GenAne(Inhale)-Specifics Flashcards
What is the effect of most inhaled anesthetics on cardiac contractility? MAP?
Decreases both
Which two inhaled anesthetics reduce MAP mainly by myocardial depression with little effect on peripheral vascular resistance?
Halothane and enflurane
Which three inhalational anesthetics produce vasodilation and have little effect on cardiac output?
Isoflurane desflurane and sevoflurane
Which inhalational anesthetics would you give to someone with impaired myocardial function? Why?
Isoflurane desflurane and sevoflurane
Mainly act as vasodilators and don’t depress myocardial contractility
Which inhaled anesthetic lowers BP the least?
Nitrous oxide
Which inhaled anesthetic sensitizes myocardium to circulating catecholamines and can lead to ventricular arrthymias?
Halothane
Which two inhalational anesthetics should be avoided in patients with bronchospasm?
Isoflurane and desflurane
Which two inhaled anesthetics are the MOST respiratory depressant?
Isoflurane and enflurane
Which inhaled anesthetic is the LEAST respiratory depressant?
Nitrous oxide
Which inhaled anesthetic should be used in patients with increased ICP? Why?
Nitrous oxide
All inhaled anesthetics raise ICP,
nitrous does it the least
Which inhaled anesthetics can cause tonic-clonic movements at high concentrations?
Enflurane (rarely and only at high conc)
Which inhaled anesthetic should you avoid in someone with a pneumothorax? Why?
Nitrous oxide - it enters air filled cavities faster than nitrogen can escape and can cause the cavity to swell and inc pressure
Patient after surgery develops severe life threatening hepatitis. What inhaled anesthetic was he most likely exposed to?
Halothane (H for Hepatotoxicity)
Which inhaled anesthetic can be nephrotoxic?
Methoxyflurane
Patient after emergency intubation with succinylcholine develops tachycardia, severe muscle rigidity, hypercalcemia and acidosis. What is this called? What inhaled anesthetic should absolutely be avoided? Treatment?
Malignant hyperthermia
Avoid halothane
Treat with dantrolene
A patient with an autosomal dominant defect in their RYR1 gene is susceptible to what condition? Why? What two drugs should be avoided?
Malignant hyperthermia - defective ryanodine receptor leads to uncontrolled release of calcium from the sarcoplasmic reticulum
Avoid succinylcholine and halothane
The ryanodine receptors on the sarcoplasmic reticulum is the equivalent of what receptor on the endoplasmic reticulum? What do they have in common?
IP3 receptor - both control calcium release
Why do you see hyperkalemia in malignant hyperthermia?
Energy stores in the muscle fiber are quickly depleted and the muscle fibers begin to die and release potassium (also myoglobin)
How do you test someone for susceptibility to malignant hyperthermia?
Halothane-caffeine test
Muscle biopsy fibers tested for strength of contraction when exposed to halothane and caffeine
A long-term dental nurse presents with megaloblastic anemia. What anesthetic agent was she most likely exposed to?
Nitrous oxide
