Volatiles Flashcards

1
Q

What is the MAC of sevoflurane

A

2

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2
Q

What is the MAC of Desflurane

A

6.5

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3
Q

What is the MAC of Isoflurane

A

1.17

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4
Q

What is the MAC of Enflurane

A

1.63

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5
Q

What is the MAC of Halothane

A

0.75

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6
Q

What is the blood:gas coefficient of Sevoflurane

A

0.69

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7
Q

What is the blood:gas coefficient of Desflurane

A

0.42

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8
Q

What is the blood:gas coefficient of Isoflurane

A

1.4

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9
Q

What is the blood:gas coefficient of Enflurane

A

1.90

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10
Q

What is the blood:gas coefficient of Halothane

A

2.54

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11
Q

What are the metabolites of Sevoflurane, and how much is metabolized?

A

Inorganic and organic fluorides
Compound A in the presence of soda lime and heat
Also compounds (B-E)
3.5% metabolised

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12
Q

What is compound A

A

A toxic compound produced by interaction of Sevoflurane with CO2 absorbers
Causes renal tubular necrosis in rodent models in concentrations >300ppm after 3hrs exposure. Human threshold is ~150ppm
Unlikely to be clinically relevant as ~20ppm measured at low flow rates after 5hrs

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13
Q

What are the metabolites of Halothane

A

Trifluoroacetic acid
Cl-, Br-
20% metabolised

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14
Q

What are the metabolites of Enflurane

A

Inorganic and organic fluorides

2% metabolised

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15
Q

What are the metabolites of Isoflurane

A

Trifluoroacetic acid and F-

0.2% metabolised

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16
Q

What are the metabolites of Desflurane

A

Trifluoroacetic acid

0.02% metabolised

17
Q

Outline the cause of Halothane hepatitis

A

Immune mediated hepatits
Antibodies are formed against liver microsomal proteins on the surface of hepatocytes that have been covalently modified to form neoantigens by the reactive oxidative trifluoroacetyl halide metabolite of halothane

18
Q

How do volatiles produce CO

A

volatile agents interact with sodalime or baralyme absorbers to form CO
Des > Enf > Iso
Production is worse if the CO2 absorber is hot and dry (eg after a machine is left idle overnight/weekends)