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Fall'20 Pharmacology III > NCE part 1 > Flashcards

Flashcards in NCE part 1 Deck (48)
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1

which two volatile anesthetics decrease SVR the most

Isoflurane and Desflurane

2

Isoflurane causes hypothermia ...why

because it suppresses the hypothalamic temperature regulators

3

which agents are volatile

Sevoflurane
Desflurane
Isoflurane
Enflurance
Halothane

4

how do volatile anesthetics affect cerebral vessels and cerebral blood flow.

Dilate cerebral vessels
Increase cerebral blood flow
Increase cerebral blood flow and ICP
Decreases neuronal function and cerebral metabolism

5

which three gases similarly depress cerebral metabolic rate

Iso, Des, Sevo

6

how do we negate the increase ICP with Isoflurance (remember its the least to dangerously increase ICP)

hyperventilate

7

Hypoxic Pulmonary Vasoconstriction is inhibited at what MAC

HPV is inhibited by a high concentration of volatile (1-1.5 or higher MAC)

8

What volatile is considered completely halogenated with fluorine?

Des is considered to be completely halogenated with fluorine

9

what volatile has fluorine substituting halogen

sevoflurance

10

which two volatile most depress ventilation

Des, Enflurane

11

which volatile depress ventilation the least

Halothane

12

what volatile agent Most depress the baroreceptor reflex

Halothane and Sevo: No increase in HR even with decreases in blood pressure

Baroreceptor: "DISH" least to greatest
-S/H no increase in HR w/low BP
-D/I increase in HR w/low BP

13

what volatile agent Least depress the baroreceptor reflex

Iso and Des: HR increases as a reflex to decrease in blood pressure

Baroreceptor: "DISH" least to greatest
-S/H no increase in HR w/low BP
-D/I increase in HR w/low BP

14

Acute ETOH intoxication effect on MAC

Decreases

15

Rank opioids most lipid soluble to least lipid soluble
Meperidine
Remifentanil
Morphine
Fentanyl
Sufentanil
alfentanil

Sufentanil >> fentanyl >>> alfentanil >>> meperidine > remifentanil > morphine

"Single Females And Males Run Marathons"
23311 (arrow pattern)

16

What receptors do spinal opioids work

Primarily Mu-2 but work on mu-1, kappa, and delta to produce supraspinal analgesia

17

Stimulation of mu-1 receptors what responses:

Spinal and supraspinal analagesia
Euphoria
Miosis
Bradycardia
Hypothermia
Urinary retention
pruritus

18

Mu-1 have a high or low abuse potential
?

Low abuse potential

19

Opioid can cause nausea and vomiting by

Stimulation of CTZ of the fourth ventricle (floor). The triggered CTZ activates vomiting center near the brain stem

20

Most opioids are metabolized by the liver. Which is not and what is it metabolized by?

Remifentanil and is metabolized by nonspecific esterases in the blood stream.

21

Agonist/antagonist opioids work on what receptor(s) for therapeutic effect

Primarily Kappa
Also on delta

22

Naloxone reverses what actions of opioids

Pruritus
Urinary retention
N/V

23

Higher doses of naloxone are required to reverse what opioid issue

Reverse profound sedation and respiratory depression

24

Does morphine produce arterial or venous dilation

Both due to histamine release

25

What two opioids cause histamine release

Morphine and Meperidine

26

There are 3 CV actions that may cause a decrease in BP in an anesthetized patient given a high dose of fentanyl

Decrease SVR (dilate arterial vessels
Decrease venous return (dilate venous capacitance vessels
Decrease in HR

27

how are esters hydrolyzed

Hydrolyzed by plasma and tissue cholinesterase

28

PABA is excreted where

urine

29

is there cross contamination between esters and amides

no

30

how could an ester be prolonged

plasma cholinesterase deficiency