Anaesthetic Drugs

Question 1

Which induction agent is an excellent airway reflex suppressor?

Answer 1

Propofol

Question 2

In previous cases of PONV, which induction agent decreases the incidence of PONV?

Answer 2

Propofol

Question 3

What side effects does propofol cause?

Answer 3

• Drop in HR
• Drop in BP
• Pain on injection
• Involuntary movements

Question 4

Which induction agent is contraindicated in patients with egg/soy allergy?

Answer 4

Propofol

Question 5

What type of drug is thiopentone?

Answer 5

Barbiturate

Question 6

Which drug has anti-epileptic properties?

Answer 6

Thiopentone

Question 7

What side effects does thiopentone cause?

Answer 7

• Rise in HR
• Drop in BP
• Rash
• Bronchospasm
• Intra-arterial injection - thrombosis and gangrene

Question 8

In which medical condition is thiopentone contra-indicated in?

Answer 8

Porphyria

Question 9

Which Induction agent has the slowest onset?

Answer 9

Ketamine - 90 seconds

Question 10

What are the benefits of using ketamine?

Answer 10

Anterograde amnesia and profound analgesia

Question 11

Which induction agent has the lowest incidence of hypersensitivity reaction?

Answer 11

• Etomidate

Question 12

What are the effects of ketamine?

Answer 12

• Rise in HR
• RIse in BP
• Bronchodilation
• N+V
• Emergence phenomenon - hallucinations

Question 13

What type of onset does etomidate have?

Answer 13

Rapid

Question 14

What are the unwanted effects of etomidate?

Answer 14

• Pain on injection
• Spontaneous movements
• Adreno-cortical suppression
• High incidence of PONV

Question 15

When is etomidate contra-indicated?

Answer 15

• Septic shock

Question 16

Which induction agent would be best for changing a burn dressing?

Answer 16

Ketamine

Question 17

Which induction agent is most appropriate for GA with an LMA?

Answer 17

Propofol

Question 18

Which induction agent would be best for a patient with a history of heart failure requiring GA?

Answer 18

Etomidate

Question 19

Patient requiring emergency laparotomy?

Answer 19

Thiopentone

Question 20

Patient with porphyria requiring for inguinal hernia repair?

Answer 20

Propofol

Question 21

Which maintenance drug has the least effect on organ blood flow?

Answer 21

Isoflurane

Question 22

Which inhalational agent is sweet smelling?

Answer 22

Sevoflurane

Question 23

Which inhalational agent can also be used for induction?

Answer 23

Sevoflurane

Question 24

Which inhalational agent has a rapid onset and offset?

Answer 24

Desflurane

Question 25

Which inhalational agent is good for long operations?

Answer 25

Desflurane

Question 26

Which inhalational agent would be best for an 8 hour finger-reimplantation operation?

Answer 26

Desflurane

Question 27

Which inhalational agent would be best for a chubby child with no IV access?

Answer 27

Sevoflurane

Question 28

Which inhalational agent would be best for organ retrival from a donor?

Answer 28

Isoflurane

Question 29

Which analgesia is short-acting and used intra-operatively?

Answer 29

Fentanyl, Remifentanyl, Alfentanyl

Question 30

Which analgesia suppresses the response to laryngoscopy?

Answer 30

Fentanyl, Remifentanyl, Alfentany

Question 31

Which analgesia is good for surgical pain?

Answer 31

Fentanyl, Remifentanyl, Alfentany

Question 32

Which long acting analgesia is best for intra-op and post-op?

Answer 32

Morphine, oxycodone

Question 33

How long does Morphine/oxycodone take to work?

Answer 33

Works best at 20mins and lasts 2 hours

Question 34

How do depolarising muscle relaxants work?

Answer 34

Compete with Ach for nicotinic receptors with similar action but slowly hydrolysed so can cause muscle contraction

Question 35

What is suxamethonium used for?

Answer 35

RSI - rapid onset, rapid offset

Question 36

What are the adverse effects of suxamethonium? Name 5

Answer 36

- Muscle pain - Fasciculations - Hyperkalaemia - Malignant hyperthermia - Rise in ICP, IOP and gastric pressure

Question 37

How do non-depolarising muscle relaxants work?

Answer 37

- Block nicotinic receptors therefore muscles relax

Question 38

What are the effects of non-depolarising relaxants?

Answer 38

- Slow onset - Variable duration - Less side effects

Question 39

Name 2 short acting, 2 intermediate acting and 1 long acting non-depolarising muscle relaxants

Answer 39

Short: - Atracurium - Mivacurium Mid: - Vecuronium - Rocuronium Long: - Pancuronium

Question 40

How are muscle relaxants reversed?

Answer 40

Neostigmine and Glycopyrrolate

Question 41

How does Neostrigmine work?

Answer 41

Anti-cholinesterase preventing breakdown of Ach

Question 42

What are the muscarinic effects of Ach?

Answer 42

Bradycardia

Question 43

Why is neostigmine combined with glycopyrrolate?

Answer 43

Antimuscarinic agent

Question 44

What are the side effects of reversal?

Answer 44

N+V

Question 45

Which drugs are used to treat hypotension?

Answer 45

- Ephidrine - Phenyephrine - Metaraminol

Question 46

What are the effects of Ephedrine?

Answer 46

- Rise in HR and contractility = rise in BP | - Direct and indirect action on alpha and B receptors

Question 47

What are the effects of phenyephrine?

Answer 47

- Vasoconstriction = rise in BP - Direct action on alpha receptors - Drop in HR

Question 48

What are the effects of metaraminol?

Answer 48

- Vasocontriction = Rise in BP | - Direct and indirect action predominantly on alpha receptors

Question 49

Which drugs are used to treat severe hypotension?

Answer 49

Noradrenaline Adrenaline Dobutamine

Question 50

What are the effects of adrenaline?

Answer 50

Bronchodilator/inotrope Prolongs anaesthetic action Administered via central line

Question 51

Which Vaso-active agent is best when the patient has low BP and HR

Answer 51

Ephedrine

Question 52

Which Vaso-active agent is best when the patient has low BP and high HR?

Answer 52

Phenylephrine | Metaraminol

Question 53

What are the effects of atropine?

Answer 53

- Decreased secretions - Reduced gastro-oesophageal sphincter tone - Urinary obstruction - Tachycardia - Confusion in elderly

Question 54

How long does thiopentone take for RSI?

Answer 54

15-30 seconds | Lasts for 4-8minutes

Question 55

How long does propofol take in RSI?

Answer 55

30 seconds | Lasts for 2-6minutes

Question 56

How long does suxamethonium last in RSI?

Answer 56

6 minutes