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1

Inhalation anesthetics

gases & volatile liquids

2

Gases

Nitrous oxide

3

Nitrous oxide

Analgesia > General anesthesia
mixed with O2
for general anesthesia, mixed with other compounds
No muscle relaxation
“Diffusion hypoxia”
toxic for staff
safest anesthetic

4

Diffusion hypoxia

The Fink effect or the "third gas effect
A factor that influences the pO2 within the alveolus

When water-insoluble gases( N2O ) are breathed in large quantities they can be dissolved in body fluids rapidly. This leads to a temporary increase in both the concentrations and partial pressures of oxygen and carbon dioxide in the alveolus

can occur with the administration of inadequate amounts of oxygen during or immediately after N2O anesthesia

5

Volatile liquids

Halogenated & Ether derivatives

6

Halogenated Volatile liquids

Halothane

7

Ether derivatives

suffix -flurane

Enflurane
Isoflurane
Desflurane
Sevoflurane

8

Halothane

Prototype
General anesthesia > analgesia
Bronchodilator, relaxes uterine and skeletal muscles
Hepatotoxic for adults (mainly in low O2 concentration)
metabolized to free radical, 50% die of hepatic necrosis
not used due to adverse effects
AE: cardiac (arrhythmias and concentration dependent hypotension), Malignant hyperthermia

9

Enflurane

Fast induction and recovery
some muscle relaxation effect
AE: stimulates respiratory reflexes (Cough), CNS (epileptiform seizures, intracranial pressure elevation)

10

Isoflurane

isomer of enflurane
Good control of intracranial pressure
AE: stimulates respiratory reflexes (Cough), Dose-dependent hypotension

11

Desflurane

rapid onset and recovery (very low solubility)
delivered using special heated vaporizer (which is expensive)
high airway irritation (not used for inhalation induction)

12

Sevoflurane

Rapid onset and recovery ( low solubility)
No airway irritation
used for induction
metabolized by the liver
AE: nephrotoxicity

13

prevention of adverse effects of halothane

phenylephrine: for arrhythmias
dantrolene: for Malignant hyperthermia