Chemistry and Anaesthesia.

Fundamental concepts of chemistry are important as well as relevant to anaesthetic practice. The human body is a bag of chemicals like oxygen, carbon, hydrogen and nitrogen. There are other chemicals in small quantities as well. It is therefore no wonder that the physiology of the body is dependent on various chemical processes of the body. The membrane potential that if fundamental to the existence of life is produced by the chemicals like sodium and potassium ions. The energy production through the electron transport chain is a chemical reaction. Respiration is a chemical reaction. Nucleic Acids forming DNA and RNA are chemicals. The food we eat is a chemical or mixture of chemicals. Diffusion , Osmosis , Osmolarity that involve the physico chemical concepts on which the body works. On the pharmacology front, you have most drugs which are either weak acids or weak bases. They behave differently when the pH of the medium changes. On the physics and measurements, you may remember the oxygen electrodes which work on the principles of electrolysis. Therefore it may be well worth spending some time on this topic. From your exam point of view, as we discuss in your syllabus, there are several chemistry concepts you are expected to understand. You will tested for your understanding of the knowledge either directly in the form of MCQs and Structured Oral examinations or indirectly where you would have to get these concepts in to context for a related question. Most text books do not go in to the actual explanation of the basic concepts for one or the other reason but it leaves the student some times baffled with confusion. A misunderstanding or incomplete understanding or no understanding at all would leave the individual unable to memorize the information. Here we are attempting to address some of those issues. We do not claim any originality in our work but simply have brought together the relevant information in one place to make it sense to the readers. It is always possible for the more interested to visit chemistry text books. The syllabus from the royal college relating to chemistry are as follows.
Pharmacology and physiology sections Organic chemistry , drugs as organic molecules; interaction between molecules; organic compared to inorganic compounds; bond strength; important atomic constituent Ionization of molecules; types of groups that ionize: amides , hydroxyl , carboxyl, permanently charged Demonstration of the knowledge of quaternary ammonium compounds solubility,partition coefficients and movement of drugs through membranes. Measuring the strength of solution Lipid solubility ; influence of pH and pKa on partition co efficient s Active and passive transport mechanisms.

Definition of strong and weak acids.

Buffers and their chemical nature. Electrolyte solutions and their application in measurements of oxygen, hydrogen and carbon dioxide. Isomerism and its relevance to anaesthesia. Protein binding and transport of the drugs in the body

if you look at the syllabus they seem to be quite diverse topics with no apparent inter connection. How ever, they are interlinked in one way or the other and we will explore this inter relationship to enhance our understanding of the subject. For the learned in chemistry it may seem to be too basic but this lecture is for the ones who have limited understanding of chemistry and those who have forgotten what they studied in the schools. Let us begin our learning with atom. Atom id the fundamental unit of any substance. An element is the pure form of a chemical made of same types of atoms These atoms differ in the way of the number of protons , neutrons and electrons in them. It can e single proton and electron as in Hydrogen or hundreds of them as in Uranium. There is a whole spectrum ODF elements in between. Such atoms have a central core nucleus- contains Protons and Neutrons. Surrounding orbit is filled by electrons which spin around the nucleus. These electrons depending on the element they belong to are active differently. So when they have sufficient energy and come across a suitable another atom, they react by exchanging the electrons to form bonds. This will lead to the formation of molecules which could be of same atoms or compounds if they are from different elements. This exchange of electrons take place in one of the three forms 1).Electron get transferred from one atom to another fully and the respective atoms gain charges so they will then be called Ions. Ions are positive (cat ion) and negative (an ion) and in that molecule they are held together by what is called an ionic bond. 2). When the electron transfer does not happen fully but instead shared by the two atoms involved is called covalent bond. Both atoms claim their share so there is no net transfer of electrons between the atoms. There fore it remains pretty much neutral. It is called non polar covalent bond. When there is a little difference between the pulling power of the two atoms there is partial imbalance in the position of the shared electron giving some polarity (charge, it is a very weak quantitatively). This type of bond is called polar covalent bond. This is what we see in the water molecule and evidently very important in determining the solubility of the substances. 3). Hydrogen Bond is a weak type of bond seen between hydrogen atoms in a compound and non hydrogen atoms in another molecule when they both have polar covalent bonds.

Diagrams representing each types of bonds:

Differences between non-polar and polar covalent compounds