility

Question 3

Solubility looks at the equilibrium state of equal __________________

Answer 3

partial pressures

Question 4

Solubility is expressed in terms of ___________ ___________

Answer 4

partition coefficients

Question 5

What is the B:G coefficient for Desflurane?

Answer 5

.42

Question 6

What is the B:G coefficient for N2O

Answer 6

.47

Question 7

What is the B:G coefficient for Sevo?

Answer 7

.69

Question 8

What is the B:G coefficient for Isoflurane?

Answer 8

1.4 (intermediate)

Question 9

What is the B:G coefficient for Enflurane?

Answer 9

1.8

Question 10

What is the B:G coefficient for Halothane?

Answer 10

2.4 (most soluble)

Question 11

Solubility will determine the ______________

Answer 11

alveolar concentration

Question 12

A lower HCT will make the gas _______ soluble which will mean a ______ induction

Answer 12

less soluble

faster

Question 13

The steeper the FA/FI slope, the __________ the onset of the agent.

Answer 13

faster

Question 14

T/F: PA = Pa = Pbr

Answer 14

true! this is how we use PA to estimate the depth of anesthesia and MAC

Question 15

The PA (pressure in alveoli) of volatile anesthetic is determined by what 4 things:

Answer 15

PI (inhaled partial pressure)
alveolar ventilation
breathing circuit
FRC

Question 16

Changes in alveolar concentration are more rapid with a _____ rate and _____ tidal volumes

Answer 16

fast
small
IE) hyperventilate for a more rapid change

Question 17

The ________ soluble agents have fastest rate of the alveolar gas matching the inspired concentration over time

Answer 17

least

Question 18

The First knee of the FA/ FI ratio is the uptake by the ____________________ and the 2nd knee represents uptake by the ________________

Answer 18

VRG

MG

Question 19

The higher the solubility, the ________ the increase in alveolar concentration rise toward inspired concentration.

Answer 19

slower.

Question 20

The use of high delivered concentrations is called “________________”. We use this with soluble agents to get a ________ induction.

Answer 20

overpressure

faster – like with Halothane

Question 21

The Lower the B/G solubility coefficient, the _________ time emergence will take

Answer 21

shorter

Question 22

If you increase the CO the FA/FI curve will

Answer 22

decrease

Question 23

The a-v difference reflects uptake of anesthetic by the _________

Answer 23

tissues

Question 24

For lean tissue (brain).. tissue/ blood partition coefficients are __________

Answer 24

between 1-2

Question 25

For Fat, tissue/blood partition coefficients are __________ except for N2O which is _____.

Answer 25

``` very high (27-67) 2.3 ```

Question 26

At the VRG, equilibrium is reached within ___-___ minutes

Answer 26

5-15

Question 27

The VRG makes up ____% of our body mass but ____ % of our CO.

Answer 27

10 | 75

Question 28

Definition of MAC is:

Answer 28

Minimum Alveolar Concentration

Question 29

MAC is the concentration that will......

Answer 29

produce absence of movement in 50% to a noxious stimuli

Question 30

Increasing ventilation will increase the FA/FI curve more for a ___________ soluble agent.

Answer 30

highly

Question 31

In a SPONTANEOUSLY ventilating pt, at % inspired increases, the FA/FI ratio ________

Answer 31

decreases (protective negative feedback mechanism against OD)

Question 32

The higher the FRC, the ___________ the speed of induction

Answer 32

slower

Question 33

The greater the alveolar ventilation/FRC ratio means the ___________ the induction

Answer 33

faster

Question 34

With a V:Q abnormality, you will get a L to R shunt and this causes a ____________ effect that will cause a _______ induction.

Answer 34

dilutional | slower

Question 35

The ________ the solubility of the agent, the more shunting you will see.

Answer 35

lower

Question 36

_____________ happens when a large volume of gas is absorbed and the remaining residual gas in the lung is concentrated as volume decreases

Answer 36

concentration effect

Question 37

The 2nd gas effect happens with the use of what gas?

Answer 37

N2O

Question 38

______ soluble anesthetics washout first

Answer 38

less

Question 39

Which is more soluble? N20 or nitrogen?

Answer 39

N20

Question 40

What is the B/G coefficient of Nitrogen vs N20?

Answer 40

N2O=.47, nitrogen = .014

Question 41

__________ hypoxia is possible with the use of N2o

Answer 41

diffusion