Anaesthetics

Question 1

Name 4 classes of anaesthetics

Answer 1

1. General anaesthetics
2. Neuromuscular blockers
3. Other agents used in anaesthesia
4. Drugs for local anaesthesia

Question 2

Name 2 classes of general anaesthetics

Answer 2

1. IV general anaesthetics
2. Inhaled anaesthetics

Question 3

Name 4 IV general anaesthetics

Answer 3

1. Ketamine
2. Midazolam
3. propOFol
4. Thiopental

Question 4

Name 2 inhaled anaesthetics

Answer 4

1. Methoxyflurane
2. Nitrous oxide

Question 5

Name 2 classes of neuromuscular blockers

Answer 5

1. Non-depolarising neuromuscular blockers
2. Depolarising neuromuscular blockers

Question 6

Name 5 non-depolarising neuromuscular blockers

Answer 6

1. Atracurium
2. Cisatracurium
3. Mivacurium
4. Rocuronium
5. Vecuronium

Question 7

Name 1 depolarising neuromuscular blocker

Answer 7

Suxamethonium

Question 8

Name 4 classes of drugs used as adjuncts to anaesthesia

Answer 8

1. Alpha2 and imidazoline agonists
2. Opioids
3. Anticholinergics
4. Drugs for reversing neuromuscular blockade

Question 9

Name 2 alpha2 and imidazoline agonists

Answer 9

1. Clonidine
2. Dexmedetomidine

Question 10

Name 2 opioids used in anaesthesia

Answer 10

1. Alfentanil
2. Remifentanil

Question 11

Name 2 anticholinergics used in anaesthesia

Answer 11

1. Atropine
2. Glycopyrronium

Question 12

Name 1 drug used for reversing neuromuscular blockade

Answer 12

Sugammadex

Question 13

Name 7 local anaesthetics

Answer 13

1. Bupivacaine
2. Cocaine
3. Levobupivacaine
4. Lidocaine
5. Prilocaine
6. Ropivacaine
7. Tetracaine

Question 14

In which patient cohort is ketamine particularly useful?

Answer 14

Opioid-tolerant patients.

Question 15

Name 12 opioid analgesics

Answer 15

1. Alfentanil
2. Buprenorphine
3. Codeine
4. Fentanyl
5. Hydromorphone
6. Methadone
7. Morphine
8. Oxycodone ± Naloxone
9. Pethidine
10. Remifentanil
11. Tapentadol
12. Tramadol

Question 16

What is the opioid of choice in surgery?

Answer 16

Morphine

Question 17

Why is morphine the opioid of choice for surgery?

Answer 17

As it has the best retention in the cerebrospinal fluid.

Question 18

What must you always consider (besides age) when determining the dose when initiating an opioid?

Answer 18

Renal function

Question 19

Why must you consider renal function when initiating an opioid?

Answer 19

As renally-cleared opioids will accumulate in poor renal function.

Question 20

What should you consider if you see oxycodone and tramadol concurrently charted?

Answer 20

Check if there has been APS involvement.

Question 21

What is the common approach to pain management by the Acute Pain Service?

Answer 21

They will commonly start a patient on paracetamol and oxycodone, then add tramadol if pain is still not sufficiently controlled

Question 22

What is the rationale for the Acute Pain Service adding tramadol to a patient already on Oxycodone?

Answer 22

Tramadol has a slightly different mechanism to oxycodone.

Question 23

What should you do if you see IV opioids charted on the ward?

Answer 23

Chase this with the team to have it removed (IV opioids can’t be given on the wards) and check to see if anything else should be charted in its place.

Question 24

What is generally a requirement for a patient to be charted opioids as an inpatient?

Answer 24

They must be on regular paracetamol.

Question 25

How must Targin be ordered by a ward?

Answer 25

A ward can send a distribution form for Targin but they must specify the patient details as they must have past history for pharmacy to be able to supply it.

Question 26

What is an example of an off-label use of oxybutynin?

Answer 26

To control sweating.

Question 27

How is clonidine used in surgery?

Answer 27

Clonidine may be used to manage anxiety (for example about pain) in the recovery room.