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82 Cards in this Set
- Front
- Back
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what is the brand name for isoflurane
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forane
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what type of chemical structure is isoflurane
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halogenated methyl ethyl ether
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what is the vapor pressure of isoflurane
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242
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is isflurane flammable
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NO
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apprise
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Inform
"before handcuffing us, the police officers apprised us of our rights" |
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what is the MAC of isoflurane
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1.17%
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what is the blood gas solubility coefficient
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1.4
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what is the induction rate of isoflurane compared to halothane and enflurane
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more rapid
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is isoflurane irritating to the airway
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YES
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are mask inductions with isoflurane slower or faster and why
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SLOWER
-d/t problems with airway irritability and coughing |
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what is the rate of recovery with isoflurane compared to enflurane
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faster
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what is the rate of recovery of isoflurane compared to halothane
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less rapid
(d/t halothanes metabolism) |
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1 MAC of isoflurane does what to EEG spikes
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DECREASES the amplitude and INCREAESES the latency
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1.5 MAC of isoflurane has what result on EEG
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results in burst suppression and DECREASED latency
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2 MAC of isoflurane results in what EEG activity
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isoelectric activity
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when can epileptiform patterns be seen with isoflurane
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during intersuppression activity at 1.5 to 2-2.5 MAC
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does isoflurane interfere with evoked potentials
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YES at greater than 1 MAC
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at 0.6 to 1.1 MAC of isoflurane what is the change in CBF
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NO CHANGE
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at 1.1 MAC of isoflurane what is the change in CBF
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increases by 19%
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what can be said about autoregulation of CBF at 1 MAC of isoflurane
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it is INTACT
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all IA agents may do what to ICP
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increase it
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the changes that all IA may cause in ICP can be attenuated by what
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decreasing PCo2
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with isoflurane when should hyperventilation be performed
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simultaneously with induction
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with halthane when should hyperventilation be performed
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previous to induction
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with enflurane when should hyperventilation be performed
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it should NOT
**DO NOT hyperventilate with enflurane** |
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CBF with isoflurane is increased about how much
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25%
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CMRO2 with isoflurane is dropped to about how much
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greater than 50%
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with isoflurane regarding CBF and CMRO2 does supply exceed demand or does demand exceed supply
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suppy exceeds demand
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which agent would be good for a craniotomy b/c it drops CMRO2 and CBF more than the other agents
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sevoflurane
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which IA is a good choice when using "hypotensive" tech and why
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*isoflurane
*b/c autoregulation of CBF is intact up until 1 MAC |
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what is production of CSF with isoflurane
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there is NO change
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what is reabsorption of CSF like with isoflurane
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it is increased
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isoflurane may be the agent of choice in what type of surgeries
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neurosurgical cases
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regarding metabolic effects during hypotension isoflurane has what type of effect on cerebral o2 balance
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does NOT cause major disturbances in it
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as you increase the dose of isoflurane and increase the MAC what happens to MAP
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it decreases
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isoflurane does what to SVR?
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*drops it
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isoflurane does what to vascular tone in many capillary beds?
this does what to blood flow? |
*decreases it
*perpheralizes it |
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the mechanism for decreased BP with isoflurane is what
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decreased SVR
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what occurs with HR until 1 MAC with isoflurane
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increase in HR secondary to decrease in SVR then HR levels off at 1 MAC
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with isoflurane are baroreceptor reflexes intact
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YES
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how can you block increases in HR with isoflurane
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with opioids
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CO is normal with isoflurane within what range
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up to 1 MAC
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what is CO at 1.5 MAC with isoflurane
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95% of awake values
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what is CO at 2 MAC with isoflurane
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90% of awake values
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when does CO begin to change with isoflurane
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between 1.5 to 2 MAC it begins to drop
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what is cardiac INDEX like on isoflurane
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within NORMAL limits
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are arrythmias common with isoflurane
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NO
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is there less or more sensitivity of the heart to epi than with halothane or enflurane with isoflurane
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LESS
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what is the safe dosage of epi with isoflurane
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may triple the dosage
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what is the safe dosage of epi with enflurane
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may double the dosage
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regarding coronary circulation a decreased HR, preload, afterload or negative inotropic state causes what to occur in vivo
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coronary vasoconstriction
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regarding metabolic autoreguation if myocardial oxygen consumption (MVO2) is decreased what happens to supply
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it is also decreased
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what drug causes potent cornary artery vasodilation and coronary artery steel syndrom
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adenosine
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what type of coronary artery vasodilation does isoflurane cause
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WEAK
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can isoflurane cause coronary artery steel syndrome
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it is NO longer thought that it does cause it even in pts with steel prone anatomy
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isoflurane, desflurane and sevoflurane have what type of effects during ischemia and reperfusion injury
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cardioprotective
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which IA produce anesthesia preconditioning
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*isoflurane
*sevoflurane *desflurane |
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what drug enhances the effect of anesthesia preconditioning
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morphine
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what is the only hemodynamic parameter significantly related to ischemia with isoflurane is what
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tachycardia
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what is the rationale for the perioperative use of b1-adrenoreceptor antagonists with isoflurane
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to prevent myocardial ischemia
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isoflurane will do what to HR
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increase it
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what happens to PaCo2 with isoflurane
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slight increase with 1 MAC then acceleration
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isoflurane causes what dose dependent change in PaCo2
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increase
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isoflurane, halothane and sevoflurane all have what effect on broncodilator tone
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all are bronchodilators
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what IA is the BEST bronchodilator
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sevoflurane
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isoflurane has what effect on NMB compared to TIVA
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potentiates a little more than TIVA
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isoflurane has what effect on NMB compared to sevoflurane and desflurane
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is not as good
-desflurane and sevoflurane are better potentiators |
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how much of isoflurane is metabolized
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minimal (< 0.2 %)
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what pathway is isoflurane metabolized via
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oxidative pathway
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what products does isoflurane produce from metabolism
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*fluorine ions
(insignificant amt) *trifluoroacetic acid |
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does isoflurane cause renal dysfunction
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NO
-fluorine ions produced in metabolism are insignificant |
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what affect does isoflurane have on RBF
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decreases it
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what effect does isoflurane have on GFR
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decreases it
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what effect does isoflurane have on urine output
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decreases it
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is isoflurane neprotoxic
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NO
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what should be done secondary to isofluranes renal effects as a pre-op measure
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pre-op hydration
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what affect does isoflurane have on the kidneys
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benign effect
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isoflurane does what to hepatic blood flow
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increases it
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hepatic o2 supply is what with isoflurane compared to halothane
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greater
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is isoflurane hepatoxic
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NO
-except for the cross sensitivity rxn with halathane |
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what are the advantages of isoflurane
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*CV stability
*ischemic preconditioning *lack of sensitization of the heart to circ catecholamines *limited biodegration *decreased hepatorenal toxicity *good muscle relaxation prop *no CNS excitatory effects |
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what are the disadvantages of isflurane
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not good for mask induction of the airways
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