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Anaesthesiology > IV Induction Agents > Flashcards

IV Induction Agents Flashcards

1
Q

An ideal induction agent must be….

A
  1. Cheap
  2. Initiate no venous sequelae
  3. Have a long shell life
  4. Must be safe to use
  5. Must be stable
  6. No pain on injection
  7. Must have analgesic properties
  8. Must be safe if mistakenly injected into an artery
  9. Should not cause too much cardiac and respiratory depression
  10. Rapid onset
  11. Rapid recovery
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2
Q

The Five Classes of IV Induction Agents are:

A
  1. Barbiturates eg. Thiopentone
  2. Imidazole eg. Etomidate
  3. Benzodiazepines eg. Midazolam
  4. Phenols eg. Propofol
  5. Phenylcyclidines eg. Ketamine
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3
Q

When all other drugs have failed in a patient in status epilepticus …….. is indicated.

A

Propofol

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4
Q

What drug is used for ICU and TIVA sedations because patients can easily recover as a result of the rapid recovery action with minimal hangover?

A

Propofol

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5
Q

What are the stages of anaesthesia?

A
  1. Induction
  2. Excitement
  3. Surgical Anaesthesia
  4. Medullary paralysis
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6
Q

At what stage of anaesthesia is surgery done?

A

Surgical Anaesthesia

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7
Q

At the medullary stage of anaesthesia there could be?

A

Irreversible nerve damage

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8
Q

Which drug causes marked adrenal supression to the extent that it is really used clinically?

A

Etomidate

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9
Q

Among all induction agents which drug causes the most marked fall in BP?

A

Propofol

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10
Q

The lack of antimicrobial property of this drug means that it has to be used immediately after it’s preparation

A

Propofol

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11
Q

This drug posses antimicrobial activity specifically of the bacteriostatic type so it can even be used 24-48hrs after its preparation.

A

Thiopentone

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12
Q

State whether these drugs are indicated or not indicated in surgeries where a laryngeal mask airway would be used and give one reason why

i. Thiopentone
ii. Propofol

A

i. Thiopentone:
It is not indicated due to the fact that it preserves airway reflexes

ii. Propofol:
It is indicated due to the fact that it causes a significant reduction in in airway and laryngeal reflexes

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13
Q

…… has the most stable effect on the cardiovascular system.

A

Etomidate

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14
Q

11 beta hydroxylase, a critical enzyme in adrenal steroid production is inhibited by?

A

Etomidate

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15
Q

Which IV induction agent must be flashed before muscle relaxants are given to prevent the formation of crystals in blood vessels?

A

Thiopentone

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16
Q

Which IV induction agent has a significant amnesia effect and has Flumazenil 100mcg as its reversal agent?

A

Midazolam

17
Q

Which Induction agent can be given through all roots?

A

Ketamine

18
Q

Which induction agent has the slowest onset time of up to 2mins?

A

Ketamine

19
Q

The active metabolite of Ketamine which is a cerebral stimulant is known as?

A

Norketamine

20
Q

In relation to Obstetrics give comments on the following IV induction agents:

i. Propofol
ii. Thiopentone

A

i. Propofol:
It crosses the placenta but safety of the newborn has not been established so it is contraindicated in neonates, lactating mothers and pregnant women.

i. Thiopentone
It crosses the placenta but it is in a low concentration in the foetus so it has no teratogenic action

21
Q

Action of Ketamine on the CNS results in:

a) Increased CBF, CMR and ICP
b) Amnesia
c) Emergence phenomena
d) Hangover effect
e) Dissociative anaesthesia

A

a) Increased CBF, CMR and ICP - TRUE
b) Amnesia - TRUE
c) Emergence phenomena - TRUE
d) Hangover effect - TRUE
e) Dissociative anaesthesia - TRUE

22
Q

Which of the following are unsafe in porphyria (i.e. can precipitate porphyria)

a) Thiopentone
b) Etomidate
c) Propofol

A

a) Thiopentone - TRUE
b) Etomidate - TRUE
c) Propofol - FALSE

23
Q

Which IV induction agent has analgesic property at sub analgesic dose and can be used in patients with hypovolaemia?

A

Ketamine

Anaesthesiology (4 decks)

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