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Pharmacology I > IV Anesthetics > Flashcards

IV Anesthetics Flashcards

1
Q

Propofol drug class

A

Alkylphenol

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2
Q

Ketamine drug class

A

Arylcyclohexylamine

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3
Q

Etomidate drug class

A

Imidazole

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4
Q

Thiopental drug class

A

Barbiturate

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5
Q

Propofol chemical name

A

2,6-diisopropylphenol

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6
Q

Ketamine chemical name

A

2-(o-Chlorophenyl)-2 (methylamino) cyclohexanone hydrochloride

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7
Q

Etomidate chemical name

A

R-1-ethyl-1-(a-methylbenzyl) imidazole-5-carboxylate

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8
Q

Thiopental chemical name

A

5-ethyl-5-(1-methylbutyl)-2-thiobarbituric acid

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9
Q

Anesthetic agents most likely to cause pain on injection:

A
  • Diazepam +++
  • Etomidate +++
  • Propofol ++
  • Lorazepam +
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10
Q

Propylene glycol is a solvent for:

A
  • Etomidate
  • Diazepam
  • Lorazepam
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11
Q

Which induction has bronchodilating properties?

A

Ketamine

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12
Q

Which “generic” formulation is likely to precipitate bronchospasm in asthmatic patients?

A

Propofol

- Diprivan (brand) contains EDTA which doesn’t cause bronchial irritation; generic has different preservatives

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13
Q

Lecithin is found in:

A
  • egg yolks
  • peanuts
  • soy products
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14
Q

Propofol may safely be administered to people with:

A
  • egg, peanut, and soy allergies
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15
Q

Risk factors for propofol infusion syndrome:

A
  • Propofol dose > 4 mg/kg/hr
  • Propofol infusion > 48 hrs
  • Sepsis (inadequate oxygen delivery)
  • Continuous catecholamine infusions
  • High-dose steroids
  • Significant cerebral injury
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16
Q

Clinical presentation of propofol infusion syndrome:

A

Acute refractory bradycardia leading to asystole and at least one of the following:
- Metabolic acidosis (base deficit > 10 mmol/L)
- Rhabdomyolysis
- Hyperlipidemia
- Enlarged or fatty liver
- Renal failure
Lipemia may be an early sign

17
Q

Treatment for propofol infusion syndrome:

A

Supportive.

D/C propofol, maximizing gas exchange, cardiac pacing, PDE inhibitors, glucagon, ECMO, and renal replacement therapy

18
Q

Which induction agent is most likely to cause PONV?

A

Etomidate (30-40% incidence)

19
Q

What is the primary pathway of etomidate metabolism?

A

Hydrolysis

20
Q

Etomidate causes adrenocortical suppression by inhibiting:

A

11 beta-hydroxylase

21
Q

Two best treatments for treating an episode of acute intermittent porphyria:

A
  • Heme arginate

- Glucose

22
Q

Which anesthetic agent is is least affected by alterations in plasma protein binding?

A

Ketamine

23
Q

At the N-methyl-D-aspartate receptor, ketamine is the antagonist of:

A

Glutamate

24
Q

Ketamine administration does not cause:

A

xerostomia

25
Q

Cardiovascular side effects of Ketamine administration:

A

SNS stimulation

Direct myocardial depression

26
Q

Respiratory side effects of Ketamine administration:

A

Bronchodilation
Intact pharyngeal/laryngeal reflexes
Spontaneous respirations usually preserved
Increased salivation

27
Q

CNS side effects of Ketamine administration:

A 
Dissociative anesthesia
Analgesia
Emergence delirium (treated with BZPs)
Increased cerebral blood flow
Neuroapoptosis in the developing brain
28
Q

Eye side effects of Ketamine administration:

A

Nystagmus
Increased intraocular pressure (only with high doses)
Increased ocular muscle tone

29
Q

Which anesthetic agent is most likely to increase oxygen consumption in the brain?

A

Ketamine

30
Q

What is the initial dose of Flumazenil?

A

0.2 mg IV

31
Q

What are repeat doses of Fluamazenil?

A

0.1 mg IV in q1min increments

32
Q

What kind of drug is Flumazenil?

A

Competitive GABA-A receptor antagonist
Very high affinity but short DOA (30-60 min)
Thus, may need repeat doses to prevent resedation

33
Q

Which anesthetic agents produce an active metabolite?

A

Ketamine

Midazolam

Pharmacology I (5 decks)

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