anesthetics

Question 1

susceptibility of nerve fiber types to local anesthetics

Answer 1

smaller, myelinated, high firing frequency fibers are blocked first
Type B( preganglionic autonomics) and C (pain) fibers have high sensitivity

Question 2

Benzocaine

Answer 2

topical agent only

anesthetic lubricant

Question 3

Bupivacaine

Answer 3

long duration and prolonged anesthesia

more sensory than motor block

Question 4

cocaine

Answer 4

topical anesthetic of upper respiratory tract

blockade of nerve impulses and local vasoconstriction actions

Question 5

dibucaine

Answer 5

topical cream only due to toxicity with injections

Question 6

lidocaine

Answer 6

amide local anesthetic
faster, more intense, longer lasting and extensive anesthesia
used as anti arrhythmic agent

Question 7

Procaine

Answer 7

lower potency, onset and duration of action
used only for infiltration anesthesia
met to para-aminobenzoic acid which inhibits action of sulfonamide abx

Question 8

MAC

Answer 8

minimal alveolar conc

ED50

Question 9

Potency

Answer 9

1/MAC

lower the MAC the greater the potency

Question 10

Toxicity of inhaled anesthetics

Answer 10

nausea
Halothane causes hepatitis
agents met to fluoride ions cause renal toxicity (enflurane and sevoflurane)
in combo with succinylcholine, causes malignant hyperthermia

Question 11

etomidate

Answer 11

rapid onset and recovery
less rapid recovery compared to propofol
decreases cerebral blood flow
CV stability
decreased steroidogenesis and muscle movements
not analgesic
causes adrenal cortical suppression by inhibitor of 11B hydroxyls

Question 12

ketamine

Answer 12

moderately rapid onset and recovery
catatonia, amnesia and analgesic w/without loss of consciousness 
CV stimulation 
increased cerebral blood flow
emergence reactions

Question 13

methohexital

Answer 13

rapid onset and recovery
for short ambulatory procedures
barbiturate

Question 14

midazolam

Answer 14

slow onset and recovery
used in balanced anesthesia and conscious sedation
CV stability and amnesia

Question 15

Propofol

Answer 15

rapid onset and recovery
induction and maintenance 
not analgesic
causes hypotension due to vasodilation
useful antiemetic action
possible allergy 
low hangover effect
decreased cerebral blood flow
respiratory depressant

Question 16

thiopental

Answer 16

rapid onset and recovery
bolus does have slow recovery following infusion
standard induction agent 
CV depression 
avoid in porphyrias

Question 17

fentanyl

Answer 17

slow onset and recovery
naloxone reversal 
marked analgesia 
conscious sedation 
opioid used in balanced anesthesia

Question 18

fospropofol

Answer 18

water soluble pro-drug of propofol
onset and recovery are prolonged
less pain on administration
parasthesias and pruitius in inguinal region common side effect

Question 19

dexmedetomidine

Answer 19

alpha2 agonist that produces hypnosis and analgesic
physiologic sleep state through activation of endogenous sleep pathways
moderate decrease in HR and SVR
used for short term intubation of ICU pts

Question 20

Opioid analgesics

Answer 20

used in combo with benzos
fentanyl
sufentanil
remifentanil
morphine

Question 21

Barbiturates

Answer 21

Thiopental 
methohexital
quick plasma:brain equilibrium 
respiratory depression
induce cyp450

Question 22

benzodiazepines

Answer 22

diazepam
lorazepam
midazolam (water soluble)
used in perioperative period due to anxiolytic

Question 23

flumazenil

Answer 23

benzodiazepine antagonist

Question 24

NO

Answer 24

incomplete anesthetic

rapid onset and recover

Question 25

desflurane

Answer 25

low volatility

poor induction agent and rapid recovery

Question 26

sevoflurane

Answer 26

rapid onset and recovery

Question 27

isoflurane

Answer 27

medium rate of onset and recovery

Question 28

enflurane

Answer 28

medium rate of onset and recovery

Question 29

halothane

Answer 29

medium rate of onset and recovery

heptotoxicity