Inhalation agents

Question 1

What is the MAC of N2O?

Answer 1

105% (least potent gas)

Question 2

Is N2O organic or inorganic?

Answer 2

inorganic

Question 3

T/F: N2O is not an effective analgesic.

Answer 3

False… it is

Question 4

_____% of N20 + O2 with significantly reduce the MAC of other agents

Answer 4

70

Question 5

N2O uses a ________ inhaled concentration

Answer 5

high

Question 6

The ______________ effect speeds induction as fresh gas is drawn into the lung from the circuit

Answer 6

concentration

Question 7

After using N20, remember to administer _________ in the PACU

Answer 7

O2

Question 8

N2O stimulates the ________________

Answer 8

SNS

Question 9

T/F : N2O is a direct myocardial contractility depressant

Answer 9

True

Question 10

N2O has what effect on PAPs?

Answer 10

Increase PVR and RA pressure

Question 11

N2O can cause ___________ induced dysrhythmias

Answer 11

epinephrine

Question 12

N2O may cause _________________ at >1 MAC

Answer 12

skeletal muscle rigidity

Question 13

_________ is probably not a triggering inhalation agent for MH.

Answer 13

N2O

Question 14

N2O _______ CBF and ________ CMRO2

Answer 14

increases and increases

Question 15

N2O may cause _____________ post operatively

Answer 15

N/V

Question 16

N2O is almost exclusively eliminated by _____________

Answer 16

exhalation

Question 17

How much biotransformation occurs with N2O?

Answer 17

VERY LITTE

Question 18

N2O can lead to a decrease in __________ synthetase and __________ enzymes…which is necessary for DNA synthesis. SO avoid N2O when?

Answer 18

Methionine
Vit. B 12
during 1st trimester

Question 19

Avoid prolonged exposure to N20 d/t what 3 things?

Answer 19

pernicious anemia
bone marrow suppression
peripheral neuropathies

Question 20

Contraindication related to N2O are due to the fact that…….

Answer 20

N20 diffuses rapidly into air - containing cavities

Question 21

Does N2O potentiate NM blockers?

Answer 21

Yes

Question 22

Volatile agents all have ______ compounds

Answer 22

carbon

Question 23

__________ substitutions increase anesthetic potency

Answer 23

halogen

Question 24

Lower weight halogens _______ potency more than those of higher atomic weight

Answer 24

decrease

Question 25

_______ substitutions on carbon compounds lead to the most stable compounds.

Answer 25

Cl-

Question 26

Cl- substitutions on Carbon compounds lead to ________________ as a s/e

Answer 26

myocardial depression

Question 27

Fluorination reduces ____________ but creates the potential for _________ as an s/e

Answer 27

flammability | renal damage

Question 28

C4H3F7O is

Answer 28

sevoflurane

Question 29

C3H2F6O is

Answer 29

Desflurane

Question 30

C3H2CLF5O is

Answer 30

Isoflurane

Question 31

C2HBrF3

Answer 31

Halothane

Question 32

What gas has the highest VP?

Answer 32

n20

Question 33

What gas has the second highest VP after N2O

Answer 33

desflurane

Question 34

_____________ is the pressure created when gas molecules bombard the surface of a liquid and the walls in a closed container

Answer 34

VP

Question 35

__________ is when the VP equals the Barometric pressure

Answer 35

Boiling Point

Question 36

If you increase the altitude, you _________ the barometric pressure

Answer 36

decrease

Question 37

What does alkalosis do to MAC?

Answer 37

nothing

Question 38

what does Hyperthermia do to MAC?

Answer 38

increase it

Question 39

What does anemia (4.3ml/dl) do to MAC?

Answer 39

decrease it

Question 40

what does a prolonged duration of anesthesia do to MAC?

Answer 40

Nothing

Question 41

What does hypotension do to MAC?

Answer 41

decrease it

Question 42

What does Hypernatremia do to MAC?

Answer 42

increase it

Question 43

What does pregnancy to do MAC?

Answer 43

decrease it

Question 44

what does variable stimulus do to MAC?

Answer 44

nothing

Question 45

what do CNS stimulants do to MAC?

Answer 45

increase it

Question 46

What does a 1 year old do to MAC?

Answer 46

increase it

Question 47

What does being elderly do to MAC?

Answer 47

decrease it

Question 48

What do Alpha 2 agonists do to MAC?

Answer 48

decrease it

Question 49

To avoid movement when no muscle relaxant is on board in 95% of pts... it requires ___-___% above MAC or ____ MAC

Answer 49

10-30 | 1.3

Question 50

MAC awake for what agents is 1/3?

Answer 50

des, sevo, iso

Question 51

MAC awake is 1/2 for what agent?

Answer 51

halothane

Question 52

What is MAC awake for N2O?

Answer 52

60%

Question 53

Which agent does not decrease SVR?

Answer 53

desflurane

Question 54

What will happen to BP and HR with Halothane

Answer 54

BP increases, HR no change

Question 55

When using halothane, use extreme caution with what drug d/t arrhythimis? what occurs?

Answer 55

Epinephrine | bradycardia/junctional

Question 56

W/ Halothane, the adult dose of EPI should not exceed _______________ within 10 mins or ______________ within 1 hour

Answer 56

10ml of 1:100K | 30ml of 1:100K

Question 57

What does Halothane do with asthma?

Answer 57

its a potent bronchodilator and reverse bronchospasm

Question 58

What does Halothane do to ICP?

Answer 58

increases it! avoid in neuro patients!!!!

Question 59

Which agent cause the least amount of skeletal muscle relaxation?

Answer 59

Halothane

Question 60

Halothane is toxic where?

Answer 60

the liver! Hepatitis due to CYP450

Question 61

What % of halothane is metabolized?

Answer 61

20%

Question 62

What drugs are contraindicated with Halothane?

Answer 62

aminophylline Tricyclics MAOIs BBlockers and Ca Ch Blockers

Question 63

Which volatile agent is the most potent trigger of MH?

Answer 63

Halothane

Question 64

What 4 major contraindications are there for halothane?

Answer 64

Liver damage/dysfunction hypovolemia pheochromocytoma aortic stenosis

Question 65

______________ is a halogenated methyl ethyl ether

Answer 65

enflurane

Question 66

What is the MAC of enflurane?

Answer 66

1.7

Question 67

With enfluranes decrease in BP, will you see an increase or decrease in HR?

Answer 67

increase! opposite of halothane

Question 68

What is the main cerebral effect of Enflurane?

Answer 68

tonic clonic seizures

Question 69

The main toxicity for enflurane is?

Answer 69

renal toxicity

Question 70

What 2 patients are contraindication for enflurane?

Answer 70

renal pts | seizure pts

Question 71

Which agent do you use for PEDs inductions? which agent do you NOT?

Answer 71

sevoflurane | isoflurane

Question 72

What agent dilates the coronary arteries but may cause coronary steal syndrome?

Answer 72

isoflurane

Question 73

Is isoflurane neuroprotective or harmful?

Answer 73

protective

Question 74

Isoflurane can cause a ___________ at 2 MAC

Answer 74

isoelectric EEG

Question 75

Which gas has a VP that is close to atmospheric pressure?

Answer 75

desflurane

Question 76

What vaporized does Desflorane use?

Answer 76

TEC 6

Question 77

When giving Desflurane, what happens when you give a rapid increase in concentration?

Answer 77

transient increase in HR, BP, catecholamine levels

Question 78

The main adverse effect of desflurane is?

Answer 78

laryngospasm and bronchoreactivity

Question 79

Which agent causes Carbon monoxide release from a used up scavenger?

Answer 79

Main one - desflurane

Question 80

The only agent that does not increase CVP is?

Answer 80

sevoflurane

Question 81

Does sevoflurane cause airway irritation?

Answer 81

NO - it is the best amount all agents!

Question 82

With what agent do you need to use FGF of >/= 2 L?

Answer 82

Sevo

Question 83

What causes toxicity with sevoflurane?

Answer 83

Compound A

Question 84

With which drug is there ZERO risk of "halothane hepatitis"?

Answer 84

Sevoflurane

Question 85

What kind of patients are contraindicated for sevo?

Answer 85

Renal Pt's