Inhalant Anesthetics

Question 1

unique because

Answer 1

• administered and eliminated through the lungs

- nothing depends on liver/kidney

Question 2

chemistry

Answer 2

• organic other than NO

- halogenated (dec. reactivity and inc potency, nonflammable)

Question 3

Halothane uses a ______ whereas Isoflurane does not

Answer 3

preservative

-> arrythmias

Question 4

difference between iso and haloflurane

Answer 4

iso has an ether bond

Question 5

which are gases v. vapors?

Answer 5

NO is gas, most inhalants are vapors

Question 6

vapors still abide by same gas laws as gases T/F?

Answer 6

T

Question 7

have to give ______ concentration of inhalant in lower pressured areas (mountains) to give the same pp of inhalant.

Answer 7

higher

Question 8

Can you give 100% iso?

Answer 8

nope, vapor pressure doesn’t allow it

Question 9

As temperature decreases vapor pressure ______

Answer 9

decreases

Question 10

boiling point is close to room temperature and so…

Answer 10

desflurane, requires headed vaporizer, needs a outlet

Question 11

solubility expressed as a

Answer 11

partition coefficient

molecules in blood/ molecules in gas

Question 12

why is solubility important

Answer 12

predicts the speed of anesthetic induction, recovery,

lower the coefficient the faster the onset and recovery

Question 13

vapor pressure determines the number of

Answer 13

molecules of inhalant available to produce anesthesia

Question 14

Desflurane is most_____ (not including N2O)

Iso is most ______ (not including halothane)

Answer 14

insoluble (fastest onset of action)

soluble

Question 15

inhalant anesthetics sites of action

Answer 15

brain (amnesia)
spinal cord (immobility)
(pp of inhalant in brain/cord is what causes anesthesia)

Question 16

potency

Answer 16

dose required to reach a desired effect (only related to dose!!!!)

Question 17

minimum alveolar concentration (MAC) has to do with

Answer 17

potency (=1/potency)
=ED50
(prevents gross purposeful movement in 50% patients)
(many different kinds of MACs)

Question 18

N2O cannot be used

Answer 18

alone

Question 19

3 factors influence anesthetic uptake (out of lungs and into blood)

Answer 19

1. solubility
2. CO
3. Alveolar-venous anesthetic pp difference

Question 20

The higher the alveolar pp the higher the _____ pp. Caused by minimizing the uptake.

Answer 20

brain

Question 21

how to speed up induction

Answer 21

1. turn up concentration
2. turn up flow rate
3. make sure patient is breathing

Question 22

more soluble =

Answer 22

more ‘reluctant’ to leave the blood

Question 23

Faster induction with _____ Cardiac output.

Answer 23

low

think super excited puppy, will take longer to induce

Question 24

must exist for uptake to occur

Answer 24

Pa - Pv gradient!

Question 25

Elimination is affected by

Answer 25

1. solubility (-)
2. CO (+)
3. duration of anesthesia

Question 26

toxic metabolites can be produced.
Iso desflurane -> _____
Sevoflurane ->______

Answer 26

CO (not a big concern)

compound A

Question 27

inhalants decrease cerebral _______ and increase _______

Answer 27

metabolic rate

cerebral blood flow (increases intercranial pressure)

Question 28

worst side effect is: all inhalants decrease cardiac ______

Answer 28

output

negative inotropic, decrease peripheral vascular resistance/ BP

Question 29

in pulmonary system the inhalants can act as a safety mechanism

Answer 29

when Pbrain inc. -> dec. ventilation -> dec. uptake ->

dec. Pbrain

Question 30

inhalant depresses spontaneous

Answer 30

ventilation

can potentially cause apnea

Question 31

use ____ in hapatocompromised

Answer 31

iso

Question 32

malignant hyperthermia

Answer 32

• most common in pigs
• genetic, when exposed to inhalant, sarcolemma inc. Ca+ -> ->death
• tx. dantrolene and get off that machine