Pharm Winter Exam 2

Front 1

Nitrous Oxide

Back 1

Nitrous Oxide
• Low solubility (blood); rapid onset and recovery
• Adjuvant with other inhaled anesthetics (↑rate of induction)
• Dentistry, good analgesia; cannot produce anesthesia alone (without total hypoxia)
• Diffusion hypoxia
• Exchange with nitrogen gas in body, trapped gas expands
• Does not depress heart fxn, no renal/liver toxicity
• Attenuates hypotension when combined with other anesthetics
• No neuromuscular blockade
• Toxicity: Megaloblastic anemia (↓prod leukocytes and RB C); bone marrow depression, peripheral neuropathy; abused

Front 2

Halothane (Fluothane®)

Back 2

• Toxic, Slow induction, rapid awakening
• BP decreases proportionally to depth of anesthesia
• Side Effects
o Respiratory depression
o Depresses myocardium (CO↓),
o Sensitization to catecholamines: arrhythmias
o Uterine relaxation
o Reduces renal function and urine flow
o Hepatic necrosis (more common with repeated administration)
o Miscarriage
o Malignant Hyperthermia (with succinylcholine)

Front 3

Isoflurane (Forane®) ***

Back 3

• Low toxicity (no hepatic or renal toxicity); pungent odor, expensive
• Low blood gas coefficient: rapid induction and emergence but easy to adjust depth of anesthesia – indicated by decreased BP (vasodilation; +N2O to ↓ effect on BP) and resp, increased HR
• Coronary steal: vasodil small art, divert blood flow from ischemic to non-ischemic areas
• Does not significantly depress myocardium, nor sensitize myocardium
• Respiratory depression, muscle relaxation, uterine relaxation (high conc)
• Dilate cerebral vasculature, ↑ cerebral blood flow and intracranial pressure; reduce cerebral metabolic O2 consumption

Front 4

Sevoflurane (Ultane®)

Back 4

• Rapid induction and emergence
• Low solubility
• Least airway irritation (used in children)
• ↑intracranial press (minimized by hyperventilation)
• Relax skeletal m., minimal cardiac and resp depression
• Rare renal and hepatic toxicity
• Safest drug: cardiovascular disease