Anesthesia Pharmacology: Autonomic Adrenergic
Practice Clinical Case Questions
Click on the correct answer.
A 48-year old woman with post-menopausal depression was admitted to the hospital after a suicide attempt.
She had been previously treated at various times with SSRIs (serotonin-specific reuptake inhibitors) antidepressants, tricyclic antidepressants, and lithium--all with marginal results.
Electoconvulsive therapy (ECT) was recommended.
case author: Hugh S. Mathewson, M.D., Professor Emeritus, School of Allied Health, Department of Nurse Anesthesia, University of Kansas Medical Center
case editor: Michael Gordon, Ph.D. Associate Professor, University of Kansas Medical Center
1 / 5
What are the principal risks associated wtih ECT?
General anesthesia with neuromuscular blockade
Consequences of sympathetic stimulation.
both
neither
What is/are the most hazardous response to sympathetic stimulation?
tachycardia
arrhythmias
hypertension
A & C
A, B & C
How can sympathetic overstimulation be to a substantial degree prevented?
An anesthetic induction agent such as thiopental will substantially reduce the risk of hypertension.
Administer hydralazine to the patient
use a long-acting alpha-receptor blocker
use a long-acting beta-receptor blocker
none of the above
In this case, how is tachycardia best controlled?
administer atropine before the procedure
administer hexamethonium before the procedure
use a selective beta1 adrenergic blocking agent prior to seizure production
infuse acetylcholine
By what route of administration should esmolol (Brevibloc) begin to this patient?