Anesthesia / Pharmacology

Question 1

Hypersensitivity Types

Answer 1

Type I -IgE antibodies - anaphylaxis, asthma, hay fever, hives, eczema

Type II - IgG and IgM antibody mediated cytotoxic hypersensitvity - blood transfusion reactions

Type III - Immune complex mediated - serum sickness, rheumatoid arthritis, glomerulonephritis, rheumatoid arthritis

Type IV - Cell-mediated hypersensitivity - contact dermatitis, graft rejection

Question 2

Oxymetazoline mechanism

Answer 2

Alpha-1 and Alpha-2 adrenergic receptor agonist

Question 3

Lidocaine Carpule

Answer 3

1% = 10mg / mL
1:100,000 = 0.01mg / mL

Sterile water
Lidocaine (34mg)
Sodium metabisulfite
Epinephrine (0.17mg)

Question 4

Pediatric Airway Considerations

Answer 4

Minimal swelling causes greater reduction in diameter of airway
Large, omega-shaped, floppy epiglottis
Larger tongue
Cricoid ring is narrowest part of the airway
Obligate nasal breathers until ~6 months of age
Larynx is higher and more anterior (C2-C3)
Large occiput, requiring shoulder roll
Fulcrum is from C1-C3 under the age of 8
ETT = (Age in years/4) + 4

Question 5

Esmolol

Answer 5

5mg per 1 minute (max 300mg)
Selective beta blocker
HTN / tachycardia

Question 6

Labetalol

Answer 6

5-10mg per 10 minutes (max 300mg)
Nonselective beta blocker / alpha blocker
Beta : alpha = 3:1 (oral) and 7:1 (IV)
HTN / tachycardia

Question 7

Hydralazine

Answer 7

5-10mg per 15 minutes (max 25mg)
Smooth muscle relaxant
HTN / bradycardia (reflex)

Question 8

Nitroglycerin

Answer 8

Venous dilator at low doses, arterial dilator at high doses
5-10mcg/min per 5 minutes
HTN / bradycardia (reflex)

Question 9

Atropine

Answer 9

Cholinergic antagonist
0.5mg every 2-3 minutes (max 3mg)
Bradycardia

Question 10

Ephedrine

Answer 10

Alpha / beta agonist
2.5mg every 5 minutes (max 50mg)
Hypotension / bradycardia

Question 11

Phenylephrine

Answer 11

Alpha agonist

100 ug every 5 minutes