Inhalation Agents

Question 1

How can you identify halogenated anesthetic molecules?

Answer 1

Question 2

Isoflurane has a _______ atom, which increases ________

Answer 2

Chlorine

Potency

Question 3

How does desflurane differ from isoflurane molecularly?

Answer 3

Instead of a chlorine atom, it has a fluoride atom

This decreases its potency and metabolism but increases its vapor pressure

Question 4

How can you identify an ether?

Answer 4

The C-O-C crossbridge

Question 5

List the ethers

Answer 5

Question 6

List the alkanes

Answer 6

Question 7

List the gases

Answer 7

Question 8

What are the effects of full fluorination?

Answer 8

Question 9

Answer 9

Desflurane

Question 10

Answer 10

Sevo

Question 11

Sevo is fully fluorinated. Why is it more potent than Desflurane?

Answer 11

Because it has a bulky propyl side chain

Question 12

Answer 12

Isoflurane

Question 13

Answer 13

Halothane

Question 14

Stability refers to:

Answer 14

the ability of a compound to resist metabolism

Question 15

Which anesthetic gas is unstable in hydrated soda lime?

Answer 15

Sevo. This is why it has minimum flow requirements.

Question 16

What is the vapor pressure of Sevo?

Answer 16

157

Question 17

What is the vapor pressure of Iso?

Answer 17

238

Question 18

What is the vapor pressure of Desflurane?

Answer 18

669

Question 19

What is the vapor pressure of nitrous?

Answer 19

38,770

Question 20

What is the boiling point of Sevo

Answer 20

59 degrees C

Question 21

What is the boiling point of Iso

Answer 21

49 degrees C

Question 22

What is the boiling point of Des

Answer 22

22 degrees C

Question 23

What is the molecular weight of Sevo?

Answer 23

200

Question 24

What is the molecular weight of Iso?

Answer 24

184

Question 25

What is the molecular weight of Des?

Answer 25

168

Question 26

What is the molecular weight of Nitrous?

Answer 26

44

Question 27

What is the boiling point of nitrous?

Answer 27

-88

Question 28

What is Dalton's Law?

Answer 28

partial pressure

Question 29

What is the blood:gas partition coefficient of Sevo?

Answer 29

0.65

Question 30

What is the blood:gas partition coefficient of Iso?

Answer 30

1.46

Question 31

What is the blood:gas partition coefficient of Des?

Answer 31

0.42

Question 32

What is the blood:gas partition coefficient of nitrous?

Answer 32

0.46

Question 33

Which factors increase FA/FI?

Answer 33

Question 34

How is rate of rise effected by solubility?

Answer 34

Question 35

In patients with R-to-L shunts, which agents are affected most?

Answer 35

Less soluble: more effected

Question 36

Do redheads have increased or decreased MAC?

Answer 36

Increased

Question 37

What is the Meyer Overton rule?

Answer 37

lipid solubility is directly proportional to potency

Question 38

What is the unitary hypothesis?

Answer 38

All anesthetics share a similar MOA, but may act at different sites

Question 39

Where do anesthetic gases produce immobility?

Answer 39

In the VENTRAL HORN of the spinal cord

Question 40

The most important sites of volatile anesthetic action in the spine are:

Answer 40

Glycine STIMULATION NMDA INHIBITION Na Channel INHIBITION

Question 41

In the brain, the most important site of volatile anesthetic action is:

Answer 41

GABA-A Agonism

Question 42

What is the MOA of the gases?

Answer 42

Nitrous and Xenon cause NMDA Antagonism Potassium 2P channel stimulation

Question 43

What effect do volatile anesthetics have on ECG?

Answer 43

Prolong QT

Question 44

Which agent impairs hypoxic drive the LEAST?

Answer 44

Des

Question 45

Why do halogenated agents depress hypoxic drive?

Answer 45

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