Inhaled Anesthetics - Sevoflurane

Question 1

Which of the following accurately describes the chemical structure of Sevoflurane? (Select 3)

A) Sevoflurane is an ether with the chemical structure R-O-R’
B) Sevoflurane exists as a gas at standard temperature and pressure (STP)
C) Sevoflurane has 7 fluoride ions in its structure
D) Sevoflurane is a liquid at STP
E) Sevoflurane is a ketone with 5 fluoride ions

Answer 1

A) Sevoflurane is an ether with the chemical structure R-O-R’
C) Sevoflurane has 7 fluoride ions in its structure
D) Sevoflurane is a liquid at STP

Question 2

Which of the following values correctly represents the Blood
Partition Coefficient of Sevoflurane?

A) 0.69
B) 1.2
C) 2.0
D) 0.46
E) 1.8

Answer 2

A) 0.69

Question 3

What is the MAC (Minimum Alveolar Concentration) of Sevoflurane?

A) 1.8%
B) 2.5%
C) 0.69%
D) 1.0%
E) 3.0%

Answer 3

A) 1.8%

Question 4

What is the primary mechanism of action (MOA) of Sevoflurane?

A) GABAA receptor activation, increasing the frequency/duration of Cl- pore opening
B) NMDA receptor inhibition in the spinal cord
C) Potentiation of K+ channels in the spinal cord
D) Glycine receptor stimulation in the brainstem
E) Na+ channel blockade in the brain

Answer 4

A) GABAA receptor activation, increasing the frequency/duration of Cl- pore opening

-GABAA (MAIN–Increased frequency/duration of Cl- pore opening–inhibits NT release presynaptically to decrease membrane potential post-synaptically) BRAIN

Question 5

What factors influence the half-life of Sevoflurane? (Select 2)

A) Cardiac output (CO)
B) Volume of distribution (Vm)
C) Hepatic metabolism rate
D) Elimination via kidneys
E) Alveolar ventilation

Answer 5

A) Cardiac output (CO)
B) Volume of distribution (Vm)

Question 5

Which mechanisms contribute to Sevoflurane’s action in the spinal cord? (Select 4)

A) Glycine receptor stimulation
B) NMDA receptor inhibition
C) Na+ channel inhibition
D) K+ channel potentiation
E) GABAA receptor activation

Answer 5

A) Glycine receptor stimulation
B) NMDA receptor inhibition
C) Na+ channel inhibition
D) K+ channel potentiation

-Glycine-R stimulation (inhibitory neurotransmitter), NMDA-R inhibition, Na+ channel inhibition, & K+ Channel Potentiation in SPINAL CORD to produce immobility in ventral horn (NOT d/t GABAA)

Question 6

Which of the following pathways are involved in the elimination of Sevoflurane? (Select 3)

A) Elimination via alveoli
B) Hepatic biotransformation
C) Percutaneous loss
D) Renal excretion
E) Metabolism by intestinal flora

Answer 6

A) Elimination via alveoli
B) Hepatic biotransformation
C) Percutaneous loss

Question 7

Action:
SVR - (the least!),
HR no change,
CVP no change,
SV -,
prolongation of QT interval

Question 8

What compound is produced when Sevoflurane interacts with dehydrated soda lime?

A) Compound A
B) Carbon Monoxide
C) Methoxyflurane
D) Nitrous Oxide
E) Halothane

Answer 8

A) Compound A

Question 9

Which of the following are common side effects associated with Sevoflurane? (Select 3)

A) Postoperative nausea and vomiting (PONV)
B) Malignant hyperthermia (MH)
C) Postoperative shivering
D) Bradycardia
E) Hypertension

Answer 9

A) Postoperative nausea and vomiting (PONV)
B) Malignant hyperthermia (MH)
C) Postoperative shivering

Question 10

In which of the following scenarios is Sevoflurane particularly useful? (Select 3)

A) Neuro cases due to the least vasodilatory effects
B) As a primary agent for induction of anesthesia
C) During an asthma attack for bronchodilation
D) For patients with severe liver disease
E) For cardiac surgery requiring high hemodynamic stability

Answer 10

A) Neuro cases due to its minimal vasodilatory effects
B) As a primary agent for induction of anesthesia
C) During an asthma attack for bronchodilation