Violate

Question 1

Inhalational anesthetics action,

Answer 1

sevoflurane, desflurane, and nitrous oxide

Mechanism unknown, leads to:
Sedation/ induction and maintance of gen anesth
Anesthesia (nitrous oxide)
↓ Respiration and arterial blood pressure, myocardial depression
↑ Cerebral blood flow and ICP, ↓ cerebral metabolic demand

AE: PONV
Risk of malignant hyperthermia
Post-op N/V
Risk of malignant hyperthermia (except nitrous oxide

Inhalational anesthetics are metabolized only to a small degree
Exception: halothane is metabolized in the liver

Question 2

N2O
Nitrous oxide .

Answer 2

Can diffuse into gas-filled body compartments → expansion of the gas in that compartment
↑ Pulmonary vessel resistance - not in pneumothorax, HT

Usually insufficient if used alone → often combined with a more potent inhalational anesthetic to achieve the “second gas effect”
Rapid onset and recovery

Question 3

Desflurane,

Answer 3

Very rapid onset and recovery
Pungent odor; irritates airways → not suitable for induction of anesthesia

sympatho-adrenergic reaction - ↑ Blood pressure and heart rate

Question 4

Sevoflurane,

Answer 4

Most commonly used inhalational anesthetic
Rapid onset~1 min and recovery
Nonpungent → suitable for induction of anesthesia

Agitation (especially in pediatric patients)

nephrotoxic breakdown products (known as compounds A–E)

Question 5

Isoflurane.

Answer 5

Most potent of the fluranes
Relatively slow onset and recovery
Pungent odor → not suitable for induction of anesthesia

Perioperative hyperkalemia

Question 6

Halothane

Answer 6

Hepatotoxic

halothane hepatitis - after 2d-3w: Signs of acute hepatitis (e.g., jaundice, fever, vomiting, hepatomegaly)

Question 7

Blood-gas partition coefficient

Answer 7

the ratio of anesthetic concentrations in the blood and alveolar space when partial pressures in the two compartments are equal

The higher the blood-gas partition coefficient of an inhalational anesthetic, the higher the solubility of that substance in the blood.

The lower the blood-gas partition coefficient of an inhalational anesthetic, the faster the substance takes/ ceases effect (less induction time)

Question 8

minimum alveolar concentration (MAC)

Answer 8

MAC is the fraction of volume of the anesthetic present in the inspired air that provides sufficient analgesia in 50% of patients

MAC is inversely related to anesthetic potency (potency = 1/MAC) and represents the ED50 value.
The lower the MAC value, the more fat soluble the anesthetic.

Halothane has a slow induction and high potency because of its high lipid and blood solubility.
Nitrous oxide (N2O), in contrast, has a fast induction and low potency due to low lipid and blood solubility.

Question 9

Second gas effect

Answer 9

The presence of N2O increases the speed at which the alveolar concentration of the other inhalational anesthetic increases, which leads to a faster onset of action.

Question 10

Entflurane

Answer 10

Proconvulsive

Question 11

Methoxyflurane

Answer 11

Nephrotoxicity
Can be used as a patient-controlled short-term pain relief