Nitrous Flashcards
What percentage of nitrous is in the liquid form in a full cylinder?
30%
What is the only inorganic anesthetic agent?
Nitrous
What is the most dangerous impurity in nitrous?
NitriC oxide
What is the metabolism rate of nitrous?
0.004%
Like James Bond 007
Nitrous blood gas partition coefficient
0.46
10% nitrous has the analgesic equivalence of 7.5 mg of __
Morphine
Nitrous has __ skeletal muscle relaxation
Poor
Diffusion hypoxia can occur with __ discontinuation of nitrous
Abrubr
If you see ANY diffusion hypoxia question, just __
Give oxygen
Outpouring of nitrous from blood to alveoli is greatest during the first __ to __ minutes
1-5
Second gas effect occurs from a __ effect and augmentation of __ gas flow
Concentrating effect
Tracheal gas flow
Concentration effect says that the greater the concentration of delivered anesthetic, the __ anesthesia is obtained. The larger the initial dose, the __ the onset of action.
Faster
Gaster
The second gas effect is when a large concentration of a first gas is taken up it __ the second gas
Concentrates
Nitrous is the __ metabolized inhalation anesthetic
Least
The metabolism of nitrous is in the GI tract by ANaerobic bacteria like pseudomonas, if the GI tract has greater than 10% oxygen, __
there will be NO metabkism
Nitrous is the only anesthetic that can oxidize vitamin __
B12
Nitrous can inactivate the enzyme methionine synthase which regulates __ and __ acid metabolism
B12
Folic acid
Patients on 50/50 nitrous for 2.5 hours have their __ synthase inactivated
Methionine
Nitrous produces analgesia via opioid like neurons in the periaqueductal grey matter of the brain stem, which project to the __
Dorsal horn of the spinal cord where they act through alpha-2b adrenergic receptors inhibiting nociception.
In short, nitrous provides analgesia by inhibition of the __
Dorsal horn nociceptive neurons
CNS saturation by nitrous occurs by displacing nitrogen and usually occurs within __
3-5 minutes
The vessel rich group receives __ amounts of nitrous
greater
When monitoring evoked potentials, __
Don’t give more than 50%
Nitrous can either give you no change or __ blood pressure
Increase
Nitrous and pulm hypertension?
NO
Nitrous and congenital heart disease with right to left shunt?
NO
Left to right shunt?
Yes
Nitrous is like breathing __, __
butter, not an airway irritant
Nitrous __ FRC
decreases
Nitrous can __ pulm vascular resistance
Raise
In high doses, nitrous may produce skeletal muscle __
Rigidity
Nitrous is a __ trigger agent for MH
Weak
Nitrous will not hasten emergence with __
Des
What is the MAC of nitrous?
104%
Nitrous has a molecular weight of __
44
Nitrous has __ preservative
No
Nitrous has __ potency and __ blood solubility.
Low
Low
80% nitrous causes h_, h_, and b_
hypoxia, hallucinations, bizarre dreams
65%= __
Excitement stage
35% provides __
The perfect mix, profound analgesia and patient cooperation
Nitrous and EEG, slower __, higher __
Slower frequency
Higher voltage
Should you use nitrous when there is a potential for hypoxia?
NO
Should you use nitrous for muscle relaxation?
NO
Should you use nitrous for a pneumothorax?
NO
Should you use nitrous for PONV?
NO
Should you use nitrous for cases with potential for air emboli like cardiac and vascular?
NO
Should you use nitrous for laparoscopic cases?
NO
Nitrous has a __ ability to lessen the body’s ability to fight infection
Minimal
Is nitrous associated with hepatotoxicy, decreased liver perfusion, or decreased hepatic drug metabolism?
NO
Is nitrous associated with fluoride induced nephrotoxicity?
NO
Is nitrous implicated with coronary steal?
NO
How does nitrous increase CVP?
Increases pulmonary vascular resistance.
Does nitrous induce seizures? Does it suppress seizures like iso/sevo/des?
NO
NO
