1. Inhalational anesthetics

Question 1

Inhalation anesthetics

Answer 1

gases & volatile liquids

Question 2

Gases

Answer 2

Nitrous oxide

Question 3

Nitrous oxide

Answer 3

Analgesia > General anesthesia 
mixed with O2 
for general anesthesia, mixed with other compounds
No muscle relaxation 
“Diffusion hypoxia” 
toxic for staff 
safest anesthetic

Question 4

Diffusion hypoxia

Answer 4

The Fink effect or the “third gas effect
A factor that influences the pO2 within the alveolus

When water-insoluble gases( N2O ) are breathed in large quantities they can be dissolved in body fluids rapidly. This leads to a temporary increase in both the concentrations and partial pressures of oxygen and carbon dioxide in the alveolus

can occur with the administration of inadequate amounts of oxygen during or immediately after N2O anesthesia

Question 5

Volatile liquids

Answer 5

Halogenated & Ether derivatives

Question 6

Halogenated Volatile liquids

Answer 6

Halothane

Question 7

Ether derivatives

Answer 7

suffix -flurane

Enflurane
Isoflurane
Desflurane
Sevoflurane

Question 8

Halothane

Answer 8

Prototype
General anesthesia > analgesia
Bronchodilator, relaxes uterine and skeletal muscles
Hepatotoxic for adults (mainly in low O2 concentration)
metabolized to free radical, 50% die of hepatic necrosis
not used due to adverse effects
AE: cardiac (arrhythmias and concentration dependent hypotension), Malignant hyperthermia

Question 9

Enflurane

Answer 9

Fast induction and recovery
some muscle relaxation effect
AE: stimulates respiratory reflexes (Cough), CNS (epileptiform seizures, intracranial pressure elevation)

Question 10

Isoflurane

Answer 10

isomer of enflurane
Good control of intracranial pressure
AE: stimulates respiratory reflexes (Cough), Dose-dependent hypotension

Question 11

Desflurane

Answer 11

rapid onset and recovery (very low solubility)
delivered using special heated vaporizer (which is expensive)
high airway irritation (not used for inhalation induction)

Question 12

Sevoflurane

Answer 12

Rapid onset and recovery ( low solubility) 
No airway irritation 
used for induction 
metabolized by the liver 
AE: nephrotoxicity

Question 13

prevention of adverse effects of halothane

Answer 13

phenylephrine: for arrhythmias
dantrolene: for Malignant hyperthermia