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241 Cards in this Set

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WHAT IS THE FAT:BLOOD PARTITION COEFICIENT OF THIOPENTAL
11
WHAT IS HALF LIFE IN HOURS OF THIOPENTAL?
METHOHEXITAL?
THIO 11.6
METHOHEXITAL 3.9
IS THERE A CLINICALLY SIGNIFICANT EFFECT OF BARBITURATES ON THE NMJ?
NO, THAT IS WHY MUSCLE RELAXATION DOES NOT OCCUR
THE MOST IMPORTANT ADVANTAGE OF METHOHEXITAL OVER THIOPENTAL IS?
MORE RAPID RECOVERY OF CONSCIOUSNESS
WHAT ISTHE DISADVANTAGE ON USING METHOHEXITAL?
MYOCLONUS
(INVOLUNTARY MUSCLE MOVEMENTS) HICCOUGHS CAN OCCUR
WHAT IS THE INDUCTION DOSE OF THIOPENTAL?
3-5 MG/KG
WHICH BARBITURATE INDUCES SEIZURE ACTIVITY?
METHOHEXITAL OR THIOPENTAL
METHOHEXITAL
CAN BARBITURATES BE USED TO DECREASE ICP?
YES
WHAT EFFECT DO BARBITURATES HAVE ON CV?
DCREASE ON BP 10-20mmHG DUE TO PERIPHERAL VASODILATION.
INCREASE ON HR 15-20 BPM
WHAT CAN HAPPEN WITH RAPID IV ADMINISTRATION OF BARBS?
HISTAMINE RELEASE
BARBS PRODUCE A DOSE DEPENDENT DEPRESSION ON VENTILATION AFFECTING WHAT TWO AREAS?
MEDULLARY AND PONTINE VENTILATORY CENTERS.
(DECREASES SENSITIVITY TO CARBON DIOXIDE)
HOW IS SPONTANEOUS BREATHING CHARACTERIZED AFTER BARBS ADMINISTRATION?
SLOW FREQUENCY
DECREASE TIDAL VOL.
WHICH TWO DRUGS AS CONSIDERED BARBITURATES?
THIOPENTAL
METHOHEXITAL
WHICH THREE DRUGS ARE CONSIDERED NON-BARBITURATES?
PROPOPHOL
KETAMINE AND
ETOMIDATE
KETAMINE IS ASSOCIATED WITH WHAT STREET DRUG?
PCP
WHAT INDUCTION AGENT DOES NOT WORK ON GABA?
KETAMINE---NMDA
WHAT IS THE MAJOR INHIBITORY TRANSMITTER IN THE CNS?
GABA
WHERE DO BARBS WORK?
GABA
WHAT THREE COMPONENTS OF THE CNS?
SPINAL CORD
CEREBELUM
CEREBRAL CORTEX
BASAL GANGLIA
WHAT ISTHE AMOUNT OF GABA SYNAPSES IN THE CNS?
1/3
HOW MANY MOLECULES OF GABA BIND TO THE RECEPTOR
2
WHICH GABA SUBUNITS WORK WITH ANESTHETICS
ALPHA AND BETA
AFTER 2 TO 7 DAYS OF SUSTAIND DRUG ADMINISTRATION, WHAT DO BARBS STIMULATE IN LIVER?
AN INCREASE IN LIVER MICROSOMAL PROTEIN CONTENT (ENZYME INDUCTION)
(INCREASE SYNTHESIS OF P-450)
CAN LEAD TO EXACERBATION OF PORPHYRIA.
SYMPTOMS OF PORPHYRIA EXACERBATION (3)?
ABDOMINAL PAIN
NEUROTOXICITY WITH PSYCHOSES
HYPOTENSION
INTRAARTERIAL INJECTION OF THIOPENTAL RESULTS IN WHAT IMMEDIATE RESPONSE?
INTENSE VASOCONSTRICITION AND INTENSE PAIN ALONG THE DISTRIBUTION OF THE ARTERY.
WITH ARTERIAL INJECTION OF THIPENTAL ONE MAY SEE WHAT CV SYMPTOMS?(5)
OBSCURED DISTAL ARTERIAL PULSES
BLANCHIN OF EXTREMITY
CYANONIS
GANGRENE
PERMANENT NERVE DAMAGE
WHAT IS THE PATHOGENESIS THAT CAUSES TISSUE NECROSIS FOLLOWING INTRAARTERIAL INJECTION OF BARBITUATES?
PRECIPITATION OF BARBITURATE CRYSTALS LEADING TO INFLAMATORY RESPONSE AND ARTERITIS COUPLED WITH MICROEMBOLIZATION
WHAT DRUGS CAN BE USED TO PRODUCE VASODILATION (INTRAARTERIAL ERROR)?
LIDOCAINE
PAPAVERINE
PHENOXYBENZAMINE
WHAT CAUSES VENOUS THROMBOSIS AFTER ADMINISTRATION OF BARBS?
DEPOSITION OF BARB CRYSTALS IN THE VEINS.
WHAT IS THE INCIDENCE OF ALLERGIC REACTION IN 30,000 CASES?
1
WHAT RESPONSE DO BARBS HAVE ON NEUTROPHILS?
IMPAIRS FUNCTION WHICH ALLOWS INFECTIONS TO DEVELOP.
IT DECREASES AUTOTISSUE INJURY
NEUTROPHIL IMPAIRMENT IS NOTED WITH WHAT DRUGS (3)?
BARBITURATES, MIDAZOLAM AND KETAMINE
PROPOPHOL IS A SUBSTITUDED__________?
ISOPROPYLPHENOL
WHAT ARE CONTENTS OF 1% PROPOFOL SOLUTION (3)?
SOYBEAN OIL 10%
GLYCEROL 2.25%
PURIFIED EGG LECITHIN 1.2%
WHAT IS THE INDUCTION DOSE OF PROPOFOL?
1.5 TO 2.5 MG/KG
WHAT IS THE PH OF 2.5% SOLUTION OF THIOPENTAL
10.5
WHAT IS THE INDUCTION DOSE OF THIOPENTAL?
3-6 MG/KG
WHAT IS INDUCTION DOSE OF KETAMINE?
METHOHEXITAL?
PROPOFOL
1-2 MG/KG
1-2 MG/KG
1-2.5 MG/KG
WHAT IS THE HIGHLIGHT OF PROPOFOL AND HOW FAST DOES IT PRODUCE UNCONSCIOSNESS?
THE RAPID RETURN TO CONSCIOUSNESS.
30 SECONDS
HOW DOES PROPOFOL WORK?
RESULTS IN HYPERPOLARIZATION OF THE POSTSYNAPTIC CELL MEMB. AND FUNCTIONAL INHIBITION OF THE POSTSYNAPTIC NEURON.
PROPOFOL HEPATIC METABOLISM IS RAPID, RESULTING IN WATER SOLUBLE SULFATE AND GLUCORONIC ACID METABOLITES EXCRETED WHERE?
KIDNEY
WHAT IS THE AMOUNT OF UNCHANGED PROPOFOL SECREATED IN THE URINE?
LESS 3%
WHAT IS THE ELIMINATION HALF LIFE OF PROPOFOL?
.5 TO 1.5 HOURS
DOES PROPOFOL CROSS THE PLACENTA AND WHAT PERCENT IS TRAPPED?
YES,
NONE, IT IS READILY CLEARED FROM NEONATAL CIRCULATION
WHAT IS THE INDUCTION DRUG OF CHOICE FOR MANY SURGICAL PROCEDURES?
PROPOFOL
AT WHAT RATE DOES PROPOFOL INFUSE FOR SEDATION? FOR MAINTENANCE?
25-75 mcg/Kg/min
100 to 300 mcg/kg/min
DO CHILDREN REQUIRE LARGER OF SMALLER DOSES OF PROPOFOL?
LARGER
WHAT IS THE MAIN REASONS THAT PROPOFOL HAS REPLACED THIOPENTAL (2)?
SHORT ELIMINATION HALF LIFE
FASTER WAKE UP
WHAT OTHER PROPERTIES DOES PROPOFOL HAVE (3)
ANTIEMETIC
ANTICONVULSANT
AMNESIC
WHERE DO THE ANTIEMETIC PROPERTIES OF PROPOFOL WORK?
CRTZ
VOMITING CENTER
AT WHAT DOSE DOES PROPOFOL HAVE ENTIEMETIC PROPERTIES FOR POST OP?
SUBHYPNOTIC DOSE
10-15 MG IV
PROPOFOL IS EFFECTIVE FOR PRURITUS THAT IS ASSOCIATED WITH ADMINISTRATION OF OPIOIDS THIS MAY BE DUE TO?
PROPOFOL ABILITY TO DEPRESS THE SPINAL CORD ACTIVITY
DOES PROPOFOL HAVE ANALGESIC PROPERTIES?
NO
DOES PROPOFOL HAVE ANTIEPILEPTIC PROPERTIES?
YES
TRUE OF FALSE. KETAMINE IS THE ONLY INDUCTION DRUG THAT DECREASES CBF, CMRO2, AND ICP
FALSE, IT INCREASES ALL.
ALL THE OTHERS DECREASE ALL THREE FUNCTIONS
PROPOFOL IN LARGE DOSES MAY ________ SYSTEMIC BLOOD PRESSURE, THEREFORE DECREASING CPP
DECREASE
PROPOFOL WILL DECREASE ORGAN SYSTEMS COMPONENTS EXCEPT IT WILL NOT AFFECT _________ OR __________.
HEART RATE-will not change
BROCHIODILATION-will not change
A QUALITY THAT MIDAZOLAM HAS AND IS ALSO POSSESSED BY PROPOFOL IS?
DEGREE OF MEMORY IMPAIRMENT.
THIOPENTAL HAS MILD MEMORY EFFECTS
FROM THE SUMMARY OF INDUCTION DRUGS WHICH IS THE ONLY ONE THAT INCREASES MAP?
KETAMINE
DOES THE HEART RATE INCREASE WITH PROPOFOL?
DOES IT CAUSE A DECREASE IN BP?
NO, BRADYCARDIA AND ASYSTOLE HAVE BEEN REPORTED.
YES
CAUTION WITH CHILDREN AND PROPOFOL IN THE LONG TERM ICU DUE TO
REFRACTORY FATAL BRADYCARDIA
PROPOFOL DECREASES ALL BUT (2)?
HEART RATE-NO CHANGE
NO CHANGE IN BRONCHIODILATION.
APNEA WILL LAST 30 SECS.
WHICH IS THE INDUCTION DRUG OF CHOICE FOR LMA PLACEMENT?
PROPOFOL
A GREATER DEPRESANT OF THE UPPER AIRWAY
HOW CAN PROPOFOL HELP IN PATIENTS WITH ASTHMA?
IT PRODUCES BROHCHIODILATION AND DECREASES INTRAOP WHEEZES.
WILL PROPOFOL CHANGE THE COLOR OR URINE?
YES, GREEN DUE TO PHENOLS
DOES A HISTORY OF EGG ALLERGY CONTRAINDICATE THE USE OF PROPOFOL?
NO,
BECAUSE MOST Egg ALLERGIES INVOLVE THE EGG ALBUMIN AND PROPOFOL LECITHIN IS EXTRACTED FROM THE EGG YOLK
WHAT PERCENT OF PATIENT THAT RECEIVE PROPOFOL REPORT VIVID DREAMS?
7%
PROPOFOL STRONGLY SUPPORTS THE GROWTH OF E. COLI, CANDIDA ALBICANS, AND PSEUDOMONAS. AN OPEN SAMPLE MUST BE DISCARDED WITHIN?
6 HOURS
TRUE OR FALSE. THE GENERIC PROPOFOL IS NOT LICENSED FOR SEDATION IN PATIENTS UNDER AGE 17.
TRUE
AN INDICATION NOT TO USE PROPOFOL IS A KNOWN HYPERSENSITIVITY. WHAT IS THE OTHER?
PATIENT WITH FAT METABOLISM DISORDERS.
PROPOFOL CAUSES PAIN ON INJECTION. WHAT CAN BE USED?
1% LIDOCAINE IV
OR ADD 20MG LIDOCAINE TO SOLUTION(MAY DESTABILIZE SOY BEAN EMULSION)
ACCIDENTAL INJECTION OF INTRAARTERIAL PROPOFOL HAS BEEN DESCRIBED AS SEVERE PAIN. DOES IT CAUSE VASCULAR COMPROMISE?
NO
STRUCTURALLY ETOMIDATE IS A?
CARBOXYLATED IMIDAZOLE RING
ETOMIDATES CI RING PROVIDES WATER SOLUBILITY IN ______ SOLUTIONS AND ______SOLUBILITY IN _______ ___.
ACIDIC
PHYSIOLOGIC PH
ETOMIDATE IS DISOLVED IN PROPYLENE GLYCOL WHICH CAUSES PAIN ON INJECTION. THERE IS HIGH INCIDENCE OF _____THAT CAN OCCUR UP TO POST OP DAY 3.
THROMBOPHLEBITIS
WHAT IS THE INDUCTION DOSE OF ETOMIDATE?
0.3MG/KG
ETOMIDATE MIMICS AND INHIBITS WHAT TRANSMITER/RECEPTOR?
GABA
WHAT IS THE INDUCTION DOSE OF ETOMIDATE FOR A 70KG MAN?
0.3MG/KG X 70 =21MG
ETOMIDATE'S DISINHIBITORY EFFECTS ON PARTS OF THE BRAIN THAT CONTROL EXTRAPYRAMIDAL MOTOR ACTIVITY RESULTS IN?
MYOCLONIC MOVEMENTS
DUE TO ITS LARGE FRACTION OF NON-IONIZED (99%)AFTER 75%IS PROTEIN BOUND IT HAS A _____ ONSET OF ACTION
RAPID ONSET OF ACTION
30 SECONDS.
ETOMIDATE IS METABOLIZED BY?
HEPATIC MICROSOMAL ENZYMES
PLASMA ESTERASES
METABOLISM IS 5 X FASTER THAN THIOPENTAL
WHICH INDUCTION AGENT HAS THE MINIMAL EFFECTS ON CV SYSTEM?
ETOMIDATE
VERY CARDIOSTABLE
ETOMIDATES MILD REDUCTION IN PVR WILL RESULT IN WHAT CHANGE IN ARTERIAL BP
SLIGHT DECLINE
WHAT PERCENT OF HISTAMINE IS RELEASED IS BY ETOMIDATE?
NONE
ETOMIDATE IS AN EXCELENT INDUCTION DRUG FOR PATEINTS WITH?
POOR CARDIAC RESERVE
HYPOVOLEMIA
ETOMIDATE INDUCTION DOSE WILL NOT RESULT IN APNEA UNLESS_________HAVE BEEN GIVEN
OPIOIDS
SINCE ETOMIDATE DECREASES CBF, CMRO2 AND ICP, IT IS A CHOICE DRUG FOR? ___________
CRANIES
CPP IS MAINTAINED BECAUSE ITS MINIMAL CV EFFECTS.
ETOMIDATE MUST BE USED WITH CAUTION IN PATIENT WITH A HISTORY OF ?
SEIZURES
ETOMIDATE CAUSES EDRENOCORTICAL SUPPRESSION BY INHIBITING OF THE ENZYME BETA-11-HYDROLAZE WHICH INHIBITS THE CONVERSION OF?
CHOLESTEROL TO CORTISOL. THIS INHIBITION LASTS 4-8 HOURS.
ETOMIDATE IS ASSOCIATED WITH HIGH INCIDENCE OF ?
NAUSEA AND VOMITING
WHAT INDUCTION DRUG IS A STRUCTURAL ANALOGUE OF PHENCYCLIDINE(PCP)?
KETAMINE
ONE TENTH AS POTENT BUT RETAINS MANY OF PSYCHOMIMETIC EFFECTS
SINCE ETOMIDATE DECREASES CBF, CMRO2 AND ICP, IT IS A CHOICE DRUG FOR? ___________
CRANIES
CPP IS MAINTAINED BECAUSE ITS MINIMAL CV EFFECTS.
ETOMIDATE MUST BE USED WITH CAUTION IN PATIENT WITH A HISTORY OF ?
SEIZURES
ETOMIDATE CAUSES EDRENOCORTICAL SUPPRESSION BY INHIBITING OF THE ENZYME BETA-11-HYDROLAZE WHICH INHIBITS THE CONVERSION OF?
CHOLESTEROL TO CORTISOL. THIS INHIBITION LASTS 4-8 HOURS.
ETOMIDATE IS ASSOCIATED WITH HIGH INCIDENCE OF ?
NAUSEA AND VOMITING
WHAT INDUCTION DRUG IS A STRUCTURAL ANALOGUE OF PHENCYCLIDINE(PCP)?
KETAMINE
ONE TENTH AS POTENT BUT RETAINS MANY OF PSYCHOMIMETIC EFFECTS
WHICH IS THE ONLY INDUCTION DRUG THAT HAS ANALGESIC EFFECTS?
KETAMINE
WHAT AREA OF THE CNS RELAYS SENSORY IMPULSES FROM THE RAS TO THE CEREBRAL CORTEX?
THE THALAMUS
WHAT FUNCTION DOES THE LIMBIC COrTEX HAS?
AWARENESS OF SENSATION
WHAT INDUCTION DRUG FUNCTIONALLY DISSOCIATES THE THALAMUS FROM THE LIMBIC CORTEX?
KETAMINE
DOES KETAMINE CAUSE TOTAL NEURON INHIBITION?
NO, SOME NEURON ARE INHIBITED WHILE OTHERS ARE TONICALLY EXCITED
ANESTHESIA WITH THE USE OF KETAMINE HAS BEEN DESCRIBED AS? WHAT WILL THE PATIENT DISPLAY?
DISSOCIATIVE ANESTHESIA.
EYE OPENING, SWALLOWING, MUSCLE CONTRACTURES BUT UNABLE TO RESPOND TO SENSORY INPUT.
KETAMINE ANTAGONIZES WHAT RECEPTOR?
NMDA
WHAT IS THE EXCITATORY NEUROTRANSMITTER WITH NMDA RECEPTOR?
GLUTAMATE
IT IS SUGGESTED THAT KETAMINE IS AN ANTAGONIST AT THE ___ RECEPTOR AND AGONIST AT THE ____.
MU
KAPPA
WHAT ARE SOME ANTICHOLINERGIC SYMPTOMS PRODUCED BY KETAMINE?
EMERGENCE DELIRIUM, BRONCHODILATION, SYMPATHOMIMETIC ACTION
BESIDES IV ADMINISTRATION, CAN KETAMINE BE GIVEN IM?
YES, AT A DOSE OF 3-5 MG/KG
WHAT IS THE IV INDUCTION DOSE OF KETAMINE?
1-2 MG/KG
KETAMINE IS METABOLIZED IN THE LIVER. ONE OF THE METABOLITES IS _____ AND RETAINS __________ ACTIVITY.
NORKETAMINE
ANESTHETIC
WHAT INDUCTION DRUG SHOULD BE AVOIDED WITH PATIENT WHO HAVE CAD, CHF, HTN, ARTERIAL ANEURISMS?
KETAMINE
WHAT INDUCTION DRUG IS EFFECTIVE IN PATIENTS WITH HYPOVELEMIC SHOCK?
KETAMINE
WHAT INDUCTION DRUG IS A POTENT BRONCHIODILATOR AND IS A GOOD INDUCTION AGENT FOR ASTHMATICS?
KETAMINE
IF KETAMINE IS TO BE USED, WHAT MEDICATION MUST BE ADMINISTERED PREOPERATIVELY?
AN ANTISIALAGOGUE DUE TO INCRASE SALIVATION AND TRACHEOBRONCHIAL SECRETIONS
ATROPINE AND SCOPOLAMINE CAN CROSS THE BBB AND CONTRIBUTE TO ?
INCIDENCE OF DELIRIUM WHEN USING KETAMINE
WHAT CAN BE A GOOD REVERSAL AGENT FOR KETAMINE?
GLYCOPYRROLATE, ROBINUL
KETAMINE INCREASES ALL LISTED FACTORS, BUT SLIGHTLY DECREASES_____?
VENTILATORY DRIVE
WHAT ARE PSYCHOTOMIMETIC SIDE EFFECTS OF KETAMINE?
WHEN ARE THESE LESS COMMON?
HALLUCINATIONS
DISTRUBING DREAMS
DELIRIUM
LESS COMMON WHEN GIVEN MIDAZOLAM
OF THE INVTRAVENOUS ANESTHETIC AGENTS KETAMINE IS THE CLOSES TO "COMPLETE ANESTHETIC SINCE IT INDUCES?
ANESTHESIA
AMNESIA
UNCONSCIOUSNESS
KETAMINE CAN CAUSE SEIZURES WHEN GIVEN WITH________.
THEOPHYLINE
KETAMINE IS UNDESIRABLE AGENT FOR OPERATIONS OF THE EYE AS IT CAUSES?
NYSTAGMUS
THE NMDA RECEPTOR IS USUALLY NOT EXcITED EXCEPT IN WHAT PATIENT POPULATION?
CHRONIC PATIENTS
WHAT CLINICAL AREA USES KETAMINE?
OB
NAME THREE BARBITURATES
THIOPENTAL METHOHEXITAL AND THIAMYLAL (NOT SOLD IN US)
NAME 3 NONBARBITUATES USED FOR INDUCTIONS?
KETAMINE
PROPOFOL
ETOMIDATE
IS THE RAS PART OF THE CNS?
NO
WHAT CAUSES THE SEDATIVE HYPNOTIC EFFECTS OF BARBITURATES?
DEPRESSION OF THE RAS
WHAT IS THIOPENTAL TRADE NAME?
PENTOTHAL
OTHER NAME FOR THIAMYLAL?
SURITAL
BREVITAL IS USED IN WHAT SETTING?
ECT
ELECTRO SHOCK THERAPY
WHAT IS THE PRIMARY CONTENT OF BARBS?
SODIUM SALTS, SOLUBLE IN WATER
BARBS ARE HIGHLY ALKALINE, WHEN MIXED IN ACID, IT WILL____?
PRECIPITATE
WHEN INJECTED PERIPHERALY, BARBS CAN CAUSE?
PHLEBITIS
WHAT IS THE PH OF THIOPENTAL?
10.5
PENTOTHAL IS INCOMPATIBLE IN WHAT FLUID?
LR
THREE DRUGS THAT ARE ACIDIC?
OPIOIDS
CATECHOLAMINES
NMBA
HOW LONG CAN BREVITAL LAST RECONSTITUTED? PENTOTHAL?
6 WEEKS
2 WEEKS
EXCITATORY NEUROTRANSMITTER THAT BINDS TO NMDA?
GLUTAMATE
KETAMINE BLOCKS THE OPEN ION CHANNEL AND PREVENTS FURTHER ION INFLUX INHIBITING THE EXCITATION RESPONSE TO?
GLUTAMATE
WHAT DETERMINES LIPID SOLUBILITY
THE UN-IONIZED PORTION OF THE DRUG.
WHAT PERCENTAGE OF WARFARIN/COUMADIN ARE BOUND TO PROTEIN?
99%
WHAT IS THE FAT/BLOOD COEFFICIENT OF THIOPENTAL?
11 TO ONE
DISTRIBUTION OF BARBITURATES IS DETERMINED BY (3) FACTORS, WHICH IS THE MOST IMPORTANT?
LIPID SOLUBILITY(MOST IMP.)
PROTEIN BINDING
IONIZATION
HOW ARE BARBS METABOLIZED AND WHERE?
OXIDATION IN THE LIVER.
CAN BE METABOLIZED EXTRAHEPATICALLY BY CNS AND KIDNEYS
WHY IS THIOPENTAL SLOWER TO METABOLIZE WHEN COMPARED TO BREVITAL?
IT IS SLOWER DUE DISTRIBUTION IN MUSCLE GROUPS
ARE BARBITURATES ELIMINATED BY EXCRETION?
NO, DONE BY CLEARANCE. IT IS FIRST PROTEIN BOUND THEN METABOLIZED IN LIVER -OXYDATION.
WHAT IS THE PH OF THIOPENTAL?
10.6
WHAT PERCENT OF THIOPENTAL IS PROTEIN BOUND AND WHAT PERCENT IS NOIONIZED?
80%
60% OF THE 20 IS NONIONIZED.
METHOHEXITAL IS 3-4 TIMES FASTER DUE TO WHAT?
LESS LIPID SOLUBLE BUT UNIONIZED.
WHAT WILL ALKALOSIS AND ACIDOSIS DO TO NON-IONIZATION OF DRUGS?
ALKALOSIS WILL DECREASE THE NON-IONIZED PORTION
ACIDOSIS WILL INCREASE THE NON-I PORTION.
WHAT 2 CONDITIONS WILL INCREASE THE SENSITIVITY OF BARBS?
CIRRHOSIS-(LESS ALBUMIN, LESS PROTEIN BINDING.)
UREMIA
THREE PROPERTIES OF THIOPENTAL?
ANTICONVULSANT-MAJOR
AMNESIC
HYPERALGESIC-MAKES PAIN MORE INTENSE
CHARACTERISTIC RESPIRATORY DEPRESSION OF BARBS?
SLOW RATE AND LOW TIDAL VOLUME.
WHAT INDUCTION DRUGS WILL YOU AVOID WITH PORPHYRIA?
THIOPENTAL
WHAT TWO CONDITIONS ARE AVOIDED WITH THE USE OF THIOPENTAL?
ASTHMA - HISTAMINE RELEASE
PORPHYRIA
IS THIOPENTAL USED FOR CONT. IV INFUSIONS?
NO, BECAUSE OF THE 11 TO 1 FAT BLOOD COMPARTMENT
WHAT DO BARBS DEPRESS TO CAUSE A DECREASE IN SYSTEMIC BLOOD PRESSURE?
SNS
IF PATIENT IS HYPOVOLEMIC, WILL THERE BE A DECREASE OR INCREASE IN SENSITIVITY TO BARBS?
INCREASE DO TO MORE CONC. OF DRUG GOING TO VRG.
IS BREVIAL A BARB OR NON-BARB?
BARB
GIVE TWO SIDE EFFECTS OF BREVITAL?
HICCOUGHS
SEIZURES-NOT ANTICONVULSANT
WHAT IS THE DOSE OF BREVITAL?
1-2 MG PER KG
WHAT PERCENT OF BREVITAL IN NON-I FORM?
76, USE SMALLER DOSES
WHAT IS THE ELIMINATION HALF LIFE OF BREVITAL?
3.9 HRS.
THIOPENTAL IS 11.6
WHAT CAUSES A DROP IN BLOOD PRESSURE WITH PROPOFOL?
BARORECEPTOR RESPOSE.
NO OR LITTLE HR DECREASE NOTED.
HOW WILL A PATIENT ON BETA BLOCKERS GET A BARORECEPTOR RESPONSE IN HYPOVOLEMIA?
NO RESPONSE, NO CARDIAC KICK FROM BARORECEPTORS
BARBS WILL CAUSE A DOSE DEPENDENT VENTILATORY DEPRESSION ON WHAT TWO AREAS?
MEDULLARY CENTER
PONTINE VENTILATORY CENTER
(DECREASING SENSITIVITY OF AREAS TO CO2 AND HYPOXIA)
RAPID INFUSION OF BARBS CAN CAUSE?
HISTAMINE RELEASE, ESPECILLY WITH ASTHMATICS
WHEN USING BARBS-PENTOTHAL IN A LIGHT PATIENT WHAT WILL HAPEN DURING INTUBATION?
LARYNGOSPAMS AS BLADE GOES IN.
BRONCHIOCONSTRICTION
(USE OPIOIDS TO BLUNT THE AIRWAY.)
WHAT CONDITION CAN ENZYME INDUCTION EXACERBATE?
PORPHYRIA
WHAT DO BARBS STIMULATE IN THE LIVER?
MICROSOMAL PROTEIN CONTENT.
WHICH IS THE MOST POTENT BARB IN PROMOTING ENZYME INDUCTION?
PHENOBARBITAL
WHAT ARE THE 3 SIGNS AND SYMPTOMS OF PORPHYRIA?
ABDOMINAL PAIN
PSYCHOSIS(NEUROTOXICITY)
HYPOTENSION
WHAT CONDITION IS IDENTIFIED AS AN INBORN ERROR OF METABOLISM CHARACTERIZED BY OVERPRODUCTION OF PROPHYRIN COMPOUNDS INVOLVED IN THE HEME SYNTHESIS PATHWAY?
PORPHYRIA
AVOID THIS TWO DRUGS WITH PORPHYRIA?
THIPENTAL
DEMEROL
WHAT INDUCTION DRUG DO YOU NOT GIVE TO ASTHMATICS?
PENTOTHAL
WHAT ARE BARBITURATES DERIVED FROM?
BARBITURIC ACID
BARBS ARE GOOD ANTICONVULSANTS DUE TO WHAT?
PHENYL GROUP
WHAT IS THE HALF LIFE OF PROPOFOL? WHAT DOES IT DO TO HR?
.5 TO 1.5 HRS.
STAYS THE SAME OR MINIMAL CHANGE
IS PROPOFOL MORE OR LESS VENT. DEPRESSANT THAN THIO AND HOW LONG WILL APNEA LAST?
MORE THAN THIOPENTAL
30 SECONDS
IS PROPOFOL A BARB ON NONBARB?
NONBARBITURATE
WHAT IS PROPOFOL INDUCTION DOSE?
1.5 TO 2.5 MG/KG
FOUR GOOD PROPERTIES OF PROPOFOL?
HOW FAST IS IT?
ANTIEMETIC
FAST-30 SECS
ANTICONVULSANT
AMNESIC
ANTIPRURETIC
AT WHAT DOSE IS PROPOFOL USED AS ANTIEMTIC SUBHYPNOTIC DOSE?
10-15MG IV
WHAT TWO INDUCTION DRUGS CAN BE GIVEN IF SEIZURES?
PROPOFOL AND PENTOTHAL
DOES PROPOFOL MAINTAIN CPP?
YES, MAINLY DUE TO QUICK ACTING. NO HANGOVER EFFECT
ALL INDUCTION AGENTS WORK ON GABA EXCEPT?
KETAMINE-NMDA
WHAT TWO PATIENT POPULATIONS ARE AVOIDED WITH PROPOFOL?
CHILDREN AND YOUNG NEURO PATIENTS
WHAT CAN PROPOFOL INFUSION CAUSE IN CHILDREN?(3)
LIPEMIA
METABOLIC ACIDOSIS
DEATH
WHY DO CHILDREN REQUIRE HIGHER DOSES?
LARGER CENTRAL DISTRIBUTION
WHAT ARE THE TWO BRAIN PROTECTIVE INDUCTION DRUGS?
ETOMIDATE AND PENTOTHAL
PENTOTHAL IS STILL THE DRUG OF CHOICE EVEN IF NO QUCICK WAKE UP.
PROPOFOL EFFECTS ON CEREBRAL SYSTEM? 3
DECREASES ICP, CMRO2 CBF
WHAT CARDIAC COMPLICATION CAN HAPPEN WITH PROPOFOL
BRADYCARDIA AND ASYSTOLE
PROPOFOL IS THE BEST CHOICE DRUG FOR LMA PLACEMENT. WHY?
DEPRESSES UPPER AIRWAY REFLEXES
WHEN CARDIAC ANTIHYPERTENSIVES(LABETOLOL, NIPRIDE...FAIL TO DROP BP WHAT CAN BE USED?
PROPOFOL
WHAT INTRAOP CONDITION CAN PROPOFOL HELP?
ASTHMA WHEEZING DUE TO BRONCHODILATION PROPERTIES
WHAT IS PROPOFOL INDUCTION DOSE AND HALF LIFE?
1.5 TO 2.5 MG/KG
.5 TO 1.5
WHAT DRUG HAS THE CARBOXYLATED RING, WHAT IS THE INDUCTION DOSE AND HOW MUCH DO YOU GIVE TO A 70KG PT?
ETOMIDATE
0.3 MG/KG
21MG
WHAT METABOLIZES THE CARBOXYLATED RING DRUG?
ETOMIDATE IS METABOLIZED BY HME AND PLASMA ESTERASES
WHAT CAUSES PAIN WITH ETOMIDATE INFUSION?
THE PROPYLENE GLYCOL ADDITIVE
ETOMIDATE ENHANCES THE EFFECTS OF WHAT NEUROTRANSMITTER?
GABA. IT ENHANCES THE EFFECTS, NOT MIMIC
ETOMIDATE IS SECOND TO WHICH DRUG IN QUICK AWAKENING PROPERTY.
PROPOFOL
WHICH ISOMER IS ACTIVE ON ETOMIDATE?
THE RIGHT
ETOMIDATE CAN BE USED WITH CRANIES, BUT WHICH IS THE TRUE BRAIN PROTECTANT?
THIOPENTAL
ETOMIDATE CAUSES WHAT NEURO EFFECTS ON THE EXTRAPYRAMIDAL TRACTS?
MYOCLONUS CAN MIMIC SEIZURES.

GIVE OPIOIDS TO MINIMIZE TONIC CLONIC MOVEMENTS
ETOMIDATE CAN INCREASE MORTALITY IN CRITICAL PATIENTS BECAUSE OF?
ADRENOCORTICAL SUPPRESSION
ETOMIDATE HAS HIGH INCIDENCE OF THIS GI SYMPTOM?
NV
WHAT MAKES KETAMINE DIFFERENT FROM OTHER INDUCTION DRUGS?
HAS ANALGESIC EFFECTS
WHAT IS THE DOSE OF KETAMINE?
1-2 MG/KG
WHAT RELAYS THE IMPULSES FROMTHE RAS TO THE CORTEX?
THALAMUS
WHAT IS KETAMINES ANESTHESIA TERMED?
DISSOCITATIVE ANESTHESIA
WHERE IS KETAMINE CONSIDERED AN ANTAGONIST?
AT MUSCARINIC SITES
WHERE IS KETAMINE CONSIDERED AN AGOINisT?
AT KAPPA RECEPTORS
WHAT IS THE DOSE OF KETAMINE?
1-2 MG/KG
WHAT RELAYS THE IMPULSES FROMTHE RAS TO THE CORTEX?
THALAMUS
WHAT IS KETAMINES ANESTHESIA TERMED?
DISSOCITATIVE ANESTHESIA
WHERE IS KETAMINE CONSIDERED AN ANTAGONIST?
AT MUSCARINIC SITES
WHERE IS KETAMINE CONSIDERED AN AGOINSIT?
AT KAPPA RECEPTORS
WHAT IS DOSE OF KETAMINE?
1-2MG/KG
WHAT IS THE FUNCTION OF THE LIMBIC CORTEX?
INVOLVEMENT IN THE AWAKRENS OF SENSATION
WHERE IS KETAMINE CONSIDERED AN AGOINST? ANTAGONIST?
AT THE KAPPA RECEPTORS
AT MUSCARINIC SITES
WHICH ONE IS MORE LIPID SOLUBLE THIOPENTAL OR KETAMINE?
KETAMINE.
10 TIMES MORE SOLUBLE THAN THIOPENTAL
WHAT IS THE ACTIVE METABOLITE OF KEATMINE FORMED IN THE LIVER AND HOW STRONG IS IT?
NORKETAMINE
ONE FIFTH AS STRONG AS KETAMINE
THE NMDA RECEPTOR IS ONLY ACTIVE IN WHAT SITUATION?
CHRONIC PAIN
CAN KETAMINE BE GIVEN IM?
YES
WHAT OTHER ROUTES CAN ETOMIDATE AND PROPOFOL BE GIVEN?
NONE
WHAT IS THE INDUCTION DOSE OF KETAMINE
1-2 MG/KG
KETAMINE SHOULD BE AVOIDED IN HX OF COCAINE USE AND STATUS OF _______ DEPLETION AND LONG TERM ILLNES.
CATECHOLAMINE
WHAT ISTHE IM DOSE OF KETAMINE?
3-5 MG/KG
IS KETAMINE A CHOICE IN THE OB SETTING?
NO
DOES KETAMINE INCREASE OR DECREASE SALIVARY AND TRACHIOBRONCHIAL SECRETIONS?
NO, INCREASES
KETAMINE IS CONTRAINDICATED IN CRANIES BECAUSE?
IT IS A CEREBRAL VASODILATOR, INCREASES ICP AND CEREBRAL PERFUSION
WHEN USING KETAMINE, PATIENT WILL NEED WHAT ELSE?
VERSED. KETAMINE WILL CAUSE VIVID DREAMS
WHAT INDUCTION AGENTS ARE GOOD CHOICE IN BAD TRAUMA?
BOP
BLOOD OXYGEN AND PAVULON
WHAT ARE THE FIVE TASKS OF DRUG ELIMINATION
CONJUGATION
HYDROLYSIS
OXYDATION
REDUCTION
EXCRETION
WHAT ARE TWO METHODS OF ELIMINATION?
METABOLISM AND EXCRETION
PHASE ONE METABOLSIM DOES WHAT TO A DRUG?
HOW?3
CONVERTS IT TO A MORE POLAR METABOLITE.
BY OXYDATION REDUCTION AND HYDROLYSIS.
WHAT IS CENTRAL TO THE OXYDATION PATHWAY?
C P-450
WHAT HAPPEN IN THE OXYDATION PROCESS?
ADDITION OF AN OXYGEN
REMOVAL OF A HYDROGEN
WHAT HAPPENS IN THE REDUCTION PROCESS?
ADDITION OF A HYDROGEN
REMOVAL OF A OXYGEN
HOW IS THE CYTOCHROME P 450 METABOLISM INVOLVED DIRECTLY IN HYDROLYSIS?
IT IS NOT!
WHAT ARE THREE DRUG EXAMPLES METABOLIZED BY HYDROLYSIS?
SUCCS
PROCAINE
ESMOLOL
WHAT ARE THE RESULTS OF CYTOCHROME P 450 REACTION?
OXYDIZED P 450
OXYDIZED DRUG(NOW POLAR AND EXCREATABLE)
WATER