Inhaled Gases: Pharmacokinetic Properties
The index of the potency of an inhaled GA.
What is MAC? (Lower MAC --> More potent the drug)
Inhaled anesthetics enhance _____ channel opening by acting on _____ receptors.
What is Cl-; GABAA? - increases inhibitory synaptic activity (also enhanced by IV drugs - barbiturates, benzodiazepines, etomidate, and propofol)
Intravenous agents are redistributed from the blood to the brain and then to ____ and ____.
What is lean tissues; fat?
Primary analgesic agents used for major surgery.
What are opioids?
As established in a previous jeopardy game, Gabrielle suffers from chronic wheezing. She was just informed that she'd need surgery for another medical issue. The anesthesiologist decides to use a non-irritating GA that has a rapid onset and recovery. While this anesthetic is considered a drug of abuse that can cause depersonalization and has low potency, the medical provider decides to use it because it is considered an analgesic that can be used in asthmatics.
What is nitrous oxide?
The idea that administering one inhalation anesthetic at a high concentration will allow another administered inhalation anesthetic to enter the blood faster than if given alone.
What is second gas effect?
Halothane, isoflurane, and succinylcholine are most likely to trigger this reaction that characterized by muscle rigidity, rapid onset of tachycardia, hyperkalemia, and metabolic acidosis.
What is malignant hyperthemia?
This potent iv anesthetic is popular for same day surgery because of its rapid induction and recovery which reduces grogginess.
What is propofol?
Amongst the benzodiazepines, this one is the most commonly used because of its short half-life.
What is midazolam?
(Diazepam = long acting, lorazepam = intermediate acting)
Jordan comes in for an outpatient procedure and is administered this pungent, green house gas anesthetic that allows for quicker recovery than isoflurane.
Liver metabolism is highest for this inhaled anesthetic.
What is halothane?
Distinct from other inhaled anesthetics, isoflurane and desflurane have this effect.
What is increase heart rate?
"Dissociative anesthesia" is a state of being induced by this iv anesthetic.
What is ketamine?
_____ prolongs the duration of action of opioid analgesics.
What is infusion?
In the middle of Harrison's surgery, the anesthesiologist decides to add in this adjunct with a short half-life and sedative and amnesic properties to reduce the dose of propofol needed to achieve anesthesia.
What is midazolam?
Other benzodiazepines: Long-acting = diazepam, intermediate acting = lorazepam
Halothane has a ____ blood:gas partition coefficient, making the induction rate ___ and the elimination rate ____.
What is high; slow; slow?
Distinct from other inhaled anesthetics, halothane and sevoflurane have this effect.
What is decreased cardiac output?
*Halothane also results in decreased heart rate
Short-acting barbiturate only used for ECT.
What is methohexital?
This adjunct is principally used for the short-term sedation of intubated and ventilated patients in an ICU setting.
What is dexmedetomidine?
An 8 year-old patient with a heart defect comes in with no other relevant medical history. She is administered this good analgesic that is an amnesia-producing iv anesthetic during cardiac surgery.
What is ketamine?
Nitrous oxide, desflurane, and sevoflurane all have rapid onset and recovery. They are distinct from each other based on these individual characteristics.
What is incomplete anesthetic; poor induction agent; unstable in soda-lime?
Inhaled GAs normally have effects of minimal consequence to the liver and the kidney. While they (typically reversibly) affect the liver by depressing hepatic blood flow by 15 to 45%, inhaled GAs affect kidneys in this way.
What is depress glomerular filtration and renal plasma flow?
Even though etomidate has a minimal effect on the cardiovascular system and respiration, it is associated with the following negative symptoms.
What is higher mortality, vomiting/nausea, and myoclonic movement?
Benzodiazepines can cause respiratory depression and decreased blood pressure, which can be reversed with this drug.
What is flumazenil?
Yane has been diagnosed with ischemic heart disease. She needs cardiac surgery, so the anesthesiologist decides to use this potent and safe GA to minimize side effects, reduction in cardiac output, and liver metabolism.
What is isoflurane?