Inhalation Agents Flashcards
How can you identify halogenated anesthetic molecules?
Isoflurane has a _______ atom, which increases ________
Chlorine
Potency
How does desflurane differ from isoflurane molecularly?
Instead of a chlorine atom, it has a fluoride atom
This decreases its potency and metabolism but increases its vapor pressure
How can you identify an ether?
The C-O-C crossbridge
List the ethers
List the alkanes
List the gases
What are the effects of full fluorination?
Desflurane
Sevo
Sevo is fully fluorinated. Why is it more potent than Desflurane?
Because it has a bulky propyl side chain
Isoflurane
Halothane
Stability refers to:
the ability of a compound to resist metabolism
Which anesthetic gas is unstable in hydrated soda lime?
Sevo. This is why it has minimum flow requirements.
What is the vapor pressure of Sevo?
157
What is the vapor pressure of Iso?
238
What is the vapor pressure of Desflurane?
669
What is the vapor pressure of nitrous?
38,770
What is the boiling point of Sevo
59 degrees C
What is the boiling point of Iso
49 degrees C
What is the boiling point of Des
22 degrees C
What is the molecular weight of Sevo?
200
What is the molecular weight of Iso?
184
What is the molecular weight of Des?
168
What is the molecular weight of Nitrous?
44
What is the boiling point of nitrous?
-88
What is Dalton’s Law?
partial pressure
What is the blood:gas partition coefficient of Sevo?
0.65
What is the blood:gas partition coefficient of Iso?
1.46
What is the blood:gas partition coefficient of Des?
0.42
What is the blood:gas partition coefficient of nitrous?
0.46
Which factors increase FA/FI?
How is rate of rise effected by solubility?
In patients with R-to-L shunts, which agents are affected most?
Less soluble: more effected
Do redheads have increased or decreased MAC?
Increased
What is the Meyer Overton rule?
lipid solubility is directly proportional to potency
What is the unitary hypothesis?
All anesthetics share a similar MOA, but may act at different sites
Where do anesthetic gases produce immobility?
In the VENTRAL HORN of the spinal cord
The most important sites of volatile anesthetic action in the spine are:
Glycine STIMULATION
NMDA INHIBITION
Na Channel INHIBITION
In the brain, the most important site of volatile anesthetic action is:
GABA-A Agonism
What is the MOA of the gases?
Nitrous and Xenon cause
NMDA Antagonism
Potassium 2P channel stimulation
What effect do volatile anesthetics have on ECG?
Prolong QT
Which agent impairs hypoxic drive the LEAST?
Des
Why do halogenated agents depress hypoxic drive?
Because they produce ROSs that impair the cells of the carotid body
The ROSs are produced during METABOLISM, so drugs that undergo the least metabolism (des) produce the least hypoxic drive suppression