Question Set #5

Ketamine (Ketalar) anesthesia:
1. awakening may be associated with bad dreams and hallucinations
2. cardiovascular system -- typically depressed due to reduced sympathetic outflow
3. useful (with diazepam (Valium)) in management of emergency surgery and certain pediatric radiological procedures
4. A & C
5. A, B & C
Propofol (Diprivan):
1. similar to sufentanil (Sufenta)
2. similar enflurane (Ethrane)
3. similar to thiopental (Pentothal)
4. similar to ketamine (Ketalar)
Propofol (Diprivan):
1. arrhythmogenic, due to reduced blood-pressure
2. Rapid emergence with minimal postoperative confusion
3. duration of anesthesia may be increased by combination with opioids
4. B & C
5. A, B & C
A primary goal in preanesthetic medication --
1. reduction in the requirement for inhalational agents
2. reduction in the acidity and volume of gastric contents
3. relief of preoperative pain
4. reduction inside effects associated with some inhalational agents
Preoperative drug categories:
1. histamine (H2) antagonists
2. gastrokinetic agents
3. opioids
4. A & C
5. A, B & C
Benzodiazepines characteristic(s) that make these drugs useful as pre-anesthetics
1. raise threshold for CNS toxicity of local anesthetics
2. amnestic properties
3. relatively little respiratory and cardiovascular depression
4. B & C
5. A, B & C
Example(s) of benzodiazepines which may be useful as preoperative medication
1. flumazenil (Romazicon)
2. lorazepam (Ativan)
3. midazolam (Versed)
4. B & C
5. A, B & C
Clinical uses of diazepam (Valium):
1. management of acute ethanol withdrawal
2. termination of status epilepticus by high-dose oral administration
3. reduction in amount of inhalational agent required
4. A & C
5. B & C
Contraindications to diazepam (Valium) use:
1. in children less than six months old (by tablet)
2. acute narrow angle glaucoma
3. untreated open angle glaucoma
4. B & C
5. A, B & C
Cautious use -- benzodiazepines
1. with impaired renal/hepatic function
2. mental depression
3. elderly
4. drug abuse
5. all of the above
Contraindications to the use of flumazenil (Romazicon)
1. in seizure-prone individuals during labor and delivery
2. in antidepressant overdosage
3. both
4. neither
Opioids as preanesthetic medication:
1. to provide sedation
2. to reduce the amount of general anesthesia required
3. both
4. neither
Adverse effect(s): opioids used in preanesthetic medication
1. biliary spasm
2. prolongation of awakening for general anesthesia
3. respiratory depression resulting in increased ICP
4. B & C
5. A, B & C
Contraindications for morphine use:
1. Addison's disease
2. acute asthma
3. increased ICP
4. acute ulcerative colitis
5. all the above
Clinical uses: morphine
1. relieves dyspnea in CHF
2. reduces pulmonary edema and pain in myocardial infarction
3. reduces preoperative pain
4. A & C
5. A, B & C
Antiemetic agents:
1. meperidine (Demerol)
2. hydroxyzine (Atarax,Vistaril)
3. ondansetron (Zofran)
4. B & C
5. A, B & C
Antiemetic drug that works through serotonin (subtype 3) receptor blockade
1. chlorpromazine (Thorazine)
2. haloperidol (Haldol)
3. ondansetron (Zofran)
Propofol (Diprivan) for induction and maintenance of anesthesia may be as effective as ondansetron (Zofran) in reducing or preventing postoperative nausea and vomiting:
1. true
2. false
Least likely to cause hypotension or sedation while providing antiemetic effect:
1. hydroxyzine (Atarax,Vistaril)
2. chlorpromazine (Thorazine)
3. ondansetron (Zofran)
Antiemetic drug with least side effects
1. chlorpromazine (Thorazine)
2. haloperidol (Haldol)
3. hydroxyzine (Atarax,Vistaril)
4. tropisetron