induction agents

Question 1

sedativ and hypnotic properties result from substitutions at the…

Answer 1

2 and 5 carbon atoms of barbaturic acid

Question 2

branched on 5…

Answer 2

greater hypnotic activity than straight chain

Question 3

phenol group on 5…

Answer 3

enhanced anticonvulsant activity

Question 4

methyl radical

Answer 4

pro-convulsive effects

Question 5

oxygen on 2

Answer 5

oxybarbituates

Question 6

sulfur on 2

Answer 6

thiobarbituates, greater lipid solubility, faster onset, greater potency, shorter DOA

Question 7

barbituric acid

Answer 7

malonic acid + urea

Question 8

return of awareness after IV administration reflects…

Answer 8

rapid redistribution to inactive sites

Question 9

distribution depends on…

Answer 9

• lipid solubility (most important)
• protein binding
• degree of ionization
• tissue blood flow

Question 10

EEG small dose

Answer 10

low volt, fast wave activity (1-5 HZ), clouding of consciousness

Question 11

EEG moderate dose

Answer 11

high volt, slow wave activity (<4 Hz), similar to physiologic sleep

Question 12

EEG large dose

Answer 12

1-3 Hz, electrical silence

Question 13

barbs stimulate activity of the mitochondrial enzyme…

Answer 13

D-aminolevulnic acid synthetase…production of heme is increased

Question 14

porphyria exacerbated d/t inc in..

Answer 14

porphobilinogen deaminase….porphyrin accumulates (s/s- abdominal pian, constipation, musc weakness, seizures, severs NV)

Question 15

Acute Intermittent Porphyria/ Variegate Porphyria Treatment

Answer 15

• d/c causative agent
• consult hematology
• 10% glucose solution
• opioids for pain
• gabapentin for seizures

Question 16

intra-arterial injection STP

Answer 16

• vasoconstriction, pain, extremity cyanosis, gangrene, limb loss
• treatment: dilution with saline, injection of lidocaine, papaverine, phenoxybenzamine, stelate ganglion block, brachial plexus block, urokinase, heparin

Question 17

propofol solution made up of…

Answer 17

1% solution (2, 6- diisopropylphenol)

• 10% soybean oil
• 2.25% glycerol
• 1.2% egg phosphatide
• 0.005% disodium edetate added as microbial retardant (or metabisulfite)

Question 18

propofol…peds require higher dose b/c…

Answer 18

• larger central distribution
• high clearance

(elderly- smaller central distribution, low clearance)

Question 19

propofol (rigid, arched back, abnormal position…)

Answer 19

opisthotonus

Question 20

etomidate structure

Answer 20

carboxylated imidazole derivative

Question 21

isomer responsible for hypnotic effects in etomidate

Answer 21

D-isomer

Question 22

etomidate metabolism

Answer 22

ester-hydrolysis by plasma esterase’s and microsomal enzymes

Question 23

ketamine more potent isomer

Answer 23

S- isomer