Term
| Blood Gas solubility coefficient tells you what of an anesthetic? |
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Definition
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Term
| The oil gas solubility coefficient tells you what of an anesthetic? |
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Definition
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Term
| Sevoflurane, Isoflurane (Forane), N20 & Desflurane (suprane) give the MAC % (Dose) |
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Definition
Anesthetic/ MAC
Sevo- 2
Iso 1.15
N20 105
Des 5.8 |
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Term
| give % metabolism of anesthetics |
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Definition
| Iso, Des, N20 all Trace except Sevo 5-7 % |
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Term
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Definition
| – the study of the absorption, distribution, metabolism, and excretion of drugs |
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Term
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Definition
| – the formulation and preparation of drugs |
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Term
| How will you do on this test? |
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Definition
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Term
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Definition
| the study of the economic impact of drugs |
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Term
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Definition
| – the study of the medicinal uses of naturally occurring compunds |
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Term
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Definition
| – the preparation and dispensing of drugs |
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Term
| Sevoflurane, Isoflurane (Forane), N20 & Desflurane (suprane) give the Blood/Gas Partition Coefficient @37C |
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Definition
Anesthetic/ Blood/Gas PC
Sevo 0.6
Iso 1.4
N20 0.47
Des 0.42 |
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Term
| Sevoflurane, Isoflurane (Forane), N20 & Desflurane (suprane) give the Oil/Gas Partition Coefficient @37C |
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Definition
Oil/Gas Partition Coefficient @37C
Sevo 50
Iso 99
N20 1.4
Des 18.7 |
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Term
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Definition
| genetic influences by and on drugs (what the body does to the drug) |
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Term
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Definition
| physiological and biochemical mechanism of action of drugs (what the drug does to the body) |
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Term
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Definition
| identifies discrete genetic differences among individuals that play a critical role in drug response |
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Term
| Define Pharmacoepidemiology |
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Definition
| the study of the use and effects of drugs on large groups of people |
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Term
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Definition
| effective dose in 50% of the population |
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Term
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Definition
| toxic dose in 50% of the population |
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Term
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Definition
| lethal dose in 50% of the population |
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Term
| What does Therapeutic window mean? |
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Definition
| an index for estimation of drug dosage which can can treat disease effectively while staying within the safety range. |
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Term
| What does Competitive binding mean? |
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Definition
| reversible (most drugs) (can compete at the receptor, whichever one there is more of wins) |
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Term
| What does Noncompetitive mean? |
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Definition
| – nonreversible (once bound to the receptor it is there forever (ASA once bound to the platelet it never lets go and the only way to get rid of it is to make more platelets) |
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Term
What does Ligand mean?
Compare Agonist to Antagonist. |
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Definition
chemical substances (drugs) that bind to a specific receptor
Agonist – bind to a receptor and stimulate the function that receptor serves
Antagonists – bind to a receptor and block the function that receptor serves |
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Term
What kinds of bonds do drugs form with receptors?
Which are strongest?
Which are weakest? |
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Definition
o Covalent – Strongest (5)
o Ionic – semi-strong (4)
o Hydrogen – Mid-strength (3)
o Hydrophobic – semi-weak (2)
o Van der Waals – weakest (1)
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Term
What 4 things can you tell from a drug response curve?
( & if so do you know what all that means?)
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Definition
Affinity, efficacy, variability, slope
Affinity of drug for receptor (potency). If you have a higher affinity you may need less drug. Drug A might have more affinity for a receptor than drug B. A>B
Efficacy- Ability to produce wanted effect. If drug a & drug b have 100% you can get wanted effect in everyone. A=B.
Individual Variability
Slope- margin of safety- A steep slope means it takes a smaller amont of drug to go from no response to full response. You can compare drugs by slope. |
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Term
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Definition
increase in number of receptors due to chronic antagonist administration (always being blocked so body makes more)
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Term
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Definition
Down regulation – decrease in receptors due to chronic agonist administration (continually being stimulated) |
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Term
In terms of drug interaction what does antagonism mean?
Explain it mathmatically |
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Definition
Antagonism – 1+1=0 (the action of one drug opposes the action of another; reversal agents) |
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Term
In terms of drug interaction explain Potentiation.
Explain it mathematically. |
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Definition
o Potentiation 1+0=3 (the enhancement of the action of one drug by a second drug that has no detectable action of its own) |
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Term
In terms of drug interaction explain Synergism.
What would that look like mathematically?
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Definition
o Synergism – 1+1=3 (the combined effect of two drugs is greater than the algebraic sum of their individual effects; greater effect than expected)
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Term
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Definition
| increase in drug metabolizing enzymes and drugs are metabolized faster |
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Term
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Definition
| decrease in drug metabolizing enzymes and drugs are not metabolized as well |
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Term
| Describe the Signs and stages of anesthesia |
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Definition
o Stage 1 – analgesia, normal VS and reflexes, amnesia euphoria o Stage 2 – excitement, heightened VS and reflexes, delirium, combative
Stage 3 – surgical anesthesia, normal VS and reflexes and start to depress, unconsciousness, decreasing eye movement o Stage 4 – overdose, respiratory arrest, cardiac depression and arrest, no eye movement, medullary paralysis and death |
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Term
| What neurotransmitters are invovlved in the pre-ganglionic & post ganglionic for the sympathetic system |
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Definition
| Pre-ganglionic sympathetic – acetylcholine acts on nicotinic cholinergic receptor Post-ganglionic sympathetic – norepinephrine acts on adrenergic receptors |
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Term
| What neurotransmitters are invovlved in the pre-ganglionic & post ganglionic for the parasympathetic system |
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Definition
| o Pre-ganglionic parasympathetic – acetylcholine acts on nicotinic cholinergic receptor o Post-ganglionic parasympathetic – acetylcholine acts on muscarinic cholinergic receptors |
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Term
| Term if a drug mimics the sympathetic side & if a drug blocks the sympathetic side |
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Definition
| sympathomimetic sympatholytic |
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Term
| Term if a drug mimics the parasympathetic side & if it blocks the parasympathetic |
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Definition
| parasympathomimetic parasympatholytic |
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Term
| How does the machine play a role in pharmacokinetics? |
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Definition
| Liter flow – the higher the gas flow rates via the anesthesia machine the faster the anesthetic will reach the patient thus the faster the patient will go to sleep . absorption into plastics etc. |
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Term
| How do the lungs play a role in pharmacokinetics? Nagel lists 6. |
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Definition
| Ventilation, Concentration, Blood/Gas Solubility, V/Q Problems, Second gas effect, N20 diffusions into closed spaces |
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Term
| How does Ventilation play a role in pharmacokinetics? |
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Definition
| the faster you breathe the faster you go to sleep |
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Term
| How does Concentration play a role in pharmacokinetics? |
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Definition
| the higher the dose the faster it works |
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Term
| How does Blood/Gas Solubility play a role in pharmacokinetics? |
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Definition
| tells you the speed of an anesthetic (the lower the number, the faster the anesthetic); the lower the blood/gas solubility coefficient the faster the rise of the anesthetic in the lungs (note…nitrous oxide is faster than desflurane in spite of a higher blood/gas coefficient due to the concentration effect, nitrous is administered at 50-70% versus desflurane at less than 10%) |
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Term
| How do V/Q problems play a role in pharmacokinetics? |
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Definition
| V/Q problems – ventilation perfusion deficit slows the delivery of all anesthetics; the fastest inhalation drugs (low blood/gas coefficient) are affected more than the slower drugs (high blood/gas coefficient) |
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Term
| How does the 2nd gas effect play a role in pharmacokinetics? |
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Definition
| Second gas effect – use a very low solubility agent along with another agent with higher solubility and use high concentrations of the fast (low solubility) drug |
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Term
| How does N20 diffusion into closed spaces play a role in pharmacokinetics? |
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Definition
| N2O diffusions into closed spaces – nitrous oxide expands closed gas spaces due to difference in solubility with the nitrogen it replaces and the high concentrations required. |
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Term
| How does Cardiac Output play a role in pharmacokinetics |
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Definition
| Cardiac output – increases in cardiac output slow the onset of all anesthetics. The highest blood gas agents are affected the most |
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Term
| How does Tissue play a role in pharmacokinetics? Nagel lists 3 |
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Definition
| Oil/Gas Solubility Metabolism Diffusion Hypoxia |
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Term
| How does Oil/Gas solubility play a role in pharmacokinetics? |
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Definition
| Oil/gas solubility – tells potency; the more lipid soluble, the more potent; the higher the number the higher the potency |
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Term
| How does metabolism play a role in pharmacokinetics? |
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Definition
| Metabolism – if the drug isn’t metabolized, this is good so that we don’t make toxic metabolites |
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Term
| How does Diffusion Hypoxia play a role in pharmacokinetics? |
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Definition
| Diffusion hypoxia – occurs when high concentrations of nitrous oxide are administered. At the end of the procedure when nitrous oxide is discontinued, it leaves the body very rapidly causing a transient dilution of the oxygen and carbon dioxide in the lungs. Hypocarbia and hypoxia may occur so administration of 100% oxygen for about 3-5 minutes when nitrous oxide is discontinued alleviates this problem. |
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Term
| What are some special considerations for pediatrics with pharmacokinetics? |
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Definition
Pediatrics – children go to sleep faster than adults because of their higher ventilation in spite of differences in drug solubility, body composition, and cardiac output and need for a higher MAC
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Term
| What are some special considerations for pregnant patients with pharmacokinetics? |
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Definition
| cardiac output and minute ventilation are increased and these offset one another therefore their need is similar to non-pregnant women |
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Term
| What are some special considerations for obese patients with pharmacokinetics? |
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Definition
| induction will be unchanged, but emergence may be slower because of deposition of anesthetics in fat |
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Term
| What are some special considerations for hypothermia with pharmacokinetics? |
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Definition
| everything slows down, so the elimination of the anesthetics are slower; slower emergence |
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