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136 Cards in this Set
- Front
- Back
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What is the MAC of Halothane?
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0.75
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What is the Blood/Gas Coefficient of Halothane?
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2.4
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What is the Vapor Pressure in mmHG of Halothane?
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244
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How much is Halothane metabolized?
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20%
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What is the Fat/Blood Coefficient of Halothane?
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51
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What is the Boiling Point of Halothane?
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50.2 degrees C
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What is the chemical formula for Halothane?
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C2ClBrF3H
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What is the chemical structure of Halothane?
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F Br
F - C - C - H F Cl |
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What is the IUPAC name for Halothane?
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2-Bromo-2-Chloro-1,1,1Triflorethane
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Which inhalation agent contains thimol as a preservative?
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Halothane
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Does Halothane have high or low airway irritability?
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Low airway irritability
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Does Halothane have a rapid onset of induction?
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It can related to low MAC and high fraction inhaled. Basically you can dial Halothane concentration to 3-5 times* MAC
* I think |
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Is Halothane used more in adults or children?
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Used in children most often
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What inhalation agent potentates cardiac dysrhythmias?
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Halothane
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What inhalation agent does NOT decrease SVR but rather depresses myocardial contractility, decreaseing cardiac output?
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Halothane
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Halothane increases sensitivity to catecholamines (like epi)? True or False.
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True
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Is Halothane a poor bronchodilator or an excellent bronchodilator?
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Halothane is an excellent bronchodilator
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Is Halothane toxic and if so what organ?
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Halothane is hepatotoxic
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Is Halothane pungent?
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No Halothane is non-pungent
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What is the MAC of Isoflurane?
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1.15
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What is the Blood/Gas coefficient for Isoflurane?
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1.4
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What is the Blood/Fat coefficient for Isoflurane?
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45
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What is the vapor pressure in mmHG of Isoflurane?
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239
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How much is Isoflurane metabolized?
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0.2%
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What is the boiling point for Isoflurane?
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48.5 degrees C
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What inhalation agent might cause coronary steal syndrome?
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Isoflurane
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What is coronary steal syndrome?
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Phenomenon caused when there is narrowing of the coronary arteries and an arteriolar vasodilator is used - "stealing" blood away from those parts of the heart. This happens as a result of the narrowed coronary arteries being always maximally dilated to compensate for the decreased upstream blood supply. Dilating the other arterioles causes blood to be shunted away from the coronary vessels.
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How does Isoflurane effect the cardiovascular system?
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Isoflurane decreases SVR and MAP, increases HR and may slightly decrease CO
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What happens when Isoflurane is degraded in dry absorbent?
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It produces carbon monoxide (CO)
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What is the recovery time for Halothane?
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It has a slow recovery time
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What is the recovery time for Isoflurane?
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It has a moderate recovery time
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Does Isoflurane have a pungent odor?
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Yes
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Why do you avoid Isoflurane in CAD patients?
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Because of coronary steal syndrome
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For economical reasons which gas would you choose: Sevoflurane, Isoflurane, Desflurane?
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Isoflurane
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Is Isoflurane a respiratory irritant?
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Yes very irritating, second only to Desflurane.
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What happens at 2 MAC in the brain with Isoflurane?
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2 MAC = silent EEG
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Enflurane causes what neurologically?
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Seizures
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What is the chemical formula for Isoflurane?
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C3H2F5ClO
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What is the chemical structure of Isoflurane?
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F Cl F
F - C - C - O - C - H F H F |
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What is the chemical structure of Enflurane?
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Cl F F
H - C - C - O - C - H F F F |
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What is the chemical formula for Enflurane?
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C3H2F5ClO
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Enflurane and Isoflurane are what kind of isomer?
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Structural isomers
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What is the MAC of Desflurane?
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6
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What is the Blood/Gas Coefficient of Desflurane?
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0.42
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What is the Fat/Blood Coefficient of Desflurane?
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27
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What is the Vapor Pressure in mmHG for Desflurane
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669
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How much of Desflurane is metabolized ?
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0.02%
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What happens to Desflurane when it goes through dry absorbent?
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It is degraded and forms carbon monoxide (CO)
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Does Desflurane have a slow wash in slow wash out?
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No, Desflurane has a fast wash in fast wash out
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Is Desflurane an airway irritant?
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Yes it is the greatest irritant, but irritant can be minimized at concentrates below 6% (Eger)
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At what temperature does Desflurane boil?
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22.8 degrees C aka room temperature
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What anesthetic agent is in a special vaporizer?
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Desflurane
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Why does Desflurane have a rapid onset?
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Rapid onset is due to low blood/gas solubility
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Does Desflurane have a rapid or slow recovery?
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Rapid
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With what anesthetic gas might your patient have a seizure?
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With Enflurane when you have a low PaCO2
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Does Desflurane have a high potency or a low potency?
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low potency
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What are the special concerns Desflurane in peds patients?
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DELERIUM
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What are the cardiovascular effects of Desflurane?
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Increase HR, decrease SVR, decrease MAP, CO is unchanged, minimal coronary vasodilation.
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Does Desflurane stimulate or depress respiration?
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marked depression
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Neurologically what happens at 2 MAC of Desflurane?
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2 MAC of Desflurane = silent EEG
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What is the chemical formula for Desflurane?
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C3H2F6O
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What is the chemical structure of Desflurane?
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F F F
F - C - C - O - C - H F H F |
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What is the IUPAC name for Desflurane?
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2-(difluoromethoxy)-1,1,1,2-tetrafluoroethane
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What is the MAC of Sevoflurane?
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2.1
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What is the chemical formula of Sevoflurane?
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C4H3F7O
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What is the chemical structure of Sevoflurane?
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F
F - C - F F H - C ----- O - C - H F - C - F H F |
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What is the IUPAC name for Sevoflurane?
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1,1,1,3,3,3-hexafluoro-2-(fluoromethoxy)propane
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What is the Blood/Gas coefficient for Sevoflurane?
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about 0.70
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What is the Fat/Blood coefficient for Sevoflurane?
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48
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What is the Vapor Pressure in mmHg of Sevoflurane?
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170 mmHg
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How much is Sevoflurane metabolized?
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2-5%
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What is the boiling point of Sevoflurane?
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58.6 degrees C
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What is the major concern with Sevoflurane and absorbers?
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Compound A with low flows
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What is the flow rule for Sevoflurane?
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At least 1 L/min up to 2 MAC hours then increase flow to at least 2 L/min
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What is a MAC hour?
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The number of MAC multiplied by the time in hours. I.e 2 MAC for 1 hr is equal to 2 MAC hours
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What organ does Compound A effect?
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It's nephrotoxic
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Is Sevoflurane pungent?
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No it is not pungent
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What happens when you give Sevoflurane at >1.5 MAC
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Increase in HR
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Sevoflurane is good at reversing bronchospasms, True or False?
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True
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Does Sevoflurane have a low or high airway irritability?
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A low airway irritability
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Describe the onset of Sevoflurane.
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It has a rapid onset related to it's low blood/gas solubility and can be given in excess of 3-4 MAC
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Is the recovery from Sevoflurane fast or slow?
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It has a rapid recovery with shorter cases but a more pronounced delay in recovery with long cases. (Do to its higher Fat/blood coefficient)
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Does Sevoflurane have a high potency or a low potency?
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Low potency
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What is a major concern with Sevoflurane and peds patients?
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DELIRIUM
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Is Sevoflurane expensive?
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Yes
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What are the cardiovascular effects of Sevoflurane?
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Decreases SVR, decrease MAP, increase HR (at greater than 1.5 MAC) may prolong QT interval
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What is the MAC of Nitrous Oxide?
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104%
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What is the blood/gas coefficient of Nitrous Oxide?
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0.46
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What is the Fat/Blood coefficient of Nitrous Oxide?
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2.3
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What is the Vapor Pressure of Nitrous Oxide?
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39,000
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How much is Nitrous Oxide metabolized?
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0.04%-Trace
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What is the boiling point of Nitrous Oxide?
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-88.5 degrees C
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What is the chemical formula for Nitrous Oxide?
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N2O
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What is the structure of Nitrous Oxide?
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Trick question because it exists in 2 isomers N=N=O or N (triple bond) N - O
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Is Nitrous Oxide more soluble than Nitrogen?
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Yes by more than 35 times
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Which inhalation agent does not cause MH?
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Nitrous Oxide
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Which Inhalation agent has teratgenic effects?
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Nitrous Oxide
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Describe the induction of Nitrous Oxide.
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Rapid onset related to low blood/gas solubility and concentration effect (second gas effect)
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What is the second gas effect?
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Because Nitrous Oxide is so soluble it quickly leave the alveoli decreasing the volume of the alveoli thereby increasing the concentration of the anesthetic gas
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Does Nitrous Oxide have a rapid or slow recovery?
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Rapid recovery
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Which inhalation agent is inorganic?
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Nitrous Oxide
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Which inhalation agent has a higher risk for hypoxia?
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Nitrous Oxide
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What is the potency of Nitrous Oxide?
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Low potency
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Why would you not use Nitrous Oxide on a laparoscopic surgery?
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Because Nitrous Oxide will readily move into the abd and increase intra-abdominal pressure
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Nitrous Oxide requires large concentrations to have anesthesia effects True or False
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True
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What are the cardiovascular effects of Nitrous Oxide?
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Increase in CO, CVP, and PVR. No changes in HR or SVR
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What is diffusion hypoxia?
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An abrupt transient decrease in alveolar oxygen tension when room air is inhaled at the conclusion of a nitrous oxide anesthesia
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Does Nitrous Oxide depress hypoxic drive?
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Yes
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How does Nitrous Oxide effect ICP?
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There is a minor increase in ICP due to increase cerebral blood volume
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All Volatile Anesthetics do: Pulmonary
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All increase respiration rate and PCO2
All decrease Tidal Volume, & CO2 response, All decrease hypoxic response All broncholdilate, but impair HPV @ > 1 MAC |
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What is HPV?
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Hypoxic pulmonary vasoconstriction
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All Volatile Anesthetics do: Cerebral
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All cerebral vasodilate, (order Hal>Enf>Des>Iso>Sevo)
All increase cerebral blood flow (dose dependent) All decrease amplitude SSEP All increase latency of SSEP |
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What is SSEP?
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Somatic sensory evoked potential
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Do all Volatile Anesthetics have skeletal muscle relaxing effects?
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All Volatile Anesthetics do relax muscles, however not all inhalation agents relax muscles, i.e. N2O
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What effect does Volatile Anesthetics have on NDNMB drugs?
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Potentiation effect
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What are the four "reservoirs of the body"?
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Vessel Rich Group
Muscle Group Fat Group Vessel Poor Group |
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What is the CO of the Vessel Rich Group?
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75%
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What is the Body Mass of the Vessel Rich Group?
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10%
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What is the Body Mass of the Muscle Group?
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50%
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What is the CO to the Muscle Group?
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19%
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What is the CO to the Fat Group?
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6%
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What is the Body Mass of the Fat Group?
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20% (that's being nice)
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What is the Body Mass of the Vessel Poor Group?
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20%
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What is the CO of the Vessel Poor Group?
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<1%
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What is MAC?
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minimum alveolar concentration of a vapor in the lungs that is needed to prevent movement (motor response) in 50% of subjects in response to surgical (pain) stimulus.
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What is MAC Amnesia?
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minimum alveolar concentration of a vapor in the lungs that is needed to prevent memory in 50% of patients
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What is MAC Awake?
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minimum alveolar concentration of a vapor in the lungs that is needed to for 50% of patients to follow simple commands
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What is MAC BAR?
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minimum alveolar concentration of a vapor in the lungs that is needed to Block Autonomic Response in 50% of patients
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What is MAC Intubation?
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minimum alveolar concentration of a vapor in the lungs that is needed to intubate a patient without autonomic response in 50% of patients
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What is the value of MAC Amnesia?
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0.25-0.30 MAC
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What is the value of MAC Awake?
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0.33-0.5 MAC
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What is the value of MAC BAR?
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1.3 MAC
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What is the value of MAC Intubation?
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1.5 MAC
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All Volatile Anesthetics: Renal
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Decrease renal blood flow, GFR, UO. ADH and Renin remain unchanged.
If the concentration of [F] >50mmol/L = Nephrotoxic *I also found that des and sevo do not decrease renal blood flow |
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All Volatile Anesthetics: OB
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All cross the placenta, all are vasodilators of the uterine and all relax the uterus
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What is the target organ of Anesthetic gases?
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The spine and to a less extent the brain (Eger)
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