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Summer Pharm (2016) ** > Inhaled anesthetics > Flashcards

Flashcards in Inhaled anesthetics Deck (107)
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1

Causes tonic clonic seizures. Exacerbated by?

Enflurane - hypocarbia and repetitive auditory stimuli

2

Only IA that suppresses seizure activity

Isoflurane

3

Used in neurosurgery at 0.5 MAC

Isoflurane

4

Can compensate for increase in ICP by hyperventilation

Desflurane Isoflurane as well - but at the time the induction agent is given

5

CANNOT compensate for increased ICP by hyperventilation

Enflurane - Hypocarbia can cause tonic clonic seizures

6

Highest amount of CO production

Desflurane Then Iso and enflurane Trace with sevo and halo

7

Compound A

Sevoflurane

8

Safest for CAD with the supplementation of opioids

Sevoflurane

9

NO increase in CVP or RAP

Sevoflurane

10

SNS stimulation

Nitrous oxide Transient with desflurane and Isoflurane

11

Giving opioids with this agent may unmask undiagnosed myocardial depression, CAD and severe hypovolemia

Nitrous oxide - opioids take away the SNS stimulation and these patients get a profound SUDDEN bradycardia and hypotension

12

Autoregulation to CO2 remains UNCHANGED with these agents up to what MAC?

Sevoflurane up to 1.5 MAC Naglhout also states Desflurane as well.

13

Which agent offers the greatest cerebral protection from ischemia?

Isoflurane - at >1 MAC it is often used for Neurosurgery but at 0.5 MAC Due to the unchanged CBF at >1 MAC (still increased CBF) and decreased cerebral metabolic oxygen requirements Greatest uncoupling of CMRO2 and CBF

14

Which agent produces only a mild increase in ICP

Nitrous oxide - likely due to the inability to administer 1 MAC

15

Isoflurane is and Isomer of Enflurane with these key differences

1. Does not induce seizures, but rather supresses seizure activity 2. It does not increase CSF production and allows CSF outflow 3. Iso has minimal myocardial depression

16

IA that increases CSF production and increases resistance to CSF outflow

Enflurane

17

Which agents cause direct myocardial depression

Halothane Nitrous oxide

18

Which agents decrease BP is a result of the agents ability to primarily decrease SVR and have minimal myocardial depression?

Sevoflurane Isoflurane Desflurane

19

Gasses that have baroreceptor reflex intact

Ennflurane, Isoflurane, Desflurane

20

Volatile anesthetic that typically increases HR but in Elderly and Neonates this effect is blunted and Heart rate is decreased

Isoflurane

21

This volatile anesthetic suppresses SA node depolarization (junctional rhythm) and decreases conduction in the bundle of his and purkinge fibers

Halothane

22

Increases BP, HR, SVR and CO d/t SNS stimulation

Nitrous oxide

23

Volatile anesthetic that produces DOSE DEPENDENT decrease in CO

Halothane

24

LVSV is decreased __________% for all volatile anesthetics. Our notes say a specific one.

15 - 30% for desflurane Often times increased HR is enough to offset the decrease in stroke volume

25

This volatile anesthetic has a wider margin of safety between that which anesthetizes the brain and that which produces cardiovascular collapse. This means it has minimal cardiac depressant effects in the doses we use it.

Isoflurane

26

Does Not have an increase in CVP or RAP

Sevoflurane

27

Has minimal effects on SVR

Halothane (all other volatile anesthetics decrease SVR)

28

_____________ increases blood flow to ____________ and ____________ areas. This distribution is similar to a ___________ effect. There is an excess perfusion relative to oxygen needs. It may manifest in the OR as ____________ due to _____________ blood flow. There also may be enhanced _______________ like NM blockers.

Isuflurane skeletal muscles and cutaneous areas ß-agonist loss of heat due to cutaneous delivery of drugs.

29

What is a possible explanation for the increase in cutaneous blood flow produced by all volatile gasses?

May reflect a central inhibitory action on temperature regulating mechanisms.

30

should be avoided in the neonate with congenital heart disease

Nitrous - d/t increased PVR which may increase the magnitude of a right to left shunt causing further decrease in arterial oxygenation.