Anesthetic Part 2

Question 1

prototype of inhalational anesthetics

Answer 1

HALOTHANE

Question 2

can be used in obstetrics when uterine relaxation is
indicated

Answer 2

HALOTHANE

Question 3

HALOTHANE A/E

Answer 3

Cardiac
Malignant hyperthermia

Question 4

blocks release of Ca2+ from the sarcoplasmic reticulum of muscle cells, reducing heat production and relaxing muscle tone

Answer 4

Dantrolene

Question 5

drastic and uncontrolled increase in skeletal muscle oxidative metabolism

Answer 5

Malignanthyperthermia

Question 6

overwhelming capacity to supply oxygen, remove CO2, regulate temp

Answer 6

Malignant hyperthermia

Question 7

not toxic to the liver or kidney becuase of its little metabolism

Answer 7

ISOFLURANE

Question 8

Has an A/E of pungent odor stimulates respiratory reflexes

Answer 8

ISOFLURANE

Question 9

Rarely use for maintenance anesthesia cos its very expensive

Answer 9

DESFLURANE

Question 10

popular for outpatient procedures

Answer 10

DESFLURANE

Question 11

rapid induction, rapid onset and recovery, ↓blood solubility. Ideal to pediatric patients

Answer 11

SEVOFLURANE

Question 12

low pungency = low irritation of airways

Answer 12

SEVOFLURANE

Question 13

least hepatotoxic of all inhalational agents

Answer 13

NITROUS OXIDE

Question 14

It can cause Diffusion hypoxia

Answer 14

NITROUS OXIDE

Question 15

non-irritating potent analgesic, weak general anesthetic

Answer 15

NITROUS OXIDE

Question 16

N2O replaces nitrogen in air spaces faster than the nitrogen leaves → N2O retards oxygen uptake during recovery

Answer 16

Diffusion hypoxia

Question 17

↓blood supply, ↓effect to redistribution

Answer 17

adipose tissue

Question 18

facilitate amnesia while causing sedation

Answer 18

Midazolam

Question 19

Alternative to midazolam

Answer 19

diazepam and lorazepam

Question 20

induces anesthesia, no analgesic activity

Answer 20

ETOMIDATE

Question 21

replaced in most countries because of the availability of
other anesthetics with fewer complications

Answer 21

HALOTHANE

Question 22

Most fatal toxicity by halothane

Answer 22

Hepatic necrosis

Question 23

T/F. If halothane will undergoe oxidative metabolism, it will yield hydrocarbons and some type of halogen which can lead to toxicity.

Answer 23

True

Question 24

What are the toxicities that lead by halogen and hydrocarbons in halogen if undergoe oxidative metabolism?

Answer 24

fever,anorexia,nausea,vomiting,hepatitis

Question 25

Halothane interval

Answer 25

NLT2-3weeks

Question 26

concentration-dependent hypotension

Answer 26

phenylephrine

Question 27

vagomimetic and may cause atropine-sensitive bradycardia

Answer 27

Cardiac, adverse effect of halothane

Question 28

Not use for anesthetic induction but can be use as anesthetic maintenance

Answer 28

Isoflurane and desflurane

Question 29

low fresh gas flow = nephrotoxicity

Answer 29

SEVOFLURANE

Question 30

usually maintained with inhalational anesthetics

Answer 30

IV anesthetic

Question 31

one "arm-brain circulation time"

Answer 31

IV anesthetics

Question 32

high proportion of initial drug bolus goes to cerebral circulation → blood to brain conc gradient → exerts effects

Answer 32

INDUCTION

Question 33

redistribution from the CNS

Answer 33

RECOVERY

Question 34

brain → other tissues with less blood supply (skeletal muscle) → plasma conc falls

Answer 34

RECOVERY

Question 35

Remedy to the reduced CO which leads to compensation

Answer 35

slow titration of the reduced dose for safe induction

Question 36

replaced thiopental (1st choice for induction of general anesthesia)

Answer 36

PROPOFOL

Question 37

IV sedative-hypnotic use for induction and maintenance

Answer 37

PROPOFOL

Question 38

Milky appearance

Answer 38

PROPOFOL

Question 39

ONSET redistribution of propofol

Answer 39

↓plasma levels (2-4 minutes)

Question 40

T/F. In propofol, pharmacokinetics not affected by hepatic or renal failure

Answer 40

True

Question 41

does not provide analgesia thats why its usually administered with narcotics

Answer 41

PROPOFOL

Question 42

No post anesthetic, no post surgery vomiting because of it antiemetic propero

Answer 42

PROPOFOL

Question 43

Its A/E may contribute to severe hypotension in px with hypovolemia or shock

Answer 43

Thiopental

Question 44

Its has an A/E of apnea, coughing, chest wall spasm, laryngospasm, bronchospasm

Answer 44

Thiopental

Question 45

onset<1minute,diffusionrapid

Answer 45

thiopental & methohexital

Question 46

⚬ 15%ismetabolizedintheliver/hour

Answer 46

thiopental & methohexital

Question 47

ultra short-acting with high lipid solubility > potent anesthetic, weak analgesic

Answer 47

Thiopental

Question 48

minimal CV depression but all are respiratory depressants

Answer 48

BZD

Question 49

erythromycin prolongs effects

Answer 49

BENZODIAZEPINES

Question 50

for sedation, induce anterograde amnesia

Answer 50

BENZODIAZEPINES

Question 51

diazepam brand name

Answer 51

Valium

Question 52

Lorazepam brand name

Answer 52

Antivan

Question 53

administered IV, epidurally, intrathecally (CSF)

Answer 53

Opioids

Question 54

Sufentanil and remifentanil derivative

Answer 54

Fentanyl

Question 55

Has an Adverse effects of hypotension, respiratory depression, musclerigidity

Answer 55

OPIOIDS

Question 56

poor water solubility of etomidate

Answer 56

propyleneglycol

Question 57

for px with Coronary Heart Disease

Answer 57

ETOMIDATE

Question 58

Called as dissociative anesthetic

Answer 58

KETAMINE

Question 59

short-acting, nonbarbiturate anesthetic

Answer 59

Ketamine

Question 60

used mainly in children and elder px for short procedures

Answer 60

KETAMINE

Question 61

• causes a dream-like state like PCP

Answer 61

Ketamine

Question 62

sedative used in intensive care settings and surgery

Answer 62

DEXMEDETOMIDINE

Question 63

reduces volatile anesthetic, sedative, and analgesic requirements

Answer 63

DEXMEDETOMIDINE

Question 64

blocksnicotinicAChreceptorsintheNMJ

Answer 64

MOA of neuromuscular blockers

Question 65

abolish reflexes for tracheal intubation and muscle relaxation for surgery

Answer 65

Neuromuscular blocker

Question 66

Lidocaine brand name

Answer 66

Xylocaine

Question 67

blocks nerve conduction of sensory impulses • higher conc, blocks motor impulses

Answer 67

Local anesthetics

Question 68

topical, infiltration, peripheral nerve blocks, neuraxial

Answer 68

Local anesthetics

Question 69

cardiotoxic if administered Iv

Answer 69

Bupivacaine

Question 70

liposome injectable suspension that can give patients post surgical analgesia for 24hrs

Answer 70

Bupivacaine

Question 71

not for OB use becase it increases neonates toxicity

Answer 71

Mepivacaine

Question 72

Metabolism site of amides

Answer 72

Liver

Question 73

Metabolism site of ester

Answer 73

plasma cholinesterase (pseudo cholinesterase)

Question 74

T/F. Alterations of pH is important

Answer 74

True

Question 75

Remedy of too much vasodilation = rapid diffusion away from the site = shorter DOA

Answer 75

epinephrine = minimize toxicity, ↑DOA

Question 76

reported"allergies"effectofepinephrine

Answer 76

Some are psychogenic reactions, ■ urticaria, edema, bronchospasm

Question 77

Treatment to Systemic local anesthetic toxicity which consider altered mental status or Cardiovascular disease

Answer 77

airway mgt, support breathing and circulation, seizure suppression, CPR ( cardiopulmonary resuscitation)

Question 78

Amides drugs

Answer 78

Lidocaine , Bupivacaine, Ropivacaine, Mepivacaine, Prilocaine

Question 79

Esters Drugs

Answer 79

Procaine, tetracaine, cocaine, chloroprocaine

Question 80

short-acting, causes a dream-like state like PCP

Answer 80

KETAMINE