Dissociatives & Inhalants

Question 1

complex mode of action; causes disruption of nerve transmission in some areas of the brain and selective stimulation in other areas.

Answer 1

dissociatives

Question 2

What receptors do dissociative agents inhibit?

Answer 2

NMDA

Question 3

What patients should dissociatives be used with caution?

Answer 3

kidney or liver disease

Question 4

Where are dissociatives metabolized and redistributed?

Answer 4

the liver

Question 5

What route are dissociatives administered by?

Answer 5

IM or IV

Question 6

What is the most commonly used dissociative agents?

Answer 6

ketamin

Question 7

T/F: There is a reversal agent for dissociatives.

Answer 7

False

Question 8

What are some of the benefits of using the ketamine-diazepam combo?

Answer 8

minimal cardiac depression, muscle relaxation, good recovery, minimal analgesia

Question 9

T/F: Ketamine-diazepam is not as effective when given IM.

Answer 9

T

Question 10

Do dissociative agents cause the patient’s eyes to close fully?

Answer 10

No, the eyes remain fully open, with central and dilated pupils.

Question 11

Why is it difficult to determine anesthetic depth in patients under dissociative anesthesia?

Answer 11

Reflex activity is preserved.

Question 12

What is a Cataleptoid state?

Answer 12

State when a patient does not respond to external stimuli and has muscle rigidity.

Question 13

What is the most common inhalant anesthetic? (think purple)

Answer 13

Isoflurane

Question 14

What is the second most commonly used inhalant anesthetic?

Answer 14

Sevoflurane

Question 15

Which inhalant anesthetic requires a special vaporizer?

Answer 15

Desflurane

Question 16

What is the Minimum Alveolar Concentration (MAC)?

Answer 16

The lowest concentration to which 50% of patients show no pain.

Question 17

T/F: The lower the MAC, the more potent the inhalant anesthetic agent.

Answer 17

True

Question 18

What causes vapor pressure and what is it correlated to?

Answer 18

Vapor pressure is the pressure created by liquid molecules bouncing off the container wall and is correlated to temperature.

Question 19

Ratio of gas in the blood and in the alveolar gas.

Answer 19

Blood-gas partition coefficient

Question 20

What does the Partition Coefficient help us determine?

Answer 20

Help determine which gas can be used for a mask/chamber. Help determine how fast recovery will be.

Question 21

Inhalation agents mode of action

Answer 21

• inhibit nerve cell function in the brain and spinal cord
• liquid is vaporized and mixed with oxygen
• given via mask or ET tube to the lungs
• goes from the lungs to blood stream to the brain

Question 22

How are inhalation agents eliminated from the body?

Answer 22

Through the lungs instead of the liver or kidneys.

Question 23

T/F: Halothane, Enflurane and Methoxyflurane are not used as much anymore because there are safer options.

Answer 23

True

Question 24

What is another name for Dissociatives?

Answer 24

Cyclohexamines

Question 25

What are dissociatives typically used in conjunction with?

Answer 25

opioids and tranquilizers

Question 26

What is apneustic breathing?

Answer 26

a pattern in which a prolonged pause follows inspiration and a short pause follows expiration

Question 27

T/F: Dissociatives should not be used in patients with seizure disorders.

Answer 27

True

Question 28

Which inhalant has the fastest induction and recovery time?

Answer 28

Desflurane

Question 29

Which inhalant has the lowest blood-gas partition coefficient?

Answer 29

Isoflurane

Question 30

What are the effects of Halogentated agents on the cardiovascular system?

Answer 30

decreased cardiac output, hypotension, decreased tissue perfusion, vasodilation

Question 31

What are the effects of halogenated agents on the respiratory system?

Answer 31

hypoventilation