Oral: IAs Flashcards
Class: ISOFLURANE
Halogenated methyl ethyl ether
Isomer of EN
MOA: ALL IAs
Controversial;
most popular theory is the Meyer Overton theory, which targets proteins (channels/receptors) as the site of action for IA, but has been disproven;
unknown MOA
Alveoli = windows to the brain
ADD to N2O: (in addition to the general MOA for this class) Used for 2nd gas effect with other IAs to ⬆ uptake and ⬇ MAC of other gas.
Pungent: ISOFLURANE and DESFLURANE
Pungent, causes cough/laryngospasm
PK: ISOFLURANE
Pungent, causes cough/laryngospasm Vd L/kg: BG = 1.4, VP = 240 Onset: 2.1 min to VRG Met: < 0.2% hepatic metab Elim: exhalation
good for liver, kidney, CV dz
Minimal cardiac depression + dilates coronary vessels
Elimination: ALL
exhalation
SE: ISOFLURANE and DESFLURANE and SEVOFLURANE
- MH
- potentiates NMBs
- inc CBF, ICP, dec CMRO2
- bronchodilation
- inc RR, dec TV = dec MV
SE: ISOFLURANE
- MH
- potentiates NMBs
- inc CBF, ICP, dec CMRO2
- bronchodilation
- inc RR, dec TV = dec MV
- a/w irritation – cough, buck, laryngospasm
- inc CSF reabsorption
- coronary steal by dec cor art BF
- dec BP and SVR, inc HR – no change in CO
- dec RBF, GFR, UOP
- HBF maintained
CI: ISOFLURANE and DESFLURANE
- peds – d/t smell/cough
2. MH hx
MAC: ISOFLURANE
1.2
Class: DESFLURANE
Fluorinated methyl ethyl ether
PK: DESFLURANE
Pungent, causes cough/laryngospasm Vd L/kg: BG = 0.42, VP = 660 Onset: Fast on/off Met: < 0.1% hepatic metab Elim: exhalation
Ideal for same day surgery
Used for maintenance – NOT induction d/t a/w irritation
SE: DESFLURANE
- MH
- potentiates NMBs
- inc CBF, ICP, dec CMRO2
- bronchodilation
- inc RR, dec TV = dec MV
- a/w irritation – cough, buck, laryngospasm
- CO RISK WITH LOW FLOWS
- dec BP and SVR, inc HR – no change in CO
- dec RBF, GFR, UOP
- “dec HBF”
MAC: DESFLURANE
6
Class: SEVOFLURANE
Fluorinated methyl isopropyl ether
PK: SEVOFLURANE
Sweet smell - No a/w irritation
Vd L/kg: BG = 0.69, VP = 157
Met: 2- 3 % hepatic metab, Compound A
Elim: exhalation
Good for liver, kidney, CV dz
