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System International Units: |
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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 |
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Standard Temperature and Pressure = |
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Definition
Temp= 273 degrees Kelvin=0 deg Celsius
Pressure= 100 kPa=1 atm= 760 mmHg |
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True or False:
Substances with similar electron configurations have better solubility. |
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Definition
True!
Like dissolves Like |
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Energy that is needed to break bonds so that a substance can dissolve
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Energy that is released in excess of energy required to break the bonds of a solute: |
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True or False:
Pressure has major influence on solubility of solids and liquids. |
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FALSE.....pressure has LITTLE influence on solubility of solids and liquids, but does have an effect on gasses. |
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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? |
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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? |
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Increasing FiO2 improves arterial O2 (Pa02)? is an example of which law? |
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This law permits calculation of dissolved O2 and CO2 in Arterial blood? |
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Multiply the PP of O2 by what constant to calculate amount dissolved in arterial blood? |
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Multiply PP of CO2 by what constant to calculate amt. of CO2 in arterial blood? |
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True or False:
Temperature is inversely proportional to kinetic energy. |
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Definition
False!
Temp is DIRECTLY proportional to kinetic energy |
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What law states:
Rate of diffusion is inversely proportional to the square root of its molecular weight? |
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Diffusion occures through an open space or permeable membrane depending on what 5 things? |
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Definition
1. gradient
2. tissue area
3. fluid tissue solubility
4. membrane thickness
5. MW |
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Law explaining diffusion hypoxia |
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*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 |
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Studies relationship of volume and temp when pressure is constant |
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Studies relationship of pressure and volume when temp constant |
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studies relationship of pressure and temp when volume is constant |
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PV=nrt p=pressure v=volume n=#moles r=constant (0.0821 liter-atm/K/mole T=Temp |
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What law explains as gas is released from a cylinder, pressure inside decreases (cylinder has a constant volume) |
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A mole of any gas has exactly: 6.023 x 10^23 molecules |
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According to Avagadro's Hypothesis, 1 mole of a gas at STP occupies a volume of: |
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Total pressure of a system is the additive pressures of each individual gas in the system represents which law? |
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T/F: A single specific anesthetic receptor has been identified. |
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Definition
FALSE- no single specific anesthetic receptor has been identified. |
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Components of an anesthetic |
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Definition
amnesia, analgesia, anesthesia, muscle relaxation |
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Factors influencing absorption of VA's |
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Definition
#1- ventilation uptake into blood, cardiac output, solubility of anesthetic in blood, alveolar to VENOUS PP difference, concentration, 2nd gas effect |
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T/F: Level of anesthesia is related to alveolar concentration of anesthetic agent which can be easily and continuously measured. |
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Determinant of speed of uptake and elimination |
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T/F: The more soluble the drug, the slower the brain and spinal cord uptake |
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T/F: low B:G coefficient= slow onset of anesthesia |
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FALSE: High B:G coefficient= slow onset |
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Which agent exhibits fastest rate of rise in the lungs? |
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Definition
N2O- note: N2O exhibits slightly faster rate of rise compared with Des even though N2O has a higher B:G coefficient |
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T/F: Anesthetic uptake speeds up throughout the surgery |
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Definition
FALSE: anesthetic uptake slows throughout the surgery |
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T/F The faster and more deeply a pt. breathes or is mechanically ventiated, the faster the induction of anesthesia. |
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T/F: Overpressurizing is less effective the more soluble the agent is. |
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Definition
False: overpressurizing is more effective the MORE soluble an agent is. |
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When do you stop overpressurizing and decrease your agent to a normal maint. level? |
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After the first few mins, as determined by CRNA. |
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T/F Use N2O with high solubility agents speeds them up. |
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A highly potent drug that is highly lipid soluble |
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Which agent has the highest O:G and is the most potent |
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T/F: during induction, decreases in C.O. slow onset |
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FALSE- during induction, INCREASES in C.O slow onset |
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Agent assoc. with hepatotoxicity |
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BEST VA for dialysis pt. and what makes them good? |
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Definition
#1 DES #2 ISO These drugs are minimally metabolized |
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Nitrogen is ______ X less/more soluble than N20 |
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Definition
34X LESS soluble than N2O |
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In 1846 ______ further used ether |
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How were the properties of ether improved? |
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All inhalation agents are either _____ or ______ |
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Ethers or aliphatic hydrocarbons with 4 or less carbons |
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The addition of halogenated agents influences what aspects of the drug? |
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Potency, arrythmogenicity, flammability, and stability |
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Adding what to a drug decreases metabolism and flammability? |
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How are all VA's except Halothane metabolized? |
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Hepatic metabolism through phase I oxidation |
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All inhalational agents work by a similar mechanism (not necessarily the same site of action) |
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Meyer Overeton rule states: |
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More lipid solubility, greater potency. (Remember Mo the OG?) |
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The Meyer-Overton rule suggests that anesthesia is produced by the ________ of an anesthetic, not the specific type. |
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Hypothermia's effects on MAC |
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Acute ETOH does what to MAC |
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Chronic ETOH does what to MAC |
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Pregnancy does what to MAC? |
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Alkalosis does what to MAC |
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Chronic HTN does what to MAC? |
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Valine is on an MAOI, how would you expect her MAC to be altered? |
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Mr. Dangle is undergoing a 12 hr. procedure, his MAC would be |
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Stages of Anesthesia: Stage 1 |
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Definition
Analgesia- mild cortical center depression, loss of pain sensation, skeletal mvmt intact, eyes midline |
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Excitement AKA "Delerium"- central depression of motor centers leaving involuntary system dominant, urinary incont., tachycardia, HTN, tachypnea, eyes divergent |
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Surgical Anesthesia: Plane 1: loss of spinal reflexes Plane 2: decreased muscle reflexes Plane 3: paralysis of intercostals Plane 4: Loss of muscle tone |
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Definition
Respiratory Paralysis-postmortem: toxic overdose with severe CV/RR depression |
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In a dose dependent manner, VA's ______ CMRO2 |
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N2O+ volitile agent does what to CMRO2 and CBF |
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Uncoupling definition and which 2 drugs are responsible for it. |
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Decreased CMRO2 with Increased CBF Halothane and ISO |
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Definition
activates it and increases SVR |
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Which agent causes least drop in SVR? |
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Which agent increases HR most? |
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HR changes are relative to agents ______? |
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Which agents may cause coronary steal? |
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How do you prevent coronary steal? |
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Definition
Keep BP within 20% of norm |
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This agent is the least vasodilatory |
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T/F All agents can produce disturbances in AV conduction or produce re-entrant rhythms in heart. |
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List the non-pungent agents |
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What agent may produce Compound A? |
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T/F: Compound A is hepatotoxic. |
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T/F: All agents increase total hepatic flow. |
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FALSE- all agents DECREASE total hepatic flow |
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Which agents maintain or increase hepatic artery flow? |
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Definition
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Pair of molecules that are mirror images but cannot be superimposed. |
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All anesthetics except _____ are chiral. |
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Expected result produced by very low dose |
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Allergy or sensitivity to drug |
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Result achieved only by extremely large dose |
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Hypoactivity acquired through chronic exposure to drug. |
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Acute tolerance acquired with a few doses of drug |
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Neuronal adaptation that is integral in developing tolerance |
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Vd= Amt of drug in body/concent. plasma |
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CL= rate of elim/concentration |
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Type of elimination depending on the concentration of drug that is achieved |
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Capacity-limited elimination |
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What drugs are eliminated by capacity-limited elim.? |
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Type of elimination determined by blood flow to organ responsible for elimination |
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Flow-dependent elimination |
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Distribution 1/2 Life- time it takes for drug concentration in plasma top decline by 50% during distribution. |
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Elimination 1/2 L. Time for pasma concentration to decline by 50% in terminal beta phase. |
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T/F: The lungs, heart, brain, liver, and kidneys are part of peripheral compartment. |
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Definition
FALSE- central compartment |
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Ratio b/w Lethal dose 50 and Effective dose 50 |
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T/F- a high therapeutic index means a drug is safe (you must give a really high dose to be toxic) |
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T/F: In first order kinetics, the rate of drug metabolism is directly proportional to concentration of free drug. |
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Constant fraction of drug metabolized over time |
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A constant amount of drug is metabolized per unit time |
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Definition
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ASA, thanol, Phenytoin are metabolized how? |
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Definition
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Changes in functional groups possibly yielding an active metabolite |
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Definition
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Involves conjugation reactions resulting in larger, more polar, inactive molecules. |
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ER= CL liver/Q
CL liver= rate of elimination in relation to drug concentration Q= hepatic blood flow (artery and vein) |
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Tubular secretion is active, passive, or both |
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Tubular reabsorption is active, passive, or both |
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Glomerular filtration is active, passive, or both |
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