Quiz 10 - Inhalation Agents and MAC Flashcards Preview

GNURS627/Respiration/Physiology for Anesthesa > Quiz 10 - Inhalation Agents and MAC > Flashcards

Flashcards in Quiz 10 - Inhalation Agents and MAC Deck (41):
1

What is MAC amnesia?

25% MAC (blocks anterograde memory in 50% of awake patients)

2

What is MAC awake?

50% MAC - prevents eye opening on verbal command

3

What is MAC intubation?

130% MAC - concentration required to prevent movement and coughing during ETT intubation

4

What is MAC BAR?

150% MAC - concentration that blocks adrenergic response to skin incision

5

What factors increase MAC?

Age - term infant to 6mos has highest MAC
Chronic ETOH abuse
Hyperthermia
Hypernatremia

6

What are some factors that decrease MAC?

- Pregnancy
- Hypothermia (every 1 degree C drop in temp, MAC decreases 2-5%)
- Elderly
- Acute ETOH ingestion
- Premature infants
- preop meds
- hyponatremia

7

Factors that have no effect on MAC

- Thyroid gland dysfunction
- Gender
- Hypo/Hyperkalemia
- Hypo/Hypercarbia

8

MAC for ISO?

1.15 (according to notes)

9

MAC for Sevo?

2.05 (according to notes)

10

MAC for Des?

6 (according to notes)

11

MAC for N2O?

105 (according to notes)

12

MAC for Halothane?

0.75

13

What alveolar factors influence uptake?

Inspired concentration, Alveolar ventilation, Anesthetic system, uptake from alveolar space

14

What is the single most important factor determining the speed of induction and rate of emergence?

Solubility

15

How is solubility of gasses expressed?

Blood:Gas partition coefficient

16

Blood gas coefficient for Des?

0.42

17

Blood gas coefficient for N2O?

0.47

18

Blood gas coefficient for Sevo?

0.68 (according to notes)

19

Blood gas coefficient for Iso?

1.4 (according to notes)

20

Which gas will have the quickest onset a poorly soluble agent or a highly soluble agent?

the poorly soluble agent

21

How does Cardiac Output affect induction of anesthesia?

CO is inversely proportional to the speed of induction - low CO will have quicker induction

22

What is Second Gas effect?

The ability of a gas (N2O) with rapid induction to speed up the rise in alveolar pressure of a second gas (agent)

23

What is diffusion hypoxia?

dilution of alveolar oxygen by a large amount of N2O "outgassing" - rapid desaturation can be seen - stop N2O before extubating and turn 100% oxygen on.

24

Is N2O a good analgesic?

yes

25

Does N2O increase or decrease PONV?

increases

26

When should you avoid N2O use?

when you have enclosed gas spaces: Pneumothorax, bowel obstruction, inner ear...

27

Will N2O increase or decrease PVR?

increase PVR - especially in pt with pre-existiing pulmonary HTN

28

Is N2O flammable?

No, but it is an O2 source and supports combustion

29

How does N2O affect methionine synthesis?

It inhbits (important for B12 and DNA sythesis)

30

What can long term use of N2O lead to?

peripheral neuropathy and megaloblastic anemia

31

How does Halothane affect contractility?

Halothane has a dose dependent decrease in contractility. Will also decrease BP, CO. SVR and PVR stay normal

32

What gives Halothane its sweet odor?

Thymol preservative

33

What effect can Halothane have on children? What do they require preanesthesia?

causes Vagal stimulation in children (bradycardia especially > 1 MAC) pretreat with atropine

34

What side effect does Halothane have on the heart?

sensitzes the heart to catecholemines, dysrhythmogenic - use epi with caution!

35

Iso and Des are good for inhalation induction (t/f)

False, the pungent odor can iritate sensitive airways

36

Will Iso and Des increase HR?

yes when rapidly increasing doses (norepi)

37

What is coronary steal syndrome and which agent causes it?

normal coronaries dilate and stenotic ones don't so blood is shunted away from diseased vessels - caused by Iso

38

Does Sevo have a pungent smell?

No, makes it a good choice for inhalation induction and children tolerate high levels within significant hemodynamic changes

39

what is a side effect of Sevo you need to look for in children?

occasional delirium.

40

How does Sevo form Compound A?
Consequences?

Formed with low fresh gas flow, high temps, high agent, dry baralyme, and long cases.
- is nephrotoxic, hepatotoxic, and brain toxic

41

How much fresh gas flow do you need when using Sevo?

at least 2 liters/min