Barbiturates and Anesthetics

Question 1

Barbiturates - suffix? (exception)

Answer 1

barbitol (except thiopental)

Question 2

MoA of barbiturates?

Answer 2

increase duration of Cl- channel opening (barbiDURATes)

Question 3

Barbiturates contraindicated for?

Answer 3

prophyria

Question 4

Barbiturate used for anesthesia induction

Answer 4

Thiopental

Question 5

Barbiturate toxicities: Most worried about?

Answer 5

Repiratory depression

Question 6

Barbiturate - effect on P450?

Answer 6

inducers

Question 7

Barbiturate: OD treatment?

Answer 7

Supportive

Question 8

Benzos - suffix (exception)

Answer 8

-lam, -pam, (chlordiazepoxide)

Question 9

Benzos - MoA

Answer 9

increases frequency of Cl channel (GABAa)opening

Question 10

Benzos - Shorter acting (higher addiction potential)?

Answer 10

triazolam, oxaepam, midazolam

Question 11

Pt comes in with night terrors and sleepwalking. Tx?

Answer 11

Benzos

Question 12

Which has larger effect on respiration - barbs or benzos?

Answer 12

barbiturates

Question 13

Benzo: OD treatment? MoA?

Answer 13

Flumazenil, Competitive antag for GABA receptor

Question 14

MoA of nonbenzodiazepine hypnotics?

Answer 14

Zs (Zolpidem, zalephlon, eszopiclone)

Act via the BZ1 subtype of the GABA receptor

Question 15

Indication of Z-drugs?

Answer 15

Insomnia

Question 16

Side effects of Z-drugs?

Answer 16

Ataxia, headaches, confusion

Question 17

Advantage of Z-drugs over benzos?

Answer 17

Modest dat-after psychomotor depression.
Few amnestic effects.
Lower dependence

Question 18

Anesthetics: What determines induction/recovery times? potency?

Answer 18

decreased blood solubilty = rapid induction

increased lipid solubility = increased potency

Question 19

Potency of anesthetics determined by?

Answer 19

1/MAC (min alveolar concentration at which 50% of the population is anesthetized)

Question 20

Anesthetic with low blood and lipid solubility?

Answer 20

N2O nitrous oxide (low potency and high induction)

Question 21

Anesthetic with high blood and lipid solubility?

Answer 21

Halothane (high potency and slow induction)

Question 22

Inhaled anesthetics - suffix? (exception)

Answer 22

-ane (Nitrous Oxide - N2O)

Question 23

Anesthetic Toxicity: hepatoxicity

Answer 23

halothane

Question 24

Anesthetic Toxicity: nephrotoxicity

Answer 24

methoxyflurane

Question 25

Anesthetic Toxicity: proconvlusant

Answer 25

enflurane

Question 26

Anesthetic Toxicity: malignany hyperthermia

Answer 26

All but N2O

Question 27

Anesthetic Toxicity: trapped gas in body

Answer 27

N2O

Question 28

Intravenous anesthetic classes (5)

Answer 28

Barbs, Benzos, Ketamine, Opioids, Propofol

Question 29

Barb with high potency and rapid entry into brain. Used to induce anesthesia. How is effect terminated?

Answer 29

Thiopental. Rapid redistribution into tissue

Question 30

Benzo used for endoscopy. Treat OD with?

Answer 30

Midazolam. Flumazenil

Question 31

IV anesthetics that blocks NMDA receptors. Stimulation of? Side effects?

Answer 31

Ketamine. Stimulate cardiovascular system. Hallucinations

Question 32

Opioid used during general anesthesia (2)

Answer 32

Morphine and Fentanyl

Question 33

Used for sedation in ICU. Rapid anesthesia induction. MoA?

Answer 33

Propofol. Potentiates GABAa.

Question 34

Local Anesthetics: esters?

Answer 34

procaine, cocaine, tetracaine

Question 35

Local Anesthetics: amides?

Answer 35

LIdocaIne, MepIvacaIne, bupIvacaIne

Question 36

Local Anesthetics: MoA?

Answer 36

The -caines. Block Na channels by binding to inner portion of ACTIVE channels

Question 37

Local Anesthetics: enhance location action by?

Answer 37

The -caines. giving with vasoconstrictors (NE)

Question 38

Local Anesthetics: why need more in infected tissue?

Answer 38

The -caines. Acidic tissue charges molecules, can't go through membrane

Question 39

Local Anesthetics: Nerves most affected? Order of sensation loss with administration?

Answer 39

The -caines. Small then myelinated. pain, temperature, touch, pressure

Question 40

Local Anesthetics: toxicity?

Answer 40

The -caines. CNS excitation

Question 41

Local Anesthetics: cardiovascular toxicity with?

Answer 41

Bupivacaine

Question 42

Local Anesthetics: arrhythmias?

Answer 42

cocaine

Question 43

Alcoholic comes in with DTs. Tx?

Answer 43

Benzos