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Brain and Behavior II > Anesthesia Review > Flashcards

Anesthesia Review Flashcards

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1
Q

What class of drug is thiopental?

A

Barbiturate

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2
Q

The electrical potential at which the sodium channel goes from the closed to the open state is also known as?

A

Threshold potential

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3
Q

Do local anesthetics work at the internal or external membrane of the sodium channel?

A

Internal membrane

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4
Q

Thiopental is a strong base or strong acid?

A

Strong acid

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5
Q

Which intravenous anesthetic also has a post-operative effect against nausea/vomiting (anti-emetic properties)?

A

propofol

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6
Q

The unconsciousness induced by inhaled anesthetics is reversible or non-reversible?

A

Reversible

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7
Q

Ketamine is most like what drug?

A

PCP

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8
Q

What is the treatment for local anesthetic toxicity?

A

Intralipid

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9
Q

True or False: Local anesthetics do not block sympathetic nerve

A

FALSE

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10
Q

What is the effect of inhaled anesthetics on EEG?

A

“flatten it” isoelectric EEG

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11
Q

What disease is associated with inhaled anesthetics that increase the patient’s temperature and may result in death?

A

Malignant hyperthermia

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12
Q

Which inhaled anesthetic is least soluble in blood?

A

Desflurane

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13
Q

Which intravenous anesthetic resulted in more deaths at Pearl Harbor than the actual attack?

A

Thiopental

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14
Q

Emergence from inhaled anesthetics depends on which: elimination or metabolism?

A

Elimination

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15
Q

Which local anesthetic has more rapid onset: Bipivucaine (pKa= 8.1); Lidocaine (pKa=7.9)

A

Lidocaine (pKa is closer to that of body’s pH)

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16
Q

Which induction agent is contraindicated in patients with egg allergy?

A

propofol

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17
Q

Which intravenous anesthetic has minimal effects on cardiovascular system?

A

Etomidate

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18
Q

For which of the following drugs is the MOA clear: intravenous anesthetics, inhaled anesthetics, local anesthetics?

A

local anesthetics

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19
Q

Rapid induction of anesthesia is achieved with an inhaled or intravenous anesthetic?

A

Intravenous

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20
Q

Maintenance of anesthesia occurs typically with an inhaled or intravenous anesthetic?

A

Inhaled

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21
Q

What hair color increases MAC?

A

Red

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22
Q

What is the effect of inhaled anesthetics on minute ventilation?

A

Goes down

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23
Q

For the inhaled anesthetics, speed of onset is determined by which property?

A

Blood solubility

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24
Q

What gas is typically administered for analgesia?

A

Nitrous oxide (used a lot in labor)

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25
Q

What is the effect of inhaled agents on uterine tone?

A

decreases uterine tone

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26
Q

What does injection of intravenous opioids do to MAC?

A

decreases (i.e. when given opioids, you don’t need as much anesthetic)

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27
Q

What do inhaled anesthetics do to the body’s response to low blood oxygen?

A

Depresses this response

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28
Q

What do inhaled agents do to bronchomotor tone?

A

Relax it

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29
Q

What do inhaled agents do to cerebral blood flow?

A

Increases it (this is why increased cranial pressure is a contraindication)

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30
Q

The inhaled agents are supplied from the manufacturer in what form?

A

Liquid

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31
Q

What class of drugs are the inhaled anesthetics?

A

Ethers

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32
Q

For the termination of a drug’s effect, which is more important: redistribution or elimination?

A

Redistribution

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33
Q

What drug is contraindicated in patients with acute intermittent porphyria?

A

Thiopental

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34
Q

What does propofol do to cerebral blood flow?

A

Decreases it

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35
Q

What is the amount of IV anesthetic to prevent awareness?

A

We don’t know

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36
Q

Which IV anesthetic can also be given IM

A

ketamine (we use it for patients that have no IV access)

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37
Q

In addition to potassium chloride and pancuronium (sp?), which IV anesthetic is used for lethal injection?

A

Thiopental

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38
Q

Thiopental causes hypotension by myocardial depression and…?

A

Vasodilation

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39
Q

The term for the concept that the longer you infuse a drug, the longer it takes to eliminate?

A

Context-sensitive half-life

40
Q

The term for how drugs get to the effect site

A

Pharmacokinetics

41
Q

The term for drug effect as a result of receptor binding

A

Pharmacodynamics

42
Q

What is the most common cause of death among anesthesiologists under 35

A

substance abuse

43
Q

Give an example where EMLA ointment would be used?

A

lumbar puncture in pediatric patients

44
Q

Which local anesthetic is also used as an anti-arryhthmic?

A

lidocaine

45
Q

Which of the following OTC drugs contains a local anesthetic: hydrocortisone; Tylenol PM; Bactim; Milk of magnesia

A

Bactim

46
Q

What agent is added to a local anesthetic to prolong the duration of blockade?

A

Epinephrine

47
Q

When a certain area receives anesthetic and this area does not respond to natural stimuli, this is also known as?

A

Regional Anesthesia

48
Q

What property of a local anesthetic influences its duration?

A

lipid solubility (also determines its potency)

49
Q

What protein channel do local anesthetics work on?

A

Sodium channels

50
Q

Which of the two stereoisomers of buvivicaine (sp?) is more cardiotoxic?

A

R enantiomer

51
Q

What type of local anesthetic is cocaine?

A

Ester

52
Q

Inhaled anesthetics have been linked to the progression of which disease in adults?

A

Alzheimer’s Disease

53
Q

The populational variance of inhaled anesthetics is large or small?

A

Small

54
Q

Induction of anesthesia occurs at the beginning, middle, or end of anesthesia?

A

Beginning

55
Q

The concentration of inhaled anesthetic necessary to prevent awareness is higher or lower than the amount needed to movement to pain?

A

Lower

56
Q

Which inhaled anesthetic has the highest MAC?

A

Desflurane

57
Q

Why is propofol used for sedation in the ICU?

A

it’s quickly reversible

58
Q

Which induction agent is also metabolized in the lungs and small intestine?

A

Propofol

59
Q

Which local anesthetic was first used for surgery?

A

Cocaine

60
Q

Which local anesthetic is more rapidly metabolized when injected intravenously?

A

Esters

61
Q

Which organ metabolizes amide local anesthetics?

A

Liver

62
Q

Is there an antagonist to the inhaled anesthetics?

A

No

63
Q

Which depends on drug metabolism: distribution half-life or elimination half-life

A

Elimination half-life

64
Q

Propofol potentiates the effects of which neurotransmitter?

A

GABA

65
Q

The primary termination of clinical effectiveness in local anesthetics is what?

A

Redistribution half-life

66
Q

Local anesthetics bind to which configurations of the sodium channel?

A

Open and inactive

67
Q

The aromatic ring of the local anesthetic is hydrophilic or lipophilic?

A

Lipophilic

68
Q

Which local anesthetic has greater potential for allergic reaction?

A

Ester (one I in generic name)

69
Q

Which intravenous anesthetic does not depress respiration?

A

Ketamine

70
Q

Which will achieve a peak level first: inhaled or intravenous anesthetics?

A

Intravenous

71
Q

Inhaled anesthetics has been linked to the progression of which disease in kids?

A

Developmental delay (learning disability)

72
Q

In the resting state, the sodium channel is in what configuration?

A

Closed

73
Q

What is the first symptom of toxicity from lidocaine?

A

Numbness of tongue

74
Q

Which local anesthetic causes vasoconstriction?

A

Cocaine

75
Q

Inhaled anesthetics with a low blood solubility will have a slow or fast onset of action?

A

Fast

76
Q

Which anesthetic agent would be best for someone scheduled to go home?

A

Propofol

77
Q

When the entire body does not respond to noxious stimuli, that’s also known as?

A

General Anesthesia

78
Q

What is the breakdown product of ester local anesthetics?

A

Para-benzoic acid (PABA)

79
Q

Which IV anesthetic increases intracranial pressure?

A

Ketamine

80
Q

Which organ is the primary site of metabolism for IV anesthetics?

A

liver

81
Q

Do inhaled agents provide analgesia?

A

Yes

82
Q

What do local anesthetics bind in the blood?

A

Albumin and alpha-1 glycoprotein

83
Q

What is the effect of inhaled anesthetics on blood pressure?

A

Decreases it

84
Q

Which IV anesthetic increases ICP and cerebral blood flow?

A

Ketamine

85
Q

Local anesthetics are weak acids or weak bases?

A

Weak bases

86
Q

The pKa of a local anesthetic determines what of the anesthetic?

A

The speed of onset

87
Q

Name the two intermediate chains of local anesthetics

A

esters and amides

88
Q

What is the term for the concentration of vapor that prevents movement and response to surgical incision in 50% of population?

A

MAC: minimum alveolar concentration

89
Q

Which term describes an unaware patient who does not respond to pain?

A

anasthesia

90
Q

Which of the following organs has the greatest uptake of local anesthetic following accidental IV injection: stomach, brain, muscle, skin?

A

brain

91
Q

Which IV anesthetic has analgesic properties?

A

Ketamine

92
Q

What determines speed of onset of inhaled anesthetics, assuming same concentration and minute respiration?

A

Blood solubility

93
Q

What is the effect of inhaled anasthetics on temperature?

A

Decreases it

94
Q

What property of a local anesthetic influences its potency?

A

Lipid solubility

95
Q

Which IV anasthetic causes adrenocortical suppression?

A

Etomidate

96
Q

What enzyme hydrolyzes ester local anasthetics?

A

pseudocholinesterase

97
Q

True/False: Anti-histamines have sedative hypnotic effect?

A

TRUE

Brain and Behavior II (3 decks)

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