anesthesia

Question 1

drugs for induction

Answer 1

thiopental, propofol, and etomidate

Question 2

etomidate adverse effects

Answer 2

accumulation, decreased CBF, brain metab. rate, ICP, and pulmonary function; decreases adrenal medulla steroid synthesis

Question 3

thiopental adverse effects

Answer 3

increased HR, decreased CBF, brain metab. rate, ICP and plum function;
porphyria
cyp inhibition

Question 4

propofol adverse effects

Answer 4

decreased CBF, brain metab. rate, ICP, and pulm. function; increased HR,
propofol infusion syndrome - cardiac arrest, multi organ system failure

Question 5

ketamine adverse effects

Answer 5

causes dissociative states, increased CBF, ICP, BP, HR, and CO (good thing); bronchodilation (good), hallucinations

Question 6

IV analgesic that increases cardiac output

Answer 6

ketamine

Question 7

short acting benzos

Answer 7

lorazepam and midazolam

Question 8

long acting benzo

Answer 8

diazepam

Question 9

benzodiazepam antagonist

Answer 9

flumazenil

Question 10

remifentanil

Answer 10

ultra rapid acting IV opiate

Question 11

neurolept analgesia (for awake surgery)

Answer 11

droperidol, fentanyl, N2O, and atropine

Question 12

causes malignant hyperthermia

Answer 12

succinylcholine, volatile anesthetic agents

Question 13

malignant hyperthermia treatment

Answer 13

dantrolene, hyperventilate with O2, correct hyperkalemia and acidosis, cool core temp

Question 14

local anesthetics pharmacology

Answer 14

lipophilicity allows them to dissolve through the membrane to get to the inside of the Na channel, hydrophilicity allows them to stay in the membrane so it can bind to the channel without passing all the way through the membrane;
have to cross the membrane in the unionized state

Question 15

local anesthetic MOA

Answer 15

blockade of voltage gated Na channels by binding to the inside of the channel in the activated and inactive states (not closed)

Question 16

require the most anesthetic

Answer 16

large, myelinated fibers and fibers in the center of the nerve (distal fibers)

Question 17

order of anesthesia of fiber types with local anesthetic

Answer 17

Beta, Adelta, C, motor

Question 18

amide local anesthetics

Answer 18

lidocaine, mepivicaine, prilocaine, bupivacaine, ropicacaine, articaine

Question 19

slow onset amides

Answer 19

mepivicaine, bupivicaine and ropivacaine

Question 20

esters

Answer 20

procaine, tetracaine, chlorprocaine, cocaine

Question 21

topical anesthetics

Answer 21

benzocaine, dibucaine, dyclonine, pramoxine

Question 22

topical anesthetics not for use on mucus membranes

Answer 22

dibucaine and pramoxine

Question 23

cause methemoglobinemia

Answer 23

benzocaine and prilocaine

Question 24

EMLA

Answer 24

lidocaine and prilocaine cream

Question 25

LET

Answer 25

lidocaine, epinephrine, and tetracaine liquid; used for peds before stitches

Question 26

lidocaine + ozymetazoline

Answer 26

used by ENT to decrease nasal engorgement

Question 27

rapid intubation

Answer 27

lidocaine, vecuronium, fentanyl, atropine

Question 28

local anesthetic with most cardiotoxic effects

Answer 28

bupivacaine

Question 29

local anesthetic with fast onset

Answer 29

prilocaine and chlorprocaine

Question 30

vasoconstrictors to use with local anesthetic

Answer 30

epinephrine, phenylephrine, and oxymetazoline (alpha agonists)

Question 31

fast onset inhalation anesthetics

Answer 31

sevoflurane and desflurane

Question 32

inhaled anesthetic that causes seizures

Answer 32

enflurane

Question 33

inhaled anesthetic that causes arrhythmia

Answer 33

halothane

Question 34

inhaled anesthetic that causes muscle relaxation

Answer 34

isoflurane

Question 35

N2O adverse effects

Answer 35

teratogen, inhibition of B12 synthesis, can cause an increase in pressure resulting in pneumothorax and perforation second gas effect - accumulation of other drugs exits system fast and can lead to diffusional hypoxia

Question 36

opoids for anesthesia

Answer 36

morphine, fentanyl and remifentanil

Question 37

IV induction drug that does not effect CV function

Answer 37

etomidate

Question 38

systemic effects of local anesthetics

Answer 38

ringing in ears, numbing of lips and tongue, metallic taste, seizures

Question 39

conversion between grams, mLs, and percents

Answer 39

100% = 1g/1mL

Question 40

to reverse anesthesia from local anesthetics

Answer 40

phentolamine (alpha-1 blocker)

Question 41

benzodiazepines to use the night before surgery

Answer 41

lorazepam and diazepam

Question 42

1st gen antihistamines for use in sedation prior to surgery (drugs and effects)

Answer 42

hydroxyzine, diphenhydramine, promethazine; useful for sedation, anxiolysis, bronchodilation, antiemesis, and analgesia; dry secretions

Question 43

to prevent aspiration pneumonitis

Answer 43

cimetidine and ranitidine - H2 blockers bicitra and polycitra - increase pH of current contents metoclopramide - D2 blocker to increase rate of gastric emptying water - increases stretch reflex

Question 44

ancillary anesthesia anticholinergics

Answer 44

atropine, glycopyrrolate and scopolamine | dry secretions, prevents reflux and bradycardia

Question 45

rapid intubation

Answer 45

oxygenate, lidocaine, vecuronium, fentanyl,and atropine

Question 46

Tx for post-anesthesia HTN

Answer 46

nitroprusside or trimethaphan

Question 47

Tx for post-anesthesia hypotension

Answer 47

dopamine, phenylephrine, or ephedrine