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Inhalation anestheics Flashcards

(50 cards)

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1
Q

Inspired gas concentration determined by

A

Fresh gas flow rate
breathing circuit volume
circuit absorption

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2
Q

Alveolar gas concentration determined by

A

uptake of anesthetic into blood
ventilation
the concentration effect and second gas effect

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3
Q

Arterial gas concentration determined by

A

ventilation/perfusion mismatching (bronchial intubation, R–>L intra cardiac shunts

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4
Q

Definition of MAC

A

alveolar concentration that prevents movement in 50% of pts in response to a standardized stimulus

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5
Q

MAC ~ ? prevents movement in 95% of pts

A

1.3

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6
Q

MAC ~? awake MAC

A

0.3

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7
Q

MAC of N20

A

105

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8
Q

MAC of Halothane

A

0.75

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9
Q

MAC of Isoflurane

A

1.2

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10
Q

MAC of Desflurane

A

6.0

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11
Q

MAC of Sevoflurane

A

2.0

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12
Q

Blood: Gas partition coefficient of NO

A

0.47

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13
Q

Blood: Gas partition coefficient of Des

A

0.42 (fastest onset)

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14
Q

Blood: Gas partition coefficient of Sevo

A

0.7

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15
Q

Blood: Gas partition coefficient of Halothane

A

2.3 (slowest onset)

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16
Q

Blood: Gas partition coefficient of Iso

A

1.4

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17
Q

Partial pressure of NO

A

39,000

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18
Q

Partial pressure of Des

A

670

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19
Q

Partial pressure of Iso

A

240

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20
Q

Partial pressure of Halothane

A

240

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21
Q

Partial pressure of Sevo

22
Q

Partial pressure of enflurane

23
Q

Factors affecting MAC: hyperthermia

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A

decreased (increased above 42 degrees Celsius)

24
Q

Factors affecting MAC: hypothermia

25
Factors affecting MAC: young
increased
26
Factors affecting MAC: old
decreased
27
Factors affecting MAC: acute etoh intox
decreased (depressant of central nervous system)
28
Factors affecting MAC: chronic etoh abuse
increased
29
Factors affecting MAC: hct less than 40%
decreased
30
Factors affecting MAC: PaCO2 > 40mmHg
decreased (caused by lower ph in CSF)
31
Factors affecting MAC: hyperthyroid
no change (same with hypothyroid)
32
Factors affecting MAC: MAP < 40mmHg
decreased
33
Factors affecting MAC: hyper Ca++
decreased (decreased excitability)
34
Factors affecting MAC: hyper Na+
increased
35
Factors affecting MAC: hypo Na+
decreased
36
Factors affecting MAC: Pregnancy
decreased (MAC dec by 1/3 at 8 weeks)
37
Factors affecting MAC: local anesthetics
decreased
38
Factors affecting MAC: lithium
decreased
39
Factors affecting MAC: sympatholytics (clonidine, dexamedetomidine)
decreased
40
Factors affecting MAC: sympathomymetics - cocaine
increased
41
Factors affecting MAC: sympathomymetics - ephedrine
increased
42
Factors affecting MAC: amphetamine, acute
increased
43
Factors affecting MAC: amphetamine, chronic
decreased
44
affect on breathing of volatile anesthetics
dec minute ventilation: dec TV and small inc RR; rapid shallow breathing (MV = TV x RR)
45
NO toxicity is due to
impaired methionine synthesis and results in neurologic sequelae. concern in substance abusers, pts with vit b12 def, and possibly unborn fetuses
46
inhalational agents ______ (inc/dec?) hypoxic pulmonary vasoconstriction response
decrease the HPV response (HPV response = pulmonary vasculature constricts in response to decreased alveolar oxygen tension in an attempt to match ventilation and perfusion)
47
which anesthetic agent is most associated with cardiac dysrhythmias?
halothane. halothane increases sensitivity of myocardium to epinephrine and results in PVC and tachydysrhythmias.
48
volatile anesthetics affect on intracranial blood flow
increases blood flow and may increase ICP
49
what is the toxic metabolic by-product of sevo? which organ does it affect? minimal flow rates to reduce risk?
compound A - sevo degraded by soda lime produces compound A which is nephrotoxic. 2-3L/min
50
What by-product of CO2 absorbent degradation is desflurane associated with?
CO. most often occurs with absorbent is dry. incidence is highest in first case of the day when machines have not been used for some time. KOH containing absorbents produce greatest CO

Anesthesia (7 decks)

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