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NU 624

Chemistry and Physics of Anesthesia - Exam 1 - Chemical Bonding

QuestionAnswer
What is the joining of elements into molecules called? Chemical bonding
What does chemical bonding depend on? The distribution of electrons in the outermost shell
The distribution of electrons among available shells of an atom or molecule is known as the ___________. Electron configuration
Which group of elements are not able to combine and recombine with other elements? The inert group
How many outer shell electrons does it take to create a stable element? 8
Which element has a stable outer shell number of 2? Helium
Elements with what number outer shell electrons react in ways to become more stable? Elements with 1 to 7 outer shell electrons react to create a stable 8 electron outer shell
Elements with 1, 2, or 3 electrons in their outer shell tend to ___________ electrons to gain stability. Lose (oxidize)
Elements with 5, 6, or 7 electrons in their outer shell tend to ___________ electrons to gain stability. Gain (reduce)
An element that loses an electron is [reduced/oxidized]. oxidized
An element that gains an electron is [reduced/oxidized]. reduced
A good reducing agent readily [gains/loses] an electron. loses
A good oxidizing agent readily [gains/loses] an electron. gains
A substance that undergoes oxidation [loses/gains] an electron. loses
A substance that undergoes reduction [loses/gains] an electron. gains
An ionic bond is formed between 2 atoms that have been ________. charged
An ionic bond requires 2 elements with what types of charges? 1 positive and 1 negative
Attractive forces in drug receptor binding is attributed to what types of bonds? Ionic bonds
The molecule NaCl is a good example of what type of bond? ionic
Why is NaCl considered to be a weak or unstable bond? Because it will readily dissociate back into its component parts when placed in solution
What are weak bonds called? Loose or unstable
What is a covalent bond? A bond between two elements that share an equal number of electrons in the outer shell
What is one of the most important non-covalent bonds in the living system? The hydrogen bond
Hydrogen bonding is responsible for what two characteristics of water? Its high boiling point and ability to float in frozen form
How is hydrogen bonding important in DNA structure? It gives DNA its double helix shape and holds proteins in their functional forms
Give four examples of hydrogen bonds holding elements together in the human body. 1)Holds the two strands of DNA together 2)Holds polypeptides together 3)Helps enzymes bind to substrates 4)Helps antibodies bind to antigens
When do covalent bonds usually form? When 2 nonmetals or a metalloid and a nonmetal combine
What ocular disease do miotics help to treat? Glaucoma
How many covalent bonds can phosphorus create? 5
Phosphorus establishes [reversible/irreversible] bonds with substances to which it attaches to. Irreversible
Phosphorus uncoupling may take up to __________ weeks. 6
Carbon and phosphorus combine to make up what types of compounds? Organophosphates
Echothiophate is a type ______________. Organophosphate
What condition is echothiophate primarily used to treat? Glaucoma
What is acetylcholine? A neurotransmitter that activates or stimulates nerve impulses
What does echothiophate inhibit? cholinesterase
What is the cholinesterase enzyme responsible for? The hydrolysis and inactivation of succinylcholine and the ester-type local anesthetics.
Succinylcholine consists of an attachment of two molecules of ___________. Acetylcholine
Echothiophate is a cholinesterase inhibitor and therefore prolongs the action of what neurotransmitter? Acetylcholine
Succinylcholine should not be given to patients receiving which miotic? Echothiophate
Patients on echothiophate should not receive _____________ during anesthesia. Succinylcholine
Echothiophate affects what type of receptors? Nicotinic
Administering succinylcholine to a patient on echothiophate would cause what type of nicotinic action? Nicotinic stimulation of skeletal muscle to the point of fatigue and paralysis
Administering succinylcholine to a patient on echothiophate would cause _____________ symptoms in the autonomic nervous system. Cholinergic
What are three cardiovascular cholinergic symptoms? 1)Bradycardia 2)Hypotension 3)Asystole
What are two airway related cholinergic symptoms that make anesthesia more difficult? 1)Increased secretions 2)Bronchospasm
How are organophosphates used in the industrial setting? As insecticides
Giving succinylcholine to a patient on echothiophate can cause ____________ toxicity. Organophosphate
Organophosphate insecticides produce a/an [reversible/irreversible] enzyme inhibition and have ______________ effects as well. Irreversible, CNS
Atropine counters the effects of echothiophate at what type of receptors? Muscarinic
What are the two main types of cholinergic receptors? Nicotinic and muscarinic
The autonomic symptoms of organophosphate poisoning are treated with what medication? Atropine
Atropine is a competitive antagonist of what neurotransmitter and at which sites? acetylcholine at muscarinic receptors
Succinylcholine causes ______________ symptoms, atropine causes ______________ symptoms. Cholinergic, anticholinergic
What medication uncouples phosphorous bonds? Pralidoxime protopam (PAM)
What medication is used to treat neuromuscular symptoms of organophosphate poisoning? Pralidoxime protopam
What is the dose of pralidoxime protopam? 1-2 grams
What is the concentration and infusion rate of pralidoxime protopam? 8mg/ml, 500mg/hr
An ion is an atom with either a __________ or ___________ charge. Positive, negative
Give one example of a positive and negative ion combination. NaCl
Give two examples of biological barriers. Blood-brain and placental barriers
Drugs with either a + or – charge [can/cannot] usually cross biological barriers. Cannot
Common ionized drugs used in anesthesia are the ____________ agents. Neuromuscular blocking
[Ionized/Nonionized] drugs have the ability to cross biological barriers. Nonionized
Nonionized drugs are ___________ compounds and not easily excreted by the ___________. lipid, kidneys
Give 4 examples of nonionized medications used in anesthesia. 1)Morphine 2)Ketamine 3)Atropine 4)Scopolamine
Glycopyrolate is a type of [ionized/nonionized] drug. ionized
Atropine and scopolamine are not ionized drugs, therefore they [can/cannot] cross biological barriers. can
Glycopyrrolate is an ionized drug, therefore it [can/cannot] cross biological barriers. cannot
What two things determine the ease at which a drug can be absorbed? Its physical and chemical forms
Most drugs are either _____________ or _______________ and are physically present in solution in both ____________ and ___________ forms. Weak acids, weak bases, ionized, nonionized
What ratio is important in determining the rate at which a drug passes across a biologic membrane? The percentage of nonionized to ionized drug
The [ionized/nonionized] form is usually lipid soluble (lipophilic) and will readily cross lipid membranes. nonionized
Nonionized medications are usually [lipophobic/lipophilic]. lipophilic
The [ionized/nonionized] form is usually water soluble (hydrophilic) and does not readily cross biologic membranes. Ionized
Ionized medications are usually [hydrophobic/hydrophilic]. Hydrophilic
The pKa represents the [ionized/nonionized] fraction of a drug. Nonionized
The pKa is known as the _______________ whereby a drug exists at ___________% of ionization. Dissociation constant, 50
What equation describes the relationship between ionized and nonionized forms of a drug? Henderson-Hasselbalch
What is the Henderson-Hasselbalch equation for an acid? pH – pKa=log[(A-)/(HA)]
In the Henderson-Hasselbaclh equation for an acid, what do the [A-] and [HA] variables represent? [A-] is the concentration of ionized acid, [HA] is the concentration of nonionized acid
What is the Henderson-Hasselbalch equation for a base? pH – pKa=log[(B)/(BH+)]
In the Henderson-Hasselbalch equation for a base, what do the variables [B] and [B+] represent? [B] is the concentration of a non-ionized base and [BH+] is the concentration of an ionized base.
For each drug, the pKa is [constant/variable]. Constant
Since the pKa is a physical constant for each drug, what factor determines the ultimate ratio of ionized to nonionized drug? The pH of the solution in which the drug dissolves
Weak acids are acids with a pKa above _________. 3
A solution with a pH of less than 3 will [increase/decrease] a weak acid’s ability to be absorbed. increase
A solution with a pH of less than 3 will [increase/decrease] a weak base’s ability to be absorbed. decrease
What is the disassociation formula to calculate the pK? [Ionized form of a drug] / [Nonionized form of a drug]
If the pH of an environment is low and acidic, a weak acid will have a [greater/lower] chance of dissociating into its ionic forms. lower
When a weak base is added to a strongly basic solution, it has a [greater/lower] chance of dissociating into its ionic forms. lower
Acidic drugs are highly ionized in __________ solutions. basic
Basic drugs are highly ionized __________ solutions. acidic
Adjusting the pH to be [equal to/greater than/less than] a drug’s pKa can help improve a drug’s ability to be absorbed. Equal to
The [ionized/nonionized] portion of a drug is the portion that will easily cross biologic membranes. Nonionized
Medications that are lipid soluble [will/will not] cross biologic membrans. will
What are the two major classifications of local anesthetics? Amino esters and amino amides
Which local anesthetic group has higher pKa values? Amino esters
What are the 3 amino esters? 1)procaine 2)Chloroprocaine 3)Tetracaine
What are the 4 amino amides? 1)Bupivicaine 2)Ropivicaine 3)Lidocaine 4)Mepivacaine
How can the addition of sodium bicarbonate affect the onset and quality of a local anesthetic? 1)speed the onset 2)improve the potency 3)prolong the block
Why does sodium bicarbonate improve the quality and potency of local anesthetics? Increases the environmental pH, bringing it closer to the pKa value of the local anesthetics and increasing the amount of nonionized drug.
Which local anesthetic has the highest pKa value? Procaine at 8.9
Which local anesthetic has the lowest pKa? Mepivicaine at 7.6
Created by: philip.truong