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30 Cards in this Set
- Front
- Back
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Excitatory Receptors
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Glutamate (NMDA aMPA), ACh, Serotonin,
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Inhibitory Receptors
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GABA, Glycine, Alpha 2, Opiod
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Least Pungent Gas
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Sevo
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Most Pungent Gas
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Des
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Percent metabolized of Sevo
Major concern with this agent? |
2-5%
Compound A |
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Percent metabolized of Iso?
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0.2%
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Percent metabolized of Des
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0.02%
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All the agents increase cerebral blood flow. Which one does it the least?
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N2O
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How do the agents offer cerebral protection?
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They uncouple the brain by increasing cerebral blood flow and reducing cerebral metabolic rate.
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What gas reduces CSF production?
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Sevo
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What gas could cause seizures?
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Sevo at 1.5-2.0 MAC
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Which gas can effect the reabsorption of CSF?
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Iso
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What are we watching for with SSEP monitoring?
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Increased latency - time
decreased amplitude - height 10/50 rule Both mean bad - ischemia or lighten anesthesia |
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What are we watching for with MEPs?
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Motor evoked potentials.
Decreased amplitude a problem. The signal runs from the brain to the hands or feet. |
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Which two agents can increase HR by 5-10%
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Des
Iso |
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Which agent can cause coronary steal?
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Iso
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The agents in general do what to your patients respiratory status?
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Decrease FRC due to relaxed intercostal muscles, diaphragm toward the head, decreased response to hypoxia or hypercapnia, decreased Tv & minute volume, increased Co2, bronchodilation
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Which agent causes broncho constriction?
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Des
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What do agents do to the kidneys?
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Reduce kidney blood flow but do not reduce flitration fraction
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Effects of agents on skeletal muscles
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relaxes both smooth muscles and skeletal muscles
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What do agents do to uterine muscle tone?
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decrease it, especially above 1 MAC
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Which gas increases CMRO2
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N2O
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Cardiovascular effects of each agent
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N2O- Stimulates SNS
Iso - minimal cardiac depression. Coronary Steal Des -minimal cardiac depression. Moderate rise in HR Sevo - mildly depresses myocardial contractility |
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Respiratory effects of each agent
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N2O - Increases RR, decreases Tv, decreases hypoxic drive
Iso - decreases MV, decreases hypoxic drive, irritates, bronchodilates Des - Increased RR, Decreased TV, decreases hypoxic drive, irritates Sevo - decreases RR, **reverses bronchospasm** |
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Cerebral effects of each agent
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N2O - mild increase ICP, increases CMRO2
Iso - Increases CBF and ICP > 1 MAC Des - Increases CBF and ICP, reduces CMRO2 Sevo - Increases CBF and ICP, reduces CMRO2 |
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Neuromuscular effects of each agent
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N2O - Little to no muscle relaxation
Iso - relaxes muscles Des - relaxes muscles Sevo - relaxes muscles enough for intubation (peds) |
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Renal effects of each agent
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N2O - Decrease renal blood flow
Iso - decreases renal blood flow Des - Non toxic Sevo - slightly decreases renal blood flow |
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Hepatic effects of each agent
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N2O - Blood flow drops slightly
Iso - Blood flow drops Des - Function tests unaffected Sevo - portal vein decreased, hepatic artery increased |
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Gastrointestinal effects of each agent
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N2O - Post op N/V
Iso - None Des - None Sevo - None |
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Contraindications of each agent
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N2O - 34 times more soluble that Nitrogen
Iso - None Des - hypovolemia, MH, intracranial HTN Sevo - hypovolemia, MH, intracranial HTN |
