Exam 2 Stoetling's Book Etomidate questions Flashcards
What is etomidate?
A. A barbiturate
B. A carboxylated imidazole–containing compound
C. A steroid
D. A benzodiazepine
Answer: B
What is the original formulation of etomidate?
A. A fat emulsion
B. Water soluble at an acidic pH
C. A single isomer
D. 35% propylene glycol (pH 6.9)
Answer: D
What is the mechanism of action of etomidate?
A. It binds directly to opioid receptors
B. It enhances the affinity of the excitatory neurotransmitter for GABAA receptors
C. It modulates other ligand-gated ion channels in the brain
D. It enhances the affinity of the inhibitory neurotransmitter for GABAA receptors
Answer: D
What is the volume of distribution (Vd) of etomidate?
A. Small, suggesting little tissue uptake
B. Large, suggesting considerable tissue uptake
C. Moderate, suggesting moderate tissue uptake
D. None of the above
Answer: B
How is etomidate metabolized?
A. By hepatic microsomal enzymes and plasma esterases
B. By hydrolysis of the ethyl ester side chain to its carboxylic acid ester
C. By recovery of unchanged drug in urine
D. Both A and B
Answer: D
How does cardiopulmonary bypass affect the plasma etomidate concentration?
A. It has no effect
B. It increases the plasma etomidate concentration
C. It decreases the plasma etomidate concentration
D. It causes a fluctuation in the plasma etomidate concentration
Answer: C
Etomidate is commonly used for:
A) inducing anesthesia
B) treating pain
C) treating anxiety
D) reducing inflammation
Answer: A) inducing anesthesia
What is the recommended standard induction dose of etomidate?
A) 0.2 to 0.4 mg/kg IV
B) 1 to 2 mg/kg IV
C) 0.5 to 1 mg/kg IV
D) 0.1 to 0.2 mg/kg IV
Answer: A) 0.2 to 0.4 mg/kg IV
What is a common side effect of etomidate during the induction period?
A) Hallucinations
B) Nausea and vomiting
C) Involuntary myoclonic movements
D) Respiratory depression
Answer: C) Involuntary myoclonic movements
How does prior administration of an opioid affect myoclonic-like activity during the induction period with etomidate?
A) It has no effect
B) It increases the frequency of myoclonic-like activity
C) It decreases the frequency of myoclonic-like activity
D) It causes respiratory depression
Answer: C) It decreases the frequency of myoclonic-like activity
How does the duration of action of etomidate change with increasing dose or continuous infusion?
A) It becomes shorter
B) It becomes longer
C) It stays the same
D) It becomes unpredictable
Answer: B) It becomes longer
Does etomidate provide analgesia?
A) Yes
B) No
C) Only in high doses
D) Only in combination with an opioid
Answer: B) No
What is the principal limiting factor in the clinical use of etomidate for induction of anesthesia?
A) Nausea and vomiting
B) Respiratory depression
C) Adrenocortical suppression
D) Allergic reactions
Answer: C) Adrenocortical suppression
Is postoperative nausea and vomiting more common in patients receiving etomidate compared to propofol?
A) Yes
B) No
C) It depends on the patient’s age
D) It depends on the type of surgery performed
Answer: B) No
What is the primary effect of etomidate on the Central Nervous System?
A. Increases cerebral blood flow and CMRO2
B. Suppresses adrenocortical function
C. Decreases cerebral blood flow and CMRO2
D. Activates seizure foci
Answer: C
What is the cardiovascular effect of induction of anesthesia with 0.3 mg/kg IV of etomidate?
A. Minimal changes in heart rate, stroke volume, and cardiac output
B. Significant decrease in systemic blood pressure and cardiac output
C. Significant decrease in heart rate, stroke volume, and cardiac output
D. Significant increase in systemic vascular resistance
Answer: A
What is the effect of etomidate on myocardial contractility?
A. Etomidate has no effect on myocardial contractility
B. Etomidate causes dose-dependent increases in developed tension in isolated cardiac muscle
C. Etomidate causes dose-dependent decreases in developed tension in isolated cardiac muscle
D. Etomidate causes irreversible depression in developed tension in isolated cardiac muscle
Answer: C
What is the effect of etomidate on ventilation?
A. Etomidate causes significant apnea
B. Etomidate has no effect on ventilation
C. Etomidate may stimulate ventilation independently of the medullar centers that normally respond to carbon dioxide
D. Etomidate causes transient decreases in tidal volume and frequency of breathing
Answer: D
What is the common excitatory effect of etomidate?
A. Dystonia
B. Tremor
C. Myoclonus
D. Seizures
Answer: C
