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Anesthesiology Master > Gas Inhalents (EB) > Flashcards

Gas Inhalents (EB) Flashcards

1
Q

Which current inhalation agents are volatile liquids?

A

iso Des Sevo

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2
Q

Which current inhalation agent is a gas?

A

nitrous oxide

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3
Q

What anesthetic properties are influenced by halogenation?

A

anesthetic potency, arrhythmic properties, flammability, chemical stability

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4
Q

Flammability of gases? NB?

A

gone for the potent agent. NB: N2O supports combustion

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5
Q

Why is recovery from gases so quick? Which one is the slowest?

A

barely any metabolism of the gases

Halothane is the slowest

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6
Q

Physical properties of an inhalant that determines the methods of administration? (4)

A

molecular weight - Boiling point - Liquid density (specific gravity) - *vapor pressure

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7
Q

Physical properties of an inhalant that influences drug kinetics (2)?

A

solubility of gases like
Blood gas solubility
Oil gas solubility

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8
Q

What is Dalton’s law?

A

each gas has it’s own partial pressure on a container’s walls
TP = sum of partial pressures

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9
Q

What is saturated vapor pressure?

A

molecules of a volatile liquid in a closed container at fixed temperature evaporate

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10
Q

What is vapor pressure?

A

pressure exerted by the gaseous phase in the container at equilibrium

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11
Q

The higher the standard vapor pressure, what does it mean for volatility?

A

The more volatile the agent, the higher the conc of molecules in gaseous phase.

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12
Q

Why is SVP important for anesthesia?

A

determines the concentration needed for anesthesia

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13
Q

Purpose of a vaporizer

A

dilute inhalational agents to a safe concentration

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14
Q

Modern vaporizers are (3)

A

Agent specific,
Concentration calibrated,
Temperature compensated

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15
Q

What special circumstances are needed because desflurance has a BP of 23.5 C?

A

vaporizer that is connected to electricity to warm it

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16
Q

Relation of the blood-gas partition coefficient and induction/recovery/change of anesthetic depth

A

inversly related

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17
Q

Relation of the oil-gas partition coefficient and anesthetic potency

A

direct correlation

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18
Q

Rate of concentration rise in blood influenced by (4)

A

Inhaled conc and FGF
Alveolar ventilation
Solubility in blood
Cardiac output

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19
Q

Sequence of partial pressure gradient

A

Vaporizer
Breathing system
Alveoli
Blood Brain

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20
Q

Primary objective of movement from anesthesia machine to the brain

A

Same partial pressures on either side of every tissue ‘interface’

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21
Q

How can you accelerated ‘washout’ from tissues

A

high FGF, Empty reservoir bag

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22
Q

Washout from different tissues occurs at _ rates

A

different

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23
Q

Factors affecting recovery (5)

A
  • Alveolar ventilation
  • Solubility
  • CO
  • Anesthesia duration
  • Metabolism
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24
Q

What is minimum alveolar concentration (MAC)?

A

The minimal alveolar conc of an inhalant anesthetic at 1 atm that provides immobility in 50% of the subjects exposed to a supramaximal noxious stimulus.

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25
Q

Relationship between MAC and potency?

A

inversely related

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26
Q

List iso, sevo, des, halo, and N2O by lowest to highest MAC

A

Lowest - Halo – Iso - Sevo – Des - N2O – Highest

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27
Q

When is anesthetic gas measured?

A

Inhaled conc, Exhaled conc

28
Q

What is the ET gas conc a reflection of?

A

agent’s tension in the brain

29
Q

Factors that decrease MAC (8)

A 
1-sedatives/analgesics/injectable anesthetics 
2- N2O 
3- increasing age 
4- hypothermia 
5- pregnancy 
6- severe hypoxemia 
7- severe hypercapnia 
8- concurrent illness
30
Q

What constitutes severe hypoxemia

A

PaO2 < 40 mm Hg

31
Q

What constitutes severe hypercapnia

A

PaCO2 > 90 mmHg

32
Q

Unique feature of N2O

A

only gaseously stored inhalant

33
Q

Why is N2O even still used today?

A

provides analgesia

34
Q

CV side effects of N2O

A

minimal

35
Q

Onset and recovery of N2O

A

rapid

36
Q

How is N2O usually given

A

combined with other inhalant anesthetic agent

37
Q

MAC of N2O in animals

A

about 200%

38
Q

Can you administer N2O with a vaporizer?

A

no

39
Q

Why can you not administer less than 1/3 O2 in mixture with N2O?

A

proportioning device on modern flowmeters

40
Q

What is the second gas effect? What gas has it?

A

N2O accelerates initial uptake of an anesthetic gas given concomitantly

41
Q

What surgeries are contraindicated with N2O? Why?

A

THINGS WITH GAS FILLED SPACES

  • Rumen
  • Stomach (GDV)
  • unfasted animals
  • closed pneumothorax
  • ocular surgery
42
Q

Why does N2O have a risk of hypoxemia? How is this combated?

A

N2O rapidly diffuses into alveoli after administration is stopped.
Dilution of O2 in alveoli -> risk of hypoxemia.
Provide O2 for 10 minutes after turning off N2O

43
Q

Advantages of N2O (3)

A

second gas effect
MAC
sparing
Analgesia

44
Q

Disadvantages of N2O (5)

A 
low potency    
Diffusion into gas-filled spaces  
Potential for hypoxia   
Drug abuse   
Environmental impact
45
Q

Why are your dials sticky after using halothane?

A

0.01% thymol preservative in the halothane -> dissoves rubber

46
Q

CV effects of halothane

A

Depressed myocardial contractility
Reduces CO, SV, MAP (dose dependent)
Arrhythmogenic

47
Q

Why is halothane arrhythmogenic

A

sensitizes myocardial conduction to catecholamines

48
Q

Potency of isoflurane? Why?

A

very potent

MAC 1.3%-1.6%

49
Q

Resp effects of isoflurane?

A

resp depressant

50
Q

CV effects of iso

A

decrease BP

51
Q

Is iso put in a preservative?

A

no

52
Q

Induction and recovery of iso

A

both rapid

53
Q

Mac of sevo

A

2.3-2.6%

54
Q

Is there a preservative in sevo?

A

no

55
Q

How is compound A formed?

A

sevo degradation

56
Q

When is compound A nephrotoxic?

A

in rats, At high concentration

57
Q

What does compound A react with? What system therefore can it not be used in?

A

interaction with CO2 absorbent. Cant really be used in a rebreathing system

58
Q

MAC of desflurane

A

7-10%

59
Q

What is malignant hyperthermia?

A

potentially life-threatening myopathy

60
Q

What triggers malignant hyperthermia?

A

all 4 current volatile inhalant agents ((and depolarizing neuromuscular blocking agents))

61
Q

Animals most like to least likely to get malignant hyperthermia?

A

pigs&raquo_space; horses and dogs > cats

62
Q

CS of malignant hyperthermia

A

hyperthermia

Muscle fasciculation Tachycardia

63
Q

How can you recognize early malignant hyperthermia?

A

monitoring temp and CO2 for early recognition

64
Q

Tx of malignant hyperthermia

A

Discontinue trigger
Cooling
Dantrolene

65
Q

US regulatory agencies for anesthetic gas toxicity (3)

A

NIOSH
OSHE
FDA

66
Q

How does halothane kill you?

A

halothane hepatitis (hepatic necrosis and death)

Anesthesiology Master (20 decks)

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