inhaled anesthetics 1 Flashcards
name this agent and how many atoms
sevoflurane (7 fluorine atoms)
fluoromethyl 2,2,2 trifluoro 1 trifluoromethyl ethyl ether
in an atmospheric temperature, the ethers and alkane exist as
liquids
name the ethers (R-O-R)
desflurane
isoflurane
sevoflurane
enflurane
methoxyflurance
ether
name the alkanes (R-H)
halothane
chloroform
name the gases
nitrous oxide
cyclopropane
xenon
name this agent and how many atoms
desflurane
difluoromethyl 1,2,2,2 tetrafluoroethyl ether
6 fluorine atoms
name this agent and how many atoms
isoflurane
5 fluorine atoms + 1 chlorine atoms
1 chloro 2, 2, 2, trifluoroethyl difluoromethyl ether
the addition of a chlorine atom increases potency as well as blood and tissue solubility
which anesthetic agents have chiral carbons
desflurane and isoflurane
which anesthetic agent does not have a chiral carbon
sevoflurane
desflurane full fluorination has the following effects
decreased potency (and decreased oil:gas solubility)–> increased MAC
increased vapor pressure (decreased intermolecular attraction) –> requires heated vaporizer
increased resistance to biotransformation (decreased metabolism) –> decreased trifluoroacetate makes an immune mediated hepatitis extremely unlikely
name this agent and its atoms
halothane
2 bromo 2 chloro 1, 1, 1, trifluoroethane
(presence of a bromide atom and lack of an ether bridge are dead giveaways)
name its agent
nitrous oxide
definition of vapor pressure
vapor pressure is directly proportional to
pressure exerted by vapor in equilibrium with its liquid or solid phase inside of a closed container
temperature (increased vapor pressure, increased temperature)
vapor pressure is less than
atmospheric pressure
boiling occurs when
vapor pressure equals atmospheric pressure
atmospheric pressure is directly proportional to
boiling point
increased atmospheric pressure, increased boiling point
daltons law of partial pressure
the sum of total gas pressure in a container is equal to the sum of partial pressures exerted by each gas
partial pressure of particular gas equation
vol% x total gas pressure
ex) 6% desflurane at sea level delivers a total partial pressure of 45.6mmHg (.06 x 760mmHg)
two inalational agents that become unstable in desiccated soda lime and what they can produce
desflurane and isoflurane –> can produce carbon monoxide (des more than iso)
sevoflurane
vp
bp
molecular weight (g)
preservative
stable in hydrated CO2 absorber
stable in dehydrated CO2 absorber
toxic byproduct
vp 157
bp 59
molecular weight (g) 200
preservative no
stable in hydrated CO2 absorber no
stable in dehydrated CO2 absorber no
toxic byproduct compound A
desflurane
vp
bp
molecular weight (g)
preservative
stable in hydrated CO2 absorber
stable in dehydrated CO2 absorber
toxic byproduct
vp 669
bp 22
molecular weight (g) 168
preservative no
stable in hydrated CO2 absorber yes
stable in dehydrated CO2 absorber no
toxic byproduct carbon monoxide
isoflurane
vp
bp
molecular weight (g)
preservative
stable in hydrated CO2 absorber
stable in dehydrated CO2 absorber
toxic byproduct
vp 238
bp 49
molecular weight (g) 184
preservative no
stable in hydrated CO2 absorber yes
stable in dehydrated CO2 absorber no
toxic byproduct carbon monoxide
nitrous oxide
vp
bp
molecular weight (g)
preservative
stable in hydrated CO2 absorber
stable in dehydrated CO2 absorber
toxic byproduct
vp 38,770
bp -88
molecular weight (g) 44
preservative no
stable in hydrated CO2 absorber yes
stable in dehydrated CO2 absorber yes
toxic byproduct none
blood: gas partition coefficient=
anesthetic dissolved in blood / anesthetic inside alveolus
describe low blood: gas solubility
less likely to be taken up by blood
as a result, more agent is available to exert a partial pressure in the alveoli and brain
describe high blood: gas solubility
more likely to be taken up by blood
less of the agent is available to exert a partial pressure in the alveoli and brain