Inhalation agents Flashcards
What is the MAC of N2O?
105% (least potent gas)
Is N2O organic or inorganic?
inorganic
T/F: N2O is not an effective analgesic.
False… it is
_____% of N20 + O2 with significantly reduce the MAC of other agents
70
N2O uses a ________ inhaled concentration
high
The ______________ effect speeds induction as fresh gas is drawn into the lung from the circuit
concentration
After using N20, remember to administer _________ in the PACU
O2
N2O stimulates the ________________
SNS
T/F : N2O is a direct myocardial contractility depressant
True
N2O has what effect on PAPs?
Increase PVR and RA pressure
N2O can cause ___________ induced dysrhythmias
epinephrine
N2O may cause _________________ at >1 MAC
skeletal muscle rigidity
_________ is probably not a triggering inhalation agent for MH.
N2O
N2O _______ CBF and ________ CMRO2
increases and increases
N2O may cause _____________ post operatively
N/V
N2O is almost exclusively eliminated by _____________
exhalation
How much biotransformation occurs with N2O?
VERY LITTE
N2O can lead to a decrease in __________ synthetase and __________ enzymes…which is necessary for DNA synthesis. SO avoid N2O when?
Methionine
Vit. B 12
during 1st trimester
Avoid prolonged exposure to N20 d/t what 3 things?
pernicious anemia
bone marrow suppression
peripheral neuropathies
Contraindication related to N2O are due to the fact that…….
N20 diffuses rapidly into air - containing cavities
Does N2O potentiate NM blockers?
Yes
Volatile agents all have ______ compounds
carbon
__________ substitutions increase anesthetic potency
halogen
Lower weight halogens _______ potency more than those of higher atomic weight
decrease
_______ substitutions on carbon compounds lead to the most stable compounds.
Cl-
Cl- substitutions on Carbon compounds lead to ________________ as a s/e
myocardial depression
Fluorination reduces ____________ but creates the potential for _________ as an s/e
flammability
renal damage
C4H3F7O is
sevoflurane
C3H2F6O is
Desflurane
C3H2CLF5O is
Isoflurane
C2HBrF3
Halothane
What gas has the highest VP?
n20
What gas has the second highest VP after N2O
desflurane
_____________ is the pressure created when gas molecules bombard the surface of a liquid and the walls in a closed container
VP
__________ is when the VP equals the Barometric pressure
Boiling Point
If you increase the altitude, you _________ the barometric pressure
decrease
What does alkalosis do to MAC?
nothing
what does Hyperthermia do to MAC?
increase it
What does anemia (4.3ml/dl) do to MAC?
decrease it
what does a prolonged duration of anesthesia do to MAC?
Nothing
What does hypotension do to MAC?
decrease it
What does Hypernatremia do to MAC?
increase it
What does pregnancy to do MAC?
decrease it
what does variable stimulus do to MAC?
nothing
what do CNS stimulants do to MAC?
increase it
What does a 1 year old do to MAC?
increase it
What does being elderly do to MAC?
decrease it
What do Alpha 2 agonists do to MAC?
decrease it
To avoid movement when no muscle relaxant is on board in 95% of pts… it requires ___-___% above MAC or ____ MAC
10-30
1.3
MAC awake for what agents is 1/3?
des, sevo, iso
MAC awake is 1/2 for what agent?
halothane
What is MAC awake for N2O?
60%
Which agent does not decrease SVR?
desflurane
What will happen to BP and HR with Halothane
BP increases, HR no change
When using halothane, use extreme caution with what drug d/t arrhythimis? what occurs?
Epinephrine
bradycardia/junctional
W/ Halothane, the adult dose of EPI should not exceed _______________ within 10 mins or ______________ within 1 hour
10ml of 1:100K
30ml of 1:100K
What does Halothane do with asthma?
its a potent bronchodilator and reverse bronchospasm
What does Halothane do to ICP?
increases it! avoid in neuro patients!!!!
Which agent cause the least amount of skeletal muscle relaxation?
Halothane
Halothane is toxic where?
the liver! Hepatitis due to CYP450
What % of halothane is metabolized?
20%
What drugs are contraindicated with Halothane?
aminophylline
Tricyclics
MAOIs
BBlockers and Ca Ch Blockers
Which volatile agent is the most potent trigger of MH?
Halothane
What 4 major contraindications are there for halothane?
Liver damage/dysfunction
hypovolemia
pheochromocytoma
aortic stenosis
______________ is a halogenated methyl ethyl ether
enflurane
What is the MAC of enflurane?
1.7
With enfluranes decrease in BP, will you see an increase or decrease in HR?
increase! opposite of halothane
What is the main cerebral effect of Enflurane?
tonic clonic seizures
The main toxicity for enflurane is?
renal toxicity
What 2 patients are contraindication for enflurane?
renal pts
seizure pts
Which agent do you use for PEDs inductions? which agent do you NOT?
sevoflurane
isoflurane
What agent dilates the coronary arteries but may cause coronary steal syndrome?
isoflurane
Is isoflurane neuroprotective or harmful?
protective
Isoflurane can cause a ___________ at 2 MAC
isoelectric EEG
Which gas has a VP that is close to atmospheric pressure?
desflurane
What vaporized does Desflorane use?
TEC 6
When giving Desflurane, what happens when you give a rapid increase in concentration?
transient increase in HR, BP, catecholamine levels
The main adverse effect of desflurane is?
laryngospasm and bronchoreactivity
Which agent causes Carbon monoxide release from a used up scavenger?
Main one - desflurane
The only agent that does not increase CVP is?
sevoflurane
Does sevoflurane cause airway irritation?
NO - it is the best amount all agents!
With what agent do you need to use FGF of >/= 2 L?
Sevo
What causes toxicity with sevoflurane?
Compound A
With which drug is there ZERO risk of “halothane hepatitis”?
Sevoflurane
What kind of patients are contraindicated for sevo?
Renal Pt’s
