Inhalation Pt 3 Sevoflurane

Question 1

Sevoflurane is a

Answer 1

Fluorinated methyl isopropyl ether

Question 2

Sevoflurane’s MAC

Answer 2

2.0

Question 3

Sevoflurane’s MAC decreases with ___

Answer 3

Increased age

Question 4

Sevoflurane’s B/G λ

Answer 4

0.65

Question 5

Sevoflurane’s induction dose:

Answer 5

Individualized

Question 6

Sevoflurane’s maintenance dose:

Answer 6

0.5-3.0

Question 7

Sevoflurane’s vapor pressure:

Answer 7

157

Question 8

Sevoflurane’s molecular weight:

Answer 8

200

Question 9

Sevoflurane’s neuromuscular effects enhance ____

Answer 9

Non-depolarizer muscle relaxants (similar to Isoflurane)

Question 10

Sevoflurane provides adequate ____ for intubation of _____

Answer 10

Relaxation for intubation of children with inhalation induction

Question 11

Sevoflurane’s respiratory effects:

Answer 11

Respiratory depressant
Non-pungent odor
No irritability
Excellent for mask induction ***children
Good bronchodilator

Question 12

Sevoflurane’s CV effects:

Answer 12

Mild depressant
No sensitization to epi
Dose dependent decreases BP
No increase in HR at < 2 MAC

Question 13

Cardiac output is ____ with Sevo

Answer 13

Not as well maintained

Question 14

Sevoflurane’s CNS effects:
Increases (2)

Answer 14

Increase in CBF
Increase in ICP

Question 15

Sevoflurane’s CNS effects:
Decreases (1)

Answer 15

CMRO2

Question 16

Sevoflurane may augment ____

Answer 16

Epileptic activity (it does not produce seizure activity)
***Caution with induction in children with hx of seizures

Question 17

Sevoflurane’s renal effects:
Fluoride metabolites are associated with–

Answer 17

Impaired renal tubule function (decreased concentrating ability)

Question 18

Sevoflurane’s safety with renal insufficiency (creat > 1.5)

Answer 18

Not established

Question 19

FDA guidelines for Sevo in renal patients

Answer 19

Avoid/use caution

Question 20

Sevoflurane transiently increases ____ concentration (renal)

Answer 20

Fluoride

Question 21

Fluoride levels associated w/ Sevo do not represent….

Answer 21

Significant risk to pts, even those with compromised renal function (Fluoride would need to be > 50 to be toxic)

Question 22

Sevoflurane’s hepatic effects:

Answer 22

Decreases portal vein blood flow
Increases hepatic artery blood flow

Question 23

It is very rare for all inhalation agents to cause ____

Answer 23

Significant liver damage

Question 24

CO2 absorbents of Sevo can degrade and cause production of ____

Answer 24

Compound A

Question 25

Compound A has been found to be nephrotoxic in ____

Answer 25

Rats-- and could potentially cause renal toxicity to humans

Question 26

Risk factors for higher levels of Compound A:

Answer 26

Increased temp Increased sevo concentration Increased CO2 production Decreased fresh gas flow

Question 27

FDA recommendations for Sevo and absorbent with hydroxide base:

Answer 27

Should be used in a minimum of 1L/min of fresh gas flow and that 2-MAC hours at this flow should not be exceeded

Question 28

MAC-hour is...

Answer 28

Anesthetic agent: 1 MAC x delivery of how many hours

Question 29

Sevoflurane metabolism:

Answer 29

5-8% body

Question 30

All volatile agents are metabolized by P450 (phase 1) specifically the ____

Answer 30

2E1

Question 31

2E1 enzymes can be induced with (2)

Answer 31

Ethanol & Phenobarbitol