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ANESTHESIA : Hall > CH3 INTRAVENOUS DRUGS > Flashcards

CH3 INTRAVENOUS DRUGS Flashcards

1
Q

Bradycardia in children secondary to SUX is due to ?

A

muscaric stimulation in the sinus node of the heart

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2
Q

succinylcholine induced tachycardia in adult is secondary to?

A

histamine release

stimulation of autonomic ganglia

post junctional cardiac muscarinic receptors

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3
Q

side effect of sux?

A 
hyperkalemia 
MH
masseter spasm
bradycardia
myalgia
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4
Q

sux contraindicated for routine intubation in children?

true or false

A

true

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5
Q

orbicularis oculi is same with

A

laryngeal muscle

diaphragm

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6
Q

onset of NMB

most sensitive to least sensitive

A

larynx
diaphragm
OO
Adductus policis

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7
Q

RECOVERY NMB

first to last

A

larynx
oo=diaphragm
AP

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8
Q

volatile anesthetics
______ NMB and
_______ reversal agents

A

volatile anesthetics
potentiates NMB and
slowed / retard reversal agents

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9
Q

Maoi + meperidine /methadone/tramadol can cause

A 
SEROTONIN SYNDROME 
agitation
skeletal muscle rigidoty
hyperpyrexia
hypotension 
respi dec 
coma
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10
Q

Risk factor for emergence delirium

A

younger than 5
volatile=sevoflurane
ent optha cases
anxious parents

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11
Q

ETOMIDATE adverse effect

A 
PONV - Highest /most common
pain
thrombophlebitis
myoclonic movement
hiccups
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12
Q

Pancuronium inc hr bp and co because?

A

moderate vagolytic effect
norepi release
dec reuptake of NE by adrenergic nerve

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13
Q

DANTROLENE
prevention of MH
control skeletal muscle spasticity

MOA

A

dec amount Calcium releases by the sarcoplasmic reticulum

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14
Q

DATROLENE most common SIDE EFFECT

A

muscle weakness -mc

nausea
diarrhea
blurred vision

iv diuresis ( mannitol to make iv) 
orally given - hepatitis and pleural effusion
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15
Q

DISULFIRAM

A

ALTERS metabolism of alcohol by irreversibly inactivating the enzyme aldehyde dehydrogenase

alcohol sensitivity up to 24 hrs

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16
Q

NALTREXONE

A

tx of alcohol addiction
combination with disulfiram

pure opiod anatgonist

prior to surgery:
inc requirement of opioids
STOPPED PRIOR TO OR

duration 24hrs

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17
Q

RSI NMB

A

sux

rocuronium

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18
Q

priming means

A

10 % of the intubating dose is followed 2-4 minutes by the 90 percent

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19
Q

NMB TERMINATES By

A

diffusiin of drug back inti the plasma

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20
Q

buprenorphine

A

agonist-antagonist
very strong affinity to mu receptor
slow dissociation from the receptor mlonger action
resistance to NALOXONE

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21
Q

vasodilator of pulmonary tree

no EFFECT IN systemic circulation

A

nitric oxide

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22
Q

sux metabolism? termination?

A

metabolism : psuedocholinesterase

termination:
diffusion to the extracellur fluid

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23
Q

DEXMEDTOMIDINE

A 
Highly selective a2 agonist
rapid onset 5min
peak at 15 mins
dec hr and co ( profouns cardiac arrest)
respi mnimal

1-2 mcg/kg/min
mild tv change
no change in rr

greater
paco2 inc

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24
Q

FOSPROPOFOL

A 
water soluble
converted to propofol 
no pain 
no risk for hypertriglyceridemia
pulmo embolism
risk of sepsis
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25
Q

CHRONIC MSO4 develop tolerance after 2-3 weeks

A

analgesia
respi depressiin
nausea
euphoria

except
miosis and
constipation

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26
Q

CIMETIDINE impairs the metabolism of ?

A

LIDOCAINE
PROPANOLOL
DIAZEPAM

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27
Q

tx for organophosphate poisoning

A

atropine 2mg-6mg q5-10mins
pralidoxime 600mg
benzodiazepine

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28
Q

ALFENTANIL

A

less potent
more rapid onset
shorter duration

alfatenail ALang KWENTA

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29
Q 
most to least potent ? 
fentanyl
alfentanil
sulfafentanyl
remifentanil
mso4
A 
sufentanyl
remifentnayl
fentanyl
alfafentanil
mso4
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30
Q

BURN :

succinyl cause HYPERKALEMIA

A

first 24 hrs - safe

hyperkalemia peak at 7-10days starts at 2nd day

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31
Q

Clonidine dose for anti shivering

A

75mcg iv

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32
Q

Fentanyl
chest rigidity
treatment with

A

sux

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33
Q

nueroleptic malignant syndorme

A

like MH
PT TAKing antipsychotic drugs
dantrolene can be used

txt

amandatine
dantrolene
bromocriptine

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34
Q

MH triggerrd by

A

sux

volatile anesthetics

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35
Q

DIBUCAINE TEST and duration of sux

A

DIBUCAINE NUMER

70-80 ( 5-10 min) normal homo typicL
50-60 ( 20-30min) hetero atypi
20 ( 3 hrs) homo atypi

36
Q

Cyanide poisoning treatment

A

Na nitrite
amyl nitrite
Na thiosulfate
hydroxocobalamin

37
Q 
sedative 
amnestic > sedative 
anterograde amnesia 
anticonvulsant activity
breakdown inhibited by cimetidine
A

MIDAZOLAM

lorazepam
oxazepam not affected by cimitidine

38
Q

POST SHIVERING TX

A 
clonidine
dexmedetomidine
propofol
ketanserine
tramadol
physostigmine 
mgs04
narcotic
39
Q

sugammadex

A

cyclodextrin
encapsulate Non depo STEROIDAL Muscle relaxant
rocu -vecu- pan

NO EFFECT IN BENZYLISOQUINOLINIUM

40
Q

AMRINONE

A

positive initropic
vasodilatory effect
no antidysrhythmic effect

41
Q

REMIFENTANIL metabolize by

A

NONSPECIFIC

PLASMA ESTERASES

42
Q

PAIN WITH IV INJECTION

A

diazepam
etomidate
methohexital
propofol

not with thiopental and ketamine

43
Q

Flumazenil can trigger seizure ? yes or no

A

yes

44
Q

irreversible alpa adrenergic blockade

A

PHENOXYBENZAMINE

45
Q

DANTROLENE

A

mannitol
300mg mannitol /20mg dantrolene cause diuresis

dec calcium

46
Q

Opioid withdrawal

A

short acting 6-12 hrs after last dose

long acting 72-84 hrs of last dose

withdrawal symptoms 5-10days

RESTLESSNESS
anxiety

irritabilitt
abdominal cramps
tremors
jerking

NALOXONE IS CONTRAINDICATED

47
Q

adrenal supression

A

ETOMIDATE

48
Q

thrombosis
phlebitis
spc antagonist

A

DIAZEPAM

49
Q

pain injection

severe hupotension in elderly

A

PROPOFOL

50
Q

increase icp

A

ketamine

51
Q

can cause lactic acidosis

A

PRIS

LACTIC ACIDOSIS
>75mcg/kg/min
>24hrs

earky signs: tachycardia

impaired fatty acid oxidation in the mitochondria

52
Q

alternative for heparin

In pt WITH HIT2

A

direct thrombin inhibitor
hirudin
bivalirudin
agatroban

53
Q

associated with opioid induced hyperalgesia

A

REMIFENTANIL

54
Q

mixed agonist antagonist

A

butophanol
nalbuphine
pentazocine

mu antagonist
k agonist

55
Q

METHADONE is a

A

NMDA ANTAGONIST

reduce opioid tolerance and withdrawal syndrome

56
Q

TAPENTADOL

A

new opioid

munreceptor agonist and NRI

57
Q

NO CHANGE IN MAC

A

hyperthyroid
hypothyroid
gender

58
Q

ANTICHOLINERGIC

A

atropine
scopolamine
glycopyrolate

59
Q

least effective antisialagogue

A

ATROPINE

60
Q

anticholinergic:

produce sedation

A

scopolamine>atropine

tertiary can pass BBB

61
Q

anticholinergic

greatest increase in heart

A

ATROPINE

62
Q

anticholinergic :

mydriasis and cyclopegia

A

scopolamine >atropine

63
Q

Elimination of the following ? Where?

pancuronium
rocuronium
atracurium 
sux 
mivacuriun
A

renal:
pipecuronium
doxacuriun
pancuronium

hepatic and billiary:
vecuronium
rocuronium
d-tubo

plasma hoffman:
atracurium
cisatracuriun

enzyme:
sux
mivacuriun

64
Q

Composition of propofol

A

10% soy bean oil

  1. 25% glycerol
  2. 2% purified egg phosphatide
65
Q

PROPOFOL INFUSION SYNDROME

A 
metab acidodid
cardiac dysfunction
rhabdomyolysus
hypertriglyceride
enlarged liver
renal failure
66
Q

Etomidate can cause…

A

ADRENAL SUPPRESSION

67
Q

DO NOT GIVE _____ with dandrolene.

A

CA CHANNEL BLOCKER

interacts with dabdrolene cause hyperkalemia and myocardial depression

68
Q

Drugs that can produce extrapyramidal effect?

A

droperidol
promethazine
thiethylperazine
meticlopramide

69
Q 
Shat the problem witht following?
parkinsons
myasthenia gravis
myastenic syndrome: Eatin lambert syndrome 
Hungtinton
A

parkinsons - dec dopa

myasthenia gravis -dec ach receptor

Eatin lambert syndrome - dec ach

Hungtinton - dec pseudocholinesterase

70
Q

Can you use sux in patient with Duchenne?

A

it is CONTRAINDICTARD

risk of rhabdomyolysus
hyperkalemia
cardiac arrest

71
Q

sensitivity of the sux with the ff dse?

A

myasthenia gravis - resistant

myasnethia syndrom- sensitive
hungtingtin - sensitive

72
Q

what iv anesthetic cause normal sleep ?

A

DEXMEDETOMIDINE

73
Q

Acute intermittent porphyria

Contraindicated which drugs?

A

etomidate
barbiturates
ketolorac
pentazocine

hydantion anticonvulsant

74
Q

Elimination of the following ? Where?

pancuronium
rocuronium
atracurium 
sux 
mivacuriun
A

renal:
pipecuronium
doxacuriun
pancuronium

hepatic and billiary:
vecuronium
rocuronium
d-tubo

plasma hoffman:
atracurium
cisatracuriun

enzyme:
sux
mivacuriun

75
Q

Composition of propofol

A

10% soy bean oil

  1. 25% glycerol
  2. 2% purified egg phosphatide
76
Q

PROPOFOL INFUSION SYNDROME

A 
metab acidodid
cardiac dysfunction
rhabdomyolysus
hypertriglyceride
enlarged liver
renal failure
77
Q

Etomidate can cause…

A

ADRENAL SUPPRESSION

78
Q

DO NOT GIVE _____ with dandrolene.

A

CA CHANNEL BLOCKER

interacts with dabdrolene cause hyperkalemia and myocardial depression

79
Q

Drugs that can produce extrapyramidal effect?

A

droperidol
promethazine
thiethylperazine
meticlopramide

80
Q 
Shat the problem witht following?
parkinsons
myasthenia gravis
myastenic syndrome: Eatin lambert syndrome 
Hungtinton
A

parkinsons - dec dopa

myasthenia gravis -dec ach receptor

Eatin lambert syndrome - dec ach

Hungtinton - dec pseudocholinesterase

81
Q

Can you use sux in patient with Duchenne?

A

it is CONTRAINDICTARD

risk of rhabdomyolysus
hyperkalemia
cardiac arrest

82
Q

sensitivity of the sux with the ff dse?

A

myasthenia gravis - resistant

myasnethia syndrom- sensitive
hungtingtin - sensitive

83
Q

what iv anesthetic cause normal sleep ?

A

DEXMEDETOMIDINE

84
Q

Acute intermittent porphyria

Contraindicated which drugs?

A

etomidate
barbiturates
ketolorac
pentazocine

hydantion anticonvulsant

85
Q

pre treatment:

self taming
precurarization
priming

A

priming :
non depo -non depo
10 percent

precuri
nond depo- depo

self SSSSS
SSSUX .1/mg/kg
SSSUX 1mg/kg

ANESTHESIA : Hall (6 decks)

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