General Anesthetics

Question 1

What is the mechanism of action of Anaesthetics?

Answer 1

Main site is reticular formation (maintains consciousness)
Other include
1. GABA(A) receptor to inhibit GABA
2. Inhibit nicotinic receptors
3. Antagonism of excitatory glutamic acid on N-methyl-D-aspartate receptor
4. Strychnine-sensitive glycine receptor

Question 2

What’s the relationship between onset of anesthesia and partial pressure of gas?

Answer 2

Direct. The higher the partial pressure, the faster the onset of anesthesia

Question 3

What’s the relationship between blood solubility and onset of anesthesia?

Answer 3

Indirect. The greater the solubility in blood, the slower the onset of anesthesia.

Question 4

Relation between onset of anesthesia and ventilation?

Answer 4

Direct. The greater the ventilation, the greater the onset of anaesthesia.

Question 5

Relation between pulmonary blood flow and onset of anesthesia?

Answer 5

Indirect. The higher the pulmonary blood flow, the slower the onset of anaesthesia.

Question 6

The rate of recovery from anesthesia is greater in low or high blood gas solubility?

Answer 6

Low blood gas solubility

Question 7

What’s the relationship between MAC and potency

Answer 7

Indirect. The greater the mac, the less potent.

Question 8

Which inhalation Anesthetics decrease cardiac output?

Answer 8

1. Enflurane
2. Halothane

Question 9

Which inhaled anesthetics cause peripheral vasodilation?

Answer 9

1. Sevoflurane
2. Desflurane
3. Isoflurane

Question 10

Which anesthetic is a pulmonary irritant and may cause bronchospasm?

Answer 10

Desflurane

Question 11

Toxicities of inhaled anesthetics?

Answer 11

1. Hepatitis
2. Renal insufficiency
3. Megaloblastic anemia
4. Milagnant hyperthermia

Question 12

What drug is used to treat malignant hyperthermia?

Answer 12

Dantrolene

Question 13

What is the name of the prodrug of propofol? Which enzyme converts it to propofol?

Answer 13

1. Fospropofol
2. Alkaline phosphatase

Question 14

Respiratory depression caused by opioids can be reversed by what?

Answer 14

Naloxone

Question 15

What is etomidate?

Answer 15

Imidazole derivative with minimal change in cardiac and respiratory rate and has a short duration of action.

Question 16

Prolonged administration of etomidate can lead to suppression of what?

Answer 16

Adrenal suppression

Question 17

Name an alpha 2- adrenergic agonist used for general anesthesia that decreases dosage requirement for both inhaled and IV anesthesia.

Answer 17

Dexmedetomidine

Question 18

Name the barbiturates used as anesthetics.

Answer 18

Thiopental
Methohexital
Thioamylal

Question 19

Which benzodiazepine is used as an anesthetic?

Answer 19

Midazolam

Question 20

What is the mechanism of action if dissociative anesthetic, ketamine?

Answer 20

Blocks excitation by gultamate at NMDA receptors.

Question 21

Name an anesthetic drug from the subclass imidazole.

Answer 21

Etomidate

Question 22

Which opioids can be used for general anesthesia?

Answer 22

1. Fentanyl
2. Alfentanil
3. Femifentanil
4. Morphine

Question 23

Which phenols are used for general anaesthesia?

Answer 23

1. Propofol
2. Fosoprpofol

Question 24

Thiopentone sodium is used for what?

Answer 24

1. Anti convulsants
2. Anesthesia
3. Narcoanalysis in psychiatry

Question 25

What are the adverse effects of thiopentone sodium?

Answer 25

1. Acute intermittent porphyria
2. Gangrene of the arm
3. Laryngospasm

Question 26

Uses of ketamine in preanesthetic medication?

Answer 26

1. Relieve pre and post operative pain
2. Reduce anxiety
3. Reduce saliva, to prevent vagal bradycardia
4. Prevent vomiting
5. Prevent stress ulcers