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ANESTHESIA : Hall > CH3 INTRAVENOUS DRUGS > Flashcards

CH3 INTRAVENOUS DRUGS Flashcards

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1
Q

Bradycardia in children secondary to SUX is due to ?

A

muscaric stimulation in the sinus node of the heart

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2
Q

succinylcholine induced tachycardia in adult is secondary to?

A

histamine release

stimulation of autonomic ganglia

post junctional cardiac muscarinic receptors

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3
Q

side effect of sux?

A 
hyperkalemia 
MH
masseter spasm
bradycardia
myalgia
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4
Q

sux contraindicated for routine intubation in children?

true or false

A

true

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5
Q

orbicularis oculi is same with

A

laryngeal muscle

diaphragm

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6
Q

onset of NMB

most sensitive to least sensitive

A

larynx
diaphragm
OO
Adductus policis

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7
Q

RECOVERY NMB

first to last

A

larynx
oo=diaphragm
AP

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8
Q

volatile anesthetics
______ NMB and
_______ reversal agents

A

volatile anesthetics
potentiates NMB and
slowed / retard reversal agents

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9
Q

Maoi + meperidine /methadone/tramadol can cause

A 
SEROTONIN SYNDROME 
agitation
skeletal muscle rigidoty
hyperpyrexia
hypotension 
respi dec 
coma
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10
Q

Risk factor for emergence delirium

A

younger than 5
volatile=sevoflurane
ent optha cases
anxious parents

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11
Q

ETOMIDATE adverse effect

A 
PONV - Highest /most common
pain
thrombophlebitis
myoclonic movement
hiccups
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12
Q

Pancuronium inc hr bp and co because?

A

moderate vagolytic effect
norepi release
dec reuptake of NE by adrenergic nerve

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13
Q

DANTROLENE
prevention of MH
control skeletal muscle spasticity

MOA

A

dec amount Calcium releases by the sarcoplasmic reticulum

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14
Q

DATROLENE most common SIDE EFFECT

A

muscle weakness -mc

nausea
diarrhea
blurred vision

iv diuresis ( mannitol to make iv) 
orally given - hepatitis and pleural effusion
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15
Q

DISULFIRAM

A

ALTERS metabolism of alcohol by irreversibly inactivating the enzyme aldehyde dehydrogenase

alcohol sensitivity up to 24 hrs

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16
Q

NALTREXONE

A

tx of alcohol addiction
combination with disulfiram

pure opiod anatgonist

prior to surgery:
inc requirement of opioids
STOPPED PRIOR TO OR

duration 24hrs

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17
Q

RSI NMB

A

sux

rocuronium

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18
Q

priming means

A

10 % of the intubating dose is followed 2-4 minutes by the 90 percent

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19
Q

NMB TERMINATES By

A

diffusiin of drug back inti the plasma

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20
Q

buprenorphine

A

agonist-antagonist
very strong affinity to mu receptor
slow dissociation from the receptor mlonger action
resistance to NALOXONE

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21
Q

vasodilator of pulmonary tree

no EFFECT IN systemic circulation

A

nitric oxide

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22
Q

sux metabolism? termination?

A

metabolism : psuedocholinesterase

termination:
diffusion to the extracellur fluid

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23
Q

DEXMEDTOMIDINE

A 
Highly selective a2 agonist
rapid onset 5min
peak at 15 mins
dec hr and co ( profouns cardiac arrest)
respi mnimal

1-2 mcg/kg/min
mild tv change
no change in rr

greater
paco2 inc

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24
Q

FOSPROPOFOL

A 
water soluble
converted to propofol 
no pain 
no risk for hypertriglyceridemia
pulmo embolism
risk of sepsis
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25
CHRONIC MSO4 develop tolerance after 2-3 weeks
analgesia respi depressiin nausea euphoria except miosis and constipation
26
CIMETIDINE impairs the metabolism of ?
LIDOCAINE PROPANOLOL DIAZEPAM
27
tx for organophosphate poisoning
atropine 2mg-6mg q5-10mins pralidoxime 600mg benzodiazepine
28
ALFENTANIL
less potent more rapid onset shorter duration alfatenail ALang KWENTA
29
``` most to least potent ? fentanyl alfentanil sulfafentanyl remifentanil mso4 ```
``` sufentanyl remifentnayl fentanyl alfafentanil mso4 ```
30
BURN : | succinyl cause HYPERKALEMIA
first 24 hrs - safe hyperkalemia peak at 7-10days starts at 2nd day
31
Clonidine dose for anti shivering
75mcg iv
32
Fentanyl chest rigidity treatment with
sux
33
nueroleptic malignant syndorme
like MH PT TAKing antipsychotic drugs dantrolene can be used txt amandatine dantrolene bromocriptine
34
MH triggerrd by
sux | volatile anesthetics
35
DIBUCAINE TEST and duration of sux
DIBUCAINE NUMER 70-80 ( 5-10 min) normal homo typicL 50-60 ( 20-30min) hetero atypi 20 ( 3 hrs) homo atypi
36
Cyanide poisoning treatment
Na nitrite amyl nitrite Na thiosulfate hydroxocobalamin
37
``` sedative amnestic > sedative anterograde amnesia anticonvulsant activity breakdown inhibited by cimetidine ```
MIDAZOLAM lorazepam oxazepam not affected by cimitidine
38
POST SHIVERING TX
``` clonidine dexmedetomidine propofol ketanserine tramadol physostigmine mgs04 narcotic ```
39
sugammadex
cyclodextrin encapsulate Non depo STEROIDAL Muscle relaxant rocu -vecu- pan NO EFFECT IN BENZYLISOQUINOLINIUM
40
AMRINONE
positive initropic vasodilatory effect no antidysrhythmic effect
41
REMIFENTANIL metabolize by
NONSPECIFIC | PLASMA ESTERASES
42
PAIN WITH IV INJECTION
diazepam etomidate methohexital propofol not with thiopental and ketamine
43
Flumazenil can trigger seizure ? yes or no
yes
44
irreversible alpa adrenergic blockade
PHENOXYBENZAMINE
45
DANTROLENE
mannitol 300mg mannitol /20mg dantrolene cause diuresis dec calcium
46
Opioid withdrawal
short acting 6-12 hrs after last dose long acting 72-84 hrs of last dose withdrawal symptoms 5-10days RESTLESSNESS anxiety irritabilitt abdominal cramps tremors jerking NALOXONE IS CONTRAINDICATED
47
adrenal supression
ETOMIDATE
48
thrombosis phlebitis spc antagonist
DIAZEPAM
49
pain injection | severe hupotension in elderly
PROPOFOL
50
increase icp
ketamine
51
can cause lactic acidosis
PRIS LACTIC ACIDOSIS >75mcg/kg/min >24hrs earky signs: tachycardia impaired fatty acid oxidation in the mitochondria
52
alternative for heparin | In pt WITH HIT2
direct thrombin inhibitor hirudin bivalirudin agatroban
53
associated with opioid induced hyperalgesia
REMIFENTANIL
54
mixed agonist antagonist
butophanol nalbuphine pentazocine mu antagonist k agonist
55
METHADONE is a
NMDA ANTAGONIST reduce opioid tolerance and withdrawal syndrome
56
TAPENTADOL
new opioid | munreceptor agonist and NRI
57
NO CHANGE IN MAC
hyperthyroid hypothyroid gender
58
ANTICHOLINERGIC
atropine scopolamine glycopyrolate
59
least effective antisialagogue
ATROPINE
60
anticholinergic: | produce sedation
scopolamine>atropine | tertiary can pass BBB
61
anticholinergic | greatest increase in heart
ATROPINE
62
anticholinergic : mydriasis and cyclopegia
scopolamine >atropine
63
Elimination of the following ? Where? ``` pancuronium rocuronium atracurium sux mivacuriun ```
renal: pipecuronium doxacuriun pancuronium hepatic and billiary: vecuronium rocuronium d-tubo plasma hoffman: atracurium cisatracuriun enzyme: sux mivacuriun
64
Composition of propofol
10% soy bean oil 2. 25% glycerol 1. 2% purified egg phosphatide
65
PROPOFOL INFUSION SYNDROME
``` metab acidodid cardiac dysfunction rhabdomyolysus hypertriglyceride enlarged liver renal failure ```
66
Etomidate can cause...
ADRENAL SUPPRESSION
67
DO NOT GIVE _____ with dandrolene.
CA CHANNEL BLOCKER interacts with dabdrolene cause hyperkalemia and myocardial depression
68
Drugs that can produce extrapyramidal effect?
droperidol promethazine thiethylperazine meticlopramide
69
``` Shat the problem witht following? parkinsons myasthenia gravis myastenic syndrome: Eatin lambert syndrome Hungtinton ```
parkinsons - dec dopa myasthenia gravis -dec ach receptor Eatin lambert syndrome - dec ach Hungtinton - dec pseudocholinesterase
70
Can you use sux in patient with Duchenne?
it is CONTRAINDICTARD risk of rhabdomyolysus hyperkalemia cardiac arrest
71
sensitivity of the sux with the ff dse?
myasthenia gravis - resistant myasnethia syndrom- sensitive hungtingtin - sensitive
72
what iv anesthetic cause normal sleep ?
DEXMEDETOMIDINE
73
Acute intermittent porphyria | Contraindicated which drugs?
etomidate barbiturates ketolorac pentazocine hydantion anticonvulsant
74
Elimination of the following ? Where? ``` pancuronium rocuronium atracurium sux mivacuriun ```
renal: pipecuronium doxacuriun pancuronium hepatic and billiary: vecuronium rocuronium d-tubo plasma hoffman: atracurium cisatracuriun enzyme: sux mivacuriun
75
Composition of propofol
10% soy bean oil 2. 25% glycerol 1. 2% purified egg phosphatide
76
PROPOFOL INFUSION SYNDROME
``` metab acidodid cardiac dysfunction rhabdomyolysus hypertriglyceride enlarged liver renal failure ```
77
Etomidate can cause...
ADRENAL SUPPRESSION
78
DO NOT GIVE _____ with dandrolene.
CA CHANNEL BLOCKER interacts with dabdrolene cause hyperkalemia and myocardial depression
79
Drugs that can produce extrapyramidal effect?
droperidol promethazine thiethylperazine meticlopramide
80
``` Shat the problem witht following? parkinsons myasthenia gravis myastenic syndrome: Eatin lambert syndrome Hungtinton ```
parkinsons - dec dopa myasthenia gravis -dec ach receptor Eatin lambert syndrome - dec ach Hungtinton - dec pseudocholinesterase
81
Can you use sux in patient with Duchenne?
it is CONTRAINDICTARD risk of rhabdomyolysus hyperkalemia cardiac arrest
82
sensitivity of the sux with the ff dse?
myasthenia gravis - resistant myasnethia syndrom- sensitive hungtingtin - sensitive
83
what iv anesthetic cause normal sleep ?
DEXMEDETOMIDINE
84
Acute intermittent porphyria | Contraindicated which drugs?
etomidate barbiturates ketolorac pentazocine hydantion anticonvulsant
85
pre treatment: self taming precurarization priming
priming : non depo -non depo 10 percent precuri nond depo- depo self SSSSS SSSUX .1/mg/kg SSSUX 1mg/kg

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