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40 Cards in this Set
- Front
- Back
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The movement of a drug into the bloodstream
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absorption
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the reversible transfer of drug from one location to another within the body
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distribution
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converts lipophilic chemical compounds to more readily excreted polar products
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metabolism
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process of eliminating waste products of metabolism
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excretion
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what does the surgeon want from an anesthetic
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rapid onset
cadeveric relaxation rapid emergence |
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the major inhibitory NT in the brain
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GABAa
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main inhibitory NT in the brainstem and SC
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glycine
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main excitatory NT
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Glutamate
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which NT are excitatory and cation specific
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ACh- sodium
Serotonin |
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Total amt drug/conc. in plasma
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volume of distribution
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what is the vessel rich group
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heart
brain kidneys liver glands |
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what is the vessel poor group
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muscle
skin fat |
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what are the parts of the three compartment model
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plasma
VRG VPG |
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Why do most of our anesthetic drugs wear-off
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redistribution
gone to non active sites |
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what is steady state concentration
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when all 3 compartments have the same concentration of the drug
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what is the time between achieving an adequate concentration of a drug and seeing the effect of the drug
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effect site equillibration
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What is pulmonary uptake and what are some common drugs this effects
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when the lung works as a storage place for the drug, but not metabolizing them.
Fentanyl, Sufentanyl Lidocaine, propanolol |
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1/2 life
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time for 1/2 drug to be cleared from body
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1/2 time
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time for 1/2 drug to be cleared from the plasma
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context sensitive 1/2 time
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time from stop of infusion till 1/2 of drug is removed from plasma
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What is partition coefficient
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describes how drugs move between compartments
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Pka equation for acid and base
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Pka-ph-for base
Ph-Pka- for acid negative #= non-ionized |
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what do acids like to bind to
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Na, K, Ca, Mg
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What do bases like to bind to
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SO4, Cl
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What ph tends to bind to albumin
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acids
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taking away functional group to make more water soluble
oxidation, reduction, hydrolysis |
phase 1
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adding a group to make more polar
conjugation |
phase 2
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three factors for hepatic metabolism
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blood flow
protein binding intrinsic ability to eliminate the drug |
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first order kinetics
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same (constant) fraction of the drug is eliminated per unit of time
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zero order kinetics
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same amount of drug is eliminated per unit of time
(subject to saturation) |
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what is resposible for most anesthesia drugs metabolism
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CYP 450
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CYP 450 undergoes what types of reactions
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oxidation
reduction |
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what is good for pts with enzyme induction
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esters
plasma and tissue cholinesterases (Succs, ester locals, esmolol) |
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What is the deal with infants and metabolism
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fully functioning liver but not fully functioning enzymes- average adult levels at age of 1
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what is the deal with enzyme acitivity of the 2-15 year olds
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drug chewing machines- may need higher doses
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What are the high hepatic clearance drugs that we have learned so far
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Etomidate
Propofol Ketamine |
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Where do most drug complications come from
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wrong dose
wrong drug |
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How well drug produces desired effect describes what
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efficacy
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How much of the drug is needed to produce 50% of the max effect describes...
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potency
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what type of dose response curve do we prefer
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steep curve- tells us the drug is titratable
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