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Fall'20 Pharmacology III > Pharm Acid/Base > Flashcards

Flashcards in Pharm Acid/Base Deck (85)
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1

Acidity of solution reflects its

hydrogen ion content

2

PH stands for

Potential of hydrogen

3

causes for metabolic alkalosis

loss of acid from extracellular space examples

loss of gastric fluid- vomiting, NG drainage

loss of acid into urine- diuretic administration, hyperaldosteronism

4

causes for metabolic alkalosis
excessive HC03 loads

NaHCO3 administration
Lactate, acetate, citrate administration
Alkali administration to patients with renal failure
Abrupt correction of chronic hypercapnia

5

respiratory alkalosis

Hyperventilation-Increase in minute ventilation to level greater than that required to excrete the metabolic production of CO2

6

respiratory acidosis

Hypoventilation-Occurs when minute ventilation is insufficient to eliminate CO2 production without an increased capillary-alveolar CO2 gradient

7

metabolic acidosis is normally accompanied by compensatory

hyperventilation

8

in metabolic acidosis the significant reduction of PH

increased PVR
reduced myocardial contractility
decreased SVR
impaired response to CV system to endogenous or exogenous catecholamines

9

what compensatory mechanism is immediate

buffer system

10

the buffer system is followed by

respiratory
renal system- renal is slow and more effective

11

when the patient is acidosis- what happens to opioids, sedatives and anesthetic agents

sedatives and anesthetic agents on the CNS are potentiated

nonionized form of opioids increases and more penetrates the brain

12

what neuromuscular blocker do we avoid in the acidotic patient

succinylcholine in the acidotic patient with hyperkalemia

13

respiratory or metabolic acidosis augments nondepolarizing NMB agents?

respiratory acidosis

14

what are the circulatory depressant effects of volatile and IV anesthetics for the acidotic patient

exaggerated

15

what acid-base imbalance prolongs the duration of opioid induced respiratory depression

respiratory alkalosis

16

what electrolyte abnormality may precipitate severe arrhythmias in alkalemia

hypokalemia

17

*especially during hypotension* cerebral ischemia can occur from marked reduction in cerebral blood flow- what acid base imbalance is this

alkalemia

18

normal clearance maintains serum concentrations of lactate at

0.5-1mmol/L

19

where is most lactate cleared

by the liver

20

in the liver what three things does lactate undergo

oxidation
gluconeogenesis
eventual conversion to bicarbonate

21

lactate undergoes both passive diffusion and active transport into the liver via

monocarboxylate transporter

22

active transport becomes saturated as serum lactate concentrations >

2.5mmol/L

23

severe reduction in hepatic blood flow will do what to hepatic lactate clearance

decrease

24

lactate acid is a strong acid and therefore dissociates almost completely under physiologic conditions into the

lactate anion

and

hydrogen ion

25

when does lactate accumulation occur

mainly during anaerobic glycolysis

generated under normoxic conditions

26

in the critically ill patient lactate production may increase while lactate clearance is impaired- meaning...

lactic acidosis may occur

27

a serum lactate ___ upon admission is an independent predictor of mortality in critically ill patients

>1.5mmol/L

28

failure to decrease lactate concentration to less than or equal to ___24 hours after admission is also associated with significant mortality

1.0mmol/L

29

this investigational drug decreases concentration of lactate

dichloroacetate (DCA)

30

dichloroacetate decreases concentration of lactate in what 4 situations

malaria
DKA
burns
cardiogenic shock