deck_2484437

Question 1

enflurane class

Answer 1

halogenated methyl ethyl ether- isomer of isoflorane

Question 2

enflurane MOA

Answer 2

unsure exact MOA but Myer overton theory is widely accepted

Question 3

enflurane PK

Answer 3

sweet mild; elimated by exhalation. metabolized but the liver 2-5%.

Question 4

enflurane SE

Answer 4

increase CBF/ICP; decreases CMRO2; increases csf secretion and resistance to csf outflow; Sz possible bc reg changes; decreases bp svr co; increase HR; bronchodilation ; decreases mucocilliary fx; decreases RBF, GFR, UOP, HBF; sensitizes heart to Epi=increase likelihood of dysthrythmias. respiratory depression

Question 5

enflourane CI

Answer 5

renal dysfunction, sz, mh. potentiates NMB

Question 6

enflurane dose

Answer 6

vp= 175; bg1.8; MAc 1.68

Question 7

Halothane class

Answer 7

halogenated alkane derivative with bromide substitution

Question 8

halothane MOa

Answer 8

uncertain- myer overtion theory widel accepted

Question 9

Halothane PK

Answer 9

nonflammable, sweet, thymol preservative, eliminated by exhalation. metabolized 15-20% in the liver

Question 10

halothane SE

Answer 10

increases CBF/ICp, decreases CMRO2. direct myocardial depressant, decrease SA/AV node transmission, sensitizes heart to EPI; decreases BP and CO. no change with SVR; no change or decreased HR; CA dilator; Bronchodilation; can cause halothane hepatitis from response to trifluroacetic acid; decreased rbf, gFR, uo. decrease hepatic BF

Question 11

halothane Cl

Answer 11

liver disorder, CCB, BB, TCA/MAoi’s, MH, AS. no kidney disease/ neuro/pheochromocytoma. aminophylline cause ventricular dysthrythmias, hypovolemia; impares metabolism of fentanyl, phenytoin, verapamil; potentiated by NMB.

Question 12

halothane dose

Answer 12

VP=244; BG 2.4; MAC 0.74

Question 13

propofol class

Answer 13

nonbarbituate induction agent 26 di isoprophenol

Question 14

propofol MOA

Answer 14

discourages GABA from disassociating from the GABA A receptor, prolonging action and increasing conductance of CL= hyperplarizes the cell and decreases neuronal transmission; inhibits glutamate at NMDA receptor

Question 15

propofol PK

Answer 15

lipid soluble; VD= 2.5-4.5L/KG; onset 30 seconts; quickly redistributed in 2-8 min; E1/2 1hr; conjugated in the liver to glucuronide and sulfate by cytochrome P-450 to produce water soluble compounds which are excreted by the kidneys; extrahepatic metabolism or extra renal elimination is suggested; lungs play role in extrahepatic metabolism and are responsible for uptake and first pass elimination

Question 16

propofol SE

Answer 16

decrease CBF/ICP/CMRO2/CPP/IOP/eeg bursts. apnea- decreased response to CO2/hypoxia, broncholdialation/pulmonary vasoconstriction reflex intact, , myoclonus, hiccups, decreases BP 25-45%, SV/CO/SVR. HR= myocardial depression, antiemetic, antipuretic, amnestic >30mcg/kg/min

Question 17

propofol CI

Answer 17

hypotension/hypovolemia/soy/egg yoke allergy. decrease dose in elderly, increase dose in <2yr old; crosses placenta. does not potentiate MR

Question 18

propofol dose

Answer 18

induciotn 1-2.5mg/kg; sedation 25-100mcg/kg/min; main 100-300mcg/kg/min

Question 19

Desflurane class

Answer 19

florinated methyl ethyl ether; structure sim to iso but a F exchanged for Cl

Question 20

Desflurane MOA

Answer 20

myer overton theory most widely accepted

Question 21

DesfluranePK

Answer 21

have to use a Tec 6 vacorizor bc VP so high; fast on fast off because of BG coefficient; eliminated by exhalation. oxidative hepatic metabolism <0.02% by p450- low risk for halothane hepatitis,

Question 22

Desflurane SE

Answer 22

increase CBF/ICP, decreased CMRO2/CPP; transient SNS activity proceeds a decreased BP/SVR/Co increased HR~; doesn’t dilate CA; myocardial contractility depressant, boncholdialtion; decreases RBF/GFR/UOP. decreases HBF- transient increase in LFTs; aW irritant- can causes cough/laryngospasm/increased secretions; dose related respiratory depression= increase RR and decreased TV, • Reduces hypoxic pulmonary vasoconstriction at doses >1 MAC increasing the risk of hypoxia during one lung ventilation ; high rate of emergence delirium esp in pecs; PONV

Question 23

Desflurane CI

Answer 23

potentiates NMB; MH, Peds, CAD and myocardial ischemia- bc of the increased Cardiac demand with HR

Question 24

Desflurane dose

Answer 24

VP 664; BG 0.42; MAC 6%