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39 Cards in this Set
- Front
- Back
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Alveolar concentration that prevents movement in response to surgical stimuli in 50% of patients
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MAC
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How do you get 95% confidence with MAC
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1.25 MAC
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MACawake
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0.15-0.5 MAC
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Does awareness leave before the ability to follow commands
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yes
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5 things that increase MAC
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Red Hair
Increased Temp. Increased CNS NTs Increased Na Chronic alcoholism |
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4 things that increase CNS NTs
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Pain
anxiety stress Drugs e.g. MAOI |
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8 things that decrease MAC
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Decreased Temp.
Decreased Na Decreased CNS NTs Pregnancy Anemia Hypoxia Hypo-osmolality Acute alcohol |
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Drugs that increase MAC
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amphetamines
cyclosporines |
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Drugs that decrease MAC
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opioid
induction agents BZD A2 agonists clonidine, precedex Ca channel blockers Hydralazine librium |
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Where do inhaled anesthetics work
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spinal cord
RAS thalamus |
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Two glutamate receptors that are not affected by inhaled agents and one that is
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AMPA
Kainate NMDA |
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Caused hepatitis when given with epinephrine
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halothane
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Inhaled anesthetics that should not be given to a patient who has previously formed halothane haptens
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Isoflurane
Desflurane |
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What are 3 undesirable effects of desflurane
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High VP
Reacts with soda lime to form CO Airway irritability |
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Least irritating inhaled anesthetic
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Sevo
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Inhaled anesthetic that doesn't form CO
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Sevo
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Inhaled anesthetic that forms compound A
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Sevo
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Cheapest inhaled anesthetic
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Iso
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What are N2O muscle relaxant, anesthetic and amnesic affects
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Terrible muscle relaxant
Good anesthetic Poor amnestic |
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In what kind of patient should NO be avoided in for 30 days
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pt with an air bubble placed for retinal detachment
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At what age is MAC highest
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6 months
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How do you adjust MAC for <20 or >60
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add 6% per decade until 40
subtract 6% per decade after 40 |
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How do inhalation agents affect spinal motor neurons
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depress excitablility of neurons
inhibit transmission |
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Where do inhaled anesthetics work to depress mobility
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spinal cord
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Non-REM sleep inducing part of the brain
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RAS
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Part of brain involved with learning
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Cerebral cortex
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Relays sensory and motor info to the cortex
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thalamus
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Theory that says that the anesthetic affects of inhaled agents are d/t a physical property
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unitary theory
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States that the potency of a gas is related to its solubility in a lipid
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Meyer-Overton
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What determines potency according to the protein binding site theory
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increasing potency up to 4-5 C
decreasing potency greater than 5 C |
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What could the protein binding site theory explain
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amnesia
not immobility |
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Amnesia site of action
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cerebral
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Immobility site of action
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spinal cord
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What are 3 qualities of a good inhaled anesthetic
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nonflammable
poorly lipid soluble resistant to metabolism |
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What does increasing the number of F ions do to an anesthetic
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decreases metabolism
decreases solubility decreases flammability decreases potency |
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2 adverse CV affects of Iso
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coronary steal syndrome
tachycardia |
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When does a decrease in CMRO2 begin
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0.5 MAC
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How might IA affect synaptic transmission
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pre and postsynaptic inhibition of glutamate
Presynaptic inhibition of GABA Postsynaptic enhancement of GABA |
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What 8 things don't affect MAC
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Sex
Anesthetic metabolism Duration of Surgery pCO 15-95 pO2 >38 MAP> 40 Thyroid function K and Mg levels |
