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241 Cards in this Set
- Front
- Back
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.
|
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WHICH IS THE MOST POTENT BARB IN PROMOTING ENZYME INDUCTION?
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PHENOBARBITAL
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WHAT ARE THE 3 SIGNS AND SYMPTOMS OF PORPHYRIA?
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ABDOMINAL PAIN
PSYCHOSIS(NEUROTOXICITY) HYPOTENSION |
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WHAT CONDITION IS IDENTIFIED AS AN INBORN ERROR OF METABOLISM CHARACTERIZED BY OVERPRODUCTION OF PROPHYRIN COMPOUNDS INVOLVED IN THE HEME SYNTHESIS PATHWAY?
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PORPHYRIA
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AVOID THIS TWO DRUGS WITH PORPHYRIA?
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THIPENTAL
DEMEROL |
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WHAT INDUCTION DRUG DO YOU NOT GIVE TO ASTHMATICS?
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PENTOTHAL
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WHAT ARE BARBITURATES DERIVED FROM?
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BARBITURIC ACID
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BARBS ARE GOOD ANTICONVULSANTS DUE TO WHAT?
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PHENYL GROUP
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WHAT IS THE HALF LIFE OF PROPOFOL? WHAT DOES IT DO TO HR?
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.5 TO 1.5 HRS.
STAYS THE SAME OR MINIMAL CHANGE |
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IS PROPOFOL MORE OR LESS VENT. DEPRESSANT THAN THIO AND HOW LONG WILL APNEA LAST?
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MORE THAN THIOPENTAL
30 SECONDS |
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IS PROPOFOL A BARB ON NONBARB?
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NONBARBITURATE
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WHAT IS PROPOFOL INDUCTION DOSE?
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1.5 TO 2.5 MG/KG
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FOUR GOOD PROPERTIES OF PROPOFOL?
HOW FAST IS IT? |
ANTIEMETIC
FAST-30 SECS ANTICONVULSANT AMNESIC ANTIPRURETIC |
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AT WHAT DOSE IS PROPOFOL USED AS ANTIEMTIC SUBHYPNOTIC DOSE?
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10-15MG IV
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WHAT TWO INDUCTION DRUGS CAN BE GIVEN IF SEIZURES?
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PROPOFOL AND PENTOTHAL
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DOES PROPOFOL MAINTAIN CPP?
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YES, MAINLY DUE TO QUICK ACTING. NO HANGOVER EFFECT
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ALL INDUCTION AGENTS WORK ON GABA EXCEPT?
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KETAMINE-NMDA
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WHAT TWO PATIENT POPULATIONS ARE AVOIDED WITH PROPOFOL?
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CHILDREN AND YOUNG NEURO PATIENTS
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WHAT CAN PROPOFOL INFUSION CAUSE IN CHILDREN?(3)
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LIPEMIA
METABOLIC ACIDOSIS DEATH |
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WHY DO CHILDREN REQUIRE HIGHER DOSES?
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LARGER CENTRAL DISTRIBUTION
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WHAT ARE THE TWO BRAIN PROTECTIVE INDUCTION DRUGS?
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ETOMIDATE AND PENTOTHAL
PENTOTHAL IS STILL THE DRUG OF CHOICE EVEN IF NO QUCICK WAKE UP. |
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PROPOFOL EFFECTS ON CEREBRAL SYSTEM? 3
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DECREASES ICP, CMRO2 CBF
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WHAT CARDIAC COMPLICATION CAN HAPPEN WITH PROPOFOL
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BRADYCARDIA AND ASYSTOLE
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PROPOFOL IS THE BEST CHOICE DRUG FOR LMA PLACEMENT. WHY?
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DEPRESSES UPPER AIRWAY REFLEXES
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WHEN CARDIAC ANTIHYPERTENSIVES(LABETOLOL, NIPRIDE...FAIL TO DROP BP WHAT CAN BE USED?
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PROPOFOL
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WHAT INTRAOP CONDITION CAN PROPOFOL HELP?
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ASTHMA WHEEZING DUE TO BRONCHODILATION PROPERTIES
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WHAT IS PROPOFOL INDUCTION DOSE AND HALF LIFE?
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1.5 TO 2.5 MG/KG
.5 TO 1.5 |
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WHAT DRUG HAS THE CARBOXYLATED RING, WHAT IS THE INDUCTION DOSE AND HOW MUCH DO YOU GIVE TO A 70KG PT?
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ETOMIDATE
0.3 MG/KG 21MG |
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WHAT METABOLIZES THE CARBOXYLATED RING DRUG?
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ETOMIDATE IS METABOLIZED BY HME AND PLASMA ESTERASES
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WHAT CAUSES PAIN WITH ETOMIDATE INFUSION?
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THE PROPYLENE GLYCOL ADDITIVE
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ETOMIDATE ENHANCES THE EFFECTS OF WHAT NEUROTRANSMITTER?
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GABA. IT ENHANCES THE EFFECTS, NOT MIMIC
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ETOMIDATE IS SECOND TO WHICH DRUG IN QUICK AWAKENING PROPERTY.
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PROPOFOL
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WHICH ISOMER IS ACTIVE ON ETOMIDATE?
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THE RIGHT
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ETOMIDATE CAN BE USED WITH CRANIES, BUT WHICH IS THE TRUE BRAIN PROTECTANT?
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THIOPENTAL
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ETOMIDATE CAUSES WHAT NEURO EFFECTS ON THE EXTRAPYRAMIDAL TRACTS?
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MYOCLONUS CAN MIMIC SEIZURES.
GIVE OPIOIDS TO MINIMIZE TONIC CLONIC MOVEMENTS |
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ETOMIDATE CAN INCREASE MORTALITY IN CRITICAL PATIENTS BECAUSE OF?
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ADRENOCORTICAL SUPPRESSION
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ETOMIDATE HAS HIGH INCIDENCE OF THIS GI SYMPTOM?
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NV
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WHAT MAKES KETAMINE DIFFERENT FROM OTHER INDUCTION DRUGS?
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HAS ANALGESIC EFFECTS
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WHAT IS THE DOSE OF KETAMINE?
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1-2 MG/KG
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WHAT RELAYS THE IMPULSES FROMTHE RAS TO THE CORTEX?
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THALAMUS
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WHAT IS KETAMINES ANESTHESIA TERMED?
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DISSOCITATIVE ANESTHESIA
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WHERE IS KETAMINE CONSIDERED AN ANTAGONIST?
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AT MUSCARINIC SITES
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WHERE IS KETAMINE CONSIDERED AN AGOINisT?
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AT KAPPA RECEPTORS
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WHAT IS THE DOSE OF KETAMINE?
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1-2 MG/KG
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WHAT RELAYS THE IMPULSES FROMTHE RAS TO THE CORTEX?
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THALAMUS
|
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WHAT IS KETAMINES ANESTHESIA TERMED?
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DISSOCITATIVE ANESTHESIA
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WHERE IS KETAMINE CONSIDERED AN ANTAGONIST?
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AT MUSCARINIC SITES
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WHERE IS KETAMINE CONSIDERED AN AGOINSIT?
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AT KAPPA RECEPTORS
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WHAT IS DOSE OF KETAMINE?
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1-2MG/KG
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WHAT IS THE FUNCTION OF THE LIMBIC CORTEX?
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INVOLVEMENT IN THE AWAKRENS OF SENSATION
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WHERE IS KETAMINE CONSIDERED AN AGOINST? ANTAGONIST?
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AT THE KAPPA RECEPTORS
AT MUSCARINIC SITES |
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WHICH ONE IS MORE LIPID SOLUBLE THIOPENTAL OR KETAMINE?
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KETAMINE.
10 TIMES MORE SOLUBLE THAN THIOPENTAL |
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WHAT IS THE ACTIVE METABOLITE OF KEATMINE FORMED IN THE LIVER AND HOW STRONG IS IT?
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NORKETAMINE
ONE FIFTH AS STRONG AS KETAMINE |
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THE NMDA RECEPTOR IS ONLY ACTIVE IN WHAT SITUATION?
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CHRONIC PAIN
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CAN KETAMINE BE GIVEN IM?
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YES
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WHAT OTHER ROUTES CAN ETOMIDATE AND PROPOFOL BE GIVEN?
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NONE
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WHAT IS THE INDUCTION DOSE OF KETAMINE
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1-2 MG/KG
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KETAMINE SHOULD BE AVOIDED IN HX OF COCAINE USE AND STATUS OF _______ DEPLETION AND LONG TERM ILLNES.
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CATECHOLAMINE
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WHAT ISTHE IM DOSE OF KETAMINE?
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3-5 MG/KG
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IS KETAMINE A CHOICE IN THE OB SETTING?
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NO
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DOES KETAMINE INCREASE OR DECREASE SALIVARY AND TRACHIOBRONCHIAL SECRETIONS?
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NO, INCREASES
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KETAMINE IS CONTRAINDICATED IN CRANIES BECAUSE?
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IT IS A CEREBRAL VASODILATOR, INCREASES ICP AND CEREBRAL PERFUSION
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WHEN USING KETAMINE, PATIENT WILL NEED WHAT ELSE?
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VERSED. KETAMINE WILL CAUSE VIVID DREAMS
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WHAT INDUCTION AGENTS ARE GOOD CHOICE IN BAD TRAUMA?
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BOP
BLOOD OXYGEN AND PAVULON |
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WHAT ARE THE FIVE TASKS OF DRUG ELIMINATION
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CONJUGATION
HYDROLYSIS OXYDATION REDUCTION EXCRETION |
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WHAT ARE TWO METHODS OF ELIMINATION?
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METABOLISM AND EXCRETION
|
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PHASE ONE METABOLSIM DOES WHAT TO A DRUG?
HOW?3 |
CONVERTS IT TO A MORE POLAR METABOLITE.
BY OXYDATION REDUCTION AND HYDROLYSIS. |
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WHAT IS CENTRAL TO THE OXYDATION PATHWAY?
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C P-450
|
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WHAT HAPPEN IN THE OXYDATION PROCESS?
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ADDITION OF AN OXYGEN
REMOVAL OF A HYDROGEN |
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WHAT HAPPENS IN THE REDUCTION PROCESS?
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ADDITION OF A HYDROGEN
REMOVAL OF A OXYGEN |
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HOW IS THE CYTOCHROME P 450 METABOLISM INVOLVED DIRECTLY IN HYDROLYSIS?
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IT IS NOT!
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WHAT ARE THREE DRUG EXAMPLES METABOLIZED BY HYDROLYSIS?
|
SUCCS
PROCAINE ESMOLOL |
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WHAT ARE THE RESULTS OF CYTOCHROME P 450 REACTION?
|
OXYDIZED P 450
OXYDIZED DRUG(NOW POLAR AND EXCREATABLE) WATER |