Desflurane Flashcards
How many compounds were discovered between 1959-1980?
over 700
What compound was Desflurane?
Compound 653, initially discarded, exposive
What caused re-evaluation of compound 653?
increased outpatient surgery
What is the other name for Desflurane?
Suprane
What is the molecular weight of Desflurane?
168
What is the vapor pressure of desflurane?
667 mmHg; HIGH, can be hard to manage.
how is des stored?
amber glass or aluminum
What are some characteristics of des?
stable, doesn’t corrode metals, no known impurities, nonflammable
What is the boiling point of des?
23.5C/74.3F; LOW!
True/false: Desflurane is not affected by body weight or kidney function.
True, not weight based.
True/false: MAC of des is not affected by age
False! Higher the age the lower the MAC.
True/false: Des needed a specially constructed/pressurized vaporizer?
True; Tech6; needed to heat Des to 104F and keep it at 2atm to ensure constant delivery. Modern anesthesia has a cassette though, no longer need special vaporizer.
What are the cardiovascular effects of Desflurane?
similar to iso, minimal effect on coronary blood flow, CO unchanged or slightly depressed at 1-2 MAC, SVR reduced, MAP reduced (dose dependent/predictable), moderate rise in HR (rapid increase in conc can cause transient increase in catecholamines), CVP, PAP, doesn’t sensitize myocardium (no arrhythmias)
What are the respiratory effects of Des?
high incidence of laryngospasm/coughing/increased secretions, decreases tidal volume, increase RR, decrease in alveolar ventilation and increase PaCO2, depress ventilatory response to increasing PaCO2, 1.5 MAC or greater can cause apnea.
What are the hepatic effects of des?
close to no metabolism, function tests unaffected, no hepatic injury
What are the renal effects of des?
close to no renal metabolism, PO creat and UOP don’t differ significantly
What are the neuro effects of des?
decreases CVR, increased CBF, increased ICP, marked decline in CMRO2–cerebral vasoconstriction and moderate increase CBF, dose dependent increase in CSF production, EEG–burst suppression at >1.2 MAC, caution if need high CBF.
What are the musculoskeletal effects of des?
dose-dependent decreased muscle tone, decreased response to TOF, synergistic effects with depolarizing and nondepolarizing agents
Can you use des for inhalation induction?
Not routinely done, could but would need blunting with narcs. AIRWAY IRRITANT!
Are there any drug interactions with Desflurane?
no clinically significant reactions, NDMR synergism, reduces ED95 of succ, can use with benzos to reduce MAC by 16% and opioids by 50%
Can des be used in combo with Nitrous Oxide?
Yes, no advantage with induction, Less PONV when used without N2O, N2O may cause increased BP and SVR and decreased HR and CO so you could use it with des.
What is the most to least expensive volatile?
Sevo, Des, Iso
Is Des bad for the environment?
Yes, 20x more potent of a greenhouse gas than sevo
Pros for des:
low B:G/fast onset, skeletal muscle relaxation, lack of toxicity, minimal metabolism
