What is MAC Week 2 – Flashcards
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MAC stands for
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minimum alveolar concentration
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1 MAC prevents movement in what % of patients
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50
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MAC is dependent on what level of anatomy
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spinal chord
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MAC measurement is of inspired or expired amount
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expired
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1.3 MAC has what % confidence of no movement
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95%
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MAC mirrors
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brain partial pressure
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Isoflurane MAC value
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1.17
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Sevoflurane MAC value
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1.8
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N20 MAC value
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104
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Desflurane MAC value
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6.6
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Hyperthermia has what effect on MAC value
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increased
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drug induced increases in CNS catecholamine levels has what effect on MAC value
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increased
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Hypernatremia has what effect on MAC value
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increased
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Having read hair increases MAC value by how much
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20%
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Cyclosporines have what effect on MAC value
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increased
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MAC value decreases what % per decade
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6
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preoperative premedication has what effect on MAC value
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decreased
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Alpha 2 agonists have what effect on MAC value
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decreased
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acute alcohol ingestion has what effect on MAC value
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decreased
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Pregnancy has what effect on MAC value
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decreased
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Postpartum has what effect on MAC value
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decreased
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Lithium has what effect on MAC value
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decreased
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lidocaine has what effect on MAC value
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decreased
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PaO2 <38 mmHg has what effect on MAC value
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decreased
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BP <40 mmHg has what effect on MAC value
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decreased
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Hyponetremia has what effect on MAC value
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decreased
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Ketanserin has what effect on MAC value
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decreased
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For an 80yo receiving Sevoflurane what is the equivalent to 1 MAC
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.5%
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For a 3yo receiving sevoflurane what is the equivalent to 1.3 MAC
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1.8%
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Anesthetic metabolism effect on MAC
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none
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Chronic alcohol abuse effect on MAC
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none
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Gender effect on MAC
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none
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Duration of anesthesia effect on MAC, 1 possible exception
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none, isoflurane
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PaCO2 15-95 mmHg effect on MAC
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none
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PaO2 >38 mmHg effect on MAC
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none
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Hyper/HypoKalemia effect on MAC
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none
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Thyroid gland dysfunction effect on MAC
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none
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Can multiple volatile anesthetics be given at the same time
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no
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Volatile anesthetics are additive with
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N2O
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If Isoflurane is at 1 MAC and N20 is at .5 MAC what is the total MAC being delivered
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1.5
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Opiates have a ceiling effect on MAC in that the max decrease in MAC is what %
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50
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Fentanyl ceiling for MAC decrease
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1.5mcg/kg
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Definition: the brain concentration of an agent, which blocks adrenergic responses to skin incision
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MAC bar
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calculation using MAC bar to determine what percent to use
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MAC bar x 1 MAC
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MAC bar for isoflurane
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1.3
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MAC bar for sevoflurane
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3.5
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MAC bar for Desflurane
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1.3 MAC
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What percent of Isoflurane is used to achieve MAC bar (show calculation)
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1.3x1.17=1.52
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Opiate effect on MAC bar
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decreased
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MAC bar for isoflurane if patient is given 1.5mcg/kg of fentanyl
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.55
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MAC bar for desflurane if patient is given 1.5mcg/kg of fentanyl
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.4
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Definition: End-tidal concentration of an anesthetic agent at which 50% of patients appropriately respond to verbal commands.
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MAC awake
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MAC awake tends to be ____ of 1 MAC for volatiles
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.35
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What is the MAC awake for Isoflurane (shoe calculation)
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.35x1.17=.4
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MAC awake for N20 tends to be ______ of 1 MAC for N20
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.0635
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What is the MAC awake for N2O (show calculation)
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.0635x104=6.6
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4 properties of volatile halogenated agents
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Amnesia, analgesia, areflexia, autonomic depression
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Amnesia for volatile agents occurs at what MAC stage
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MAC awake
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3 properties of N2O
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amnesia, analgesia, autonomic depression
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Areflexia is taking place at what level anatomically
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spinal cord
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Glycine is excitatory or inhibitory
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inhibitory
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Areflexia from anesthetics relies on agonism of what receptor
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Glycine
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Areflexia from anesthetics relies on antagonism of what 2 receptors
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AMPA, NMDA
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Areflexia from anesthetics relies on antagonism of what ion gated channel
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Na channels
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4 receptor locations that anesthetics work at for areflexia
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glycine, AMPA, NMDA, Na channels
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Anesthetics are lipid soluble or water soluble
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lipid soluble
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Anesthetics alter the thickness of the lipid bilayer true or false
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true
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Anesthetics disrupts secondary messenger function true or false
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true
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Anesthetics disrupts the conversion of phospholipids true or false
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true
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Anesthetics alter plasticity of lipid bilayer true or false
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true
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How anesthetic gas penetrate lipid bilayer is what theory
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Meyer-Overton
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Does temperature affect anesthetic potency
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yes
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Does barometric pressure affect anesthetic potency
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yes
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Whos easier to put a sleep a hyperthermic patient or hypothermic patient
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hypothermic
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If a oil:gas coefficient is very low does that correlate to high or low anesthetic potency
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High
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are there other theories disputing Meyer-Overton
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yes
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Does the amount of cholesterol present affect the anesthetic agent
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no
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Cholesterol is a precursor to
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steroid hormones
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Cholesterol is excreted from the
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Liver
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Fat soluble vitamins (4)
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A,D,E,K
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Globular protein example
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enzymes
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fibrous proteins function
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structural
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2 examples of fibrous proteins
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collagen, keratin
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Anesthetics are most likely affecting which protein structure (primary, secondary, tertiary, quaternary)
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tertiary
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Anesthetics being structurally different have similar effects. What can explain this
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ligand binding
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Anesthetics are reversibly bound or irreversibly bound structurally
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reversibly
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Anesthetics have some degree of effect on Ca++ channels. true or false
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true
