Inhalational Dosages Flashcards
Desflurane alternate name:
Suprane
Desflurane structure:
3 Carbon, 6 Fluorine
Desflurane MOA:
- Positively modulate GABA-A receptors and glycine receptors
- Inhibit excitatory NMDA glutamate receptors and neuronal nicotinic Ach receptors
- Activate K+ channels
- Inhibit voltage gated Na+ channels and Ca2+ channels
Desflurane Boiling point:
23.5 C
Desflurane Vapor pressure:
669
Desflurane Oil:Gas solubility
19
Desflurane Blood:Gas solubility
0.42
Desflurane Metabolism:
0.02% by CYP2E1
Desflurane MAC%:
6%
MAC awake = 0.3-0.5 MAC, MAC 95 = 1.3 MAC, MAC BAR = 1.5 MAC
Desflurane Side Effects:
- Bronchospasm
- PONV
- Amnesia
- unconsciousness
- immobility
Desflurane Contraindications / cautions
- MH trigger
- Most pungent (may cause laryngospasm)
- Need special vaporizer (Tech-6)
- PONV
- Smokers/asthmatics due to bronchospasm
- Reduces MAP, CO, CI in a dose dependent fashion
- Prolongs QT interval
- Reduces SVR
- Decrease NMBA dose needed (25-50%)
Nitrous alternate name
Inomax
Nitrous Structure:
- Only inorganic anesthetic gas- no carbon atoms
- 2 atoms nitrogen, 1 atom oxygen
Nitrous MOA:
- Positively modulate GABA-A receptors and glycine receptors
- Inhibit excitatory NMDA glutamate receptors and neuronal nicotinic Ach receptors
- Activate K+ channels
- Inhibit voltage gated Na+ channels and Ca2+ channels
Nitrous Boiling Point:
-88.5 C
Nitrous Vapor pressure:
39,000
Nitrous Oil:Gas solubility:
1.4
Nitrous Blood:gas solubility:
0.46
Nitrous Metabolism:
0.004% metabolized by CYP2E1
Nitrous MAC%:
104%
MAC awake = 0.3-0.5 MAC, MAC 95 = 1.3 MAC, MAC BAR = 1.5 MAC
Nitrous side effects:
- Increased CBF
- PONV
- Amnesia
- unconsciousness
- Increased CMRO2
Nitrous Contraindications / cautions:
- Diffusion hypoxia
- Avoid in pneumothorax
- Avoid in intraocular air bubble
- Can diffuse into ETT/LMA cuff
- Do not use as sole anesthetic
- Avoid in pregnant patients if possible
- Decrease NMBA dose needed (25-50%)
Sevoflurane alternate name:
Ultane
Sevoflurane structure:
4 Carbon, 7 Fluorine
Sevoflurane MOA:
- Positively modulate GABA-A receptors and glycine receptors
- Inhibit excitatory NMDA glutamate receptors and neuronal nicotinic Ach receptors
- Activate K+ channels
- Inhibit voltage gated Na+ channels and Ca2+ channels
Sevoflurane Boiling point:
58.6 C
Sevoflurane Vapor Pressure:
160
Sevoflurane Oil:Gas solubility:
47
Sevoflurane Blood:Gas solubility:
0.69
Sevoflurane metabolism:
2% by CYP2E1
Sevoflurane MAC%:
2%
MAC awake = 0.3-0.5 MAC, MAC 95 = 1.3 MAC, MAC BAR = 1.5 MAC
Sevoflurane side effects:
- Increased CBF
- PONV
- Amnesia
- unconsciousness
- immobility
Sevoflurane Contraindications / cautions:
- MH trigger
- Caution in renal patients
- PONV
- May induce seizure activity (particularly in peds with seizure history)
- Must use fresh gas flow of 2L
- Reduces MAP, CO, CI in a dose dependent fashion
- Prolongs QT interval
- Reduces SVR
- Decrease NMBA dose needed (25-50%)
Isoflurane alternate name:
Forane
Isoflurane structure:
3 Carbon, 5 Fluorine
Isoflurane MOA:
- Positively modulate GABA-A receptors and glycine receptors
- Inhibit excitatory NMDA glutamate receptors and neuronal nicotinic Ach receptors
- Activate K+ channels
- Inhibit voltage gated Na+ channels and Ca2+ channels
Isoflurane boiling point:
48.5 C
Isoflurane Vapor pressure:
238
Isoflurane Oil:Gas solubility:
91
Isoflurane Blood:Gas solubility:
1.4
Isoflurane metabolism:
0.2% metabolized by CYP2E1
Isoflurane MAC%:
1.2%
MAC awake = 0.3-0.5 MAC, MAC 95 = 1.3 MAC, MAC BAR = 1.5 MAC
Isoflurane side effects:
- Bronchodilation
- PONV
- Amnesia
- unconsciousness
- immobility
Isoflurane Contraindications / Cautions:
- MH trigger
- CO poisoning from degradation in CO2 absorbents
- Severe PONV
- Reduces MAP, CO, CI in a dose dependent fashion
- Prolongs QT interval
- Reduces SVR
- Decrease NMBA dose needed (25-50%)
Halothane alternate name:
Fluothane
Halothane Structure:
2 Carbon, 3 Fluorine
Halothane MOA:
- Positively modulate GABA-A receptors and glycine receptors
- Inhibit excitatory NMDA glutamate receptors and neuronal nicotinic Ach receptors
- Activate K+ channels
- Inhibit voltage gated Na+ channels and Ca2+ channels
Halothane boiling point:
50.2 C
Halothane Vapor pressure:
243
Halothane Oil:Gas solubility:
224
Halothane Blood:Gas solubility:
2.4
Halothane MAC%:
0.75%
Halothane metabolism:
20% by CYP2E1
Halothane side effects
- Bronchodilation
- PONV
- Amnesia
- unconsciousness
- immobility
Halothane Contraindications / cautions:
- MH trigger
- Allergy
- previous PONV
- resp depression
- Can prolong QT interval
- Decrease NMBA dose needed (25-50%)