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Anesthesia and Analgesia > Chapter 15- Inhalation Anesthetics and Gases > Flashcards

Chapter 15- Inhalation Anesthetics and Gases Flashcards

1
Q

How is inhaled anesthesia produced?

A

By controlled administration of gaseous volatile drugs

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2
Q

How can the magnitude of depression of the CNS be controlled when using inhaled anesthetics?

A

By altering the partial pressure or concentration of anesthetic

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3
Q

Why is it important to be able to supplement a horse with oxygen during anesthesia?

A

Because GA and recumbency reduce the horse’s ability to oxygenate arterial blood

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4
Q

The degradation process of the sevoflurane produces ____

A

Compound A

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5
Q

The degradation of sevoflurane and isoflurane produces ____

A

Carbon monoxide

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6
Q

What is the partition coefficient?

A

It is the ratio of the anesthetic between two phases after equilibration

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7
Q

Solubility of an inhaled anesthetic is expressed as the ____

A

Partition coefficient

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8
Q

What happens at equilibrium with:
1. Partial pressure of the anesthetic
2. The concentration of the anesthetic

A
  1. The partial pressure in the two phases is the same
  2. The concentration can differ greatily
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9
Q

What does a PC of 2.5 mean for an anesthetic X in equilibrium?

A

The concentration of the anesthetic in blood is 2.5 times greater than in gas, whereas partial pressure is equal in both phases

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10
Q

If anesthetic X has a PC of 2.5 and anesthetic Y has a PC of 0.5, which one can induce the patient faster?

A

Anesthetic Y

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11
Q

How is solubility (PC) related to the speed of induction?

A

Higher solubility (PC) is related to slower induction

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12
Q

The blood:Gas PC correlates inversely with ____

A

Anesthetic potency

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13
Q

Relationship between the administered dose and the magnitude if the effect is an expression of ____

A

Potency of the anesthetic

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14
Q

What is the ED50

A

The dose at which 50% of the horses het anesthetized

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15
Q

True/False: MAC is represented by the vaporizer setting

A

False, MAC is ALVEOLAR concentration and not the inspired concentration

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16
Q

At equilibrium of gas and arterial blood, and the arterial and brain anesthetic partial pressure, MAC should be an indication of ____

A

Partial pressure of the anesthetic in the CNS

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17
Q

MAC of most common anesthetics

A
  1. Halothane 0.9-1.05%
  2. Isoflurane 1.31-1.64%
  3. Sevoflurane 2.31-2.84%
  4. Desflurane 7.02-8.06%
  5. Nitrus oxide 205%
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18
Q

Most patients require ____ to ____ MAC or less for an adequate anesthesia

A

1.2 to 1.4 MAC

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19
Q

True/False: Sites of action for the inhaled anesthetics are located in the brain and the spinal cord

A

True

20
Q

Anesthetic moves through phases by

A

Down the partial pressure gradients

21
Q

Measuring alveolar anesthetic pressure is a reliable method to monitor ____

A

Anesthetic dose (MAC)

22
Q

What happens after reducing the anesthetic to zero?

A

Reversal on gradients occur

Moving down from CNS to blood to alveoli to athmosphere

23
Q

Delivery of the anesthetic to alveoli depends on

A

Inspired concentration and alveolar ventilation

24
Q

What can increase delivery of anesthetic to the alveoli?

A

Increasing the vaporized dial setting or supplementing alveolar ventilation

25
Q

How can an elevated PC make the induction slower?

A

It enhances the removal of the anesthetic from the alveoli retarding equilibration of partial pressure between alveoli:blood:brain

26
Q

How can a high cardiac output affect the induction?

A

It increases the amount of blood match with alveoli per unit time decreasing the rise of alveolar partial pressure and slowing down the induction

27
Q

Venous partial pressure is dictated by

A

Solubility in tissues (tissue:blood PC), blood flow, PC arterial blood:tissue

28
Q

Solubility of the common inhaled anesthetics

A
  1. Halothane 2.4
  2. Isoflurane 1.4
  3. Sevoflurane 0.7
  4. Desflurane 0.5
  5. Nitrous oxide 0.5
29
Q

Organize the most common anesthetics from higher to lower solubility

A

Halothane > Isoflurane > Sevoflurane > Desflurane/Nitric oxide

30
Q

Alveolar partial pressure decreases ____ with more soluble anesthetics

A

More slowly

31
Q

If large quantities of the anesthetic are dissolved in tissues, they serve as reservouir that maintains alveolar partial pressure, this leads to

A

Slower recovery

32
Q

Halothane effect on CO

A

It decreases stroke volume decreasing CO

33
Q

True/False: With halothane, there is usually no change in vascular resistance

A

True

34
Q

What effect do inhaled anesthetics have in EEG?

A

Brain waves become larger and slower in frequency

35
Q

The risk of developing elevations of hepatic enzymes in serum can happen after ____ of surgery

A

After 3 hours of surgery

36
Q

Halothane depresses these in the kidney (2)

A
  1. Renal blood flow
  2. GFR
37
Q

About ____ of the administered halothane undergoes biotransformation

A

20-25%

38
Q

The major metabolite from halothane biotransformation is

A

Trifluoroacetic acid

Eliminated by the kidney

39
Q

Isoflurane undergoes a ____ of biotransformation

A

0.17%

40
Q

What effect do variations in temperature have on desflurane delivery?

A

Unacceptable variations in delivery

41
Q

True/False: Desflurane has the lowest solubility providing the fastest induction and recovery

A

True

42
Q

What happens with desflurane after 1.5 MAC?

A

Looses hemodynamic advantage and becomes a similar or greater cardiovascular depressant

43
Q

Desflurane undergoes a ____ of biotransformation

A

0.02%

44
Q

Sevoflurane undergoes a ____ of biotransformation

A

3%

45
Q

What byproduct of sevoflurane biotransformation is potentially nephrotoxic?

A

Fluoride

46
Q

What are the methods of control for occupational exposure with inhaled anesthetics? (3)

A
  1. Clean up sources of gas spillage
  2. Adequate ventilation
  3. Use waste anesthetic scavenging
47
Q

Anesthesia machines
(Table)

A

Anesthesia and Analgesia (4 decks)

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