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My Pharm 1 > Quiz 6 > Flashcards

Quiz 6 Flashcards

1
Q

How do Volatile agents typically decrease MAP? What exceptions?

A

SVR is decreased

  • Halothane decreases MAP by decreased CO
  • N2O no change to slight increase in MAP
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2
Q

Starting at concentrations 0.25 MAC, a linear, dose dependent increase in HR is observed - What agent?

A

Isoflurane or “Forane”

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3
Q

At concentrations ≥ 1 MAC , a linear, dose dependent increase in HR is observed - What agent?

A

Desflurane

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4
Q

HR does not increase until concentrations >1.5 MAC - what agent?

A

Sevoflurane

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5
Q

Abrupt increases of _______ and ______ > 1 MAC cause transient circulatory stimulation in the absence of anesthetic adjuncts

A

Desflurane and Isoflurane

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6
Q

Inhaled anesthetics prolong the QT interval on the electrocardiogram. which specifically? but safe if?

A

Sevoflurane

on B-Blockers

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7
Q

coronary steal seen more in which agent?

A

Isoflurane

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8
Q

two distinct periods of protection in Ischemic preconditioning?

A
  • 1-2 hours after the conditioning episode

- 24° later and can last as long as 3 days

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9
Q

Opening of mitochondrial _______-sensitive ________ channels (KATP) is the crucial event that confers the protective activity in Ischemic preconditioning

A

adenosine triphosphate (ATP)

potassium

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10
Q

_______ increases proportionate to anesthetic depth

A

PaCO2

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11
Q

Dose related _______ of the respiratory response to increased CO2

A

blunting

so co2 may have to climb higher than normal to stimulate breathing

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12
Q

______ stimulation to breath comes on sooner, but _______ is a stronger response

A

Co2

hypoxia

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13
Q

________ displacement of the diaphragm and ________ displacement of the rib cage occur from enhanced expiratory muscle activity. This results in a ________ in FRC

A

Cephalad

inward

reduction

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14
Q

Most pungent agent?

A

Desflurane

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15
Q

Least pungent agent?

A

Sevoflurane

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16
Q

how does the pungency of an agent effect the patient?

A
  • Coughing
  • Breath-holding
  • Laryngospasm
  • Arterial oxygen desaturation
  • Asthmatics, smokers, ppl sensitive tosmells
17
Q

cerebral vasodilatation occurs at concentrations above ____ MAC. Who is this good and not good for?

A

0.6

good for ischemic pts

not good for ^ICP pts

18
Q

At concentrations ≥ ___ MAC, __________ effects predominate and cerebral blood flow _________, especially if systemic blood pressure is maintained at awake values.

A

1

vasodilating

increases

19
Q

How does N2O differ from others? What to avoid? give what to counter effects?

A

^CMRO2 (cerebral oxygen consumption)

avoid in cranial injuries

opioids, barbiturates, or propofol

20
Q

ICP increases with all volatile anesthetics at doses ____ MAC

A

> 1

21
Q

Autoregulation is impaired at concentrations ______ MAC

A

< 1

22
Q

Volatile anesthetics and nitrous oxide ______ the amplitude and ______ the latency of SSEP in a dose-dependent manner

A

depress

increase

23
Q

concentrations of _____ MAC decrease the reliability of motor evoked potentials

A

0.2-0.3

24
Q

Avoid in epileptic or hx seizure pts

A

sevoflurane

25
Q

which gas has most potentiation of NMBs

A

Desflurane

26
Q

causitive agent of hepatic effects?

A

trifluoroacetate metabolite

27
Q

________ (trifluoroethyl vinyl ether) is produced from the breakdown of _______ and ________. In animal studies, Compound A is nephrotoxic after prolonged exposure.

A

Compound A

sevoflurane

halothane

28
Q

In humans, Compound A exposure significant to cause? Prevention?

A

transient proteinuria, enzymuria, and glycosuria occurs after prolonged sevoflurane at low fresh gas flows (1L/min).

Keep Sevo to at least 2L of flow or more

29
Q

N2O administration contraindicated in patients with?

A

preexisting vitamin B12 deficiency

30
Q

N2O other risk?

A

Gas transfer to closed spaces aka Pneumothorax, pneumoperotoneum, pneumocephalus, air emboli, bowel air, eye bubble procedures, inner ear procedures, avoid in craniotomies as well

31
Q

Gas with highest risk of fire in dessicated CO2 absorber?

A

Sevoflurane

32
Q

Which gases produce Carbon monoxide when exposed to dessicated absorbant?

A

Iso and Des

33
Q

________ are tempurature compensated vaporizors

A

Variable bypass

34
Q

another name for desflurane

A

suprane

35
Q

Required vaporizer setting for higher altitude equation =

A

(desired vaporizer setting at sea level × 760mm Hg)/local barometric pressure (in mm Hg.)

My Pharm 1 (10 decks)

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