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