NBME 18 Low blood solubility (NBME Answers)

NBME 18 Answers

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7 yo boy appendectomy
Low blood solubility 🔍 / 📺 / 🌳 / 📖
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submitted by ∗match95(56)

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Ildehna taseincseth taht haev owl odobls:ga tpirotina oociflit/eedfnocb iyotsillub liovssde ni ooldb rmoe asiyl.e ohefr,ereT heert is SSEL ags eeddne to aautesrt ldboo -- aka afsret anauorstti fo ool.db iTsh eldas ot stafer orusinttaa of ab.irn

r;dtl lwo oyiusliblt &-;g-t sfreat oetsn ;g-&-t serfta ovyrecer

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pelparente great answer; just to add to it. Lipid solubility determines potency, not onset/offset (that is determined by blood solubility as stated above). The more lipid soluble the more potent the drug. The more lipid soluble the drug the higher the oil:gas partition (directly proportional to potency) and the lower the MAC (inversely proportional to potency). Source: Boards and Beyond General Anesthesia Neurology +6

cbreland I really went down a rabbit hole on this one... Convinced myself that it had something to do with mask v. IV anesthesia even though I haven't seen/heard that anywhere. Taking step in a week🙏🏼 +1

jer040512 I thought a low blood:gas partition coefficient meant that it has a low solubility and therefore DOESN'T dissolve in the blood that easily. +2

dhpainte22 Think onset/offset is about blood solubility and potency of drug higher with higher lipid solubility so low blood gas coefficient has faster onset and recovery. +

jurrutia Just to drill point home further: consider halothane, high lipid solubility (so high potency) and high blood solubility (slow onset). If you want fast onset, low solubility is the key. +2

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submitted by ∗hello_planet(43)

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ehT toreh ocemmtn si tryalapli recic.ornt If the urdg luleseocm oldivess ni boo,dl eyht od otn evha an ecneashitt ef.cfte If yeht avhe a wol doobl oi,tyslbliu ythe od NOT vidlseso in ldobo llew hihcw aedsl to a aefrst shnatetcie fte.fec

Teh yepnoct si eaerdtl ot het piild libiotyuls ecsabeu the gudr sah to be diilp ulelbos ot sscro hte dnoibbloa-r rearb.ir A urgd iwht a hirghe lipdi uyoitsibll liwl eb aleb to caher a heactprueit osde ni eht nbira ta a erwlo eesiddrintam osde, so leowr dilip liutsboily = more noe.ptt

iTsh qnsetuio skdae buoat a icuqk idtunconi i,met so ew tawn a gudr tiwh a wlo dobol boisytilul os the gurd will otn eslsodvi ni hte obdlo and ilwl emor ykuqcil srosc noit the .abrni

In hroet ,rtems a lwo oablsg:do niarotpti coceeftinif = wlo dloob biiutyolsl = tsohr niiodtncu ime.t

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hello_planet Ugh, it appears you can't edit comments. I meant that a higher lipid solubility = more potent. +1

drdoom nice explanation! +1

ringarosie agree, with explanation and "aside" +

freebie Correct. Anyone confused on this should go watch the Boards & Beyond anesthesia video covering this topic. +

kcyanide101 The explanation also applies to the blood gas coefficient. Another factor that affects induction is Aterio/Venous conc. The higher it is the lower the induction as it shows the peripheral tissue is taking it up.......... Here's a youtube video that simplify's it https://www.youtube.com/watch?v=Zsjs_mDc_AM +

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submitted by ∗an1(114)

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odl↑Bo olyitbs:iul swol peesd

olBd↓o uibltios:ly ftsa psdee

↑Ldipi liob:iyluts eyrv pnetot

piidL↓ :tiislbyoul ont tpnoet

tyecoPn = 1/ MAC

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