Anethesia/analgesia

Question 1

What is the treatment for dystonic reactions due to neuroleptic medications (haloperidol)?

Answer 1

benztropine

Question 2

What are the classic features of a dystonic reaction?

Answer 2

cholinergic symptoms
-increased salivation
-spasmodic or sustained involuntary contractions of muscles

Question 3

How does quetiapine increase a patient’s risk for aspiration?

Answer 3

it antagonizes dopamine signaling which affects the swallowing mechanism

Question 4

What are risk factors for local anesthetic toxicity?

Answer 4

-extremes of age
-pregnancy
-low body weight
-pre-existing cardiovascular disease

Question 5

What is the PO morphine equivalent of 20mg of PO oxycodone?

Answer 5

30mg morphine PO

Question 6

What is the IV to PO conversion rate of morphine?

Answer 6

1 to 3

Question 7

What is the equianalgesic dose of fentanyl IV to morphine IV?

Answer 7

0.1 - 0.2mg fentanyl to 10mg morphine

Question 8

What is the equianalgesic dose of methadone IV/IM to morphine IV?

Answer 8

1:1

Question 9

What is the equianalgesic dose of methadone PO to morphine PO?

Answer 9

20mg methadone PO is equivalent to 30mg morphine PO

Question 10

What is the equianalgesic dose of dilaudid IV to morphine IV?

Answer 10

1.5mg dilaudid IV is equivalent to 10mg morphine IV

Question 11

What is the equianalgesic dose of methadone PO to morphine PO?

Answer 11

7.5mg dilaudid PO is equivalent to 30mg morphine PO

Question 12

What signs/symptoms are concerning for the onset of malignant hyperthermia?

Answer 12

-tachycardia
-trismus
-masseter muscle spasms
-arrhythmias

Question 13

Why should propofol be avoided in patients with known mitochodrial disease?

Answer 13

propofol infusion syndrome is thought to result from inhibition of mitochondrial enzymes in mitochondria and on their membranes

Question 14

Why is the benzodiazepine antidote flumazenil (anexate) contraindicated for patients who chronically use alprazolam (xanax)?

Answer 14

may precipitate withdrawal seizures