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Pharmacology (Spring 23 edit) > Exam 3 (VAs pt II) > Flashcards

Exam 3 (VAs pt II) Flashcards

1
Q

What VA would be safer to use in a patient with concerns for an elevated ICP?
A. Sevoflurane
B. Desflurane
C. Isoflurane

A

A. Sevoflurane

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2
Q

What VA would be best to use for a patient with myocardial injury or heart failure?

A. Desflurane
B. Sevoflurane
C. Isoflurane

A

B. Sevoflurane

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3
Q

How much pressure is required to increase ICP?

A

7 mmHg

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4
Q

What VA has the best bronchodilatory effects?

A. Isoflurane
B. Desflurane
C. Sevoflurane

A

C. Sevoflurane

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5
Q

What VA may increase the risk of bronchospasm in patients who smoke, have COPD or an URI?

A. Isoflurane
B. Desflurane
C. Sevoflurane

A

B. Desflurane

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6
Q

VAs promote skeletal muscle relaxation primarily through _________ receptors and the inhibitory NT _________.

A

nACh ; Glycine

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7
Q

What gas has NO effect on skeletal muscle relaxation?

A

Nitrous

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8
Q

Cardiac ischemic preconditioning followed by exposure to VAs is mediated by _________.

A

Adenosine

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9
Q

EEG Burst suppression occurs with ______ MAC.

A

1.5

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10
Q

Which of the following VAs have anticonvulsant effects?
select all that apply

A. Isoflurane
B. Enflurane
C. Desflurane
D. Sevoflurane
E. Nitrous

A

A, C, and D

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11
Q

The VA ______ can potentiate seizure activity. What two factors further increase the risk?

A

Enflurane ; PaCO2 < 30 or 2 MAC

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12
Q

What anesthesia options are useful in a surgery where monitoring of SSEPs or MEPs is required?

A

60% nitrous with 0.5 MAC of a VA
or
TIVA

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13
Q

What VA has no effect on the refractory period of accessory pathways in the cardiac conduction system, and is useful for anesthesia during a catheter ablation?

A. Sevoflurane
B. Desflurane
C. Isoflurane

A

A. Sevoflurane

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14
Q

Specify if general anesthetics maintain/ increase / or decrease blood flow for the following vessel-rich groups

Total hepatic flow: maintain/ increase / decrease
Hepatic artery flow: maintain/ increase / decrease
Portal vein flow: maintain/ increase / decrease

A

Total hepatic flow: maintain
Hepatic artery flow: maintain
Portal vein flow: increase (at 1-1.5 MAC)

Iso=Des=Sevo
*halothane does decrease hepatic flow

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15
Q

Sevoflurane reacts with desiccated absorbant to form what byproducts? What is added to help prevent this?

A

Baralyme, methanol, formaldehyde
water added

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16
Q

What test can confirm suspected MH in a patient with a family history?

A

Caffeine contracture test

17
Q

Dantrolene works by blocking intracellular release of _______

A

Calcium

18
Q

Nitrous is ematogenic at what percent?

A

> 50%

19
Q

Nitrous can cause what vitamin deficiency?

A

B12

20
Q

Nitrous can cause what type of immune suppression? How long would the exposure need to be?

A

Megaloblastic bone marrow suppression; 24 hours or repeated exposures within a 3 day period

21
Q

Nitrous can increase _____ which is associated with a higher rate of atherosclerosis.

A

homocysteine

22
Q

VAs decrease ______ contractility

A

uterine

23
Q

OB
VAs can be useful with a retained _______ BUT they can increase blood loss in uterine ______

A

placenta; atony

24
Q

4 big concerns with halothane

A

catecholamine-induced arrhythmias
hepatic necrosis
pediatric bradyarrhythmias
decomposition into HCl acid

25
Q

A highly pungent, longer acting VA that isnt great for mask induction

A

Isoflurane

26
Q

A surgical patient’s post-operative plan involves admission to the ICU where they will require a few days of mechanical ventilation. What VA may be useful in this scenario?

A. Isoflurane
B. Desflurane
C. Sevoflurane

A

A. Isoflurane

27
Q

what volatile is the MOST pungent

A

Desflurane

28
Q

VAs can degrade into CO when absorbent is dehydrated. Organize the following VAs from most CO degredation to least CO degradation.

Isoflurane
Sevoflurane
Desflurane
Enflurane

A

Des>Enf>Iso>Sevo

Dah Environment Is Screwed

29
Q

VA of choice for inhalation induction

A

Sevo

30
Q

What ratio does this represent and what property of nitrogen makes it the highest?

A

The ratio of end-tidal alveolar concentration of an anesthetic (FA) relative to the inspired anesthetic concentration (FI). The ratio climbs faster for drugs related to their low solubility. When the decrease becomes more stable/plateaus this represents tissue saturation of vessel-rich groups.

Pharmacology (Spring 23 edit) (4 decks)

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