Pharmacology VI

Question 1

What is the mechanism of action of inhaled anesthetics?

Answer 1

Unknown mechanism (p.453)

Question 2

Name four effects of inhaled anesthetics.

Answer 2

Myocardial depression, respiratory depression, nausea/emesis, increased cerebral blood flow (decreased cerebral metabolic demand) (p.453)

Question 3

What toxicities are associated with Halothane use?

Answer 3

Hepatotoxicity (p.453)

Question 4

What toxicities are associated with methoxyflurane use?

Answer 4

Nephrotoxicity (p.453)

Question 5

What toxicities are associated with enflurane use?

Answer 5

It is a proconvulsant (p.453)

Question 6

What toxicity is associated with inhaled anesthetic use?

Answer 6

Malignant hyperthermia in all but nitrous oxide (rare, lifethreatening, inherited susceptability) (p.453)

Question 7

What toxicity is associated with use of nitrous oxide?

Answer 7

Expansion of trapped gas in the body cavity (p.453)

Question 8

What five types of anesthetic drugs are administered intravenously?

Answer 8

Barbiturates, benzodiazepines, arylcyclohexylamines (ketamine), opioids, propofol (p.454)

Question 9

Describe the anesthetic properties of thiopental.

Answer 9

High potency, high lipid solubility, rapid entry to the brain; decreases cerebral blood flow (p.454)

Question 10

What is thiopental used for?

Answer 10

Induction of anesthesia and short surgical procedures (p.454)

Question 11

How is thiopental’s effect terminated?

Answer 11

By rapid redistribution of the drug into tissues (i.e. skeletal muscle) and fat (p.454)

Question 12

What benzodiazepine is most commonly used for endoscopy?

Answer 12

Midazolam; used adjunctively with gaseous anesthetics and narcotics (p.454)

Question 13

What toxicities are associated with benzodiazepine use as an IV anesthetic?

Answer 13

Severe postoperative respiratory depression, decreased blood pressure, amnesia; treat with flumazenil (p.454)

Question 14

What are arylcyclohexylamines?

Answer 14

PCP analogues used as dissociative anesthetics (ketamine); cardiovascular stimulants; increase cerebral blood flow (p.454)

Question 15

What is the mechanism of action of arylcyclohexylamines?

Answer 15

Block NMDA receptors (p.454)

Question 16

Name the most frequently used arylcyclohexylamine.

Answer 16

Ketamine (p.454)

Question 17

What toxicities are associated with arylcyclohexylamines?

Answer 17

Disorientation, hallucination, bad dreams (p.454)

Question 18

Describe the role of opioids in general anesthesia.

Answer 18

Used with other CNS depressants during general anesthesia (p.454)

Question 19

What two opioids are most commonly used in general anesthesia?

Answer 19

Fentanyl, morphine (p.454)

Question 20

What is propofol used for?

Answer 20

Sedation in the ICU, rapid anesthesia induction, short procedures (p.454)

Question 21

What is the mechanism of action of propofol?

Answer 21

Potentiates GABA(a) (p.454)

Question 22

What is the advantage of using propofol over thiopental for anesthesia induction?

Answer 22

Less postoperative nausea (p.454)

Question 23

What are the two classes of local anesthetics?

Answer 23

Esters, amides (amides have 2 I’s) (p.454)

Question 24

Name three ester anesthetics.

Answer 24

Procaine, cocaine, tetracaine (p.454)

Question 25

Name three amide anesthetics.

Answer 25

Lidocaine, mepivacaine, bupivacaine (p.454)