Premeds Revision Questions

Question 1

Give 2 reasons why we use premedicants?

Answer 1

Calming effect, smooth induction & recovery, analgesia effect, reduces the dose of induction and maintenance agents.

Question 2

Name 3 premedicant drug categories.

Answer 2

Phenothiazines, Alpha2 adrenoceptor agonist, Benzodiazepines, Opiods, Anti Muscarinics.

Question 3

Name one drug that is classified as a Benzodiazepines.

Answer 3

Diazepam, Midazolam

Question 4

What are opioids?

Answer 4

Analgesic

Question 5

Give one example of a full agonist opioid.

Answer 5

Morphine, pethidine, fentanyl, methadone

Question 6

What is opioid antagonist?

Answer 6

It has an antagonising effect on the agonist e.g. it can be used as an antidote in case of overdose or inappropriate depth of anaesthesia.

Question 7

Name 2 disadvantages of a phenothizine?

Answer 7

Slow to peak effect, Long duration, no analgesia, unpredictable sedation, poor muscle relaxation, can cause syncope.

Question 8

Name 2 advantages of using Alpha 2 adrenoreceptor?

Answer 8

Profound drug sparing effect, provides good muscle relaxation, analgesia, duration and level of sedation.

Question 9

Why would you avoid using or use with extreme caution when using Alpha 2 adrenoreceptors?

Answer 9

Patients where vomiting would be risky, patients with liver and cardiovascular disease?

Question 10

What drug category can be used in anaesthesia alongside ketamine?

Answer 10

Alpha 2 adrenorecpetors

Question 11

What does the route of administration of the pre-med effect? (3)

Answer 11

Duration of action
Time to peak effect
Incidence of side effects

Question 12

PHENOTHIAZINES

1. example
2. advantages (3)
3. disadvantages (3)

Answer 12

1. Acetylpromazine (ACP)
2. Anti - histamine, anti- arrhythmic, anti-emetic
3. Hypothermia, hypotension, reduces epileptic seizures theshold, slow onset peak action

Question 13

OPIOD ANALGESICS

1. example
2. advantages (3)
3. disadvantages (3)

Answer 13

1. methadone, fentanyl, butorphanol
2. dose dependent analgesia, cardiac output maintainance generally good,
   drug sparing effect
3. Excitation on overdose, anti- tussive effect, GI effects

Question 14

NEUROLEPTANALGESIA

1. example
2. advantages (3)
3. disadvantages (3)

Answer 14

1. Combination of the phenothiazine eg ACP and an opiod eg methadone
2. reduces side effects, increases predictability and sedation, stable cardiopulmonary performance
3. behavioural chnages, sensitivity to stimuli, only opiod antagonism

Question 15

ALPHA -2 AGONISTS

1. example
2. advantages (3)
3. disadvantages (3)

Answer 15

1. medetomidine, dexmedetomidine
2. sedation and duration of action dose dependent, muscle relaxation
3. Cardiovascular depression, hypertension then hypotension, respiratory obstruction in brachycephalics

Question 16

BENZODIAZEPINES

1. example
2. advantages (3)
3. disadvantages (3)

Answer 16

1. diazepam and midazolam
2. anti-epileptic, muscle relaxation and minimal cardiopulmonary effects
3. unpredictable, formulation - may be painful

Question 17

ANTI-MUSCARINICS

1. example
2. advantages (3)
3. disadvantages (3)

Answer 17

1. atrophine, glycopyrrolate
2. reduce bronchodilation, controlls intra-operative bradycardia, protects against adverse vagel effects during reversal or neuromuscular block
3. increases metabolic rate, heart rate and myocardial oxygen consumption