Drugs

Question 1

GABAa receptor MOA

Answer 1

chloride flux into cell

Question 2

drugs that augment GABAergic neurotransmission

Answer 2

propofol and barbs and benzo

Question 3

binding sit of benzo receptor (what receptor do benzos enhance)

Answer 3

GABAa

Question 4

competitive antagonist of BNZ receptor

Answer 4

flumazenil

Question 5

agonists of GPCR system reduce activity of what?

Answer 5

adenyl cyclase –> cause dephosphorylation of ion channels –> activates K channels and hyperpolarization

Question 6

opioids and central alpha-2 receptors are examples of what receptor class?

Answer 6

GPCR

Question 7

central alpha 2 receptor agonists (2)

Answer 7

clonidine and dexmedetomidine

Question 8

opioid (mew1/2) receptor agonists

Answer 8

fentanyl, morphine

Question 9

Ketamine blocks what receptor?

Answer 9

NMDA

Question 10

midazolam dosing

Answer 10

0.05-0.1mg/kg

Question 11

midazolam onset

Answer 11

<60sec

Question 12

midazolam repeat dose

Answer 12

0.05-0.1mg/kg

q3-5min

Question 13

midazolam duration

Answer 13

15-30min

Question 14

AE midazolam

Answer 14

antegrade amnesia, disinhibition, DIZZINESS

Question 15

central alpha-2 agonists affect what channels?

Answer 15

potassium channels - K efflux out of cell and membrane hyperpolarization

Question 16

CI to dexmedetomidine use

Answer 16

BP instability, bradycardia, (i.e. volume depleted)

SA/AV node block, digoxin therapy

Question 17

Dexmedetomidine dosing bolus

Answer 17

0.5-2 (1-3) mcg/kg over 5-10min

Question 18

demedetomidine infusion dose?

max infusion rate?

Answer 18

1-2mcg/kg/hr (max 100mcg/hr)

Question 19

propofol does NOT have what property (i.e. anxiolytic, amnestic, hypnotic, anesthetic)

Answer 19

analgesic

Question 20

AE of propofol

Answer 20

respiratory depression (dose dependent decrease in ventilatory response to CO2 –> decrease VT decrease)

Question 21

propofol dosing and interval frequency

Answer 21

1-2mg/kg q1min (repeat dose 0.5-1mg/kg)

Question 22

propofol duration

Answer 22

5-10min

Question 23

fentanyl peak effect

Answer 23

4-5min

Question 24

fentanyl dose

Answer 24

1-2mcg/kg infused slowly

Question 25

AE of fentanyl if pushed fast

Answer 25

chest wall rigidity

Question 26

fentanyl duration

Answer 26

30 min

Question 27

Ketamine properties at lowest doses v. highest doses (i.e. anxiolytic, amnestic, hypnotic, anesthetic)

Answer 27

lowest doses - anxiolysis and analgesia mid doses - antegrade amnesia highest - dissociative sedation

Question 28

ketamine physiologic effects

Answer 28

increased HR, BP, CO (good for hypovolemic patients)

Question 29

CI of ketamine

Answer 29

increased intraocular pressure, Increased ICP (i.e. incracranial mass), HTN, psych

Question 30

what drug causes visual hallucinations, emergence agitation

Answer 30

ketamine

Question 31

use antisialogogue with what drug?

Answer 31

ketamine

Question 32

ketamine dose 1st v. subsequent

Answer 32

``` #1 = 0.5-1 (1-2) mg/kg #2 = (1/2 first dose) 0.5 mg/kg ```

Question 33

20% of patients have ___ side effect with ketamine?

Answer 33

nausea/emesis

Question 34

ketamine onset

Answer 34

<60s

Question 35

peak of ketamine

Answer 35

1-2min

Question 36

peak versed

Answer 36

2-3min