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Anesthesia Drug Test Quick Facts > Inhaled Anesthetics > Flashcards

Inhaled Anesthetics Flashcards

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1
Q

classification of desflurane

A

fully fluorinated methyl ethyl ether

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2
Q

metabolism of desflurane

A

0.0-0.02 % undergoes metabolism

low solubility- like Nitrous Oxide- undergoes very little metabolism

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3
Q

MAC for desflurane

A

6.6%

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4
Q

Blood/Gas Particion Coef for Desflurane

A

0.42

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5
Q

Vapor Pressure of Desflurane

A

669

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6
Q

Boiling Point of Desflurane

A

22.8

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7
Q

Cardiovascular Effects of Desflurane

A

abrupt increases = sympathetic stimulation
increased HR and BP

in general = decreased BP and HR no change in CO, increased RAP, decreased SVR, no change in PVR

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8
Q

Pulmonary effects of Des

A 
dose-dependent increase in RR
decreased Vt
decreased ventilatory response to PaCO2 and hypoxemia
above 1 MAC = airway irritation
bronchoconstriction ** SMOKERS
increased secretions
coughing
breath holding
laryngospasm
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9
Q

Neuro effects of Des

A

no retrograde amnesia
decreased CMRO2
increased CBF
increased cerebral vasodilation

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10
Q

hepatic effects of des

A

oxidatively metabolized by CYP45-
forms acetylated liver protein
can evoke antibody repines and hepatotoxicity
NOT common b/d minimal metabolism

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11
Q

renal effects of des

A

dose-related decreases in renal blood flow
& GFR
&UOP
decrease in BP and CO

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12
Q

misc. effects of des

A

dose-dependent enhancement of the effects of NMBAs
decrease uterine smooth msucle contractility & blood flow
EXCEPT N2O

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13
Q

what properties of desflurane require the Tec 6 vaporizer and what does it do?

A

Desflurane’s high vapor pressure- 669
and boiling point near room temp 22.8C

require Desflurane to be heated to 23-25C
and pressurized to 1500 mmHg to achieve predictable concentrations of delivered Des

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14
Q

blood: brain of des

A

1.3

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15
Q

muscle: blood of des

A

2

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16
Q

fat: blood of des

A

27.2

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17
Q

classification of isoflurane

A

halogenated methyl ethyl ether

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18
Q

metabolism of iso

A

0.0-0.2% hepatic metabolism
oxidative metabolism by CYP450 to form difluoronmethanol & trifluoroacetic acid
antibody formation - hepatotoxicity

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19
Q

MAC of iso

A

1.2%

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20
Q

BGPC of Iso

A

1.46

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21
Q

Vapor Pressure of iso

A

240

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22
Q

boiling point of iso

A

48.5C

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23
Q

brain:blood of iso

A

1.6

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24
Q

muscle:blood of iso

A

2.9

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25
fat:blood of iso
44.9
26
oil:gas iso
98
27
contraindications with Iso
Prolongation of the QTc
28
CV effects of iso
``` QTc prolongation coronary vasodilation- cardioprotective dose-dep decrease in reflex of sympathetic flow decrease BP increase Hr minimal CO change increase RAP decrease SVR no change in PVR ```
29
which agent is the most cardioprotective?
Iso- even though it has prolonged QTc
30
which agent is the most potent vasodilator
isoflurane
31
reps effects iso
dose sep increase in RR decrease in Vt decrease in ventilation response to increase Pa Co2 and hyperemia bronchodilation
32
neuro effects of iso
``` NO retrograde amnesia decrased CMRO2 incrase CBF cerebral vasodilation decreases resistance to reabsorption ```
33
which agent is the most cerebral protection?
iso
34
hepatic effects of iso
vasodilator of hepatic circulation | CYP450 metabolism- hepatotoxicity risk
35
renal effects of iso
dose-dep decrase in RBF, &GFR &UOP d/t decreased BP and CO
36
which agent costs more, iso, des, sevo
sevo>des> iso
37
classification of sevoflurane
halogenated methyl isopropyl ether
38
metabolism of sevo
5-8% of sevo is metabolized oxidative metabolism trifluoroacetic acid is NOT formed thus NOT hepatotoxic
39
Blood:Gas PC of sevo
0.69
40
MAC of sevo
1.8-2
41
Sevo Vapor Pressure
160-170
42
Boiling Point of sevo
58.5 C
43
brain:blood sevo
1.7
44
muscle:blood sevo
3.1
45
fat:blood sevo
47.5
46
oil:gas sevo
55
47
contraindications with sevo
compound A formation- renal damage QTc prolongation agitation 7-15%
48
CV affects of sevo
``` coronary vasodilation RARE cardioprotective decreased temp- all cutaneous vasoconstriction decreased: BP and CO increased: HR decreased RAP decreased SVR no change in PVR ```
49
reps effects of sevo
``` dose-dep increase in RR decrease in Vt decrease vent response to CO2 & hypoxemia- ALL POTENT bronchodilator NON-PUNGENT! ```
50
which inhaled anesthetic causes the least degree of airway irritation
sevo
51
neuro effects of sevo
no retrograde amnesia decreased CMRO2 increased CBF increased cerebral vasodilation
52
renal effects of sevo
all dose related decrease in renal blood flow &GFR & UOP d/t decreased BP and CO
53
misc effects of volatiles
Volatile Anesthetics produce dose-dependent enhancement of the effects of NMBAs (ethers>halothane). • Obstetrical- Volatile Anesthetics produce similar dose-dependent decreases in uterine smooth muscle contractility & blood flow (except ).
54
how do we protect against production of compound A with sevo
At increased temperatures, desiccated CO2 absorbent may degrade Sevoflurane to produce Compound A (trifluoromethyl vinyl ether) which is nephrotoxic & hepatotoxic in animals. Fresh gas flows of 2 L/min are recommended to decrease the production of Compound A. Flows of 1L/min may be used for up to 2 MAC-hours. Flows below 1L/min are not recommended.
55
which agent is the least likely to form Carbon Monoxide when reacting with the CO2 absorbent?
sevo
56
MAC of enflurane
1.6%
57
BGPC of enflurane
1.9
58
Vapor pressure of enflurane
172
59
BP of enflurane
56.5
60
metabolism of enflurane
0-3% CYP450 oxidative metabolism to form organic and inorganic fluoride compounds and possibly neoantigens in susceptible patients
61
contraindications with Enflurane
QTc prolongation EEG activity- seizure like tonic-clonic twitching! MAC >2 trifluroacetic acid- hapatotoxic but less than halothane
62
CV effects of enflurane
``` decrease BP no change in HR decrease CO decrease SVR no change in PVR ```
63
hepatic effects of enfluane
ALT is increased after enflurane admin
64
classification of halothane
halogenated alkane
65
MAC of halothane
0.75%
66
blood:gas PC halothane
2.54
67
Vapor Pressure halothane
244
68
Boiling Point halothane
50.2 C
69
metabolism of halothane
15-40% metabolized by the liver * Halothane undergoes oxidative metabolism by CYP-450 enzymes when ample oxygen is present. * Halothane undergoes reductive metabolism by CYP-450 enzymes when oxygen is reduced. - metabolites: trifluoroacetic acid, chloride, & bromide * triflouroacetic acid may stimulate formation of antibodies against hepatic microsomal proteins

Anesthesia Drug Test Quick Facts (19 decks)

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