Farmacologie van de inhalatie-anesthetica

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History: • 1951: Halothane: Suckling • 1960’s: Methoxyflurane • 1970’s: Enflurane Isoflurane ( isomer of enflurane) Sevoflurane Desflurane • Xenon: first used in 1951 by Cullen Mechanism of action 1: of excitatory and enhancement of inhibitory transmission Lipid solubility membrane changes ??? ( historical )
Mechanism of action 2: • GABA A receptor – chloride channel : inhibitory • Voltage – sensitive calcium channels: • T – type calcium channel • L – type • N – type • Specific mechanism for Isoflurane • NMDA receptor : Ketamine is inhibitor • Nicotinic i acetylcholine li receptors • Voltage – gated sodium channels The notion MAC: definitions: • Mac awake : allows a voluntary response to commands in 50% of patients ( ~ amnestic dose: e.g. 0,7 MAC Halothane) • MAC 95 : prevents 95% of patients responding to defined noxious stimulus ( original standard MAC stimulus = skin incision in humans) = 1,3 MAC Halothane (other stimulus = other MAC value for that particular stimulus e.g.: intubation-MAC) • MAC BAR : blocks adrenergic response in 50% of patients = 1,5 MAC Halothane • MAC BAR95 : blocks 95% of patients = 2 MAC Halothane
Page 1: Volatiele anesthetica Farmacodynami
Page 5 and 6: The notion MAC Additiviteit van MAC
Page 8 and 9: MAC N2O Halo Enfl Isofl Desfl Sevo
Page 10 and 11: F Br F Cl F F C C H H C O C C F F C
Page 12 and 13: Nitrous oxide • 30 maal meer oplo
Page 14 and 15: Nitrous oxide: biotransformatie en
Page 16 and 17: Isoflurane: hemodynamica • matige
Page 18 and 19: Sevoflurane: hemodynamica • vermi
Page 20 and 21: HR (bts/min) 30 20 halothane isoflu
Page 22 and 23: Cerebrale effecten • enflurane is
Page 24 and 25: PaCO2 (mmHg) 90 80 70 60 50 40 desf
Page 26 and 27: Bronchomotor tonus • bronchodilat
Page 28 and 29: Mucociliaire functie • andere fac
Page 30 and 31: Maligne hyperthermie Alle volatiele
Page 32 and 33: Toxiciteit: halothane • reductiev
Page 34 and 35: Toxiciteit: isoflurane en desfluran
Page 36 and 37: Xenon : Xenon :

Farmacologie van de inhalatie-anesthetica

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