Inhalants Flashcards

1
Q

Effects of inhalant anesthetics?

A
  1. unconsciousness
  2. Immobility
  3. anti-nociception
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2
Q

Inhalants are administered and eliminated by the ____, have a _____&________ Titration making it easy to control over anesthetic depth, and are easy to ______.

A

lungs
predictable and rapid titration
reverse

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3
Q

Which inhalant is most/least expensive?

A

Desflurance $$$ > Sevoflurance $$ > Isoflurane

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4
Q

Saturated vapor pressure determines the

A

number of molecules of vapor available for delivery to a patient

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5
Q

Why do we need a vaporizer?

A

Dilutes the inhalant with a carrier gas (oxygen) to deliver a safe concentration to the patient

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6
Q

Modern vaporizers are all?

A

Temperature compensated (so that saturated vapor pressure is predictable and not changed by differing room temperatures)

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7
Q

The greater the vapor pressure of the inhalant the ______ the volatility

A

greater

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8
Q

What do you do if someone puts the wrong inhalant in the vaporizer?

A
  1. send to manufacturer for servicing

2. drain, run high flow oxygen for several hours then check for trace levels with an analyzer.

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9
Q

partial pressure =?

What does this mean at higher altitudes?

A

concentration x atm P

Harder to keep patients anesthetized at higher altitudes using the same concentration.

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10
Q

Rapid increase in Alveolar pressure will?

A

rapidly increase anesthetic depth

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11
Q

Two ways we increase anesthetic depth?

A

increase alveolar delivery & minimize uptake from alveoli

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12
Q

How do we increase alveolar delivery

A

Turn up concentration, increase fresh gas flow, minimize circuit volume

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13
Q

Time Constant

A

time to make a 50% change in a closed system; = Volume / Flow

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14
Q

How do we minimize uptake from alveoli?

A
  1. use an agent with low blood solubility like Isoflurane
  2. Slow CO
  3. high alveolar: pulmonary blood partial pressure gradient
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15
Q

Summary for quickly changing anesthetic depth

A
  1. inc. inspired concentration
  2. inc. fresh gas flow
  3. ventilate
  4. minimize dead space
  5. pre-medicate for pain/anxiety
  6. use agent with low blood:gas partition coefficient
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16
Q

Summary for quickly recovering from an inhalant?

A
  1. Turn off vaporizer/remove excess from reservoir bag/remove patient from machine
  2. use agent with low blood solubility
  3. inc. fresh gas flow
  4. assist with ventilation
  5. shorten duration under anesthesia
  6. increase CO
17
Q

Potency of an inhalant is _______ to its MAC

A

inversely related

18
Q

potency of inhalants?

A

iso > sevo > desflurane

19
Q

induce patients at _____ MAC

and maintain at _____ MAC

A

2-3 x (or ED95)

1.2-1.5x

20
Q

What will increase MAC?

A

hyperthermia, hypernatremia, drugs that stimulate the CNS, increased excitatory NTs

21
Q

Effect of inhalants on the cardiovascular system?

A

decreased contraction, CO, hypotension. dose dependent

can tx with fluids, inotrope/vasopressors

22
Q

Effect of inhalants on the respiratory system?

A

hypoventilation -> apnea
bronchodilation
dose dependent
tx: support ventilation

23
Q

Effect of inhalants on the Neurologic system?

A

increase ICP when >1 MAC, cerebral vasodilation, worsened by hypoventilation

24
Q

Effect of inhalants on the Musculoskeletal system?

A

Malignant Hyperthermia
massive release of Ca -> inc. arterial CO2, tachycardia, hyperthermia, acidosis, electrolyte imbalance, circulatory shock and death