IV Anesthetics

Question 1

What type of chemical compound is propofol?

Answer 1

Alkylphenol

Question 2

Other ingredients in propofol?

Answer 2

Soybean oil
Egg phospholipid
Glycerol

Question 3

pH of propofol?

Answer 3

7.0

Question 4

How is propofol cleared?

Answer 4

Mostly oxidization then glucuronidation in liver.
Then excretion in kidneys. 
Less than 1% unchanged in urine. 
2% in feces.
Some in lungs.

Question 5

Distribution half-life of propofol?

Answer 5

2-8 minutes

Question 6

Context sensitive half-time of propofol for infusion <8hrs?

Answer 6

30-40 mins

Question 7

Site of action for propofol hypnotic effects?

Answer 7

GABA-A receptor, bets subunits

Question 8

How does propofol work as antiemetic?

Answer 8

Decreases serotonin levels in the area postrema via GABA ergic activity.

Question 9

ED50 of propofol for loss of consciousness?

Answer 9

1.0-1.5 mg/kg

Question 10

Duration of hypnosis after 2.0-2.5 mg/kg propofol bolus?

Answer 10

5-10 mins

Question 11

Name the water soluble pro-drug of propofol.

Answer 11

Fospropofol

Question 12

What does propofol do to ICP and how does it work?

Answer 12

Decreases by 30-50% if already normal or elevated. Lowers cerebral perfusion pressure.

Question 13

What does propofol do to intraocular pressure?

Answer 13

Decreases by 30-40% acutely.

Question 14

Induction dose of propofol?

Answer 14

1.0-2.5 mg/kg

Question 15

ED95 of propofol for induction of anesthesia in children?

Answer 15

2.0-3.0 mg/kg

Question 16

Infusion dose rate for maintenance with propofol?

Answer 16

100-200 mcg/kg/min

Question 17

Antiemetic infusion dose rate for propofol?

Answer 17

20-25 mcg/kg/min

Question 18

Typical induction dose of etomidate?

Answer 18

0.3 mg/kg

Question 19

What are the two classes of barbiturates?

Answer 19

Oxybarbiturates

Thiobarbiturates

Question 20

What type of chemical compound is thiopental?

Answer 20

A thiobarbiturate

Question 21

What type of chemical compound is methohexital?

Answer 21

An oxybarbiturate

Question 22

How are barbiturates cleared?

Answer 22

Thiopental, methohexital metabolized in liver, excreted in urine. Phenobarbital mostly excreted unchanged in urine.

Question 23

What determines termination of action of induction dose of barbiturates?

Answer 23

Rapid redistribution, not metabolism

Question 24

Primary mechanism of action of barbiturates for hypnosis?

Answer 24

GABAa receptor

?NMDA

Question 25

What do barbiturates do to CPP?

Answer 25

Unchanged to increase, decrease in MAP is less than decrease in ICP. (CPP = MAP - ICP or CVP)

Question 26

This agent(s) can give a garlic or onion taste in mouth after IV administration.

Answer 26

Barbiturates

Question 27

This agent can cause twitching, tremors, hiccup, coughing after IV administration.

Answer 27

Methohexital

Question 28

Time to onset of action after induction dose thiopental?

Answer 28

15-30 secs

Question 29

This induction agent can be given rectally.

Answer 29

Methohexital 25mg/kg, 10% solution, 14-French catheter, 7cm in rectum

Question 30

Induction dose of thiopental

Answer 30

3-4 mg/kg

Question 31

Induction dose of methohexital?

Answer 31

1-1.5 mg/kg

Question 32

Mechanism of action of benzodiazepines?

Answer 32

GABA-A agonism