Inhalation Pharmacokinetic

Question 1

Malignant Hyperthermia Mech

Answer 1

Abnormal ryanodine receptor -> release Ca++ from sarcoplasmic reticulum -> uncontrolled muscle contraction -> increased aerobic+anareobic metabolism + muscle breakdown -> hyperK+

Question 2

MH sx [4]

Answer 2

Muscle: Masseter Muscle Regidity (trimus; forceful contraction of jaw) +/- muscle rigidity
Symp: Inc HR, BP, arrythmia
Temp: Inc T, diaphoresis
Resp: ETCO2, O2 Consumption (Cyanosis)

Question 3

MH labs [4]

Answer 3

Inc met H+
Inc K
Inc CK
Myoglobinemia, myoglobinuria,

Question 4

MH protocool [10]

Answer 4

1. DC Volatiles and Succ; Call help
2. O2: FIO2 100% at high flow and Hypervent
3. NaHCO3 (1-2 meq/kg IV)
4. Dantrolene with Sterile distilled Water 2.g mg/kg + repeat
5. Cooling measures: lavage, cooling blanket, cold IV
6. Circuit/Soda Lime Change
7. Monitors + Lyte + Coags
8. Treat K appropriately
9. A-Line + Central Line,
10. MH hotline

Dantrolene + HCO3 + EQ change
Vital control + Monitor (Oxyx2 Vent x 2, Circx4, Temp)
Labs: Coag, ABG, Lyte, treat appropriately,
Hotline

Question 5

MH RF, MC and others

Answer 5

Central Core Dz (MCC, same RYR1 defect on Chrome 19)
Duchenne Muscular Dystrophy (X-Linked Reces)
-Succ -> HyperK -> fatal rhabdo