Chemistry and Physics of Anesthesia Exam 2 Flashcards

Terms Definitions
Where is Morphine metabolized?
Liver
Do anesthetics have pharmacologic antagonists?
No
Both barbiturates and benzodiazepines potentiate the binding of GABA to GABA receptors. True or False?
True
What are opioids?
Includes opiates, opiopeptines, synthetic, and semisynthetic drugs
What is blood viscosity determined by?
Hematocrit
Chloral hydrate suppresses REM. True or False?
False
Children are susceptible to halothane hepatitis. True or false
False
How much Morphine is protein-bound when in the body?
30%
What was the first benzodiazepine?
Valium (Diazepam)
What concentration of nitrous oxide maintains anesthesia?
75-80%
Where is Morphine well absorbed?
GI Tract
Methadone is orally more effective than morphine. True or False.
True
What anesthetic dissolves in rubber, stimulates salivation, and suppresses laryngeal reflexes?
Enflurane
What is the density of water?
1g/cm3
What does one atmosphere equal?
760mmHg mercury
What percentage of membrane potential is responsible for negative cell charge?
20%
What was the first pure opioid antagonist?
Naloxone
What is the molecular weight of methadone?
309.45
What is the molecular weight of Meperidine?
247.3
Why was diethyl ether halted in use?
Flammable
Halothane is safe for children. True or false?
True
What is the solubility of nitrous oxide in blood at a temp 37 and partial pressure of 100kPa?
0.47L
What do barbiturates stimulate physiologically?
Hepatic microsomal system
What is the absolute zero of Kelvin?
273.15C
How many granules are released with each action potential?
300
What is the atmospheric percentage of oxygen?
20.9%
What is the potency of codeine?
1/12th of morphine
What are the symptoms of withdrawal?
Lacrimation, violent coughing/sneezing, insomnia, hypertension, tachycardia, depression, vomiting, diarrhea, and dehydration
What are the Morphine-like agonists?
Morphine Sulphate, Hydromorphone, Oxymorphone, and Heroin
What are opiopeptines?
Endogenous peptides meaning they are produced in the body naturally
How much nitrous oxide dissolves in 1 L of blood?
0.47
What is at the foundation of anesthesia?
Overton-Meyer correlation
What is the parent compound of barbiturates?
Barbituric acid
Which system is the most important in blood flow control?
Nervous
What happens when high doses of Fentanyl are given?
Muscular rigidity
Why is Kelvin important?
Kelvin temperature is directly proportional to its kinetic energy. Thus, if Kelvin temperature increases 2x, it will correspond to a doubling of the kinetic energy of gases.
What is pressure?
The force applied to a surface
What are the three CGS units?
Centimeter, gram, second
What is the atmospheric percentage of nitrogen?
78.6 %
What is a synapse?
A space between two neurons
What is the percentage of nitrogen in alveoli?
74.9%
How long does Acetylcholine bind to the post-synaptic receptor?
2 milliseconds
What is the analgesic potency of Fentanyl?
80/1 of morphine
Why is meperidine preferred to morphine during labor?
Shorter duration of action
How much blood is in the heart and arterioles/capillaries?
7%
What happens to methadone in the tissues?
It gradually accumulates
What drug interactions should be avoided in benzodiazepines?
Alcohol, opioids, anesthetics, antidepressants, and MAO inhibitors
What are the long-acting barbiturates, what is their time of action, and what is their classification?
Barbital, phenobarbital, >6hours, hypnotics/sedatives/antiepileptics
What are the parasympathetic effects on the heart?
Acetylcholine increases permeability of fibers to potassium and increases negativity. Decreases HR. No effect on contractility
What is an opiate?
A drug delivered from opium poppy
What is a pneumothorax?
A life-threatening condition in which pressure within the pleural cavity is equivalent to atmospheric pressure
What are the respiratory/digestive side effects of Morphine?
Respiratory depression, chest wall rigidity, bronchoconstriction, decreased peristalsis, stomach motility, and biliary/pancreatic secretion. Also constricts the sphincter of Oddi in pancreas
What factors decrease your MAC?
Anemia, other anesthetics, CNS depressants/sedation, Lithium, Lidocaine, opioids, hypothermia, pregnancy, very young age, and alpha 2 agonists
What are they two types of dynorphins?
A and B
What are the synthetic opioid agonists?
Meperidine, Fentanyl, Methadone, Levophanol
What is an astrocyte?
Supporting cells found in close contact with endothelial wall of the brain capillaries and are part of the blood/brain barrier
What two factors determine conduction velocity?
Axon diameter and myelin
What is the formula for Charles law?
V1T2 = V2T1
What are microglia?
Supporting cells that are similar to the WBC of the periphery
What is the formula for Boyle's law?
P1V1 = P2V2
What are the physiological effects of anesthesia on the respiratory system?
Bronchodilation, increased RR, decreased minute volume, decreased alveolar ventilation, depressed cerebral chemoreceptors, depressed response to hypoxia
What organ is responsible for the elimination of nitrous oxide?
The lungs via respiration
How does one determine cardiac output?
CO = HR x SV
What are the anesthetic properties of opioids?
Analgesia, respiratory depression, constipation, N/V, prolongs awakening, wheezing, hypotension
What is solubility?
The ability for a given solute to dissolve in a solvent. During equilibrium, dissolved gas molecules leave liquid at the same rate as other molecules that are dissolving
What four factors determine the solubility of a gas?
Partial pressure, temperature, gas, liquid
If pO2 decreases and/or pCO2 rises, what happens?
Peripheral chemoreceptors are triggered and ventilation increases to increase pO2 or decrease pCO2
What are the two ways axons are connected to one another?
Convergence and divergence
How many cm of water is equal to 1mmHg?
1.36cm H20
What is temperature?
A measure of the changing of kinetic energy within a molecule
How does botulin work?
It binds to the postsynaptic receptor to block the binding of acetylcholine and leads to the inability of the muscle to contract.
What is a neuron?
A functional unit of the central nervous system. It is an extremely specialized cell with unique qualities. It absolutely depends on uninterrupted supply of glucose and oxygen.
What direction do gases diffuse in?
Higher pressure to lower pressure
What is the percentage of CO2 in the atmosphere? In alveoli?
0.04%, 5.2%
What characterizes saltatory conduction?
Myelinated schwann cells with a change in potential in the nodes of Ranvier
What is depolarization?
The influx of sodium to initiate an action potential
Methoxyflurane is characterized by what two side effects?
Free flouride in the body and nephrotoxicity
What are the 3 categories of general anesthesia?
Inhalation, intravenous, and balanced
What are the anesthetic properties of IV barbituates?
Rapid induction, rapid recovery, respiratory depression, cardiac depression
What are the three factors in blood flow control?
Local, humoral, and nervous
What populations are susceptible to halothane hepatitis?
Middle age, women, preexisting liver disease
If you increase MAC, do you stimulate or depress the CNS?
You stimulate the CNS
What are the clinical uses of Morphine?
Analgesia, pulmonary edema, severe diarrhea, cough suppression, and anesthesia
What are the three major classes of sedative-hypnotics?
Barbiturates, benzodiazepines, and miscellaneous
What two barriers are crossed by barbiturates?
Blood-brain barrier and placental barrier
What are the CNS effects of Morphine?
Dose-related analgesia, sedation and euphoria, stimulation of chemoreceptor trigger zone (CTZ), N/V, miosis, small permeability of blood brain barrier, hypothermia, and convulsions at high doses
What are the therapeutic uses of Valium?
Treatment of anxiety, anesthetic premedication, sedative-hypnotic, seizures, treatment of alcohol withdrawal, treatment of night terrors, treatment of panic attacks, obstetrics during labor
What is the action and half-life of Diazepam?
Long-acting and 2-4 days
What is atmosphere?
It is the pressure exerted by air over 100,000 square meters
What are the major functions of the hypothalamus?
Regulation of homeostasis (temperature, urine output, hunger, thirst), link to nervous and endocrine systems, emotions, behavior
What is the formula for the 3rd gas law?
P1/T1 = P2/T2
What are the 5 elements of an action potential?
Depolarization, repolarization, threshold, refractory period, and all-or-none law
What is relative refractory?
It is still impossible to create an action potential
What is the importance of refractory period?
Provides unidirectional propogation of the action potential. Can't move backward into refractory period.
What are the two types of transport within an axon of a neuron?
Axoplasmatic (unidirectional) and axonal (bidirectional)
What are the three fundamental classes of dimensions?
Dimensions, SI unit, CGS unit
What are the benefits of codeine over morphine?
Less sedation, decreased respiratory depression, less GI effects, decreased rate of addiction, it is a good oral analgesic for mild pain
What is vital capacity?
The volume of air that can be forced out of the lungs after maximal exhalation
What is the major cardiac effect of halothane?
It increases sensitivity to catecholamines
What is alveolar ventilation rate?
The volume of air that reaches the alveoli per unit time
What are the four ions responsible for membrane potential?
Na+, K+, Cl-, and Proteins-
How is Acetylcholine broken down and what are the by-products?
It is broken down by Acetylcholinesterase and the by-products are choline and acetate
How does one determine absolute pressure?
Absolute pressure = gauge pressure + atmospheric pressure
What is a neuroglandular synapse?
A space between a neuron and a gland
What is Avogadro's gas law?
An equal volume of gases at equal pressure and temperature will have the same number of molecules
What is the action and 1/2 life of Lorazepam?
Intermediate acting and 14 hours
What is the action and 1/2 life of Midazolam?
Short acting and 2.5 hours
Why do we use premedications in anesthesia?
They reduce the amount of anesthesia needed
What is anemic hypoxia?
When total O2 in blood is low but pO2 is normal
What is functional residual capacity?
The volume of air that resides in the lungs after normal exhalation
What is the Bunsen Solubility Coefficient?
The volume of gas in milliliters at standard temperature and pressure that is dissolved in one milliliter of liquid
What are the two roles of Na+ and K+ ions?
Concentration and membrane permeability
How many cm3 does one Liter equal? What about one ml? What about 1ul?
1000cm3, 1cm3 or 10-3,.001cm3 or 10-6
What is the formula for determining partial pressure?
(Barometric pressure x gas %)/100 = partial pressure of a gas
What is expiratory reserve volume and what does it equal?
ERV is the additional volume of air that can be exhaled after normal respiration. It equals 1100ml.
What happens to the acetate and choline once they are broken down by Acetylcholinesterase?
Acetate is removed as a toxin through the urine and choline is reuptaken by the presynaptic neuron by cotransport with Acetylcoenzyme A. Together, they produce acetylcholine
What is tidal volume and what does it equal?
The volume of air that is breathed with normal respiration. It is typically 500ml
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