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Spring 2020 - Physiology 1 > Inhalation Agents & MAC - Quiz 10 > Flashcards

Inhalation Agents & MAC - Quiz 10 Flashcards

1
Q

The lower the MAC the ______ potent the inhaled agent

A

The lower the MAC the more potent the inhaled agent

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2
Q

What is MAC-Amnesia?

A

25% MAC

Concentration that blocks anterograde memory in 50% of awake patients

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3
Q

What is MAC-Awake

A

50% MAC

Concentration needed to prevent eye opening on verbal command

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4
Q

What is MAC-Intubation?

A

130% MAC

Concentration needed to prevent movement & coughing during intubation

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5
Q

What is MAC-BAR?

A

150% MAC

Concentration needed to block autonomic/adrenergic response to incision

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6
Q

What factors Increase MAC?

A

Babies < 6 months old - highest MAC needed

Chronic EtOH

Hyperthermia

Hypernatremia

Drugs that Increase Catecholamines

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7
Q

What factors Decrease MAC?

A
  • Pregnancy
  • Hypothermia
  • Hypoxemia
  • Premature Babies & Elderly
  • Acute ETOH
  • Hyponatremia
  • Lithium
  • Alpha 2 Agonist/C-Channel Blockers
  • Bypass Machine
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8
Q

How much does MAC decrease for every drop in degree of body temperature?

A

Every 1 degree Celsius drop = 2-5% Decrease in MAC

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9
Q

What factors have ZERO effect on MAC?

A

Thyroid Problems

Duration of Anesthesia

Gender

Potassium Level

CO2 Level???

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10
Q

What is the MAC % of Halothane?

A

0.75 %

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11
Q

What is the MAC % of Isoflurane?

A

1.15 %

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12
Q

What is the MAC % of Enflurane?

A

1.68 %

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13
Q

What is the MAC % of Sevoflurane?

A

2 %

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14
Q

What is the MAC % of Desflurane?

A

6 %

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15
Q

What is the MAC % of N2O?

A

105 %

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16
Q

How does a high Inspired Concentration affect Induction?

A

Speeds Indunction d/t Concentration Effect

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17
Q

What does Increased Alveolar Ventilation effect Induction?

A

Increased Ventilation speeds Induction

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18
Q

What factors are invovled in the Uptake of gas from Alveolar Space?

A

Gas Solubility

Cardiac Output

Alveolar/Venous Partial Pressure Difference

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19
Q

What is the most important single factor in determining Induction Speed & Emergence Rate?

A

Solubility (Blood:Gas Partition Coefficient)

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20
Q

What is the Blood:Gas for Desflurane?

A

0.42

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21
Q

What is the Blood:Gas for N2O?

22
Q

What is the Blood:Gas for Sevoflurane?

23
Q

What is the Blood:Gas for Enflurane?

24
Q

What is the Blood:Gas for Isoflurane?

25
Q

What is the Blood:Gas for Halothane?

26
Q

A poorly soluble agent will have a _______ Induction & a _______ Emergence

A

A poorly soluble agent will have a faster Induction & a faster Emergence

27
Q

How does a High Cardiac Output affect speed of Induction?

A

High Cardiac Output = Slowed Induction

28
Q

What enchances Uptake & Speed of Induction?

A

A Large Partial Pressure Difference

29
Q

What Percentage of body weight is

Vessel Rich: ?

Vessel Poor: ?

Fat: ?

Muscle?

A

Vessel Rich: 10%

Vessel Poor: 20%

Fat: 20%

Muscle: 50%

30
Q

What percentage of Cardiac Output does each Tissue Group receive?

A

Vessel Rich: 75%

Vessel Poor: 0%

Fat: 6%

Muscle: 19%

31
Q

What is the Second Gas Effect?

A

Large intake of first gas (N2O) causes increase rate of intake of second gas (agent)

32
Q

What is Diffusion Hypoxia?

A

When a lot of N2O is leaving the body into the lungs creating Hypoxia

Prevention: Dont extubate on 70% N2O & Give 100% Oxygen

33
Q

What characteristics are shared by All Gases?

A

Bronchodilation

Trigger MH

Nonflammable

Inhibit HPV

Decrease Mucus Clearance

Potentiates NMBs

Flourinated Hydrocarbons

34
Q

Which Gas is this?

35
Q

What gas is this?

A

Isoflurane

36
Q

What Gas is this?

A

Desflurane

37
Q

What Gas is this?

A

Sevoflurane

38
Q

Which supplemental anesthetic is considered a good analgesic and does not trigger MH?

39
Q

Which inhaled anesthetic should be avoided in closed gas spaces?

A

N2O - 35x more soluble than Nitrogen

40
Q

What complications can occur if N2O is given in closed gas spaces?

A

Pneumothorax

Bowel Obstruction

Inner Ear Pneumocephalus

Air Embolism

Intraocular Bubbles

41
Q

What are the effects of N2O on patients w/ Pre-existing Pulmonary HTN?

A

↓Contractility

↑SVR & PVR

↑CBF

42
Q

What inhibits Methionine Synthesis causing skeletal abnormalities?

A

50% N2O

Long Term Exposure = Peripheral Neuropathy & Megaloblastic Anemia

43
Q

What serves as an O2 sources and supports Combustion?

44
Q

How does Halothane affect the Cardiovascular System?

A

↓Contractility

↓Cardiac Output

↓BP & SVR

Vagal Stimulation –> Bradycardia –> Give Atropine

45
Q

Which gas was previously the most commonly used for children?

A

Halothane - sweet odor d/t thymol preservative

46
Q

Why should caution be used when giving Epinephrine with Halothane?

A

Halothane makes the heart more sensitive to catecholamines causing dysrhthmias

47
Q

Which gases are Pungent and increases heart rate when there is a rapid increase in dose?

A

Isoflurane & Desflurane

48
Q

Which gas uses a special heated Vaporizer?

A

Desflurane - heated to 2 atm

49
Q

Which gas causes Coronary Steal?

A

Isoflurane - blood shunted away from damaged vessels to normal vessels

50
Q

Which gas is Nonpungent and is considered good for inhalation induction?

A

Sevoflurane - kids can tolerate high levels w/o hemodynamic changes

Rapid Induction & Emergence, but can cause delerium in kids

51
Q

Which gas needs to have Fresh Gas Flow > 2L to avoid Compound A production?

A

Sevoflurane

52
Q

Characteristics of Enflurane

A

↓Contractility

↓SVR

↓Renal Blood Flow - Avoid in Renal Failure & Seizure

Profound Respiratory Depression

Spring 2020 - Physiology 1 (24 decks)

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