induction agents Flashcards

1
Q

sedativ and hypnotic properties result from substitutions at the…

A

2 and 5 carbon atoms of barbaturic acid

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2
Q

branched on 5…

A

greater hypnotic activity than straight chain

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3
Q

phenol group on 5…

A

enhanced anticonvulsant activity

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4
Q

methyl radical

A

pro-convulsive effects

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5
Q

oxygen on 2

A

oxybarbituates

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6
Q

sulfur on 2

A

thiobarbituates, greater lipid solubility, faster onset, greater potency, shorter DOA

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7
Q

barbituric acid

A

malonic acid + urea

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8
Q

return of awareness after IV administration reflects…

A

rapid redistribution to inactive sites

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9
Q

distribution depends on…

A
  • lipid solubility (most important)
  • protein binding
  • degree of ionization
  • tissue blood flow
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10
Q

EEG small dose

A

low volt, fast wave activity (1-5 HZ), clouding of consciousness

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11
Q

EEG moderate dose

A

high volt, slow wave activity (<4 Hz), similar to physiologic sleep

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12
Q

EEG large dose

A

1-3 Hz, electrical silence

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13
Q

barbs stimulate activity of the mitochondrial enzyme…

A

D-aminolevulnic acid synthetase…production of heme is increased

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14
Q

porphyria exacerbated d/t inc in..

A

porphobilinogen deaminase….porphyrin accumulates (s/s- abdominal pian, constipation, musc weakness, seizures, severs NV)

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15
Q

Acute Intermittent Porphyria/ Variegate Porphyria Treatment

A
  • d/c causative agent
  • consult hematology
  • 10% glucose solution
  • opioids for pain
  • gabapentin for seizures
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16
Q

intra-arterial injection STP

A
  • vasoconstriction, pain, extremity cyanosis, gangrene, limb loss
  • treatment: dilution with saline, injection of lidocaine, papaverine, phenoxybenzamine, stelate ganglion block, brachial plexus block, urokinase, heparin
17
Q

propofol solution made up of…

A

1% solution (2, 6- diisopropylphenol)

  • 10% soybean oil
  • 2.25% glycerol
  • 1.2% egg phosphatide
  • 0.005% disodium edetate added as microbial retardant (or metabisulfite)
18
Q

propofol…peds require higher dose b/c…

A
  • larger central distribution
  • high clearance

(elderly- smaller central distribution, low clearance)

19
Q

propofol (rigid, arched back, abnormal position…)

A

opisthotonus

20
Q

etomidate structure

A

carboxylated imidazole derivative

21
Q

isomer responsible for hypnotic effects in etomidate

A

D-isomer

22
Q

etomidate metabolism

A

ester-hydrolysis by plasma esterase’s and microsomal enzymes

23
Q

ketamine more potent isomer

A

S- isomer