Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesia > Drugs—ITE > Flashcards

Drugs—ITE Flashcards

1
Q

Reduced cardiac output has what effect on inhalational induction? Which gases are most affected?

A

Reduced cardiac output promotes a faster rate of induction. This is especially true with soluble volatiles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Solubility of volatiles is based on blood-gas coefficients. Is a volatile with low blood gas coefficient more or less soluble? List the gases from least to most soluble.

A

Low blood gas coefficient is less soluble.

Des < nitrous < sevo < iso < halothane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which volatile anesthetic undergoes the most extensive metabolism?

A

Sevoflurane. Despite elevations in serum fluoride in long cases, it has not been shown to cause fluoride induced nephrotoxicity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

By what mechanism do volatiles potentiate neuromuscular blockade?

A

Volatiles potentiate NMB by decreasing the sensitivity of the post-junctional membrane to depolarization, increasing skeletal mm blood flow, and depressing upper motor neurons.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Volatile anesthetics are thought to cause an uncoupling effect. What does this mean?

A

They decrease CMRO2 while increasing CBF via a direct vasodilatory effect.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When a patient is administered 75% NO, the gas will rapidly diffuse from the blood into air filled cavities. How long does is take a pneumothorax to double in size with nitrous? To triple?

A

A PTX will double in 10m and triple in 30m

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Effect of L to R intracardiac shunt on inhalational induction speed? IV induction speed?

A

No effect on either

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

R to L intracardiac shunt effect on inhalational induction speed? IV induction speed?

A

Decreased inhalational induction speed

Increased IV induction speed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Effect of intrapulmonary shunt on inhalational induction speed? IV induction speed?

A

Decreased speed of inhalational induction

No effect on IV induction speed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Factors decreasing MAC

A 
Hyponatremia
Hypothermia
Hypoxia
Older age
Metabolic acidosis
Anemia hgb
Pregnancy
Acute EtOH use
Chronic methamphetamine use
Hypercarbia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Factors increasing MAC

A 
Red hair
Acute methamphetamine use
Chronic etoh use
Cocaine
Young age
Hypernatremia
Hyperthermia
Ephedrine
Levodopa
MAOIs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Metabolic effects of epinephrine

A

—Hyperglycemia (increased gluconeogenesis, increased glycogenolysis, decreased insulin)
—increased free fatty acids
—hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which volatile most significantly augments neuromuscular blockade?

A

Desflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Glycopyrrolate MOA

A

Muscarinic anticholinergic in the periphery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Neostigmine MOA

A

Anticholinesterase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Side effects of anticholinesterase

A

Bradycardia, hypotension, bronchospasm, secretions, miosis, decreased intraocular pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The onset of effect of local anesthetic is affected by what 4 factors?

A
  1. Concentration (higher is faster)
  2. Lipid solubility (higher is faster)
  3. pKa (lower is faster; more unionized at physiologic pH)
  4. Environmental pH (higher is faster; more basic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Physiologic changes associated with bicarbonate administration

A 
Increased preload
Decreased contractility
Increased hgb affinity for oxygen
Increased lactate
*can cause intracranial hemorrhage
19
Q

Which opioid receptor does naloxone bind to most strongly?

A

Mu

20
Q

What is the preferred method of beta blockade in pts with reactive airway disease?

A

Beta 1 selective antagonists because they do not cause bronchoconstriction or vasoconstriction s/t sparing of beta 2 antagonism.

21
Q

List the ester local anesthetics

A

Procaine
Chlorprocaine
Tetracaine

(Preservatives Can Taint)

22
Q

Propofol should be used within what time frame of opening a vial?

A

12 hrs

23
Q

Terbutaline MOA and SFx

A

MOA: beta 2 agonist
SFx: hyperglycemia, tachycardia, hypokalemia

24
Q

Clopidogrel is a prodrug activated by what enzyme?

A

Cyp450

25
Q

Beta-1 selective blockers

A 
Atenolol
Bisoprolol
Esmolol
Acebutolol
Metoprolol
26
Q

Non selective beta blockers

A 
Carvedilol
Timolol
Labetalol
Nadolol
Propranolol
Pindolol

Careful, This Lot’s Nor Particularly Picky

27
Q

Active metabolite of meperidine and SFX

A

The active metabolite of meperidine is normeperidine and it causes seizure activity.

28
Q

Metabolites of morphine and their SFX

A

Primary active metabolite is M6G, it is 100x more potent than morphine, and accumulation causes respiratory depression.

Inactive metabolite is M3G and causes myoclonus and allodynia

29
Q

What is the best induction agent for pts with hypovolemic trauma at no risk for elevated ICP?

A

Ketamine

30
Q

Lithium effect on NMBDs

A

Prolongs action if NDNMBDs and depolarizing NMBDs

31
Q

What percent of platelet function is restored when an irreversible platelet inhibitor is held for one day?

A

10-15%

32
Q

Aspirin MOA

A

Blocks the formation of thromboxane A2 in platelets which prevents platelet aggregation.

33
Q

Succinylcholine effect on lower esophageal sphincter tone and on intragastric pressure

A

Increases both

34
Q

Which inhalational agent is associated with megaloblastic hematologic changes?

A

Nitrous oxide

NO inhibits the vitamin B12-dependent enzymes methionine synthetase and thymidylate synthetase. Usually sub clinical effects in healthy pts but can cause neurologic and hematologic sequelae in critically ill and B12 deficient pts

35
Q

List the volatile anesthetics in order of NDNMB potentiation. Where does propofol fall on this spectrum?

A

Des>sevo>iso>halothane>propofol

36
Q

Treatment for delirium associated with scopolamine

A

Physostigmine

37
Q

List commonly tested medications that cause pain on injection

A 
Prop
Roc
Etomidate
Diazepam
Methohexital
38
Q

List commonly tested medications that are not associated with pain on injection

A 
Midazolam
Opioids
Ketamine
Dexmedetomidine
Fospropofol
39
Q

herbal supplements associated with increased risk of bleeding

A

Ginger, garlic, ginkgo, vitamin E

40
Q

Most common side effects of fospropofol

A

Parenthesias (general and perianal) and pruritis

41
Q

Chlorprocaine’s rapid onset of action is secondary to what characteristic of the drug?

A

Concentration

42
Q

Name the 4 potassium soaring diuretics

A

Spironolactone
Eplerenone
Amiloride
Triamterene

all can be associated with hyperkalemia

43
Q

Nicardipine metabolism and excretion

A

Metabolized by liver

Excreted by kidneys

44
Q

By what mechanism does etomidate cause adrenal suppression?

A

Inhibition of 11 beta hydroxylase

Anesthesia (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions