BARBITURATES/NONBARBITURATES PHARMACOLOGY
Terms
undefined, object
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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?
- 3-6 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 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 - 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?
- 10.6
- 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 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
- 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