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52 Cards in this Set
- Front
- Back
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Characteristics of Ideal Inhalant
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1. Min Toxicity to cardio, resp, hepatic, renal & nervous
2. Min tox to sx personel 3. Ease of admin 4. Rapid & gentle induct & recovery 5. Depth easily controlled 6. Good musc relsx 7. Adequate post op analgesia 8. Low Cost 9. Adequate potency to get proper depth 10. Non flammable & non - exposive 11. No expesnive equipment |
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What is the purpose of inhalant agents
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Anesthetic & O2 delivery to alveoli where it croses the membrane & enters the bloodstream.
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How does inhalant agent work
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pressure gradient
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Define vapro pressure
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the measure of the amount of liquid anesthetic that will evaporate @ 68F
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What is the advantage of the precision vaporizer
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delivers an EXACT concentration of anesthetic slelected
Control the delivery closely |
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Which gen. anest can be used with a nonpecision or "wick vaporizer
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mehoxyflurane
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What do agents with low solubility coefficients then to do
& why is this important |
Remain a gas
Rapid induction & recover & rapid change of depth |
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Define Solubility Coefficient
(or Partition Coefficient) |
A measure of the distribution of inhalant agent btwn blood & gas phases in the body.
Tendency of anesthetic agent to exist as a gas or tendency of agent to disolve in blood |
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What to High solubiliity coefficients act
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extremely soluble in blood & tissue so
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In decending order which is the fastest induction agent
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1. Desflurane
2. Nitrous Oxide 3.Sevoflurane 4. Isoflurane 5. Halothane 6. Methoxyflurane |
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Define MAC
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Minimum Alveolar Concentration of an anesthetic at 1 atmosphere that produces immobility in 50% of subjects exposed to a noxious stimulus
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Why use MAC
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Used to compare inhalation anesthetic potency
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The ------ the MAC vale, the -----potent the anesthetic agent
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Lower MAC, the potent the anesthetic
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MAC is ----- related to oil/gas partition coefficient (solubility)
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inversely
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What is the surgical plane of MAC
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1.5 X MAC
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Agent with slow induction & recovery rates
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Methoxyflurane
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Agent NOT recommended for mask or chamber induction
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Methoxyflurane
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What is MOST POTENT agent
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Methoxyflurane
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List the drugs which cause potent respiratory depressant
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1.Methoxyfluranee
2. Ketamine 3. barbituates 4. propofol 5. opioids |
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Disadvantages of Methoxyflurane
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1. Toxic metabolists may lead to renal damag3
2. Potent respiratory depressant |
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Advantages to Methoxyflurane
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1. Excellent musc relaxant
2. Good post-op analgesia |
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Halothane has a ----- induction & recovery
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fairly rapid
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Adverse effects of Halothane
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1. sensitives heart to epinephrine
2. < vagal tone - bradycardia (decrease heart rate 3.mild myocardial depressant 4. causes vasodilation (hypothermia & poss. hypotension 5. Respiration depression 6. unstable & has a preservative 7. rare hepatic toxicity in humans 8. Asso w/ malignant hyperthermia (patient cooking) |
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isofluran is ------induction & recovery
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extremely rapid
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Which is more potent iso or halothane
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halothane
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Why use isoflurane
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1. patients with cardiac dz
2. patients w/ hepatic or renal dz 3. Good muscle relaxant |
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Disadvantages to using isofluran
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1. respiratory depression
2. little to NO analgesia |
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Which is the FASTER induction agent iso or sevoflurane
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low solubility coefficient to VERY RAPID
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Which is more potent iso or sevoflurane
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Iso has HIGHER MAC so iso is less potent
Sevoflurane is more potent |
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Big disadvantage to seoflurane
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reacts with soda lime in rebreather to produce Chemical A producing renal damage in rats
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Why would sevoflurane cause renal damage in rates
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b/c low lipid solubility????
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Big + to sevoflurane
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rapid induction & recovery so less monitoring
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Disadvantages of sevoflurane
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1. greater effect on the heart than iso
2. No analgesic effect |
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Advantages of sevoflurane
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1. rapid inducton, recovery & depth control
2. good muscle relaxant 3. Minimal biotransformation in liver |
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Advantages of Nitrous Oxide
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1.Speeds up take of other agents
2. rapid induction & recovery 3. reduces MAC of other agents - so need less of them 4. Wide margine of safety on organs 5. good analgesic & muscle relax |
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Disadvantages of NO2
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1. risks of hypoxia ( b/c 2x O2 fow)
2. Dissusion into air pockets 3. Diffusion hypoxia if O2 not left on at end of procedure to 4. Cognitive disorders in staff 5. |
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What agent can cause diffusion hypoxia & how can it be avoided?
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Nitrous oxide.
Allow O2 to flow & bag for at least 5 minutes after procedure to |
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How does Nitorus oxide cause diffusion hypoxia
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Larger molecules of nitrous exiting thru respiratory
displace the O2 molecules in the alveoli |
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Advantages to desflurane
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Super high vapor pressure
2. lowest volitility 3. NOT sensitize myocardium to epinephrine 4. little metabolism in body - excreted thru respiration |
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Disadvantagesto desflurane
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1. requires new equipment
2. irritating to breath - dose related respiratory depression 3. sympathetic storm in humans (transient increase in Heart rate & BP) 4. May produce CO when passes dry CO2 absrpant. |
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Which inhalation agest has excellent muscle relaxation
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methoxyflurane
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Which inhalant caused marked respiratory depression
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methoxyflurane
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Which inhalant causes sever cardiac depression
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Halothane
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Which inhalant has the potential to cause cardiac arrythemia
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Halothan & to a lesser degree methoxyflurane
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Which agent has reported kidney toxicity
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Methoxyflurane (animal & human)
2. sevoflurane (rats |
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Which inhalant has the highest lipid solubility
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methoxyflurane
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What drugs can cause bradycardia
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1. xylazine
2. medetomidine 3. opioids 4. methoxyflurane |
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Which drugs can cause cardiac arrythemia
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1. barbituates thiopental)
2. xyzlaine 3. halothane |
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What drugs can cause apnea or repsiratory arrest
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1. IV ketamine
2. Barbituates 3. Propofol 4. opioid |
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Which inhalant has provides the best analgesia
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methoxyflrane
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Which inhalants can increase heart sensitivity to epinephrine
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1.Halothane
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Which inhalants decrease the BP
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1. Methoxyflurane
2. Halothane 3. Isoflurane 4. Sevoflurane |
