Inhaled anesthetics 1: Pharmacokinetics

Question 1

How many flourine atoms in Iso?

Answer 1

5

Question 2

How many flourine atoms in Des?

Answer 2

6

Question 3

How many flourine atoms in Sevo?

Answer 3

7

Question 4

Desflurane is nearly identical to Isoflurane in chemical structure except?

Answer 4

Desflurane has a Fl in place of the Cl atom which makes it fully fluorinated

Question 5

Does being fully flourinated make the gas more or less potent?

Answer 5

Less

Question 6

Which more potent, Sevo or Des?

Answer 6

Sevo

Question 7

Isoflurane has what atom on it that is unique?

Answer 7

Cl-

Question 8

Put the anesthetic gases in order from most potent to least

Answer 8

Iso > Sevo > Des

Question 9

What atom does Halothane have that is unique to it

Answer 9

Bromine

Question 10

What class is Halothane?

Answer 10

Alkane

Question 11

What class is Des?

Answer 11

Ether

Question 12

What class is Iso?

Answer 12

Ether

Question 13

What class is Sevo?

Answer 13

Ether

Question 14

What is vapor pressure?

Answer 14

Pressure exerted by a vapor in equilibrium with its liquid

Question 15

What does increased temp do to vapor pressure?

Answer 15

Increase!

The 2 factors are directly proportional

Question 16

Is vapor pressure less than or more than atmospheric pressure?

Answer 16

less

Question 17

Boiling occurs when vapor pressure equals __

Answer 17

atmospheric pressure

Question 18

What does increased atmospheric pressure do to boiling point?

Answer 18

Increases it

Question 19

Daltons law discusses?

Answer 19

Partial pressures adding up to equal total pressure of the mixture

Question 20

Even with adequately hydrated soda lime, what byproduct does Sevo form?

Answer 20

compound A

*Which is why there is minimal required flow!!!

Question 21

What byproducts do Iso and Des form when they pass through desiccated soda lime?

Answer 21

carbon monoxide

Question 22

VApor pressure of Sevo

Answer 22

157

Question 23

Vapor pressure of Des

Answer 23

669

Question 24

Vapor pressure of Iso

Answer 24

238

Question 25

What does a gas with a low blood:gas solubility want to do in the blood?

Answer 25

Less likely to be taken up in the blood and more available in the brain

Question 26

Partition coefficient of Nitrous?

Answer 26

0.46

Question 27

Partition coeffienct of Des?

Answer 27

0.42

Question 28

Partition coeffienct of Iso?

Answer 28

1.46

Question 29

Partition coeffienct of Sevo?

Answer 29

0.65

Question 30

What role does solubility of an anesthetic gas play in onset of action?

Answer 30

Decreased solubility --> faster onset Increased solubility --> slower onset

Question 31

What are the components of the vessel rich group?

Answer 31

Heart Lungs Kidney Liver

Question 32

how much of CO does the VR group receive?

Answer 32

75

Question 33

How much CO does muscle receive?

Answer 33

20

Question 34

What falls under the muscle group?

Answer 34

Sk m Skin

Question 35

What percent of CO goes to the fat?

Answer 35

5

Question 36

What % of CO goes to vessel poor group?

Answer 36

<1

Question 37

What falls under the vessel poor group?

Answer 37

Bone Tendon Cartilage

Question 38

Inhaled anesthetics are primarily eliminated from the body through exhalation, what is the secondary mechanism?

Answer 38

Liver metabolism

Question 39

What is the rule of 2's when it comes to hepatic biotransofrmation?

Answer 39

Halothane = 20 % hepatic bio Sevo = 2-5% Iso = 0.2 Des = 0.02 N2O = .004

Question 40

Which metabolites that can cause hepatitis are produced by metabolism of iso, deso, halothane?

Answer 40

TFA Flouride ions

Question 41

What byproduct does sevoflurane produce?

Answer 41

Flouride ions

Question 42

Minimum FGF for Sevo?

Answer 42

1-2 L/min?

Question 43

Does minute ventilation overall increase or decrease with anesthetic gas use?

Answer 43

Decrease

Question 44

Nitrous is how much more soluble in the blood than Nitrogen?

Answer 44

34

Question 45

In the presence of a right to left shunt, the Fa/Fi of an agent with __ solubility will be more affected than an agent with ___ solubility (higher or lower)

Answer 45

lower higher

Question 46

Is IV induction faster or slower with a right to left intracardiac shunt

Answer 46

faster

Question 47

Is inhalation induction faster or slower with a left to right intra-cardiac shunt

Answer 47

it will NOT have a meaningful effect on anesthetic uptake or induction time.

Question 48

A left to right shunt produces a _____ IV induction (IV agent is recirculated in the lungs) slower or faster

Answer 48

slower (IV agent is recirculated in the lungs)