Brainscape's Knowledge GenomeTM

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


See full index

Anesthesia Pharm > Anesthesia Pharm Test 1 Part 2 > Flashcards

Anesthesia Pharm Test 1 Part 2 Flashcards

1
Q

what are the most popular benzos for IV anesthetics

A
  1. diazepam 2. lorazepam 3. midazolam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

structure of benzos

A

heterocyclic ring structure with benzene & diazepene ring

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

_________________ is the one benzodiazepine that has a imidazole ring as primary structure allowing it to dissolve in aqueous solutions

A

midazolam

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

midazolam undergoes conformational change once in the blood stream making it more _________________

A

lipophillic

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

_________________ rose to popularity for their anterograde amnesia, anxiolytic, and sedative effects with miminal s/e

A

benzodiazepines

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

which benzo has the greatest incidence of causing phlebitis

A

diazepam

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

benzos are highly _________________, and ___________________ protein bound

A

lipophilic; highly

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

metabolism of benzodiazepines

A

liver via CYP450

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

excretion of bz

A

renal

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

MOA of benzodiazepines

A

bind to allosteric site of GABA-A receptor in the cortex and brainstem causing Cl- channels to open more frequently

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

CNS effects of benzos

A
  1. dose dependent CNS effect 2. small amount of centrally mediated muscle relaxation 3. higher dose = sedation 4. lower dose = anxiolytic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CV effects of benzo

A
  1. induction dose –> decrease of SVR and BP 2. otherwise HD stable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

respiratory effects of benzos

A
  1. depress upper airway reflexes (esp with other sed/opioids) 2. caution in those with OSA/compromised airway
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

benzos are primarily used for what

A

pre-medication for sedation

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

which drug is primarily used as pre-medication for sedation

A

midazolam

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

what drug is typically used as a first line therapy for status epilepticus

A

lorazepam

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

for peds, if you give midazolam pre-procedure you give ________ mg/kg via __________ route, _________ min prior to procedure

A

0.5; p.o; 30

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

s/e of benzos

A
  1. irritation and phlebitis 2. delirium in elderly and critically ill
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

_______________ is a benzodiazepine reversal agent

A

flumazenil

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

MOA of flumazenil

A

competitive antagonist with high affinity to the “benzo” receptor site on the GABA-A receptor

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

dose of flumazenil

A

administer 0.2 mg then redose at 0.1 mg as needed

22
Q

typically ________ mg of flumazenil is enough to reverse sedation, but you may need ___________ mg to reverse bz toxicity

A

1; 3

23
Q

flumazenil will act within __________ min and has a duration of action of __________ min

A

1-2; 45-90

24
Q

c/i of flumazenil

A
  1. seizure d/o 2. Bz dependance
25
Q

T/F: flumazenil has a short 1/2 when compared to bz

A

TRUE

26
Q

propofol “SHARP LAD”

A
  1. stimulates GABA 2. hypotension 3. antiemetic qualities 4. respiratory depression 5. pain on injection 6. lipid soluble 7. avoid in allergies 8. decreases CBF and ICP
27
Q

what is the most widely used IV anesthetic drug

A

propofol

28
Q

T/F: propofol is recognized as “essential medicine”

A

TRUE

29
Q

what feature of propofol allows for “fast-on, fast-off”

A

highly lipophillic structure

30
Q

propofol is formulated as an emulsion of ?

A

soybean oil, glycerol, and egg lecithin

31
Q

all vials of propofol are single use and syringes should be discarded after __________ hours, and vials after __________ hours

A

6; 12

32
Q

propofol formulation adds what preservatives to reduce the infection risk in the vial?

A

ETDA + sodium metabisulfite or benzyl alcohol

33
Q

propofol is metabolized in the liver by _____________, _____________, & ______________

A

CYP2B6; UGTHP4; CYP2C6

34
Q

plasma clearance of propofol is high and exceeds hepatic blood flow, therefore ____________________ metabolism is vital

A

extra-hepatic sites of

35
Q

what are the extrahepatic sites of metabolism for propofol

A

lungs and kidneys

36
Q

MOA of propofol

A

allosterically binds to GABA-A in brainstem and cortex increases the receptor affinity for GABA (thus increasing more GABA to the bind to the receptors)

37
Q

which IV anesthetic can cause a total isoelectric EEG with higher dose

A

propofol

38
Q

CNS effects of propofol

A
  1. dose dependent anxiolysis 2. sedation 3. amnesia 4. lowers CMRO2, ICP, and CPP 5. aniemetic effect 6. anti-epileptic effect
39
Q

__________________ is used as neuroprotective agent when combined with other agents

A

propofol

40
Q

CV effects of propofol

A

induction –> decrease BP, MAP, and CO

41
Q

respiratory effects of propofol

A
  1. bronchodilatory 2. dose dependent apnea 3. decreases TV and response to hypoxia/hypercarbia
42
Q

T/F: in diprivan there is a preservative than can predispose pts to bronchospasm

A

false; only in generic propofol is there a preservative that predisposes to bronchospasm, not diprivan

43
Q

uses of propofol

A
  1. induction of anesthesia 2. TIVA 3. sedation 4. PONV
44
Q

induction dose of propofol for adults

A

1-2.5 mg/kg

45
Q

induction dose of propofol in children

A

2.5-3.5 mg/kg

46
Q

infusion rate of propofol for TIVA

A

100-200 mcg/kg/min

47
Q

infusion rate of propofol for sedation

A

25-75 mcg/kg/min

48
Q

dose of propofol infusion for PONV prevention

A

10-30 mcg/kg/min

49
Q

s/e of propofol

A
  1. pain on injection 2. allergic response 2/2 egg lecithin 3. PRIS
50
Q

PRIS is seen in icu patients on propofol at dose of > ________ mg/kg/hr for more than ___________ hours

A

4; 48

Anesthesia Pharm (18 decks)

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