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Anesthesia Pharm > Inhaled Anethetics > Flashcards

Inhaled Anethetics Flashcards

1
Q

Why chloroform bad/good

A

Bad: hepatotoxic, cv depressant, deaths assoc, hard to admin
Good: good odor, nonflammable

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2
Q

First halogenated hydrocarbon anesthetic, why taken off market

A

Fluroxene. Organ tox

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3
Q

Methoxyflurane: pro and con

A

Pro: potent, mac 0.16, soluble
Bad: vasopressin resistant high output renal failure

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4
Q

Guedel stages of anesthesia

A

1- amnesia/analgesia
2- delirium/excitement
3- surgical anes 4 planes
4- OD

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5
Q

N20
Mac
Blood gas partition coefficient

A

105%. 0.47

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6
Q

Balanced technique=

A

N20 + induction agent + muscle relaxant + opioids +/- volatile agent

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7
Q

N20
Effective ___
70% n20 + 02 ___ mac for halothane, Enflurane, ISO, sevo, and des

A

Analgesic

Reduces

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8
Q

Contraindications to N2O

A

Air embolism, ptx, intestinal obstruction (acute), intracranial air, pulm air cysts, intraocular air bubbles, tympanic membrane grafting. Others: 1st tri preg, b12 def, CAD

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9
Q

Drug consid w N2O

A

Can’t use alone (high MAC), decreases MAC reqs of other agents, potentiates NMB

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10
Q

Halothane
VP
B/G
MAC %

A

VP 243
B/G 2.3
MAC .74

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11
Q

Enflurane
VP
B/G
MAC

A

VP 175
B/G 1.8
MAC 1.68

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12
Q

Isoflurane
VP
B-G
MAC

A

VP 239
B-G 1.4
MAC 1.15

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13
Q

Des
VP
B-G
MAC

A

VP 664
B-G 0.69
MAC 6

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14
Q

Sevo
VP
B-G
MAC

A

VP 157
B-G 0.69
MAC 2.05

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15
Q

N20
VP
B-G
MAC

A

38, 770
0.47
104

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16
Q

Factors that dont affect MAC 6

A

Variable stimuli, species, gender, duration of anesthesia, acid-base disturbances, Pa02 (40-500 torr)

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17
Q

Factors that decrease MAC

A

Inc age, hypothermia, low Na, BP <40, pregnancy, 02 <38, anemia 4.3, opioids, ketamine, benzos, clonidine, A2 agonists, LAs, ETOH acute

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18
Q

Factors that increase MAC

A

Hyperthermia, CNS stimulants, under 1 year old

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19
Q

___% move at 1 MAC

Give what to avoid movement when no muscle relaxant given

A

50%

Give 10-30% above 1 mac (1.3)

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20
Q

MAC awake

Concentrations you have to give of anesthetics

A

1/3: des, sevo, iso
1/2: halothane
60%: n20

21
Q

Which inhaled agent decreases BP the least

A

N20- no change

Sevo- mild decrease

22
Q

Which inhaled agents increase HR

A

Methoxyflurane, enflurane, isoflurane, Des (or no change)

23
Q

Which inhaled agents decrease or dont affect hr

A

N20 (n/c), halothane decreases, sevo (inc or n/c), sevo (n/c)

24
Q

Which agents drastically decrease SVR

A

Isoflurane, desflurane

25
Q

Which agents mildly decrease SVR

A

Enflurane, sevoflurane

26
Q

Which agents decrease CO

A

Halothane, methoxyflurane, isoflurane (the most), des (or n/c), sevoflurane

27
Q

Which agents decrease TV a lot

A

Halothane, methoxyflurane, enflurane, isoflurane

28
Q

Which agents decrease TV a little

A

N2O, desflurane, sevoflurane

29
Q

Which agents inc RR a lot

A

Halothane, methoxyflurane, enflurane

30
Q

Which agents inc rr a little

A

N20, isoflurane, desflurane, sevoflurane

31
Q

Which agents inc paco2 the most

A

Enflurane and desflurane

32
Q

Which agent inc cerebral bf the most

A

Halothane

33
Q

Which agents inc ICP the most

A

Halothane, enflurane

34
Q

Which agents dec cmro2 the most

A

Isoflurane, desflurane, sevoflurane

35
Q

Which agent inc seizures

A

Enflurane (all others decrease them)

36
Q

Which agent inc NMDR 1 on scale of 1-3

A

N20

37
Q

Which agent inc NMDR 2 on scale of 1-3

A

Halothane, methoxyflurane, sevoflurane

38
Q

Which agents inc NMDR the most

A

Enflurane, isoflurane, desflurane

39
Q

Which agents dec renal bf the least

A

Desflurane and sevoflurane

40
Q

Which agents dec hepatic bf the most

A

Halothane, methoxyflurane, enflurane

41
Q

Metab %
Halothane
Enflurane

A

15-20%

2.5-3%

42
Q

Metab %
Sevoflurane
Isoflurane

A

2-5%

0.2-2%

43
Q

Metab %
Desflurane
N20

A
  1. 02%

0. 004% (gi tract)

44
Q

When to not use halothane

A 
CAD 
Arrhythmias, epi use 
Hepatotoxicity (esp prev halothane exposure) 
Hypovolemia 
AS 
Pheochromocytoma 
MH- most potent trigger
45
Q

Halothane drug interac

A

Myocardial dep w/: bb and ccb. TCAs and MAOI may cause BP instability. Aminophylline- v dysrhythmias

46
Q

When to not use enflurane

A

Seizures, renal disease, MH trigger

47
Q

Isoflurane contraindications

A

Peds (laryngospasm), CAD (coronary steal), MH

48
Q

When to not use Des

A

Not used for inhalation in peds bc of smell, neurosurgery, MH

49
Q

Sevo

When to use/not use

A

Good for peds. Fast on/off.

Not: kidney function dec, MH

Anesthesia Pharm (12 decks)

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