A.23.inhalational anesthetics Flashcards

1
Q

what is the blood/gas partition coefficient?

A

it’s a pharmacokinetic parameter
the ratio of–> concentration of an anesthetic in the blood phase (bound, inactive form) to the concentration of the anesthetic in the gas phase (free active form)

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2
Q

when is the blood/gas coefficient low?

A

nitrous oxide
drug is less blood soluble
equilibrates faster with blood
rapid onset and recovery from anesthesia

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3
Q

when is the blood/gas coefficient high?

A

halothane
drug is more blood soluble
slower onset and recovery from anesthesia

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4
Q

parameters affecting the kinetics of inhaled anesthetics?

A

the partial pressure of inspired gas
ventilation rate
pulmonary blood flow

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5
Q

how does the partial pressure of inspired gas affect the kinetics of inhaled anesthetics?

A

↑ partial pressure of the gas in the lung–> ↑ rapid achievement of anesthetic effect

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6
Q

how does ventilation rate affect the kinetics of inhaled anesthetics?

A

↑ ventilation rate–> faster onset of the anesthesia

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7
Q

how does pulmonary blood flow affect the kinetics of inhaled anesthetics?

A

↑ pulmonary blood flow–> slower onset of anesthesia

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8
Q

what is the minimum alveolar anesthetic concentration? (MAC)

A

measure of drug potency (ED50)

the alveolar concentration at which 50% of patients do not respond to a surgical stimulus

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9
Q

what affects the MAC?

A

the ↑ lipid soluble anesthetic the ↓ MAC –> the greater potency

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10
Q

when are MAC values low?

A

in elderly, infants, opiates or sedative-hypnotics

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11
Q

are MAC valures additive?

A

yes

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12
Q

what is the clinically used gas?

A

nitrous oxide (N₂O)

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13
Q

list the volatile liquids

A
Desflurane
Isoflurane
Sevoflurane
Halothane
Enflurane
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14
Q

which agent has the highest B/g coefficient?

A

halothane–> 2.3

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15
Q

which agent has the lowest B/g coefficient?

A

Desflurane–> 0.42

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16
Q

which agent has a MAC value of >100%?

A

N₂O

17
Q

what is the fraction metabolized by the liver for N₂O?

A

none

18
Q

what is the second gas effect in N₂O?

A

due to the rapid diffusion of N₂O in the alveoli there a ↑ concentration of a second agent

19
Q

what are the potential SE of N₂O?

A

risk of spontaneous abortion (trigger uterine contraction)
potential drug of abuse (‘laughing gas’)
diffusional hypoxia

20
Q

MAC value of desflurane

A

6.5%

21
Q

fraction metabolized by the liver of desflurane

A

<0.1%

22
Q

MAC value of isoflurane

A

1.4%

23
Q

fraction metabolized by the liver of isoflurane

A

<2%

24
Q

fraction metabolized by the liver of sevoflurane

A

2-5%

25
Q

MAC value of sevoflurane

A

2%

26
Q

what agent causes nephrotoxicity?

A

sevoflurane

*enflurane

27
Q

what agent causes hepatotoxicity?

A

halothane

28
Q

what agent causes arrhythmias?

A

isoflurane

halothane

29
Q

what agent has a potential risk for malignant hyperthermia?

A

halothane

30
Q

what agent causes bronchospasm?

A

desflurane

isoflurane

31
Q

what agent causes peripheral vasodilation?

A

isoflurane