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5230 > Inhalation Agents > Flashcards

Inhalation Agents Flashcards

1
Q

Variations in Induction Speed

A

Machine: air flow rate, absorption into plastic

Lungs: ventilation, concentration, blood gas solubility, v/q problems, second gas effect

Blood: cardiac output

Tissues: oil/gas solubility, metabolism, diffusion hypoxia, obesity, hypothermia

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2
Q

Blood/Gas Coefficient

A

how fast an anesthetic goes in and out of the body

sevo - 0.6
iso - 1.4
nitrous 0.47
des 0.42

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3
Q

MAC

A

minimum alveolar concentration required to achieve surgical anesthesia in 50% of patients

sevo - 2%
iso - 1.15%
nitrous 105%
des 5.8%

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4
Q

Oil/Gas Coefficient

A

potency

sevo - 50
iso - 99
nitrous 1.4
des 18.7

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5
Q

The lower the blood/gas coefficient the _____ the rise of anesthetic in the lungs

A

faster

fast in, fast out

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6
Q

The faster you breathe, the ____ you go to sleep

A

faster

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7
Q

The higher the dose and concentration, the _____ it works

A

faster

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8
Q

A V/Q mismatch ____ the delivery of all anesthetics, affecting the ____ agents more than the _____ agents

A

slows

fast, slow

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9
Q

Nitrous Oxide

A

expands in closed spaces - use caution in certain surgery

is an inorganic molecule

contraindicated in pregnancy

inactivates vitamin b12 causing accumulation of homocysteine resulting in inability to copy DNA

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10
Q

Blood Flow

A

vessel-rich - 75%
muscle - 18%
fat - 5%
vessel-poor - 2%

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11
Q

Increases in cardiac output ____ the onset, affecting the _____ agents more than the _____ agents

A

slows

slower, faster

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12
Q

Inhalation Gas Metabolism

A

sevo - 5-7%
iso - <1%
nitrous oxide - trace
des - <0.1%

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13
Q

Children have a ____ MAC dose than adults

A

higher

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14
Q

MAC awake

A

the alveolar concentration of anesthetic that inhibits responses to command in half of the patients

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15
Q

MAC bar

A

the alveolar concentration of anesthetic that blunts the autonomic response to noxious stimuli in half of the patients

approximately 1.6 time higher than MAC

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16
Q

halogenated ethers

A

all inhaled anesthetics except nitrous oxide and halothane

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17
Q

Inhalation Agents Mechanism of Action

A

actions on GABA receptors - allows CL- to enter cell

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18
Q

inhalation anesthetics _____ cerebral blood flow

A

increase

19
Q

inhalation anesthetics _____ CMRO2

A

decrease, except nitrous oxide increases?

20
Q

inhalation anesthetics _____ intracranial pressure

A

increase, except nitrous oxide decreases

21
Q

inhalation anesthetics _____ cerebral perfusion pressure

A

decrease

22
Q

inhalation anesthetics _____ intro-ocular pressure

A

decrease

23
Q

inhalation agents mechanism for decreased blood pressure (5)

A 
CNS depression
direct cardiac depression
decreased systemic vascular resistance
baro-receptor depression
hormonal changes (decreased renin and vasopressin release)

*except nitrous oxide where BP stays the same

24
Q

____ sensitizes myocardium to effect of catecholamines

A

halothane

25
Q

____ produce tachycardia on induction

A

desflurane >isoflurane

26
Q

inhalation anesthetics _____ cardiac output

A

iso and nitrous decrease

sevo and des no effect

27
Q

inhalation anesthetics _____ systemic vascular resistance

A

decrease, nitrous oxide increase

28
Q

inhalation anesthetics _____ MAP

A

decrease, nitrous oxide same stable

29
Q

inhalation anesthetics _____ heart rate

A

increase, sevo no change

30
Q

inhalation anesthetics _____ the bronchioles

A

relax, except nitrous oxide

31
Q

do inhalation anesthetics cause respiratory depression?

A

yes, except nitrous oxide

32
Q

inhalation anesthetics that are respiratory irritants

A

des and iso

33
Q

inhalation anesthetics depress _____ before _____

A

tidal volume before respiratory rate

34
Q

fluoride nephrotoxicity

A

sevo

free fluoride ion release, avoid in renal patients

35
Q

inhalation anesthetics _____ GI function

A

depress

36
Q

inhalation anesthetics _____ the uterus

A

relax

37
Q

emergence delirium

A

10-15 minutes
sevo & des
children

38
Q

compound A

A

sevo - baralyme & sodalime

produces nephrotoxicity

39
Q

inhalation anesthetics _____ hypoxic pulmonary vasoconstriction

A

depress

40
Q

inhalation anesthetics _____ that cause analgesia

A

nitrous oxide

41
Q

hepatoxicity

A

halothane

42
Q

MAC ______ percent per decade

A

decreases 6%

43
Q

epi rules

A

no stronger than 1:100,000 (0.01 mg/ml)
no more than 10 ml (0.1 mg) in 10 minutes
no more than 30 ml (0.3 mg) in 1 hour

5230 (12 decks)

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