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Anesthesia
PBT test #1
123
Other
Graduate
06/13/2009

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Term
System International Units:
Definition

Meter(m)..........length

Kilogram (kg)...............mass

Second (s)............time

Ampere(A).............electric current

Kelvin (K).............temperature

Candela (cd)...............luminous intensity

Mole (mol).................amount substance

Term
Standard Temperature and Pressure =
Definition

Temp= 273 degrees Kelvin=0 deg Celsius

 

Pressure= 100 kPa=1 atm= 760 mmHg

Term

True or False:

 

Substances with similar electron configurations have better solubility.

Definition

True!

 

Like dissolves Like

Term

Energy that is needed to break bonds so that a substance can dissolve

 

Definition

 

 

Endothermic Energy

Term
Energy that is released in excess of energy required to break the bonds of a solute:
Definition
Exothermic Energy
Term

True or False:

 

Pressure has major influence on solubility of solids and liquids.

Definition
FALSE.....pressure has LITTLE influence on solubility of solids and liquids, but does have an effect on gasses.
Term
What law states: at a constant temperature, the amount of gas dissoved in a liquid is directly proportional to the partial pressure of that gas at equilibrium above the gas-liquid interface?
Definition

 

Henry's Law

Term

This statement pertains to which law?

Increasing the PP of a gas above a liquid will increase the amt of gas that dissolves in the liquid?

Definition

Henry's law
Term
Increasing FiO2 improves arterial O2 (Pa02)? is an example of which law?
Definition
Henry's Law
Term
This law permits calculation of dissolved O2 and CO2 in Arterial blood?
Definition
Henry's Law
Term
Multiply the PP of O2 by what constant to calculate amount dissolved in arterial blood?
Definition
0.003
Term
Multiply PP of CO2 by what constant to calculate amt. of CO2 in arterial blood?
Definition
0.067
Term

True or False:

 

Temperature is inversely proportional to kinetic energy.

Definition

False!

 

Temp is DIRECTLY proportional to kinetic energy

Term

What law states:

 

Rate of diffusion is inversely proportional to the square root of its molecular weight?

Definition

 

Graham's Law

Term
Diffusion occures through an open space or permeable membrane depending on what 5 things?
Definition

1. gradient

2. tissue area

3. fluid tissue solubility

4. membrane thickness

5. MW

Term
Law explaining diffusion hypoxia
Definition
Ficks Law
Term
Kinetic Molecular Theory
Definition
*Molecules have no volume
*Molecules exert no volume unless colliding
*Collisions of molecules do not increase energy of system
*Molecules are in constant random motion
*Temp of a gas depends entirely on its average kinetic energy
Term
Studies relationship of volume and temp when pressure is constant
Definition
Charles Law
Term
Studies relationship of pressure and volume when temp constant
Definition
Boyles Law
Term
studies relationship of pressure and temp when volume is constant
Definition
Gay-Lussac's Law
Term
Universal Gas Law
Definition
PV=nrt
p=pressure
v=volume
n=#moles
r=constant (0.0821 liter-atm/K/mole
T=Temp
Term
What law explains as gas is released from a cylinder, pressure inside decreases (cylinder has a constant volume)
Definition
Ideal Gas Law
Term
Avagadro's Number
Definition
A mole of any gas has exactly:
6.023 x 10^23 molecules
Term
According to Avagadro's Hypothesis, 1 mole of a gas at STP occupies a volume of:
Definition
22.4 liters
Term
Total pressure of a system is the additive pressures of each individual gas in the system represents which law?
Definition
Dalton's Law of PP
Term
T/F: A single specific anesthetic receptor has been identified.
Definition
FALSE- no single specific anesthetic receptor has been identified.
Term
Components of an anesthetic
Definition
amnesia, analgesia, anesthesia, muscle relaxation
Term
Factors influencing absorption of VA's
Definition
#1- ventilation
uptake into blood, cardiac output, solubility of anesthetic in blood, alveolar to VENOUS PP difference, concentration, 2nd gas effect
Term
T/F: Level of anesthesia is related to alveolar concentration of anesthetic agent which can be easily and continuously measured.
Definition
TRUE
Term
Determinant of speed of uptake and elimination
Definition
B:G
Term
T/F: The more soluble the drug, the slower the brain and spinal cord uptake
Definition
True
Term
T/F: low B:G coefficient= slow onset of anesthesia
Definition
FALSE: High B:G coefficient= slow onset
Term
Which agent exhibits fastest rate of rise in the lungs?
Definition
N2O- note: N2O exhibits slightly faster rate of rise compared with Des even though N2O has a higher B:G coefficient
Term
T/F: Anesthetic uptake speeds up throughout the surgery
Definition
FALSE: anesthetic uptake slows throughout the surgery
Term
T/F The faster and more deeply a pt. breathes or is mechanically ventiated, the faster the induction of anesthesia.
Definition
TRUE
Term
T/F: Overpressurizing is less effective the more soluble the agent is.
Definition
False: overpressurizing is more effective the MORE soluble an agent is.
Term
When do you stop overpressurizing and decrease your agent to a normal maint. level?
Definition
After the first few mins, as determined by CRNA.
Term
Induction % of SEVO
Definition
4-8%
Term
Maintenance rate of SEVO
Definition
1-4
Term
Induction rate of DES
Definition
3-9
Term
Maintenance rate of DES
Definition
2-6
Term
Induction rate of ISO
Definition
1-4
Term
Maintenance rate of ISO
Definition
0.5-2
Term
Induction rate of N20
Definition
50-70
Term
Maintenance rate of N2O
Definition
50-70
Term
T/F Use N2O with high solubility agents speeds them up.
Definition
TRUE
Term
Indicator of potency
Definition
O:G solubility
Term
A high O:G indicates
Definition
A highly potent drug that is highly lipid soluble
Term
Which agent has the highest O:G and is the most potent
Definition
ISO
Term
Least potent agent
Definition
N2O
Term
T/F: during induction, decreases in C.O. slow onset
Definition
FALSE- during induction, INCREASES in C.O slow onset
Term
Agent assoc. with hepatotoxicity
Definition
Halothane
Term
BEST VA for dialysis pt. and what makes them good?
Definition
#1 DES
#2 ISO
These drugs are minimally metabolized
Term
Nitrogen is ______ X less/more soluble than N20
Definition
34X LESS soluble than N2O
Term
1st person to use ether
Definition
Crawford Long
Term
In 1846 ______ further used ether
Definition
Morton
Term
How were the properties of ether improved?
Definition
Add halogen atoms
Term
All inhalation agents are either _____ or ______
Definition
Ethers or aliphatic hydrocarbons with 4 or less carbons
Term
The addition of halogenated agents influences what aspects of the drug?
Definition
Potency, arrythmogenicity, flammability, and stability
Term
Adding what to a drug decreases metabolism and flammability?
Definition
Fluorine atoms
Term
How are all VA's except Halothane metabolized?
Definition
Hepatic metabolism through phase I oxidation
Term
What drug does to body
Definition
Pharmacodynamics
Term
Unitary Hypothesis
Definition
All inhalational agents work by a similar mechanism (not necessarily the same site of action)
Term
Meyer Overeton rule states:
Definition
More lipid solubility, greater potency.
(Remember Mo the OG?)
Term
The Meyer-Overton rule suggests that anesthesia is produced by the ________ of an anesthetic, not the specific type.
Definition
Volume
Term
Hypothermia's effects on MAC
Definition
Decreases MAC
Term
Acute ETOH does what to MAC
Definition
decreases
Term
Chronic ETOH does what to MAC
Definition
Increases
Term
Pregnancy does what to MAC?
Definition
Decreases
Term
Alkalosis does what to MAC
Definition
No change
Term
Chronic HTN does what to MAC?
Definition
No change
Term
Valine is on an MAOI, how would you expect her MAC to be altered?
Definition
Increased
Term
Mr. Dangle is undergoing a 12 hr. procedure, his MAC would be
Definition
Not changed
Term
Stages of Anesthesia: Stage 1
Definition
Analgesia- mild cortical center depression, loss of pain sensation, skeletal mvmt intact, eyes midline
Term
Stage 2 of anesthesia
Definition
Excitement AKA "Delerium"- central depression of motor centers leaving involuntary system dominant, urinary incont., tachycardia, HTN, tachypnea, eyes divergent
Term
Stage 3 anesthesia
Definition
Surgical Anesthesia:
Plane 1: loss of spinal reflexes
Plane 2: decreased muscle reflexes
Plane 3: paralysis of intercostals
Plane 4: Loss of muscle tone
Term
Stage 4 of anesthesia
Definition
Respiratory Paralysis-postmortem:
toxic overdose with severe CV/RR depression
Term
In a dose dependent manner, VA's ______ CMRO2
Definition
Decrease
Term
N2O+ volitile agent does what to CMRO2 and CBF
Definition
Increases both
Term
Uncoupling definition and which 2 drugs are responsible for it.
Definition
Decreased CMRO2 with Increased CBF
Halothane and ISO
Term
N2O does what to SNS?
Definition
activates it and increases SVR
Term
Which agent causes least drop in SVR?
Definition
SEVO
Term
Which agent increases HR most?
Definition
DES
Term
HR changes are relative to agents ______?
Definition
Concentration
Term
Which agents may cause coronary steal?
Definition
ISO and DES
Term
How do you prevent coronary steal?
Definition
Keep BP within 20% of norm
Term
This agent is the least vasodilatory
Definition
SEVO
Term
T/F All agents can produce disturbances in AV conduction or produce re-entrant rhythms in heart.
Definition
TRUE
Term
List the non-pungent agents
Definition
Halothane, SEVO, N2O
Term
What agent may produce Compound A?
Definition
SEVO
Term
T/F: Compound A is hepatotoxic.
Definition
FALSE: renal toxic
Term
T/F: All agents increase total hepatic flow.
Definition
FALSE- all agents DECREASE total hepatic flow
Term
Which agents maintain or increase hepatic artery flow?
Definition
ISO, SEVO, DES
Term
Pair of molecules that are mirror images but cannot be superimposed.
Definition
Enantiomers
Term
All anesthetics except _____ are chiral.
Definition
SEVO
Term
Expected result produced by very low dose
Definition
Hyperreactive
Term
Allergy or sensitivity to drug
Definition
Hypersensitive
Term
Result achieved only by extremely large dose
Definition
Hyporeactive
Term
Hypoactivity acquired through chronic exposure to drug.
Definition
Tolerance
Term
Acute tolerance acquired with a few doses of drug
Definition
Tachyphylaxis
Term
Neuronal adaptation that is integral in developing tolerance
Definition
Cellular tolerance
Term
2 basic parameters of PK
Definition
Clearance and Vd
Term
Vd equation
Definition
Vd= Amt of drug in body/concent. plasma
Term
Clearance equation
Definition
CL= rate of elim/concentration
Term
Rate of Elimination=
Definition
Rate of elim.= CL X C
Term
Type of elimination depending on the concentration of drug that is achieved
Definition
Capacity-limited elimination
Term
What drugs are eliminated by capacity-limited elim.?
Definition
ASA, phenytoin, Ethanol
Term
Type of elimination determined by blood flow to organ responsible for elimination
Definition
Flow-dependent elimination
Term
T 1/2 Alpha
Definition
Distribution 1/2 Life- time it takes for drug concentration in plasma top decline by 50% during distribution.
Term
T 1/2 Beta
Definition
Elimination 1/2 L. Time for pasma concentration to decline by 50% in terminal beta phase.
Term
T/F: The lungs, heart, brain, liver, and kidneys are part of peripheral compartment.
Definition
FALSE- central compartment
Term
Ratio b/w Lethal dose 50 and Effective dose 50
Definition
Therapeutic Index
Term
T/F- a high therapeutic index means a drug is safe (you must give a really high dose to be toxic)
Definition
True
Term
T/F: In first order kinetics, the rate of drug metabolism is directly proportional to concentration of free drug.
Definition
True
Term
Constant fraction of drug metabolized over time
Definition
First order kinetics
Term
A constant amount of drug is metabolized per unit time
Definition
Zero order kinetics
Term
ASA, thanol, Phenytoin are metabolized how?
Definition
Zero-order kinetics
Term
Changes in functional groups possibly yielding an active metabolite
Definition
Phase 1 metabolism
Term
Involves conjugation reactions resulting in larger, more polar, inactive molecules.
Definition
Phase II Metabolism
Term
Extraction Ratio
Definition
ER= CL liver/Q

CL liver= rate of elimination in relation to drug concentration
Q= hepatic blood flow (artery and vein)
Term
Tubular secretion is active, passive, or both
Definition
Active
Term
Tubular reabsorption is active, passive, or both
Definition
Both
Term
Glomerular filtration is active, passive, or both
Definition
Passive
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