Nagelhout Pharm 1, Test 2 Exam
Questions with Answers
ventilation effect - -the greater the alveolar ventilation, the faster the
patient achieves anesthesia
- blood/gas solubility coefficient - -indicator of speed. The higher the
number, the SLOWER the anesthetic.
- concentration effect - -the higher the concentration, the faster the onset
- oil/gas solubility - -potency. the higher the number, the MORE potent
- second gas effect - -high conc of fast (nitrous) and a slower gas. The
slower gas achieves anesthetic levels more quickly than if given alone
- diffusion hypoxia - -seen when high level of nitrous given. at end of case,
diffuse into lungs and dilute 02 concentrations
- cardiac output effect - -increase in CO DECREASES speed of onset
- ventilation-perfusion abnormalities - -REDUCE the speed of onset
- Peds - -achieve anesthesia more quickly due to an increased RR
- Obesity - -slower emergence
- which gas is a halogenated hydrocarbon - -halothane
- which gas is the only inorganic molecule (without carbon) - -nitrous oxide
- all gases except nitrous oxide are: - -halogenated ethers
- what is a GABA receptor - -transmembrane receptor, permeable to Cl-,
anesthestics can either activate/gate GABA or modulate GABA to potentiate
GABA response. A separate site in GABA appears to interact with volatile
anesthetics, alcohol and etomidate.
- CNS and ANS effects of anesthesia - -depression of both to provide LOC
Decreased 02 consumption (CMRO2)
Decreased intraocular pressure
Increased ICP resulting from cerebrovasodilation (can be counteracted by
modest hyperventilation, pco2 30-35, based on the concept that CPP=MAP-
ICP)
, - CVS-Mechanism for decreased BP
(all except nitrous oxide) - -1. CNS depression
2. direct cardiac depression
3. decreased systemic vascular resistance
4. baro-receptor depression
5. hormonal changes, decreased renin or vasopressin
- which gas sensitizes the myocardium to the effect of catecholamines? - -
halothane
- Rules for epi administration - -no stronger than 1:100,000 (which contains
0.01mg/ml)
no more than 10ml in any 10 minute period (=0.1mg)
or 30ml per hour total (0.3mg)
- epi concentrations - -1:1000-1mg/ml
1:10000- 0.1mg/ml
1:100,000-0.01mg/ml
1:200,000- 0.005mg/ml
- strongest epi concentration a surgeon can use? - -1:100,000
- all anesthetic gases bronchodilate except - -nitrous oxide
- all anesthetics cause dose dependent ____________ except nitrous oxide - -
respiratory depression
- which two gases are respiratory irritants and may cause coughing during
induction and emergence? - -des and iso
- what effect do anesthetics have on tidal volume? and what class of
medications have an opposite effect? - -depress tidal volume before RR
opiates
- anesthetics produce hypoxic pulmonary vasoconstriction in a - -dose
dependent manner
- which gases trigger MH? - -ALL except for nitrous
- which gas has is the highest trigger for MH? - -halothane
- which gas is contraindicated in pregnancy? - -nitrous oxide
- what effect do all gases have in the pregnant woman? - -relax the uterus
Questions with Answers
ventilation effect - -the greater the alveolar ventilation, the faster the
patient achieves anesthesia
- blood/gas solubility coefficient - -indicator of speed. The higher the
number, the SLOWER the anesthetic.
- concentration effect - -the higher the concentration, the faster the onset
- oil/gas solubility - -potency. the higher the number, the MORE potent
- second gas effect - -high conc of fast (nitrous) and a slower gas. The
slower gas achieves anesthetic levels more quickly than if given alone
- diffusion hypoxia - -seen when high level of nitrous given. at end of case,
diffuse into lungs and dilute 02 concentrations
- cardiac output effect - -increase in CO DECREASES speed of onset
- ventilation-perfusion abnormalities - -REDUCE the speed of onset
- Peds - -achieve anesthesia more quickly due to an increased RR
- Obesity - -slower emergence
- which gas is a halogenated hydrocarbon - -halothane
- which gas is the only inorganic molecule (without carbon) - -nitrous oxide
- all gases except nitrous oxide are: - -halogenated ethers
- what is a GABA receptor - -transmembrane receptor, permeable to Cl-,
anesthestics can either activate/gate GABA or modulate GABA to potentiate
GABA response. A separate site in GABA appears to interact with volatile
anesthetics, alcohol and etomidate.
- CNS and ANS effects of anesthesia - -depression of both to provide LOC
Decreased 02 consumption (CMRO2)
Decreased intraocular pressure
Increased ICP resulting from cerebrovasodilation (can be counteracted by
modest hyperventilation, pco2 30-35, based on the concept that CPP=MAP-
ICP)
, - CVS-Mechanism for decreased BP
(all except nitrous oxide) - -1. CNS depression
2. direct cardiac depression
3. decreased systemic vascular resistance
4. baro-receptor depression
5. hormonal changes, decreased renin or vasopressin
- which gas sensitizes the myocardium to the effect of catecholamines? - -
halothane
- Rules for epi administration - -no stronger than 1:100,000 (which contains
0.01mg/ml)
no more than 10ml in any 10 minute period (=0.1mg)
or 30ml per hour total (0.3mg)
- epi concentrations - -1:1000-1mg/ml
1:10000- 0.1mg/ml
1:100,000-0.01mg/ml
1:200,000- 0.005mg/ml
- strongest epi concentration a surgeon can use? - -1:100,000
- all anesthetic gases bronchodilate except - -nitrous oxide
- all anesthetics cause dose dependent ____________ except nitrous oxide - -
respiratory depression
- which two gases are respiratory irritants and may cause coughing during
induction and emergence? - -des and iso
- what effect do anesthetics have on tidal volume? and what class of
medications have an opposite effect? - -depress tidal volume before RR
opiates
- anesthetics produce hypoxic pulmonary vasoconstriction in a - -dose
dependent manner
- which gases trigger MH? - -ALL except for nitrous
- which gas has is the highest trigger for MH? - -halothane
- which gas is contraindicated in pregnancy? - -nitrous oxide
- what effect do all gases have in the pregnant woman? - -relax the uterus
