COPY: Inhaled Anesthetics
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Questions and Answers

What is the preferred inhaled anesthetic for inhalation induction?

  • Sevoflurane (correct)
  • Xenon
  • Nitrous oxide
  • Desflurane
  • Which of the following is true about the volatile anesthetics and triggering MH (Malignant Hyperthermia)?

  • Nitrous oxide and xenon trigger MH
  • Sevoflurane does not trigger MH
  • Only desflurane triggers MH
  • All volatile agents trigger MH in a susceptible patient (correct)
  • How do the volatile anesthetics affect cerebral blood flow and cerebral metabolic rate of oxygen consumption (CMRO2)?

  • Decrease both cerebral blood flow and CMRO2
  • Increase both cerebral blood flow and CMRO2
  • Decrease cerebral blood flow and increase CMRO2
  • Increase cerebral blood flow and decrease CMRO2 (correct)
  • What effect do the volatile anesthetics have on evoked potential monitoring?

    <p>Can cause unpredictable effects on evoked potential monitoring</p> Signup and view all the answers

    What is the main effect of 0.5 MAC of an inhaled anesthetic?

    <p>Loss of self awareness and recall</p> Signup and view all the answers

    Which factor does NOT increase MAC?

    <p>Gender</p> Signup and view all the answers

    What is the main difference between MAC-awake and MAC-BAR?

    <p>Alveolar concentration that opens eyes to command vs. blunts adrenergic response</p> Signup and view all the answers

    Which inhaled anesthetic is least pungent and produces the least airway irritation?

    <p>Sevoflurane</p> Signup and view all the answers

    Which agent results in NO CHANGE in CSF resorption?

    <p>Nitrous oxide</p> Signup and view all the answers

    What effect do Isoflurane, Desflurane, and Sevoflurane have on CMRO2 and EEG?

    <p>Decrease CMRO2 consistent with EEG decrease</p> Signup and view all the answers

    Which anesthetic agent is associated with an improvement in cognitive recovery over isoflurane?

    <p>Sevoflurane</p> Signup and view all the answers

    At what concentration range does the shift to increasing frequencies occur on EEG when using N2O?

    <p>30-70%</p> Signup and view all the answers

    Which type of evoked potential monitoring is least affected by volatile agents?

    <p>Subcortical monitoring</p> Signup and view all the answers

    In terms of hemodynamics, what effect do volatiles have on blood pressure?

    <p>Dose-related decrease</p> Signup and view all the answers

    How do isoflurane and desflurane affect heart rate compared to sevoflurane?

    <p>Isoflurane and Desflurane increase heart rate, Sevoflurane does not change it</p> Signup and view all the answers

    Which anesthetic agent may slightly prolong the QT interval?

    <p>Desflurane</p> Signup and view all the answers

    Which organ system experiences sensitization to catecholamines under halothane?

    <p>Myocardium</p> Signup and view all the answers

    In terms of contractility, how do volatile agents impact cardiac patients with ejection fraction (EF) less than 40%?

    <p>No change in contractility</p> Signup and view all the answers

    Which volatile anesthetic has the highest blood solubility?

    <p>Halothane</p> Signup and view all the answers

    What is the most potent currently available volatile anesthetic?

    <p>Isoflurane</p> Signup and view all the answers

    Which volatile anesthetic has the lowest blood solubility?

    <p>Desflurane</p> Signup and view all the answers

    What is the primary metabolic byproduct of desflurane in a dry CO2 absorber?

    <p>Carbon monoxide</p> Signup and view all the answers

    Which volatile anesthetic has the least airway irritation?

    <p>Sevoflurane</p> Signup and view all the answers

    Which volatile anesthetic results in an extremely rare incidence of immune-mediated hepatitis?

    <p>Desflurane</p> Signup and view all the answers

    Which volatile anesthetic has the lowest potency?

    <p>Desflurane</p> Signup and view all the answers

    Which gas is odorless to sweet smelling but supports combustion?

    <p>Nitrous oxide</p> Signup and view all the answers

    What is the primary concern associated with Nitrous Oxide postoperatively?

    <p>Inactivation of Vitamin B12</p> Signup and view all the answers

    Which volatile anesthetic is associated with dose-dependent nephrotoxicity in rats but appears safe in humans even at low fresh gas flows?

    <p>Sevoflurane</p> Signup and view all the answers

    What is the primary property of Xenon that distinguishes it from other volatile anesthetics?

    <p>Low blood solubility</p> Signup and view all the answers

    Which statement about the Minimum Alveolar Concentration (MAC) is correct?

    <p>It is measured at atmospheric pressure.</p> Signup and view all the answers

    Which anesthesia for cesarean section shows transient depression following general anesthesia?

    <p>General anesthesia</p> Signup and view all the answers

    What is a long-term effect of neonatal or early childhood exposure to anesthetics in humans?

    <p>Behavioral changes</p> Signup and view all the answers

    What contributes to renal injury in rats based on the text?

    <p>Sevoflurane</p> Signup and view all the answers

    What is the FDA recommendation for fresh gas flow concerning sevoflurane in humans?

    <p>&gt; 2 L/min fresh gas flow after 2 MAC hours</p> Signup and view all the answers

    Which volatile agent undergoes ~ 5% metabolism and increases fluoride concentration?

    <p>Sevoflurane</p> Signup and view all the answers

    What is the primary inhalation induction agent used in pediatrics according to the text?

    <p>Sevoflurane</p> Signup and view all the answers

    Which agent provides relaxation of skeletal muscle during anesthetic maintenance?

    <p>Volatile agents</p> Signup and view all the answers

    What is a benefit of volatile agents for anesthetic maintenance according to the text?

    <p>Provide some protection from ischemic injury</p> Signup and view all the answers

    Which agent is noted for easy and rapid titration of depth of anesthesia during maintenance?

    <p>Volatile agents</p> Signup and view all the answers

    What is the main cost driver of indirect costs in pharmacoeconomics?

    <p>PACU time</p> Signup and view all the answers

    Which type of induction technique with high inspired concentration of sevoflurane provides rapid loss of consciousness but does not ensure adequate depth of anesthesia for airway instrumentation?

    <p>1-2 breath technique</p> Signup and view all the answers

    Long-term effects of neonatal or early childhood exposure to anesthetics in humans are well understood and definitive answers have been found.

    <p>False</p> Signup and view all the answers

    Volatile anesthetics have been shown to cause accelerated neuronal apoptosis in rodents.

    <p>True</p> Signup and view all the answers

    The long-term effects of exposure to volatile anesthetics have been extensively studied in humans and conclusive results are available.

    <p>False</p> Signup and view all the answers

    Sevoflurane undergoes significant metabolism, leading to the production of renal concentrating injury.

    <p>False</p> Signup and view all the answers

    Halothane is primarily used in adults for inhalation induction due to its high pungency and low acceptance.

    <p>False</p> Signup and view all the answers

    Desflurane has the lowest blood solubility among the volatile anesthetics.

    <p>True</p> Signup and view all the answers

    Sevoflurane inhalation induction can be used in both pediatric and adult populations with equal success rates.

    <p>False</p> Signup and view all the answers

    The primary metabolic byproduct of desflurane in a dry CO2 absorber is carbon dioxide.

    <p>False</p> Signup and view all the answers

    Volatile agents are known to cause a decrease in cerebral blood flow and cerebral metabolic rate of oxygen consumption (CMRO2).

    <p>False</p> Signup and view all the answers

    Low-flow or closed circuit anesthesia has been associated with decreased Compound A production.

    <p>False</p> Signup and view all the answers

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