Pharm IV, Inhalational Anesthetics

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HLW
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74913
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Pharm IV, Inhalational Anesthetics
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2011-03-27 22:19:01
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Pharm
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Pharm IV, Inhalational Anesthetics
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  1. Ideal Inhalational Anesthetic:
    • Non-toxic to all tissues
    • Non-Flammable
    • Non-reactive w/ metal, rubber or soda lime
    • Inert (not absorbed/metab by body)
    • Pleasant to inhale
    • Stable in light and heat
    • Min CVS/Resp depression
    • Easily and quickly alter anesthetic depth
    • Potent, with large safety margin
  2. Saturated Vapor Pressure, is when...
    • The number of molecules leaving liquid = number of molecules entering liquid
    • Vapor Pressure is at a maximum for a liquid
  3. MAC-
    • Minimum concentration of an anesthetic agent, which will prevent purposeful movement in response to a supramaxiaml stimulus in 50% of P
    • Minimal Alveolar Concentration
  4. What is the MAC for...
    Halothane:
    Iso:
    Sevoflorane:
    Desoflorane:
    • Halothane: 0.8-0.9
    • Iso: 1.5
    • Sevoflorane: 2.4
    • Desoflorane: 8.0
  5. A higher MAC indicates...
    • Decreased Potency
    • low Blood Gas Solubility= Rapid Uptake and Removal
  6. Desofluranehas a high ____ , but a low ___
    • High MAC
    • Low Solubility Partition Coefficient
  7. The Partition Coefficient is an indication of...
    • the relative affinity of two tissues in contact have for the same substance
    • (higher partition coefficient=> higher affinity)
  8. Saturated Vaporization Pressure is an indication of...
    degree of solubility and ability to evaporate
  9. As a general rule, the more ____ a gas is, the faster it works for induction and recovery
    insoluble
  10. The Blood:Gas coefficient influences...
    The magnitude of the effect of the an individual anaesthetic
  11. What influences the uptake into the blood?
    • Blood:Gas Coefficient
    • CO
    • Aveolar to Venous Partial Pressure Difference (Pa-Pv)
    • (Increased Pulmonary Ventilation and Decreased CO, as in shock, -> ++ uptake)
  12. Degredation of Halogenated ethers, vs halothane:
    • Halogenated ethers undergo 0.2-5% hepatic degredation
    • Halothane undergoes 20%
  13. Which gas is poorly soluble?
    N2O
  14. N2O shuld not be used in animals with....
    • Head Trauma
    • Cerebral Edeam
  15. When is N2O used?
    • Adjunctive anesthetic
    • (especially when hypotension is a concern)
  16. N2O can reduce ___ by 20-25%
    MAC
  17. Dangers of N2O:
    • Distention in gas filled spaces of the body
    • Diffusion Hypoxia
  18. Where does N2O accumulate?
    • Rumen
    • Gastric Dilation/volulvus
    • Pneumothorax
    • Eye
  19. Why does Nitrous Oxide cause hypoxia?
    Less soluble than O2, so it diffuses out of the blood, into alveoli
  20. With which gas should O2 be admin for 5-10 mins post op?
    Nitrous Oxide
  21. Isoflurane is classified as a ____
    Halogenated Ether
  22. Respiratory Fx of Iso:
    • Respiratory Depression (more than halothane)
    • Irritant
  23. When exposed to Carbond Dioxide Absorbant, _____ produces Compoune A
    Sevo
  24. Sevo isn't rec for P with...
    • Head Trauma
    • Brain Tumors
  25. Desflurane is classified as a____
    Highly fourinated methyl ether
  26. Desflurane solubility partition coefficient...
    • 0.8
    • low
  27. Desfluran MAC...
    • 8.0
    • high
  28. Hepatic Metabolism of Iso: Sevo: Deso:
    • Iso: >1%
    • Sevo: 3-5%
    • Halothane: >20%
  29. Soluble anesthetic => ___ Blood:Gas Coeffiecient => ____induction/recovery
    • Low Blood:Gas
    • Rapid induction/recovery
  30. The vessel rich group, which reaches equilibrium first, includes:
    • Brain
    • Heart
    • Liver
    • Kidney
    • Splanchnic Bed
  31. Relevant Pressures as the anesthetic flows from the liquid phase and through the P
    • P Delivered
    • P Circuit
    • P Inspired
    • P Alveolar
    • P Arterial

    P Brain

    • P Arterial
    • P Alveolar
    • Exhaust
  32. What two factors determine the rate at which the alveolar concentration increases to the concentration being inspired?
    • Inspired Concentration
    • Alveolar Ventilation
  33. Solubility of O2 and N2O relative to anesthetics?
    Why is this relevant to induciton?
    • O2 & N2O are MORE soluble
    • Increases transfer of anesthetics into the blood stream
  34. Factors that influence anasthetic uptake into the blood:
    • Blood:Gas Solubility
    • CO (Q)
    • Alveolar to Venous Partial Pressure (PA-PV)
  35. How does shock affect anesthesia uptake into blood?
    • Increased Pulmonary Ventilation
    • Decreased CO
    • => increases uptake
  36. Decreased CO and Increased pulmonary ventilation can accelerate induction in agents w/...
    Examples include(2):
    Intermediate Gas Solubility

    • Halothane
    • Iso
  37. What anesthetic property affects recovry?
    Solubility
  38. Hepatic Degredation...
    Halogenated Ethers= ____%
    Halothane= ____%
    • Halogenated Ethers= 0.2-5%
    • Halothane= 20%
  39. What factors Decrease MAC (5)?
    • Narcotics/Sedatives/Tranquilizers
    • Age
    • Hypothermia
    • Pregnancy
    • Hypoxia
  40. Factors that increase MAC (2):
    • Hyperthermia (increases cerebral metabolic rate)
    • Neurotransmitter Release
  41. When is N2O used (2):
    • Adjunctive Anesthetic
    • When Hypotension is a concern (reduce cardio depressant anesthetics)
  42. Benefits of N2O (3):
    • Good Analgesia
    • MAC sparing (for other drugs)
    • Second Gas effect (Accelerates uptake of volatile anesthetics)
  43. Disadvantages of N2O (5):
    • Low potentcy
    • Expensive
    • Abuse
    • Hypoxia if wrong concentration
    • Diffusion Hypoxia at recovery
  44. Solubility of O2 VS N2O:
    • O2 MORE Soluble
    • N2O LESS Soluble
    • (both are less soluble than other anesthetics)
  45. How can N2O => Hypoxia?
    Upon recovery, N2O diffuses more rapidly from blood to alveoli
  46. Which gas => Compound A when exposed to CO2?
    Sevo

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