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Anaesthesia > Module 3 Inhalational agents > Flashcards

Module 3 Inhalational agents Flashcards

1
Q

What do all modern volatiles have in common

A

They are all halogenated hydrocarbons

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2
Q

What are the factors that affect the concentration of the volatile in the brain 3

A
  1. Delivery of the agent to the lungs
  2. Uptake of the agent by the blood
  3. Uptake of the agent by tissues other than the brain
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3
Q

What does the LOC depend on

A

The conc. of the anaestetic agent in the brain

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4
Q

Decreased alveolar conc. will cause

A

Slowing of the induction

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5
Q

What are the 2 factors that affect the delivery of the agent to the lungs

A
  1. Inspired concentration of the drug [Higher is faster]
  2. Alveolar ventilation (Movement of air in and out) [Higher is faster]
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6
Q

How does the solubility affect the conc

A

Higher solubility have slower inductions

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7
Q

How does cardiac output affect the speed of induction

A

Increased cardiac output slows induction this is because the is decreased time for interface

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8
Q

What are the 3 factors that affect how much non brain tissue takes up the drugs

A
  1. Solubility in tissues
  2. Tissue blood flow
  3. Conc. gradient
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9
Q

What are the 3 phases of tissue uptake of anaestetics

A

Phase 1: Brain, lungs, kidneys and liver
Phase 2: Muscles
Phase 3: Poorly vascularised tissue like fat and bone can take hours

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10
Q

What is the fastest recovery volatile and what is the slowest

A

Des and sevo
And halothane is the slowest

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11
Q

What is the proportion of each anesthetic that is metabolised by the liver

A

Halothane 20
Sevo 4
Enflurane 2
Iso 0.2
Des 0.02

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12
Q

What causes halothane hepatitis

A

CF3

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13
Q

What is the potencially harmful chemical that is fromed from sevo and what can it cause

A

Compound A can cause renal impairment

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14
Q

Are low or high MACs more potent

A

LOW

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15
Q

Define MAC

A

Minimum alveolar concentration: Is the minimum percentage of anesthetic that is required to prevent movement from a standard surgical stimulus in 50% of individual at sea level

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16
Q

What are the factors that decrease MAC values

A

Things that slow metabolism:
Sedation
Analgesia
N2O
Increased age
Hypotension
Hypothermia
Myxedema

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17
Q

What are the 4 factors that increase MAC values

A
  1. Alcoholism
  2. Children
  3. Hyperthermia
  4. Thyrotoxicosis
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18
Q

What is the MAC of N2O

A

105%

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19
Q

What are the 2 main benifits of N2O

A
  1. It decreases the amount of other agents that are needed
  2. Analgesia
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20
Q

What is the 4 adverse effects of N2O

A
  1. It has a negative inotropic effect
  2. It diffuse into air filled body cavities and so can worsen problems e.g. pneumo
  3. PONV
  4. Bone marrow suppression
21
Q

What colour is N2O

22
Q

What is meant by a diffusional hypoxia in N2O

A

When the N2O is switched off it rapidly diffuses out of the blood and into the alveoli displacing the O2 and thus causing hypoxia. To prevent this give higher O2 at the end

23
Q

What colour is halothane, iso, sevo ad des

A

Halo: Red
Iso: Purple
Sevo: Yellow
Des: Blue

24
Q

What is the MAC of Halothane

25
Q

What affect does halo have on the CNS

A

Can increase ICP

26
Q

What affect does halo have on the CVS

A

Vasodialates and causes myocardial depression

27
Q

What affect does halo have on the resp

A

Broncodialator

28
Q

What affect does halo have on the muscles

A

Can cause MH and causes some relaxation of muscles

29
Q

What affect does halo have on the uterus

A

Decreases tone

30
Q

What affect does halo have on the Liver

A

Increases liver enzymes and in some cases can cause hepititis

31
Q

What is the MAC of ISO

32
Q

What is ISO good for

A

Neurosurgery

33
Q

What is the MAC of Sevo

34
Q

WHat is the best gas induction agent

35
Q

Which volitile has the lowest solubility and fastest action

36
Q

What is sevo ideal for

A

Cardiovascular cases

37
Q

What is the MAC of des

38
Q

Which volitile is not suited for gas inductions

A

Des it is an irritant

39
Q

Which muscle relaxant can trigger MH

40
Q

What is the treatment for MH

A

Dantrolene

41
Q

What are some signs of MH

A
  1. Tachy
  2. Hypercapnia
  3. Skeletal muscle rigidity
42
Q

MAC (“Minimum Alveolar Concentration) is a measure of

A

An inhalational agent’s potency

43
Q

Which inhalational agent is irritant to the airway?

A

Desflurane

44
Q

Which inhalational agents both have similar identification colours?

A

Nitrous oxide and desflurane

45
Q

Which inhalational agent has analgesic properties?

A

Nitrous oxide

46
Q

A volatile that is highly soluble in blood will typically lead to which scenario:

A

Delayed onset of anaesthesia and prolonged recovery

47
Q

Many of the side-effects of volatiles can be explained by

A

Smooth muscle relaxation

Anaesthesia (13 decks)

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