DAANCE- MODULE 3- ANESTHETIC DRUGS & TECHNIQUES PRACTICE QUESTIONS WITH ANSWERS

Brevital (Sodium Methohexital) - correct answer Primary anesthetic agent introduced in the 1960's. Balanced Anesthesia - correct answer Use of several agents together Basic Requisites of an Anesthetic - correct answer Lack of toxicity, non-flammable, non-addictive, minimal allergenicity. Analgesia - correct answer Given to feel no pain (ex: Fentanyl and Local) Amnesia - correct answer Benzodiazepines (ex: Versed) Relaxation & Immobility - correct answer Versed, Propofol (Diprivan), Brevital (Methohexital), Ketamine Loss of Consciousness (Hypnosis) - correct answer Propofol & Brevital Wakefulness System - correct answer Core of brainstem, neurons to cerebrum. When a sleep inducing drug is introduced it interrupts transmission. Anxiolytic (Anxiety Reducing) Meds - correct answer Diazepam or Midazolam Relay Center - correct answer Sensory neurons that sense pain pass through this. Homeostasis (Homeostatic State) - correct answer Normal state in which there is minimal variation in respiration and circulation. Pharmacokinetics - correct answer The effects that the body has on drugs. Pharmacodynamics - correct answer The effects that the drug has on various body systems. Rapid Redistribution - correct answer Short acting drug only remain attached to the receptor sites for a short time and then move to the other tissues. PO (per os) - correct answer Through the mouth. (Delayed onset, unpredictable effects, patient compliance, not good when pt in nauseated) Subcutaneous (SQ) - correct answer Beneath the Skin (Absorption is somewhat delayed compared to IM or IV) Intramuscular (IM) - correct answer In the muscle (Unpredictable onset of drug effect, cannot titrate the dose) Intravenous (IV) - correct answer In the vein Inhalation Route - correct answer Inhaled (Very rapid absorption and titration) 4 Levels of Continuum - correct answer Minimal Sedation, Moderate Sedation, Deep Sedation (Analgesia), and General Anesthesia Minimal Sedation (Anxiolysis) - correct answer Normal response to verbal stimulation, cardiovascular function unaffected. Moderate Sedation (Conscious Sedation) - correct answer Normal response to verbal or light tactile stimulation with cardiovascular function usually maintained. Deep Sedation (Analgesia) - correct answer Not easily aroused but has purposeful response after repeated or painful stimulation. General Anesthesia - correct answer Not a rousable even with painful stimulation. Diffusion hypoxia - correct answer Nitrous Oxide rapidly moves from the blood to the alveoli of the lungs and displaces other gases, including oxygen. Hypoxia - correct answer Low levels of oxygen in the bodies tissues. Hypercarbia - correct answer An increased level of carbon dioxide. Anxiolytic - correct answer Triazolam, Diazepam, Modazolam Propofol (Diprivan) - correct answer Has antiemetic (anti-nausea) properties, insoluble in water, highly lipid soluble. Propofol (Diprivan) - correct answer Respiratory depressant and apnea may be noted after on induction dose. Ketamine (Ketalar) - correct answer Dissociative drug. Eye, cough and swallow reflexes are still present, eyes are open, but gaze in distant or wandering. Nystagmic Gaze - correct answer Distant or wandering gaze. Ketamine (Ketalar) - correct answer Undergoes metabolism in the liver, and excreted in the urine. Ketamine(Ketalar) - correct answer Increase in cerebral oxygen consumption, cerebral blood flow and intracranial pressure. Ketamine (Ketalar) - correct answer Stimulates the cardiovascular system, increases BP, heart rate and cardiac output. Contraindications to Ketamine use. - correct answer Severe cardiovascular disease, severe hypertension, glaucoma (not controlled), severe psychotic illnesses, pregnancy. Barbiturates - correct answer Taken up by body fat and released into the system slowly, depressing the CNS. Barbiturates - correct answer Detoxified in the liver. Side effects of Brevital - correct answer Apnea on induction, laryngospasm, bronchospasm, hypotension, tachycardia, hiccups, and muscle twitching. Esters - correct answer Metabolized in the bloodstream by an enzyme known as pseudocholinesterase. Amides - correct answer Metabolized more slowly in the liver. Esters - correct answer Cocaine, Procain (Novocaine) Amides - correct answer Lidocaine (max 10 or 11 carpules) Amides - correct answer Mepivacaine (Carbocaine) (max 7-8 carpules) Amides - correct answer Prilocaine (Citamest) (max 6 carpules) Amides - correct answer Bupivacaine (Marcaine) (max 10 carpules) Amides - correct answer Articaine (Septocaine) (max 7 carpules) Sympatho-mimetic - correct answer Mimics the effects of the sympathetic nervous system. Anxiolytic - correct answer Dissolving anziety Paradoxical Effect - correct answer Patients exhibit an excitement with the administration of Diazepam rather than a tranquilization. Midazolam (Versed) - correct answer 3-6 times more potent than Diazepam. Morphine - correct answer Major action in analgesia but also produces drowsiness, euphoria and sedation. Meperidine (Demerol) - correct answer Has a slight drying effect, commonly used for postoperative pain. Fentanyl (Sublimaze) - correct answer 100 times more potent than morphine. Rapid onset of action, duration of only 30-45 minutes Remifentanil (Ultiva) - correct answer Metabolized by enzymes throughout the body. Very rapid dissipation. Rapid onset of action, duration of only 5-10 minutes. Can be used in patients with liver and kidney failure. Narcotic Reversals - correct answer Naloxone (Narcan), Pentazocine (Talwin), Nalbuphine (Nubain), Butorphanol Tartrate (Stadol), Flumazenil (Romazicon) Narcotic Agonist-Antagonist - correct answer Reverse the effects of narcotics, and when given by themselves have agonistic or therapeutic properties. Anticholinergic - correct answer Decrease secretions of the salivary glands, thus helping to provide a dry airway during surgery. Anticholinergic Agents - correct answer Atropine, Scopolamine, Glycopyrrolate (Robinul) Antiemetics - correct answer Antihistamines, Chlorpromazine (Thorazine), Prochlorperazine (Compazine), Metoclopramide (Reglan) Antiemetics - correct answer Trimethobenzamide (Tigan), Ondansetron (Zofran), Corticosteroids, Benzodiazepines Steroids - correct answer Dexamethasone (Decadron), Methylprednisolone (Solu-Medrol), Hydrocortisone (Solu-Cartef) Muscle Relaxants - correct answer Succinylcholine (Anectine) Fasciculation - correct answer Total body muscle twitching. Succinylcholine (Anectine) - correct answer Can be a significant trigger for malignant hyperthermia in susceptible individuals, either adults or children. Short Acting. Rocuronium - correct answer Steroid based, short to intermediate acting muscle relaxant with rapid onset of action. Not a triggering agent for malignant hypertheria. Long acting Halogenated Hydrocarbons - correct answer Inhalation agents used for general anesthesia.