Farmacologie van de inhalatie-anesthetica
Farmacologie van de inhalatie-anesthetica Farmacologie van de inhalatie-anesthetica
Toxiciteit: isoflurane en desflurane • wegens de geringe metabolisatie de veiligste producten • desflurane: keuzeproduct voor langdurige anesthesies • No degradation by absorbent • BUT CO production especially by Desflurane in excessively dry absorbant ( first case of day) ( less with Iso and Enfl): pulse oxym. may be fooled Chronische toxiciteit • mutageen ?: enkel anesthetica met dubbele bindingen (divinyl ether, fluroxene, trichloorethyleen) • cancerogeen: surveys: zeer twijfelachtig: iets meer kanker (1.3x) bij vrouwen met chronische expositie • teratogeen: ?
% increase above control women wives of exposed men abortion major anomaly abortion major anomaly Askrog 1970 Cohen 1971 Knill-Jones 1972 65 270 30 negative - 160 170 - - negative - - Rosenberg 1973 Corbett 1974 ASA 1974 Knill-Jones 1975 Cohen 1975 Pharoah 1977 70 - 30 40 - negative negative 190 60 negative - negative - - negative negative 80 - - - 30 negative negative - Ericson 1979 Cohen 1980 Axelsson 1985 Hemminki 1985 Guirguis 1990 negative 160 negative negative 98 negative 60 - negative 124 - 50 - - 130 - negative - - 46
- Page 1 and 2: Volatiele anesthetica Farmacodynami
- Page 3 and 4: Mechanism of action 2: • GABA A r
- 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 36 and 37: Xenon : Xenon :
% increase above control women wives of exposed men<br />
abortion major anomaly abortion major anomaly<br />
Askrog 1970<br />
Cohen 1971<br />
Knill-Jones 1972<br />
65<br />
270<br />
30<br />
negative<br />
-<br />
160<br />
170<br />
-<br />
-<br />
negative<br />
-<br />
-<br />
Rosenberg 1973<br />
Corbett 1974<br />
ASA 1974<br />
Knill-Jones 1975<br />
Cohen 1975<br />
Pharoah 1977<br />
70<br />
-<br />
30<br />
40<br />
-<br />
negative<br />
negative<br />
190<br />
60<br />
negative<br />
-<br />
negative<br />
-<br />
-<br />
negative<br />
negative<br />
80<br />
-<br />
-<br />
-<br />
30<br />
negative<br />
negative<br />
-<br />
Ericson 1979<br />
Cohen 1980<br />
Axelsson 1985<br />
Hemminki 1985<br />
Guirguis 1990<br />
negative<br />
160<br />
negative<br />
negative<br />
98<br />
negative<br />
60<br />
-<br />
negative<br />
124<br />
-<br />
50<br />
-<br />
-<br />
130<br />
-<br />
negative<br />
-<br />
-<br />
46
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