IV Induction Agents

Question 1

Sympathetic Nervous System evokes the

Answer 1

fight or flight response
SEAN:
Sympathetic
Epi/Norepi
Adrenergic
Nicotinic

Question 2

Parasympathetic Nervous System evokes the

Answer 2

Rest and DIgest
Parasympathetic
Acetycholine
Cholinergic
Muscarinic

Question 3

Most induction agents work at

Answer 3

the GABA receptor

Question 4

Advantages of IV anesthesia/induction agents:

Answer 4

-Provide rapid onset of general anesthesia.

Question 5

Disadvantages of IV induction/anesthesia agents

Answer 5

Lack of true “Ideal” IV anesthetic.

Question 6

Balanced Anesthesia is the

Answer 6

Use multiple drugs to achieve goal:   Inhalation agents
  IV induction agents
  Sedative/hypnotic agents
  Opioids
  Neuromuscular blocking drugs

Question 7

All IV induction agents are

Answer 7

lipophilic, cross BBB

Question 8

Recovery from a single dose of drug is caused by

Answer 8

redistribution of the drug to less perfused tissues.

Question 9

T/F Single dose termination is determined by extent or speed of metabolism.

Answer 9

FALSE

Single dose termination IS NOT determined by extent or speed of metabolism.

Question 10

Two of the most common barbiturates in Anesthesia:

Answer 10

Thiopental (no longer used, death penalty)

Question 11

In Alpha 2 receptors, the medication binds to _______ and slows the release of _______, which slows fight or flight (sympathetic)
An agonist that slows down the body

Answer 11

norepinephrine, norepinephrine

Precedex

Question 12

Mechanism of action for Barbiturates:

Answer 12

Post synaptic enhancement of GABA mediated neurotransmitters

Question 13

Barbiturates are reversibly bound to

Answer 13

protein (plasma albumin)

an increased free level if albumin levels are low

Question 14

Barbiturates have a prompt and predictable __________, but does not have any _________

Answer 14

loss of consciousness

NO analgesic properties

Question 15

Barbiturates can abruptly stop

Answer 15

seizures

Question 16

Barbiturates blunt the baroceptor relfex, which may cause a compensatory

Answer 16

increase in HR

Question 17

Barbiturates cause a

Answer 17

histamine release

Question 18

Barbiturate contraindications:

Answer 18

Porphyria

Allergy

Question 19

Benzodiazepines scope of properties include

Answer 19

Anxiolytic
Sedation
Anticonvulsant
Muscle Relaxation
Amnesia

Question 20

Midazolam has a _______ and work on _______

Answer 20

imidazole ring, GABA

Question 21

Midazolam is highly

Answer 21

lipid soluble and protein bound

Question 22

Midazolam (is/ is not) neuroprotective

Answer 22

IS NOT

Question 23

Withdrawal of barbs/ benzos may last

Answer 23

weeks to months
must be tapered off
cause opposite symptoms, HTN, tachy

Question 24

Flumazenil reverses

Answer 24

benzos (benzo agonist) competitive

may precipitate withdrawal

Question 25

Propofol requires a

Answer 25

lipid vehicle, which makes it prone to bacterial growth

Question 26

some formulations of propofol have a

Answer 26

sulfite, which may cause allergic reactions

Question 27

Mechanism of action for propofol

Answer 27

GABA

Question 28

Propofol has/ does not have neuroprotective effects

Answer 28

HAS

Question 29

Side effects of propofol include

Answer 29

rare but potential for PE

Question 30

Propofol Infusion Syndrome is a

Answer 30

lactic acidosis seen generally at higher doses for >24 hours, causes Kidney Fx, Rhabdo, Cardiac Arrest tx: stop propofol, tx acidosis, support organ fx

Question 31

Ketamine works on

Answer 31

NMDA receptors

Question 32

Ketamine requires a ______ with administration for amnesia

Answer 32

benzo

Question 33

Use of ketamine may cause _______ if not additionally given a benzo

Answer 33

emergence delirium

Question 34

The active metabolite of Ketamine is

Answer 34

norketamine

Question 35

Do not use ketamine in patients with

Answer 35

intracranial pathology

Question 36

Ketamine may be used for ______, when other drugs fail

Answer 36

status epilepticus

Question 37

Etomidate causes a depression of

Answer 37

adrenocortical function for 4-8 hours after a dose. Patients with sepsis/hemorrhage may be at a disadvantage receiving Etomidate if the cortisol response is compromised.

Question 38

Etomidate works on

Answer 38

the GABA receptor

Question 39

Etomidate is the drug of choice for

Answer 39

unstable cardiac patients. (provides cardiovascular stability)

Question 40

The use of etomidate increases incidence of _______ and dose not effect duration of induced seizure activity, good for _______, low incidence of ________

Answer 40

PONV ECT allergic reaction

Question 41

Dexmedetomidate is a

Answer 41

highly selective alpha-2 adrenergic agnonist

Question 42

With dexmedetomidate use, all other concentrations of anesthetic agents must be __________

Answer 42

decreased (synergistic effects with other anesthetics)

Question 43

With use of dexmedetomidate, there is a risk of ___________.

Answer 43

Tolerance