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Anesthesia Drug Test Quick Facts > Inhaled Anesthetics > Flashcards

Inhaled Anesthetics Flashcards

1
Q

classification of desflurane

A

fully fluorinated methyl ethyl ether

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2
Q

metabolism of desflurane

A

0.0-0.02 % undergoes metabolism

low solubility- like Nitrous Oxide- undergoes very little metabolism

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3
Q

MAC for desflurane

A

6.6%

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4
Q

Blood/Gas Particion Coef for Desflurane

A

0.42

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5
Q

Vapor Pressure of Desflurane

A

669

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6
Q

Boiling Point of Desflurane

A

22.8

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7
Q

Cardiovascular Effects of Desflurane

A

abrupt increases = sympathetic stimulation
increased HR and BP

in general = decreased BP and HR no change in CO, increased RAP, decreased SVR, no change in PVR

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8
Q

Pulmonary effects of Des

A 
dose-dependent increase in RR
decreased Vt
decreased ventilatory response to PaCO2 and hypoxemia
above 1 MAC = airway irritation
bronchoconstriction ** SMOKERS
increased secretions
coughing
breath holding
laryngospasm
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9
Q

Neuro effects of Des

A

no retrograde amnesia
decreased CMRO2
increased CBF
increased cerebral vasodilation

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10
Q

hepatic effects of des

A

oxidatively metabolized by CYP45-
forms acetylated liver protein
can evoke antibody repines and hepatotoxicity
NOT common b/d minimal metabolism

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11
Q

renal effects of des

A

dose-related decreases in renal blood flow
& GFR
&UOP
decrease in BP and CO

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12
Q

misc. effects of des

A

dose-dependent enhancement of the effects of NMBAs
decrease uterine smooth msucle contractility & blood flow
EXCEPT N2O

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13
Q

what properties of desflurane require the Tec 6 vaporizer and what does it do?

A

Desflurane’s high vapor pressure- 669
and boiling point near room temp 22.8C

require Desflurane to be heated to 23-25C
and pressurized to 1500 mmHg to achieve predictable concentrations of delivered Des

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14
Q

blood: brain of des

A

1.3

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15
Q

muscle: blood of des

A

2

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16
Q

fat: blood of des

A

27.2

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17
Q

classification of isoflurane

A

halogenated methyl ethyl ether

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18
Q

metabolism of iso

A

0.0-0.2% hepatic metabolism
oxidative metabolism by CYP450 to form difluoronmethanol & trifluoroacetic acid
antibody formation - hepatotoxicity

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19
Q

MAC of iso

A

1.2%

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20
Q

BGPC of Iso

A

1.46

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21
Q

Vapor Pressure of iso

A

240

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22
Q

boiling point of iso

A

48.5C

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23
Q

brain:blood of iso

A

1.6

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24
Q

muscle:blood of iso

A

2.9

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25
Q

fat:blood of iso

A

44.9

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26
Q

oil:gas iso

A

98

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27
Q

contraindications with Iso

A

Prolongation of the QTc

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28
Q

CV effects of iso

A 
QTc prolongation
coronary vasodilation- cardioprotective
dose-dep decrease in reflex of sympathetic flow 
decrease BP
increase Hr
minimal CO change
increase RAP
decrease SVR
no change in PVR
29
Q

which agent is the most cardioprotective?

A

Iso- even though it has prolonged QTc

30
Q

which agent is the most potent vasodilator

A

isoflurane

31
Q

reps effects iso

A

dose sep increase in RR
decrease in Vt
decrease in ventilation response to increase Pa Co2 and hyperemia
bronchodilation

32
Q

neuro effects of iso

A 
NO retrograde amnesia
decrased CMRO2
incrase CBF
cerebral vasodilation
decreases resistance to reabsorption
33
Q

which agent is the most cerebral protection?

A

iso

34
Q

hepatic effects of iso

A

vasodilator of hepatic circulation

CYP450 metabolism- hepatotoxicity risk

35
Q

renal effects of iso

A

dose-dep decrase in RBF,
&GFR
&UOP
d/t decreased BP and CO

36
Q

which agent costs more, iso, des, sevo

A

sevo>des> iso

37
Q

classification of sevoflurane

A

halogenated methyl isopropyl ether

38
Q

metabolism of sevo

A

5-8% of sevo is metabolized
oxidative metabolism
trifluoroacetic acid is NOT formed thus NOT hepatotoxic

39
Q

Blood:Gas PC of sevo

A

0.69

40
Q

MAC of sevo

A

1.8-2

41
Q

Sevo Vapor Pressure

A

160-170

42
Q

Boiling Point of sevo

A

58.5 C

43
Q

brain:blood sevo

A

1.7

44
Q

muscle:blood sevo

A

3.1

45
Q

fat:blood sevo

A

47.5

46
Q

oil:gas sevo

A

55

47
Q

contraindications with sevo

A

compound A formation- renal damage
QTc prolongation
agitation 7-15%

48
Q

CV affects of sevo

A 
coronary vasodilation RARE
cardioprotective
decreased temp- all cutaneous vasoconstriction
decreased: BP and CO
increased: HR
decreased RAP
decreased SVR
no change in PVR
49
Q

reps effects of sevo

A 
dose-dep increase in RR
decrease in Vt
decrease vent response to CO2 & hypoxemia- ALL
POTENT bronchodilator
NON-PUNGENT!
50
Q

which inhaled anesthetic causes the least degree of airway irritation

A

sevo

51
Q

neuro effects of sevo

A

no retrograde amnesia
decreased CMRO2
increased CBF
increased cerebral vasodilation

52
Q

renal effects of sevo

A

all dose related decrease in renal blood flow
&GFR
& UOP
d/t decreased BP and CO

53
Q

misc effects of volatiles

A

Volatile Anesthetics produce dose-dependent enhancement of the effects of NMBAs (ethers>halothane). •

Obstetrical- Volatile Anesthetics produce similar dose-dependent decreases in uterine smooth muscle contractility & blood flow (except ).

54
Q

how do we protect against production of compound A with sevo

A

At increased temperatures, desiccated CO2 absorbent may degrade Sevoflurane to produce Compound A (trifluoromethyl vinyl ether) which is nephrotoxic & hepatotoxic in animals.

Fresh gas flows of 2 L/min are recommended to decrease the production of Compound A.

Flows of 1L/min may be used for up to 2 MAC-hours.

Flows below 1L/min are not recommended.

55
Q

which agent is the least likely to form Carbon Monoxide when reacting with the CO2 absorbent?

A

sevo

56
Q

MAC of enflurane

A

1.6%

57
Q

BGPC of enflurane

A

1.9

58
Q

Vapor pressure of enflurane

A

172

59
Q

BP of enflurane

A

56.5

60
Q

metabolism of enflurane

A

0-3%
CYP450 oxidative metabolism to form organic and inorganic fluoride compounds and possibly neoantigens in susceptible patients

61
Q

contraindications with Enflurane

A

QTc prolongation
EEG activity- seizure like tonic-clonic twitching! MAC >2
trifluroacetic acid- hapatotoxic but less than halothane

62
Q

CV effects of enflurane

A 
decrease BP 
no change in HR
decrease CO
decrease SVR 
no change in PVR
63
Q

hepatic effects of enfluane

A

ALT is increased after enflurane admin

64
Q

classification of halothane

A

halogenated alkane

65
Q

MAC of halothane

A

0.75%

66
Q

blood:gas PC halothane

A

2.54

67
Q

Vapor Pressure halothane

A

244

68
Q

Boiling Point halothane

A

50.2 C

69
Q

metabolism of halothane

A

15-40% metabolized by the liver

  • Halothane undergoes oxidative metabolism by CYP-450 enzymes when ample oxygen is present.
  • Halothane undergoes reductive metabolism by CYP-450 enzymes when oxygen is reduced.
  • metabolites: trifluoroacetic acid, chloride, & bromide
  • triflouroacetic acid may stimulate formation of antibodies against hepatic microsomal proteins

Anesthesia Drug Test Quick Facts (19 decks)

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