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GNURS627 Resp/Physiology > Week 10 MAC and Inhalation Agents > Flashcards

Week 10 MAC and Inhalation Agents Flashcards

1
Q

What is MAC?

A

Minimum Alveolar Concentration= the minimum concentration necessary to prevent movement in 50% of patients in response to skin incision

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2
Q

MAC amnesia is

A

25% MAC = concentration that blocks anterograde memory in 50% of awake patients

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3
Q

MAC intubation is

A

130% MAC= concentration required to prevent movement and coughing during endotracheal intubation

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4
Q

Factors that increases MAC include

A

Age: term infant to 6 months= highest MAC requirement

Chronic ETOH abuse

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5
Q

Factors that decrease MAC

A

Pregnancy
Lithium
Cardiopulmonary Bypass

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6
Q

Factors that have no effect on MAC

A

Thyroid gland dysfunction

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7
Q

MAC Values:

A

Sevo 1.1
Iso 2.2
Des 6.6
N2O 105

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8
Q

A high inspired concentration of an agent speeds/slows induction

A

speeds

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9
Q

Increased alveolar ventilation increases/decreases rate of rise of agent and speeds/slows induction

A

increases

speeds

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10
Q

The anesthetic system alveolar uptake of agents depends on

A

volume, solubility of components, gas flow rates- higher rates speed induction

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11
Q

Uptake from alveolar space depends on

A

solubility, cardiac output, and alveolar/ venous partial pressure difference

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12
Q

_______ is the important single factor in determining the speed of induction and the rate of emergence

A

Solubility

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13
Q

Blood Gas Coefficients

A 
Sevo 0.69
Iso 1.43
Des .42
N20 .47
Enflurane 1.8
Halothane 2.3

an increased ratio wants to stay in the blood
a decreased ratio wants to be in the gas phase

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14
Q

A poorly soluble agent has a faster/slower inhalation induction and a faster/slower emergence

A

faster

faster

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15
Q

A high cardiac output speeds/slows induction

A

slows

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16
Q

A low cardiac output speeds/slows induction

A

speeds

17
Q

A large alveolar / venous partial pressure difference with an agent enhances uptake and speeds/slows inhalation induction

A

speeds

18
Q

The ______________ is the ability of a large volume uptake of a first gas (N2O) to accelerate the rate of rise of the alveolar partial pressure of a concurrently administered companion gas (agent) thus speeding induction

A

second gas law

19
Q

__________ results from the dilution of alveolar O2 concentration by a large amount of N2O “outgasing” or leaving the pulmonary capillary blood at the conclusion of N20 administration
Rapid desaturation can be seen

A

Diffusion Hypoxia

20
Q

WHy would you not want to extubate while on 70% N2O?

A

Diffusion Hypoxia

This is avoided by administering 100% O2 following N2O use

21
Q

N2O is a good ______ that can increase ________. Avoid use of N2O with ________________________. N2O increases PVR especially in patients with __________.

A

good analgesic
increases PONV
avoid in closed gas spaces, PTX, complete bowel obstruction, inner ear, pneumocephalus, air embolism, intraocular bubbles

pulmonary htn

22
Q

N2O is nonflammable but is an _______ source that __________.

A

O2

supports combustion

23
Q

In rat experiments with N2O given to pregnant rats for greater than 24 hours, N2O inhibited _________, needed for DNA synthesis. Long term use can lead to __________.

A

Methionine Synthesis

Peripheral neuropathy and megaloblastic anemia

24
Q

Halothane causes a dose dependent decrease in __________. Halothane contains a ____________ preservative, used for inhalation induction in children which may cause a __________ stimulation, and may see ___________ with a MAC>1, pretreat with __________. Halothane sensitizes the heart to ___________. Use _________ with caution.

A 
contractility
thymol preservative
vagal stimulation
bradycardia
atropine
catecholamines, dysrhythmogenic
use epinephrine with caution
25
Q

Iso/Des increase ______ especially when rapidly increasing dose.

A

heart rate

26
Q

Desflurane is special in that it is ______ and _______.

A

heated

kept at 2 atm

27
Q

Iso can cause _____________, where normal coronaries dilate and stenotic ones don’t so blood shunted away from diseased vessels.

A

Coronary steal syndrome (ISO)

28
Q

Sevoflurane has a nonpungent smell, making it good for __________. Children tolerate __________ of sevo. Sevo allows for __________________ (occasional __________ in children). Can react with soda lime to form ____________. Keep FGF at least ________.

A 
inhalation induction
high levels
rapid induction and emergence
delerium
Compound A
FGF at least 2L/min

GNURS627 Resp/Physiology (6 decks)

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