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Advanced Pharm Fall 24 > Inhalation Pt 2 Desflurane > Flashcards

Inhalation Pt 2 Desflurane Flashcards

1
Q

Desflurane is a ____ methyl ethyl ether

A

Fluorinated

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2
Q

Which inhalation agent is the gold standard?

A

Isoflurane

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3
Q

Fluorination is responsible for ___

A

The loss of anesthetic potency and decreased flammability

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4
Q

What is the only difference between Desflurane and Isoflurane?

A

Substitution of a fluorine atom for Isoflurane’s chlorine atom (just one atom)

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5
Q

Iso and sevo are liquids/gases

A

Liquids

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6
Q

Desflurane is liquid, but is packaged in ____ because ____

A

Special bottle
Boiling point is at 23.5 degrees celsius (can boil at room temp)

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7
Q

Desflurane’s B/G λ

A

0.42

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8
Q

Which agent is the least soluble of all potent inhalations agents?

A

Desflurane

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9
Q

Desflurane’s molecular weight:

A

168

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10
Q

Desflurane’s vapor pressure:

A

Highest vapor pressure of all inhalation agents…. 669 mmHg at 20 degrees C

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11
Q

At high altitudes… you must dial a ____ concentration to get same effect with ____

A

Higher
Desflurane

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12
Q

Desflurane MAC

A

6.0

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13
Q

Desflurane’s % required in inhaled mixture:

A

4-11%

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14
Q

Is Desflurane a good mask induction agent? Why?

A

No
Bad odor, larynx irritation, increased salivation, cough, breath holding, laryngospasms

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15
Q

Airway resistance is most common in ____ with what drug?

A

Children with reactive airways
Desflurane

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16
Q

Desflurane maintenance dose in adults and maintenance dose in children

A

Adults: 2.5-8.5%
Children: 5.2-8.5%

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17
Q

Desflurane’s respiratory decreases (3)

A

Dose dependent decrease in TV
Minute ventilation slight decrease
Decreased ventilatory response to PaCO2

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18
Q

Which inhalation agent is the most pungent?

A

Desflurane

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19
Q

Desflurane’s respiratory increases (1)

A

Rate

20
Q

Desflurane is poor for mask induction, but a good ____

A

Bronchodilator

21
Q

Desflurane’s concentration > 1 MAC may increase…

A

Heart rate

22
Q

What measurement is the best guide to anesthetic depth?

A

BP (see a dose dependent decrease in BP because of vasodilation)

23
Q

Rapid increase in Desflurane concentrations lead to ____

A

Transient increase in HR, BP, and catecholamine levels (des > iso)

24
Q

Which agent should not be used as a sole induction agent where increased BP or HR would be undesirable (ex CAD)?

A

Desflurane

25
Q

Does Desflurane increase coronary artery blood flow?

A

NO, it does not increase coronary artery blood flow. There is NO CORONARY ARTERY STEAL

26
Q

ALL volatile agents increase ____ in patients with space occupying lesions

A

ICP

27
Q

Desflurane’s CNS effects:
Increases (2)

A

ICP
CBF

28
Q

Desflurane’s CNS effects:
Decreases (1)

A

CMRO2

29
Q

Desflurane is not indicated in what kind of surgery?

A

Neuro

30
Q

What is an easy way to decrease ICP?

A

Hyperventilate patient

31
Q

Desflurane ____ both depolarizing and nondepolarizing neuromuscular blocking agents

A

Potentiate

32
Q

Desflurane + depolarizers… you should decrease maintenance by
***Not induction

A

30%

33
Q

Desflurane + nondepolarizers… you should decrease maintenance by
***Not induction

A

50%

34
Q

Desflurane is a trigger for ____

A

Malignant hyperthermia

35
Q

Do isoflurane and sevoflurane trigger MH?

A

Yes

36
Q

Fat/blood λ of Sevoflurane

A

47

37
Q

Fat/blood λ of Isoflurane

A

45

38
Q

Fat/blood λ of Desflurane

A

27

39
Q

Which agent is preferred for bariatric surgeries?

A

Desflurane

40
Q

Desflurane rapid induction and rapid recovery produces…

A

Greater nausea/vomiting than seen with Propofol

41
Q

Desflurane’s biotransformation:

A

<0.1%
Very minimal, the LEAST of all volatile agents

42
Q

Desflurane degradates to ___

A

Carbon monoxide when exposed to dry CO2 absorbents

43
Q

Desflurane biotransformation most to least carbon monoxide production:

A

Desflurane —-> Isoflurane

44
Q

Desflurane’s advantages:

A

Control over depth of anesthesia
Hemodynamic stability
Rapid recovery and early neuro assessment
Advantages in elderly and obese
Renal advantage

45
Q

Desflurane’s disadvantages:

A

Cerebral vasodilation and increased ICP
Atmospheric pollution
CAN TRIGGER MH

Advanced Pharm Fall 24 (3 decks)

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