Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MOHD4: Exam 4 Drugs > Anesthesia > Flashcards

Anesthesia Flashcards

1
Q

Put in order the stages of anesthesia:

  1. Disorientation
  2. Surgical anesthesia
  3. Respiratory paralysis
  4. Excitatory stage
A

1, 4, 2, 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q 
Which of the following has the highest perfusion rate?
A. Liver, lungs
B. muscle, skin
C. Adipose tissue
D. Bone
A

A. Also heart and brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Drug is redistributed to ____ first from blood

A

Brain and viscera: follows concentration gradient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name the 3 volatile anesthetics most commonly used

A

Isoflurane
Desflurane= ideal b/c fast in, fast out (That’s what she said!)(according to the tutor review…?)
Sevoflurance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which of the following about volatile agents is FALSE?
A. Vaporized at room temperature
B. Potent
C. High solubility in blood
D. Minimal metabolized
E. Depth of anesthesia depends on partial pressure in brain

A

C. Low solubility. Good b/c otherwise it would take a long time for partial pressure of drug to build up to a level that can drive it to the brain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T/F: Oil:gas partition coefficient determines speed of anesthetic induction and recovery

A

False. Oil:gas partition coefficient determines lipid solubility –> potency
High oil:gas = highly lipophilic –> more potent

Blood:gas partition coefficient determines speed of anesthetic induction and recovery
Low blood:gas = fast in, fast out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T/F: The higher the MAC, the higher the dose of a drug needed to reach potency.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Concentration of an inhaled anesthetic at which 50% of patients do not move in response to standard surgical stimulation.

A

1 MAC = Minimum alveolar concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name the anesthetic:

Can be used as inhaled anesthetic

A

Sevoflurane w/ or w/o NO

Desflurane and isoflurane not used b/c very pungent and can cause bronchospasms and airway irritation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Physiological effects of inhaled anesthetic include all of the following EXCEPT:
A. Decreased cerebral metabolism
B. Decrease in heart rate and systemic vascular resistance
C. Decrease in tidal volume
D. Decrease in vagal tone

A

D. Totally made option up.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

All inhaled anesthetics except nitrous oxide and succinylcholine (muscle relaxant) have this undesired effect

A

Malignant hyperthemia: mms release a lot of energy –> fatal if not treated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q 
Which of the following is NOT a commonly used intravenous agent?
A. Propofol
B. Pentothal sodium
C. Ketamine
D. Enflurane 
E. Etomidate
A

D. Enflurane is a volatile agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which of IV agents is preferred for the fact that it causes less of a hangover.

A

Propofol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which of the following is FALSE about Propofol?
A. Rapid onset
B. Long duration
C. Can cause hypotension and profound respiratory depression
D. Rapid hepatic metabolism
E. Lipid soluable

A

B. Short duration –> less hangover

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which of the following is TRUE about Sodium Pentothal?
A. Can be used as infusion
B. Slow onset
C. Long duration
D. Causes hypotension, tachycardia, upper airway obstruction and apnea

A

D

A. Long elimination half-life –> can NOT be used as infusion
B. Rapid onset
C. Short duration

*Sodium Pentothal is hardly used anymore due to its adverse effects.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name the drug:
Most cardio-stable of IV induction agents.
Ventilation less affected than other agents.

A

Etomidate

Use when in high sympathetic state and difficult to sedate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name the drug:
30-60% incidence of myoclonus
May cause adrenocortical suppression –> not used in ICU

A

Etomidate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name the 2 drugs that are safer agents b/c of its stable cardiac and respiratory profiles and short half life.

A

Etomidate

Ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name the drug:
Causes central stimulation of sympathetic nervous system.
Beneficial in hypovolemic shock

A

Ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which of the following is TRUE?
A. Benzodiazepines are GABA antagonists
B. Midazolam is used more frequently for premedication and procedural sedation
C. Benzodiazepine causes minimal respiratory depression
D. Benzodiazepines are enhanced by flumazenil

A

B. More than laorazepam and diazepam

A. GABA agonist
C. POTENT respiratory depressant
D. Antagonized by flumazenil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

T/F: Local anesthetics work easier on thinner unmeylinated nerve bundles.

A

False. MEYLINATED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Arrange the following in order of blockade:

  1. pain
  2. touch
  3. deep pressure
  4. motor
  5. cold
  6. warmth
A

1, 5, 6, 2, 3, 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Esters or amides?

Rapid metabolism by plasma cholinesterase

A

Esters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Esters or amides?

More likely to cause systemic toxicity

A

Amides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Esters or amides?

Slow metabolism by hepatic carboxylesterase

A

Amides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Esters or amides?

Slow onset of action

A

Esters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Esters or amides?

pKa close to pH

A

Amides

28
Q

Esters or amides?

Moderate to fast onset of action

A

Amides

29
Q

Esters or amides?

pKa higher than pH

A

Esters

30
Q

Local anesthetics work by ____

A

reversible intracellular binding of voltage gated sodium channels

31
Q

T/F: Higher lipid solubility causes lower potency and longer duration of action

A

False: Higher solubility, higher potency, longer duration

32
Q

T/F: In alkalic tissue, less nonionized LA is available to cross the cell membrane.

A

False. In acidotic tissue

More ionized LA in acidic pH, less non-ionized

33
Q

LA that has the highest pKa –> longest onset of action

A

Procaine: 14-18 min onset

34
Q

LA that has the lowest pKAa

A

Mepivacaine: 2-4 min onset

35
Q 
Which of the following is NOT an ester?
A. Cocaine
B. Lidocaine
C. Procaine
D. Tetracaine
E. Benzcaine
A

B. Lidocaine is an amide

all the amides have two “I”s in their name

36
Q

Name the 3 amides

A

Lidocaine
Mepivacaine
Bupivacaine

37
Q

Ester with short duration of action

A

Procaine

38
Q

Ester used only topically

A

Benzocaine

39
Q

Cocaine has ___ duration of action

A

medium

40
Q

Tetracaine has ___ duration of action

A

long

41
Q

Lidocaine and mepivacaine have ___ duration of action

A

medium

42
Q

Bupivacaine has ___ duration of action

A

long

43
Q 
Which of the following LA is NOT used topically?
A. Benzocaine
B. Mepivacaine
C. Lidocaine
D. Tetracaine
A

B

44
Q 
Which TWO of the following LA is used via infiltration of peripheral nerve ending?
A. Lidocaine
B. Mepivacaine
C. Benzocaine
D. Tetracaine
A

A, B

C. Benzocaine is only used topically

45
Q 
Which TWO of the following LA is used as nerve block? 
A. Lidocaine
B. Mepivacaine
C. Benzocaine
D. Tetracaine
A

A, B

46
Q 
Which of the following is used epidurally?
A. Bupivacaine
B. Mepivacaine
C. Lidocaine
D. Tetracaine
A

A

47
Q 
Which TWO of the following LA is used via spinal? 
A. Bupivacaine
B. Mepivacaine
C. Lidocaine
D. Tetracaine
A

A, D

48
Q 
Which TWO of the following LA is used cadually?
A. Bupivacaine
B. Mepivacaine
C. Lidocaine
D. Tetracaine
A

A, C

49
Q

T/F: Epinephrine slows absorption of LA which allows us to give more LA without getting high blood concentrations.

A

True

50
Q

Effective treatment of LA toxicity

A

Intralipid IV administration: Chelates LA and takes it away from blood concentration

51
Q

Area of slowest absorption of LA

A

Subcutaneous

52
Q

Which of the following is TRUE about procedural sedation?
A. It is a loss of consciousness induced by medication
B. Response to verbal and/or stimulation is not preserved
C. Airway reflexes, latency and cardiopulmonary function are preserved.
D. Used for surgery on extremities.

A

C.

A. REDUCED level of consciousness
B. Response to verbal and/or stimulation is preserved
D. Used to facilitate diagnostic or therapeutic procedures

53
Q

T/F: Propofol has short context-specific half life

A

True. Thus have least hangover effect

54
Q

T/F: Propofol is used as a procedural anesthetic and an induction agent

A

True

55
Q

T/F: Midazolam is used as a procedural anesthetic and induction anesthetic.

A

False. Procedural anesthetic and premedication agent

56
Q

The effect of Midazolam is reversed by ___

A

Flumazenil

57
Q

T/F: Midazolam is a anxiolytic and hypnotic.

A

False. Anxiolytic and amnestic

58
Q

The effects of Fentanyl are reversed by ____

A

Naloxone

59
Q

T/F: Fentanyl has a short context-specific half-life.

A

False. Prolonged b/c its lipophilic, so its absorbed into fat.

60
Q

T/F: Fentanyl causes respiratory depression

A

True

61
Q

Fentanyl belongs to what class of drugs?

A

Opioid

Used as procedural anesthetic

62
Q

Name the drug:

Ultra-short acting opioid used as a procedural anesthetic that most often has to be administered as an infusion.

A

Remifentanil

63
Q

The effects of Remifentanil are reversed by ____

A

Naloxone

64
Q

Higher doses of Remifentanil will cause ___

A

Chest rigidity and respiratory depression

65
Q

T/F: Ketamine can be used as a procedural anesthetic and causes minimal respiratory depression and indirect sympathetic stimulation.

A

True. Its an NMDA receptor antagonist

66
Q

Side effect of Ketamine (2)

A

Sialorrhea: excessive oral secretions

Hallucinations

67
Q

Which of the following about Dexmedetomidine is FALSE?
A. Its an alpha-2 agonist
B. Causes minimal respiratory depression
C. Side effects cause tachycardia and hypertension
D. Has some analgesia effects

A

C. Bradycardia, hypotension

Dexmedetomidine used as procedural anesthetic.

MOHD4: Exam 4 Drugs (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions