Question Set #4

Diffusional hypoxia:
1. high rate of transfer of anesthetic from the alveoli to the blood and tissues
2. high rate of transfer of anesthetic from blood and tissues to the alveoli
Diffusional hypoxia
1. dilutes alveolar oxygen; may cause postoperative hypoxia
2. lessened by supplemental oxygen administration
3. both
4. neither
Rationale for use of intravenous (fixed) anesthetic agents with inhalational agents:
1. enhance or provide analgesia
2. enable lower doses of inhalational agent to be used
3. reduce visceral reflex responses
4. B & C
5. A, B & C
Thiopental (Pentothal):
1. excellent analgesic
2. rapid recovery (20-30 minutes) due to rapid hepatic metabolism
3. absence of respiratory depression
4. crosses the placental barrier, depressing the fetus
5. significant cardiovascular effects, except in the presence of hypovolemia
Characteristics of thiopental (Pentothal) administration:
1. cough, laryngospasm, bronchospasm
2. significant post-operative excitement or vomiting
3. absolute contraindications in patients with acute intermittent porphyria or variegate porphyria
4. A & C
5. A, B & C
Benzodiazepines in anesthesia: may be used alone for procedures not requiring analgesic, including
1. DC cardioversion
2. some radiological procedures
3. endoscopy
4. cardiac catherization
5. all the above
Benzodiazepines: Diazepam (Valium) pharmacology --
1. advantage: combination with opioids do not result in significant cardiovascular depression
2. Central nervous system depression can be reversed with naltrexone (ReVia)
3. Effective analgesic
4. Associated with anterograde amnesia
Example(s) of intravenous benzodiazepines used in anesthesia --
1. diazepam (Valium)
2. flumazenil (Romazicon)
3. midazolam (Versed)
4. A & C
5. A, B & C
Component(s) of balanced anesthesia may include:
1. muscle relaxants
2. thiopental (Pentothal)
3. midazolam (Versed)
4. A & C
5. A, B & C
Benzodiazepines are ineffective in altering seizure likelihood associated with local anesthetic used in regional operative procedures
1. true
2. false
Examples of intravenous opioids -- used in anesthesia
1. remifentanil (Ultiva)
2. pentazocine (Talwain)
3. alfentanil (Alfenta)
4. A & C
5. A, B & C
IV opioids -- anesthesia:
1. hypotension not associated opioid use
2. For certain procedures, large-dose morphine can be used to obtain anesthesia
3. both
4. neither
Compared to morphine -- fentanyl (Sublimaze)
1. less amnestic
2. more likely to provoke hypotensive responses
3. increased duration of respiratory depression
4. none of the above
More potent then fentanyl (Sublimaze):
1. alfentanil (Alfenta)
2. sufentanil (Sufenta)
3. both
4. neither
Reverses respiratory depression cause by opioids:
1. naloxone (Narcan)
2. nalmefene (Revex)
3. naltrexone (ReVia)
4. A & C
5. A, B & C
Rapid recovery time associated with remifentanil (Ultiva) use: Cause --
1. fast renal excretion of unchanged drug
2. rapid hepatic, cytochrome P450 metabolism
3. esterase-mediated inactivation
4. A & C
5. A, B & C
Innovar --
1. haloperidol (Haldol) + nitrous oxide
2. chlorpromazine (Thorazine) + midazolam (Versed)
3. droperidol (Inapsine) + nitrous oxide
4. fentanyl (Sublimaze) + meperidine (Demerol)
5. fentanyl (Sublimaze) + droperidol (Inapsine)
Antagonizes droperidol (Inapsine)-mediated extrapyramidal side effects
1. L-DOPA
2. phentolamine (Regitine)
3. benztropine (Cogentin)
4. propranolol (Inderal)
5. none of the above
Droperidol (Inapsine) + fentanyl (Sublimaze):
1. neuroleptic analgesia
2. dissociative anesthesia
3. both
4. neither
Ketamine (Ketalar) --
1. reduced muscle tone
2. significant amnesia
3. minimal analgesia
4. A & C
5. A, B & C