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Anaesthesiology > IAA > Flashcards

IAA Flashcards

1
Q

What is MAC?

A

Minimum alveolar concentration- where 50% of the patients do not respond to painful stimulus

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2
Q

What is MAC awake?

A

It is a third of MAC and the patient starts to wake up but is still in sleep

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3
Q

What is MAC Bar?

A

It stands for Minimum alveolar concentration that blocks autonomic response- so things like pupil dilation,heart rate and blood pressure

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4
Q

What factors decreases MAC?

A
  1. shock
  2. pregnancy
  3. acute alcohol intoxication
  4. Elderly
  5. low body temperature
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5
Q

What factors increases MAC?

A
  1. chronic alcohol intoxication
  2. ephedrine
  3. cocaine
  4. acute amphetamine
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6
Q

What receptor does N20 work at and what does it do?

A

It works at NMDA and it inhibits it

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7
Q

Where do the 4 IAA work on?

A

GABA A receptor and it increases it

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8
Q

What is a medical metabolism condition that halothane is assciated with?

A

Hepatitis because 15-20% of it is metabolised in the liver

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9
Q

What is the effect of halothane on the cardiovascular system?

A

-Decreases BP
-Decreased CO
-Decreased Heart Rate
which leads to hypercarbia and evidently ventricular extra systoles (VES)

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10
Q

What is the MAC of halothane?

A

0,75 which means it is the most potent of all the IAA drugs

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11
Q

What can we use halothane for when it comes to bronchospasm?

A

It can be used as a potent bronchodilator

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12
Q

Which IAA smells noxious?

A

isoflurane

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13
Q

What is the MAC of isoflurane?

A

1,15

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14
Q

Which IAA do we prefer for liver and neurosurgery?

A

Isoflurane

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15
Q

What is the MAC of sevoflurane?

A

2

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16
Q

Which IAA smells the best?

A

sevoflurane

17
Q

Why is sevoflurane faster for the pt to wake up?

A

Because the blood gas ratio is 0,65 which means it is not very soluble in the blood and so we can reverse it easily

18
Q

What about sevoflurane makes it nephrotoxic?

A

Potential to have compound A in rats which is nephrotoxic

19
Q

Why is desflurane not recommended for inhaled induction?

A

It causes severe laryngospasm and coughing and possible increase in airway resistance

20
Q

What is the effect of halothane, isoflurane and sevoflurane on the respiratory system?

A

It causes bronchodilation

21
Q

Properties of N20 that are positve?

A
  • It is a drug used concurrently with other IAA
  • has a fast wash in and wash out mechanism(so has low solubility)
  • analgesic
22
Q

Disadvantages of N20?

A
  • mac 105%
  • hypoxic diffusion
  • suppresses vitamin B12
  • Expands air filled spaces(cannot use in pneumothorax)
23
Q

What are some basic influences of the alveolar concentration?

A
  1. Fresh Gas Flow
  2. Inspiratory fraction of the inhalational agent
  3. alveolar minute ventilation
24
Q

What would cause a decrease in the alveolar inhalational agent concentration?

A
  1. Cardiac output- a increase in co means that blood flows past the alveolar more
  2. solubility of the IAA
  3. Mixed venous concentration IAA
25
Q

Which two inhalational agent drugs can be used with or without nitrous oxide and suitable for children?

A

-halothane and sevoflurane

26
Q

What is the second gas effect?

A

When nitrous oxide is added with an inhalational gas to speed up induction

27
Q

What is alveolar concentration directly proportional to?

A

-It is directly proportional to alveolar partial pressure which will in turn affect how much anaesthetic agent is in the blood and then the brain

28
Q

What colour gas cylinder is NO2?

A

BLUE

29
Q

What is entonox?

A

-it is a mixture of 50% oxygen and 50% nitrous oxide that is used for analgesia in labor and mild procedures

30
Q

What is diffusion hypoxia?

A
  • this is a phenomenon that happens after we switch off N2O and it diffuses from the blood back into the alveoli and causes decreased oxygen and hypoxia
  • because of this we have to give oxygen at 80-100% for 5-10 minutes after N20 is switched off
31
Q

Which gas contributes potently to PONV?

A

-Nitrous oxide

32
Q

Which IAA does not contribute to malignant hyperthermia?

A

-nitrous oxide

33
Q

What effect does halothane have on the CNS?

A

-It increases the ICP and bloodflow

34
Q

What is the effect of isoflurane on CVS?

A
  • Decreases blood pressure
  • decreases SVR
  • increases HR
35
Q

What is compound A?

A

-Compound A is a toxic end product found when sevoflurane reacts with soda lime

36
Q

Which two gases are not used as inhalational induction agents?

A

-isoflurane and desflurane

37
Q

What is the Mac of N20?

A

105%

Anaesthesiology (25 decks)

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