Question Set #7

Anesthetic most likely to cause seizure activity
1. halothane (Fluothane)
2. enflurane (Ethrane)
3. isoflurane (Forane)
Anticonvulsant medication and inhalational anesthetic use:
1. Anticonvulsant medication should be slowly reduced in dosage and stopped several days before surgery
2. Phenobarbital (Luminal) may increase anesthetic agent metabolism
3. Increased metabolism of volatile, halogenated anesthetics decrease organ toxicity risk
4. the following surgery, anticonvulsant medication should be held until the patient is able to take the medication orally
A drug of choice in management of petit mal epilepsy:
1. carbamazepine (Tegretol)
2. primidone (Mysoline)
3. ethosuximide (Zarontin)
4. phenytoin (Dilantin)
Factor(s) that increase likelihood of enflurane (Ethrane)-induced seizure activity
1. hypoventilation decreasing PaCO2 < 30 mm Hg
2. repetitive auditory stimuli during enflurane (Ethrane) administration
3. enflurane (Ethrane) concentration > 2 MAC
4. B & C
5. A, B & C
Children are particularly susceptible to enflurane (Ethrane)-induced seizure activity compared to adults
1. true
2. false
Inhalational anesthetic most likely to cause EEG seizure activity
1. sevoflurane (Sevorane, Ultane)
2. desflurane (Suprane)
3. enflurane (Ethrane)
4. isoflurane (Forane)
Propofol (Diprivan) is more likely to induce seizure activity compared to ketamine (Ketalar):
1. true
2. false
Fentanyl (Sublimaze)/sufentanil (Sufenta) & seizure activity:
1. high-dose fentanyl (Sublimaze) or sufentanil (Sufenta): use cautiously if patient has seizure disorder
2. Patients receiving anticonvulsants often require more fentanyl (Sublimaze) during surgery than patients not receiving anticonvulsants
3. both
4. neither
Drug-drug interaction involving anticonvulsant agents and agents used in anesthesia protocols:
1. phenytoin (Dilantin): may cause increased patient resistance to nondepolarizing muscle relaxant action
2. Carbamazepine (Tegretol) because increased patient resistance to the action of nondepolarizing muscle relaxants
3. both
4. neither
Cerebrovascular effects of volatile anesthetics at concentrations > 0.6 MAC:
1. cerebral vasoconstriction
2. dose-dependent increase in cerebral blood flow (CBF)
3. both
4. neither
Cerebrovascular effects of volatile anesthetics at concentrations > 0.6 MAC:
1. cerebral blood flow increases
2. cerebral metabolic requirements decreased
3. both
4. neither
Inhalational anesthetic agent with least effect on cerebral blood flow
1. halothane (Fluothane)
2. isoflurane (Forane)
3. enflurane (Ethrane)
direct cerebral vasodilation:
1. thiopental (Pentothal)
2. etomidate (Amidate)
3. halothane (Fluothane)
4. midazolam (Versed)
5. propofol (Diprivan)
Anesthetic or anesthetic combination least likely to change cerebral blood flow or cause direct cerebral vasodilation:
1. ketamine (Ketalar)
2. propofol (Diprivan)
3. nitrous oxide + intravenous anesthetic
4. nitrous oxide + volatile anesthetics
5. nitrous oxide alone
Inhaled anesthetic agents: dose-dependent decrease in cerebral metabolic requirements (CMR):
1. true
2. false