Inhalation Anesthesia Part 3 - Quiz 6 Flashcards Preview

Spring 2020 - Pharmacology 1 > Inhalation Anesthesia Part 3 - Quiz 6 > Flashcards

Flashcards in Inhalation Anesthesia Part 3 - Quiz 6 Deck (66)
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1

What is the relationship of the concentrations of Des, Sevo, and Isoflurane have with Mean Arterial Pressure?

As the concentration of these gases increase, MAP decreases in a dose dependent manner d/t a decrease in SVR

2

Out of Des, Sevo, and Isoflurane, which gas has the least Dose-Response relationship in regards to MAP

Sevoflurane

3

How does Halothane decrease MAP?

Halothane decreases MAP by decreasing Cardiac Output

4

How does N2O affect the MAP?

N2mildly increases MAP if at all

Activates SNS to increase SVR

5

What happens if you add N2O to other gases?

Decreases the magnitude of BP drop

6

At what concentration of Isoflurane would you start to see HR increase?

0.25 MAC

7

At what concentration of Desflurane would you see start to see a HR increase?

< 1 MAC: mininmal HR increase

≥ 1 MAC: linear dose dependent HR increase

8

At what concentration of Sevoflurane would you start to see a HR increase?

> 1.5 MAC

9

How do Inhalation Anesthetics affect Cardiac Index?

Cardiac Index is minimally influenced by gases

10

What are the Circulatory Effects with an abrupt increase of Desflurane & Isoflurane

to > 1 MAC?

Transient Circulatory Stimulation - increased plasma Epi & Norepi

Not seen w/ other gases

11

How do gases (except for Halothane) effect Myocardial Conduction?

Does not cause PVC's d/t prolonging effective refractory period

Halthone makes it easier for PVCs to happen

12

How do Inhaled Anesthetics affect the QT Interval?

Prolongs QT Interval

Avoid Sevo in pts w/ Long QT Syndrome

13

What is Coronary Steal?

Side effect of Isoflurane that can worsen myocardial ischemia - Not found valid

Reduced blood flow from ischemic part of the heart & increases blood flow to the healthy part of the heart

14

What is Ischemic Preconditioning?

  • Anesthetic gas exposes heart to brief episodes of ischemia that protects it from subsequent prolonged ischemia
  • Present in all tissues

15

When do the Two Periods of Ischemic Preconditioning occur?

  1.  1-2 hours after episode
  2. 24 hours later & lasts 3 days

16

What is the crucial event in Ischemic Preconditioning that causes the protective activity?

Opening of ATP-Sensitive Potassium (KATP)

30-40% d/t this

17

How does the concentration of anesthetic gas relate to Respiratory Rate & Tidal Volume?

As gas concentration increases, Respiratory Rate increases & Tidal Volume decreases

18

How does anesthetic gas affect Minute Ventilation, Gas Exchange & PaCO2?

Minute Ventilation: Same

↑Dead Space Ventilation

 ↑PaCO2

↓Gas Exchange

19

How does Anesthetic Gas affect Respiratory Response to CO2?

Dose Dependent decreased/blunted response to CO2

20

How does Anesthetic Gas affect the Chest Wall?

Diaphragm goes toward the Head

Ribs go Inward

Results in Decreased FRC & Atelectasis

21

How does Anesthetic Gas affect Hypoxic Pulmonary Vasoconstriction (HPV)?

Limited Effect unless there is Bronchoconstriction

22

Which volatile gases are Nonpungent?

Sevo

Halothane

N20

23

Which volatiles gases are Pungent?

Desflurane & Isoflurane

Produces Irritation - Cough, Breath Holding, Laryngospasm

24

What affect does Anesthetic Gas have on Cerebral Vascular response to PaCO2?

No Effect

25

Inhalation agents ________ CMRO2, cerebral metabolic O2 requirement, except for N2O?

Inhalation agents decrease CMRO2, cerebral metabolic O2 requirements

N2O increases CMRO2

26

At what MAC does Cerebral Vasodilation occur?

> 0.6 MAC

Dose-dependent increase in CBF

27

What happens in the 2 Phases of dose-dependent effect of inhalation agents on CBF?

  • First Phase
    • @ 0.5 MAC: Decreased CMRO2 offsets Vasodilation - No change in CBF
  • Second Phase
    • ≥  1 MAC: Vasodilation takes over - Increased CBF

28

What are the effects of N2O on the CNS?

Cerebral Vasodilation

&

↑CMRO2

29

What would you give with N2O to counteract its effect on the CNS?

Opioids

Barbituarates

Propofol

30

Which gases would Increase ICP with a MAC > 1?

All of them @ MAC > 1