Anesthesia Pharmacology Exam Quiz

This statement is true because anesthesia is indeed a drug-induced reversible depression of the central nervous system (CNS). When a person is under anesthesia, they lose their ability to respond to external stimuli, such as touch or sound. This is why anesthesia is commonly used during surgeries or medical procedures to ensure that the patient does not feel any pain or discomfort.

The correct answer is incision because an incision is a surgical cut made in the body to access an organ or perform a procedure. In the given statement, it is mentioned that MAC is the level at which 50% of patients do not move on, but MAC does not relate to intubation, extubation, or excision. Therefore, the only option that is relevant to the statement is incision, as it is a procedure that may require anesthesia at the MAC level.

A complete anesthetic should have the components of amnesia, analgesia, and muscle relaxation. Amnesia is important to ensure that the patient does not remember the surgical procedure or any discomfort associated with it. Analgesia is necessary to provide pain relief during and after the surgery. Muscle relaxation is crucial to ensure that the patient's muscles are relaxed and immobile, making it easier for the surgeon to perform the procedure. Euphoria and dysphoria are not essential components of a complete anesthetic.

Unconsciousness occurs before MAC (Minimum Alveolar Concentration) is reached. MAC is a measure of the potency of an inhaled anesthetic agent, indicating the concentration required to prevent movement in 50% of patients exposed to a surgical stimulus. Unconsciousness occurs at a lower concentration than MAC, as it is the initial stage of anesthesia where the patient loses awareness and responsiveness. Therefore, the statement is true, as unconsciousness precedes reaching MAC levels.

With MAC (Monitored Anesthesia Care), the patient is typically conscious and able to respond to verbal commands. However, they may not have any recall of the procedure due to the use of sedatives. Additionally, there should be no movement on the incision site as the patient is under anesthesia. Furthermore, the patient should not respond to the placement of an Endotracheal Tube (ETT). Therefore, all of the given options are correct and are not expected to occur during MAC anesthesia.

The correct answer is 6%. This means that the MAC (Media Access Control) changes by 6% every decade. This could refer to the rate at which MAC addresses, which are unique identifiers assigned to network interfaces, change or become obsolete over time. It suggests that there is a gradual but consistent evolution or turnover of MAC addresses in the networking industry.

The given answer of 1.15 is likely the MAC (Minimum Alveolar Concentration) of isoflurane. MAC is a measure of the potency of an inhaled anesthetic and represents the concentration needed to prevent movement in response to a painful stimulus in 50% of patients. In this case, an MAC of 1.15 indicates that isoflurane is a potent anesthetic and a relatively low concentration is required to achieve the desired effect.

The duration of anesthesia does not have an impact on Minimum Alveolar Concentration (MAC). MAC is a measure of the potency of an inhaled anesthetic and represents the concentration required to prevent movement in response to a surgical stimulus in 50% of patients. It is determined by various factors such as the type of anesthetic, patient factors, and the presence of other drugs. The duration of anesthesia may vary depending on the procedure, but it does not directly affect MAC.

The spinal cord is responsible for transmitting signals between the brain and the rest of the body. Potent gases can affect the spinal cord by inhibiting the transmission of nerve signals, leading to immobility. This means that the individual is unable to move their body voluntarily. The other options, such as analgesia (pain relief), amnesia (memory loss), loss of recall, and homeostasis (maintaining internal balance) are not directly related to the spinal cord's function in this context.

MAC stands for Minimum Alveolar Concentration, which is a measure of the potency or strength of an inhaled anesthetic. It represents the concentration of the anesthetic required to prevent movement in 50% of patients exposed to a painful stimulus. Therefore, MAC is a measure of movement inhibition rather than analgesia (pain relief), amnesia (memory loss), or homeostasis (maintenance of internal balance).

The correct answer is that all of these statements are correct. Peripheral sensory receptors are not affected by inhalation agents, meaning they do not have a direct impact on these receptors. Inhaled anesthetics will not stop hyperalgesia, which is increased sensitivity to pain, and they also do not work for pre-emptive analgesia, which is the use of pain medication before a surgical procedure to prevent pain. Additionally, inhaled anesthetics do not block SSEPs (somatosensory evoked potentials), meaning that the stimulus in the periphery still reaches the cortex.

So it doesn't work supraspinally to alter pain. From the notes, I didn't really understand this one.

The movement, reflex, or withdrawal to pain reflexes can be stopped by blocking the spinal cord. The spinal cord is responsible for transmitting sensory information from the peripheral sensory nerves to the brain. By blocking the spinal cord, the signals of pain and reflexes cannot be transmitted to the brain, effectively stopping the reflexes. The brain stem, cerebral cortex, and peripheral sensory nerves are not directly involved in stopping these reflexes.

Attenuating = Gradually decreasing force/intensity.

The maximum aerobic capacity (MAC) refers to the maximum amount of oxygen that an individual can utilize during intense exercise. It is commonly known that MAC tends to decrease with age due to various physiological changes. However, the correct answer states that MAC does not change between 20-60 years of age. This suggests that during this specific age range, MAC remains relatively stable and does not significantly decrease.

MAC BAR stands for minimum alveolar concentration blocking adrenergic responses. It refers to the concentration of anesthetic required to blunt the sympathetic nervous system's response to a noxious stimulus such as a surgical incision. In other words, when the MAC BAR is reached, the patient will not experience an increase in heart rate, blood pressure, or other signs of stress in response to the incision. This is an important measure of the anesthetic's effectiveness in preventing pain and maintaining physiological stability during surgery.

The correct answer is "opens eyes to commands." This means that when the MAC (Minimum Alveolar Concentration) of an anesthetic reaches a certain level, patients will respond by opening their eyes when given commands. It indicates that the patient is becoming conscious and aware of their surroundings. It does not necessarily mean that they are fully awake or able to follow complex instructions, but it is a sign of emerging consciousness.

Peripheral sensory receptors are NOT affected by inhalation anesthesia.

There is NO evidence of teratogenic or carcinogeic effects of inhaled anesthetics.

Inhalation agents inhibit the ACh receptor at the myoneural junction. This is important because ACh (acetylcholine) is the neurotransmitter responsible for transmitting signals between nerves and muscles. By inhibiting the ACh receptor, inhalation agents can prevent the binding of ACh and therefore inhibit the transmission of signals from nerves to muscles. This leads to muscle relaxation, which can be desired in certain situations where muscle relaxants cannot be administered. High levels of anesthetic can further enhance this muscle relaxation effect.

Anesthetics have a depressant effect on the spinal motor neuron, which means they decrease its excitability. This leads to a decrease in the transmission of signals from the neuron, resulting in a decrease in muscle activity and relaxation. Additionally, anesthetics also inhibit the excitatory nerve synaptic transmission, further contributing to the overall depressant effect on the neuron.

"Free drug" is measured in partial pressure or % (fraction of inspired/expired) rather than plasma concentrations.

MAC (Minimum Alveolar Concentration) is a measure of the potency of an inhaled anesthetic. A higher MAC value indicates a lower potency, meaning more anesthetic is required to achieve the desired effect. Opioids are known to decrease the MAC value of an anesthetic, making it more potent. Therefore, when opioids are administered along with an anesthetic at 1.5 MAC, the MAC BAR (Bispectral Index-guided Anesthesia Depth) will decrease, indicating a deeper level of anesthesia.

Loss of self-awareness/recall occurs at 0.3-0.4 MAC. At this level of anesthesia, the patient is in a state of moderate sedation where they are responsive to verbal commands but have impaired memory and recall. They may not remember events that occurred during this period. This level of anesthesia is commonly used for procedures that require some level of sedation but do not require complete unconsciousness.

Sodium levels can change MAC (minimum alveolar concentration). MAC is the minimum concentration of anesthetic gas required to prevent movement in response to a surgical stimulus in 50% of patients. Sodium levels can affect the excitability of neurons and alter the response to anesthetic agents, therefore influencing the MAC.

None of the options listed (Nitrogen, Nitrous oxide, Room air, Oxygen, Zabaflurane) are considered potent gases. Potency refers to the strength or effectiveness of a substance, and in this context, a potent gas would typically refer to a gas that has a strong physiological or pharmacological effect on the body. However, none of the options provided fit this description, hence the correct answer is "None of these are correct."

Ages 20-60 MAC does NOT change. The middle of the scale. For patients below 20, and greater than 60. Count how many decades there are from 40-year sof age. If a patient is 90, that is 5 decades from 40. 5 x 6%/decade = 30%. If a patient is 10, that is 3 decades from 40. 3 x 6%/decade = 18%, but you would increase MAC by 18% in this case because they are younger.

Minimum ALVEOLAR concentration of an anesthetic at one ATM that prevents movement in response to surgical incision.

Pregnancy (decreases MAC 30%)
Hypoxia (brain starts to shut down by itself bc it's missing oxygen)
Calcium channel blockers (decreases nerve-nerve communication)

The factors that increase MAC (Minimum Alveolar Concentration) are Red Hair, Acute amphetamines, Cyclosporines, Hyperthermia, Increased CNS neurotransmitters, Hypernatremia, and Chronic alcohol consumption. These factors can enhance the effects of anesthesia, requiring a lower concentration of anesthetic agent to achieve the desired effect.