Anesthesia MidTerm (LS) Flashcards

1
Q

U.S. recommended trace limits for the

inhalant anesthetics

A
  • 25 ppm N2O
  • 2 ppm all others
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2
Q

Women should be particularly careful when using what inhalant anesthetic?

A

N2O

(miscarriages, decr. fertility)

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3
Q

List methods to reduce exposure to Inhalants.

A
  • Gas scavenger
  • Regular inspection of anesthethic equipment
  • No N2O w/ activated charcoal scavenger
  • Minimize use of face mask & induction chamber
  • Adequate ventilation
  • Inflate cuffs appropriately
  • Low flow anesthesia (when possible)
  • Keep distance during recovery
  • Vaporizer with key-filler system
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4
Q

2nd Gas Effect?

A

one gas accelerates the inital uptake of a different anesthetic gas when given together

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5
Q

What is the MOA of Inhalants?

A

Not clear!

suggestions:

  • Meyer-Overton theory
  • Protein-receptor hypothesis
  • Activation of GABA receptors
  • Inhibition of certain Ca2+ channels
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6
Q

Factors DECREASING MAC?

(8)

A
  • Pre-meds
  • N2O
  • Increasing age
  • Hypothermia
  • Pregnancy
  • Severe hypoxia (PaO2 < 40 mm Hg)
  • Severe hypercapnia (PaCO2 > 90 mm Hg)
  • Concurrent illness
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7
Q

Which measurement reflects the inhalant agent’s tension in the brain?

A

Exhaled Conc.

a.k.a

End Tidal or ET

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8
Q

What is used as the standard index of anesthetic potency?

A

MAC

(Min. Alveolar Conc)

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9
Q

Definition of MAC?

A

the minimum concentration of anesthetic in the alevoli that produces immobility in 50% of subjects exposed to a supramaximal noxious stimulus @ 1 atmosphere

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10
Q

MAC is _______ related to Potency.

A

INVERSELY

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11
Q

5 factors affecting recovery from Inhalants?

A
  • Alveolar ventilation
  • Solubility
  • CO
  • Duration of anesthesia
  • Metabolism
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12
Q

How can you accelerate “Washout” of Inhalants?

(2)

A
  • High FGF
  • Empty reservoir bag
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13
Q

What influences the rate of [inhalant] rise in blood?

(4)

A
  • Inhaled conc. → FGF
  • Alveolar ventilation
  • Solubility in blood
  • CO
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14
Q

When will an inhalant agent cross from the blood into the brain?

A

when there is an equilibrium btwn alveolus, blood & the brain

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15
Q

Which coefficient describes how quickly an agent moves from the alveoli → blood?

A

Blood-Gas Coefficient

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16
Q

Which coefficient determines how quickly an agent passes from the blood → brain?

A

Oil-Gas Coefficient

17
Q

Oil-Gas Partition Coefficient is _____ correlated to anesthetic Potency.

A

DIRECTLY

18
Q

List the Inhalants in order from High→Low based on their Oil-Gas Partition Coefficient

A
  1. Halothane
  2. Iso
  3. Sevo
  4. Des
  5. N2O
19
Q

Blood-Gas Coefficient is ________ related to speed of induction, recovery & change in anesthetic depth.

A

INVERSELY

20
Q

List the inhalant agents from High→Low by their Blood-Gas Partition Coefficients.

A
  1. Halothane
  2. Iso
  3. Sev
  4. Des
  5. N2O
21
Q

@ Equilibrium btwn the different phases (oil, gas, water), the _______ is the same while the ______ may be different.

A
  • Same partial pressure
  • Different conc.
22
Q

3 things about Modern vaporizers

A
  • Agent specific
  • Conc. calibrated
  • Temp compensated
23
Q

Saturated Vapour Pressure (SVP) refers to?

A
  • Max. possible conc. of molecules in the gaseous phase at a specific temp.
  • Higher the SVP→ more volatile the agent→high [molecules] in the gas phase
24
Q

Which Local Anesthetics are Esters?

(4)

A
  • Cocaine
  • Procaine
  • Tetracaine
  • Amethocaine

All others are Amides

25
Q

MOA of LAs?

A

directly blocks Na+ channels→ prevents Na+ influx → membrane stabilization (can’t depolarize)

26
Q
A