Local and General Anesthetics/Substances of Abuse Flashcards
Current evidence supports the view that most intravenous general anesthetics act predominantly through
A
5-HT receptors.
B
D2dopamine receptors.
C
GABAA receptors.
D
α2-adrenergic receptors.
E
β1-adrenergic receptors.
C
GABA receptors.
Termination of anesthesia after a single bolus of a parenteral anesthetic primarily reflects
A
redistribution out of the CNS.
B
metabolism by the liver.
C
excretion by the kidney.
D
enhanced protein plasma protein binding.
E
hydrolysis by plasma esterases.
A
redistribution out of the CNS.
A 23-year-old man is having outpatient surgery for a torn anterior cruciate ligament as the result of a skiing injury. He is most likely to receive which of the following drugs as a parenteral anesthetic?
A
Phenobarbital
B
Diazepam
C
Propranolol
D
Lidocaine
E
Propofol
E
Propofol
A 35-year-old woman is anesthetized with desflurane for outpatient surgery. The induction with desflurane is rapid because desflurane is not very soluble in fat and because desflurane
A
has a high blood:gas partition coefficient.
B
is highly protein bound.
C
is metabolized rapidly to an active metabolite.
D
increases cerebral vascular resistance.
E
has a low blood:gas partition coefficient.
E
has a low blood:gas partition coefficient.
If a 35-year-old woman is anesthetized with desflurane for outpatient surgery. The induction with desflurane is rapid. If the patient is anesthetized with equipment in which the CO2 absorbent is not well hydrated, she is at risk of poisoning with
A
NO.
B
O2.
C
CO.
D
H2S.
E
He.
C
CO.
A 19-year-old woman is undergoing dental surgery. Immediately upon infiltration of the local anesthetic, tetracaine with epinephrine, she begins to wheeze and have an allergic reaction. The cause of her allergic reaction is likely
A
epinephrine.
B
sulfite.
C
tetracaine.
D
nickel.
E
penicillin.
B
sulfite.
A 44-year-old man is undergoing surgery on the fifth finger of his right hand. A local anesthetic without epinephrine is used because epinephrine in this setting may cause
A
methemoglobinemia.
B
renal impairment.
C
liver injury.
D
gangrene.
E
necrosis of the optic nerve.
D
gangrene.
While eating mussels, a 36-year-old woman develops numbness and tingling of her lips and tongue. She begins to have difficulty breathing and rapidly becomes unconscious. Her apparent respiratory paralysis is the result of
A
the block of Na+ channels.
B
serotonin syndrome.
C
malignant hyperthermia.
D
depletion of norepinephrine.
E
inhibition of monoamine oxidase (MAO).
A
the block of Na+ channels.
A 24-year-old woman has increased her dosage of hydrocodone to achieve the same analgesic effect. This is a demonstration of
A
physical dependence.
B
first-pass metabolism.
C
tolerance.
D
an adverse effect.
E
addiction.
C
tolerance
A 28-year-old man has been taking the same dose of oxycodone for several weeks as the result of a knee injury. He has not needed to increase his dose of oxycodone to achieve analgesia. He develops irritability and muscle aches upon abruptly stopping his oxycodone. This is a demonstration of
A
physical dependence.
B
first-pass metabolism.
C
tolerance.
D
an adverse effect.
E
addiction.
A
physical dependence.
A 47-year-old man has consumed approximately 1 bottle of whiskey daily for the past 5 years. He is brought to the emergency room one evening because he is belligerent. In the emergency room he does not appear sedated despite a blood alcohol concentration of 275 mg/dL. Within minutes of his blood being drawn he develops a respiratory arrest and is intubated successfully. Because of tolerance to alcohol’s sedative effect the therapeutic index of alcohol in this patient is
A
increased.
B
decreased.
C
unchanged.
D
irrelevant.
E
negative reinforcement.
B
decreased.
A 33-year-old woman who smokes 1 pack of cigarettes per day has recently begun getting up at 3 AM to smoke a cigarette. This is a demonstration of
A
positive reinforcement.
B
negative reinforcement.
C
insomnia.
D
depression.
E
increased therapeutic index of nicotine.
B
negative reinforcement
A 34-year-old man is a recreational user of cocaine. He is also a regular consumer of alcohol. The effect of alcohol on cocaine metabolism is demonstrated by the presence in the urine of
A
benzoylecgonine.
B
methanol.
C
benzocaine.
D
cocaethylene.
E
methylecgonine.
D
cocaethylene
A 19-year-old woman is brought to the emergency room because of fearful hallucinations and suicidal thoughts after consuming methylenedioxymethamphetamine (MDMA). MDMA is thought to interact with
A
α2 adrenergic receptors.
B
β1 adrenergic receptors.
C
D2 dopaminergic receptors.
D
μ opioid receptors.
E
5-HT2 serotonergic receptors.
E
5-HT2 serotonergic receptors.
A 48-year-old woman is undergoing chemotherapy for advanced breast cancer. To allay her nausea and vomiting, she is given
A
diphenhydramine.
B
pseudoephedrine.
C
Δ-9-THC.
D
LSD.
E
10, 11-epoxycarbamezepine.
C
Δ-9-THC.
