Sevoflurane Flashcards
No more than __ carbon atoms, non flammable, and stable to soda lime
Four
Is sevo a methyl isopropyl ether or a methyl ethyl ether?
Methyl isopropyl ether
Fully halogenated compounds are usually __ anesthetics and convulsants
Poor
Metabolism rate of sevo
3-5%
Blood gas partition coefficient of sevo
0.69
Sevo is __ an airway irritant
Not really
Can do a one breath sevo induction
How many fluorine atoms on sevo?
Seven
Des is synthesized from __
ISO
Mac of sevo
2.1%
Addition of nitrous __ mac of sevo
Decreases
Mac awake __
0.3 x mac (2.1)
Mac BAR
1.5x mac
Mac intubation
2x mac
Hypothermia, increased age, benzo, opiates, alpha2 agonists, nitrous, pregnancy, acute ethanol, sick, hypoNA, hyperMag
All __ mac
Decrease
CNS catecholamine stim, chronic ethanol, hyperNa
All __ mac
Increase
The lower the BGPC, the __ alveolar conc equilibrates to arterial conc
Quicker
Low solubility of sevo facilitates __ lung elimination
Rapid
Sevo vapor pressure
160 mmHg
Increased ventilation = __ equilibration
Quicker
Increased cardiac output = __ equilibration
Slower
Sevo could equilibrate in __ minutes in the vessel rich group
4-8
Can sevo provide retrograde amnesia or long term impairment of intellectual function?
NO
Sevo __ reduce cerebral metabolic oxygen requirements
Will
Sevo has the potential to increase ICP in patients with space occupying lesions not receiving hyperventilation.
Slide 37
It is a cerebral blood vessel dilator
Treat by hyperventilate to end tidal CO2 around 30
Around 2 mac you may have an __ EEG
Isoelectric
Sevo does not produce seizures and can actually __ seizure activity
Suppress
Sevo increases cerebral blood flow for up to __ hours
Four
Hyperventilate to an end tidal CO2 of __ to counteract increased cerebral blow flow
30
Sevo iso des ALL lower BP by decreasing __
SVR
Sevo __ delivery of NMB
Enhances
Sevo and right to left shunt?
Yes
Sevo has __ effect on PVR
No
Spontaneous ventilation causes CO, SBP, and SVR to __ more, but HR will increase more
Decrease
Can you abruptly change concentrations in sevo?
Yes, unlike iso and des
Inhalation induction with a sick heart?
NO
Sevo causes apnea around
1.5-2 mac
Sevo breathing is like a lizard on a hot rock
Small tidal, fast rate, decreased minute ventilation, increased CO2
The ventilatory effects __ over time
Decrease
Does sevo have muscle relaxant properties?
Yes, weak
__ is the best way to counteract the ventilatory effects of sevo
Put a garden hose down their gullet
Sevo is a __ bronchodilator and can break an attack of status asthmaticus
Potent
Where is sevo metabolized?
Liver by cytochrome p450
If your patient has a hx of post anesthesia hepatitis, that cannot occur with use of __
ONLY SEVO cannot be implicated in post-anesthetic hepatotoxicity.
Sevo
What is a byproduct of sevo metabolism that is nephrotoxic?
Free fluoride
Two bad compounds that sevo can metabolized into?
Compound A
HFIP
Amsorb produces the lowest concentration of compound _
A
Test question
Keep sevo __ during obstetrics due to uterine atony and possible hemorrhage
Minimal
