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Anesthesia Pharmacology > Inhalation Agents > Flashcards

Inhalation Agents Flashcards

1
Q

Inhalation Agents MOA (3)

A

Volatile anesthetics primarily affect the function of ion channel and neurotransmitter receptor proteins in the membranes of nerve cells, which are lipid environments.

CNS ; GABAa stimulation produces supraspinal inhibition of transmission.

The Spinal Cord mediates immobility via inhibition of glycine channels.

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2
Q

Inhalation Agent Effects (4)

A

Unconsciousness : cerebral cortex, thalamus

Amnesia : amygdala , hippocampus

Analgesia: spinothalamic tract

Immobility : spinal cord receptors

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3
Q

Vapor Anesthetic Effects on Cardiac (4)

A

decrease BP, CO, SVR

+/- heart rate

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4
Q

Vapor Anesthetic Effects on Respiratory (2)

A

increase rate, decrease TV

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5
Q

Vapor Anesthetic Effects on Cerebral (2)

A

increase blood flow , decrease CMRO2

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6
Q

Vapor Anesthetic Effects on Muscular

A

Neuromuscular relaxation

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7
Q

Vapor Anesthetic Effects on Renal (2)

A

decrease blood flow and filtration rate

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8
Q

Vapor Anesthetic Effects on Hepatic

A

decrease blood flow

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9
Q

Vapor Anesthetic Effects on Metabolism (2)

A

slight decrease if normothermic

all are MH triggers

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10
Q

Isoflurane Class

A

Halogenated methyl ethyl ether

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11
Q

Isoflurane Vapor Pressure (pressure exerted by molecules from a volatile liquid that escape the liquid phase and become vapor, higher number= more molecules in vapor phase)

A

VP 239 mm Hg at 20 degrees C

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12
Q

Isoflurane MAC (relative potency)

A

MAC 1.17 in oxygen

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13
Q

Isoflurane B/G Coefficient (speed of onset, lower # = faster)

A

B/G = 1.4

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14
Q

Isoflurane Oil/Gas Coefficient (usually inversely related to MAC)

A

Oil /gas = 0.99

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15
Q

Isoflurane Considerations (3)

A

Not degraded
Non flammable
Irritating to airways

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16
Q

Desflurane Class

A

Fluorinated methyl ethyl ether

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17
Q

Desflurane Vapor Pressure (pressure exerted by molecules from a volatile liquid that escape the liquid phase and become vapor, higher number= more molecules in vapor phase)

A

VP 673 mmHg at 20 degrees

18
Q

Desflurane Boiling Point (temperature at which the vapor pressure equals atmospheric pressure)

A

BP 23.5 degrees C

19
Q

Desflurane B/G Coefficient (speed of onset, lower # = faster)

A

B/G = 0.42

20
Q

Desflurane Oil/Gas Coefficient (usually inversely related to MAC)

A

Oil/Gas = 18.7

21
Q

Desflurane MAC (relative potency)

22
Q

Desflurane Considerations (6)

A

Needs special heated vaporizer d/t low boiling point (Tec-6)

When heated under pressure it exists as vapor

Low tissue solubility

Irritating to airways

Cardiac: tachycardia more common

CO formation in desiccated absorber

23
Q

Sevoflurane Class

A

Flourinated isopropyl ether

24
Q

Sevoflurane Vapor Pressure (pressure exerted by molecules from a volatile liquid that escape the liquid phase and become vapor, higher number= more molecules in vapor phase)

A

VP = 162 mm Hg

25
Q

Sevoflurane B/G Coefficient (speed of onset, lower # = faster)

A

B/G=0.59-0.6

26
Q

Sevoflurane Oil/Gas Coefficient (usually inversely related to MAC)

A

Oil/Gas= 50

27
Q

Sevoflurane MAC (relative potency)

A

MAC 2 in oxygen

28
Q

Sevoflurane Considerations (4)

A

Degrades in Baralyme absorber
-Compound A ( sub clinical)

Not irritating to the airways
-Best for inhalation induction**

Moderate fat solubility

Combustion risk in desiccated absorber

29
Q

Nitrous Oxide Class

A

Inorganic, supports combustion

30
Q

Nitrous Oxide Vapor Pressure (pressure exerted by molecules from a volatile liquid that escape the liquid phase and become vapor, higher number= more molecules in vapor phase)

A

VP 39,000mm Hg

31
Q

Nitrous Oxide B/G Coefficient (speed of onset, lower # = faster)

32
Q

Nitrous Oxide Oil/Gas Coefficient (usually inversely related to MAC)

A

Oil/Gas = 1.4

33
Q

Nitrous Oxide Boiling Point (temperature at which the vapor pressure equals atmospheric pressure)

A

Boils at 88 degrees C.

34
Q

Nitrous Oxide MAC (relative potency)

35
Q

Nitrous Oxide Considerations

A

Stored as liquid under pressure

Pleasant smell

Danger of hypoxia with high concentration or low atm. pressure

Because it is 30-34 x more soluble the nitrogen it can cause closed air spaces (bowel, ET cuff, air embolism) to expand as it replaces the N2 in the air.

36
Q

Nitrous Oxide Critical Temperature

A

Critical temperature= 36.5 degrees C.

37
Q

Nitrous Oxide Summary

A

Incomplete anesthetic

Rapid Onset and Recovery

38
Q

Desflurane Summary

A

Low Volatility

Poor Induction Agent (very pungent and irritating to airway)

Rapid Recovery

39
Q

Sevoflurane Summary

A

Rapid onset and recovery

Unstable in soda lime

40
Q

Isoflurane Summary

A

Medium rate of onset and recovery

Anesthesia Pharmacology (23 decks)

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