Notes in 09 Intravenous Anesthetics

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Published	12/13/2023	Midazolam is metabolized by {{c1::CYP 450}} in the {{c3::liver and intestines}} into inactive {{c2::hydroxylated}} metabolites.
Published	12/13/2023	Barbiturates cause a {{c1::decrease::increase/decrease}} in cerebral blood flow, cerebral blood volume, and intracranial pressure.
Published	12/13/2023	Which induction agent increases arterial blood pressure, heart rate, and cardiac output? {{c1::ketamine}}
Published	12/13/2023	Etomidate produces transient {{c1::adrenal}} suppression by inhibiting {{c2::11 β-hydroxylase::enzyme}}, which causes accumulation of {{c3::11-de…
Published	12/13/2023	Propofol should be administered within {{c1::6}} hours of opening the ampule.
Published	12/13/2023	Methohexital is useful for providing anesthesia for {{c1::electroconvulsive therapy}} due to its {{c2::proconvulsant}} effects.
Published	12/13/2023	The duration of barbiturates is determined by {{c1::redistribution}}, not by metabolism or elimination.
Published	12/13/2023	Barbiturates are principally biotransformed via {{c1::hepatic oxidation}} to inactive, water-soluble metabolites.
Published	12/13/2023	Barbiturates {{c1::do not::do/do not}} impair the perception of pain.
Published	12/13/2023	Barbiturates are contraindiciated in patients with {{c1::acute intermittent porphyria}} because they promote {{c2::aminolevulinic acid synthetase…
Published	12/13/2023	Benzodiazepines exert their effect on the central nervous system by binding to {{c2::benzodiazepine receptor}} sites on {{c1::GABAA}} recept…
Published	12/13/2023	Rapid {{c1::redistribution}} for benzodiazepines and barbiturates is responsible for awakening.
Published	12/13/2023	The principle metabolite of midazolam, {{c1::1-hydroxymidazolam}}, is conjugated to {{c2::1-hydroxymidazolam glucuronide}} and cleared by th…
Published	12/13/2023	Diazepam has a long half-life because it undergoes {{c1::enterohepatic recirculation}}.
Published	12/13/2023	The metabolites of benzodiazepines are excreted mainly in {{c1::urine}}.
Published	12/13/2023	Benzodiazepines display {{c1::minimal::major/minimal}} left-ventricular depressant effects.
Published	12/13/2023	Benzodiazepines {{c1::reduce::increase/reduce}} cerebral oxygen consumption, cerebral blood flow, and intracranial pressure.
Published	12/13/2023	The mild muscle-relaxing property of benzodiazepines is mediated at the {{c1::spinal cord}} level.
Published	12/13/2023	Do benzodiazepines provide analgesia?{{c1::No}}
Published	12/13/2023	Cimetidine binds to cytochrome P-450 and {{c1::inhibits}} the metabolism of diazepam.
Published	12/13/2023	Ketamine is a structural analogue of {{c1::phencyclidine}}
Published	12/13/2023	The cardiovascular effects of ketamine are due to release of {{c1::catecholamines}} and decreased production of {{c2::nitric oxide}} in the vasculatur…
Published	12/13/2023	Racemic ketamine is a potent broncho{{c1::dilator::constrictor/dilator}}.
Published	12/13/2023	Ketamine is a direct myocardial {{c2::depressant::depressant/stimulant}}, which is unmasked in patients with a {{c1::sympathectomy}} or depleted {{c3:…
Published	12/13/2023	Etomidate may cause {{c1::myoclonus}} due to uneven drug distribution in the brain.
Published	12/13/2023	Etomidate is characterized by a very rapid onset of action due to high {{c1::lipid solubility}} and {{c1::nonionized fraction}} at physiologic pH.
Published	12/13/2023	Etomidate is metabolized by {{c1::Hepatic microsomal enzymes}} and {{c1::plasma esterases}} to inactive {{c2::carboxylic acid}} metabolites.…
Published	12/13/2023	Etomidate is excreted in the {{c1::urine::85%}} and {{c1::bile::13%}}.
Published	12/13/2023	Etomidate causes a {{c1::mild decrease::decrease/increase}} in peripheral vascular resistance which is responsible for a {{c1::decrease::decrease…
Published	12/13/2023	Etomidate causes dose-dependent respiratory depression. At lower doses, it will {{c1::increase}} the respiratory rate and {{c1::decrease}} the minute …
Published	12/13/2023	Etomidate {{c1::decreases::increases/decreases}} cerebral metabolic rate.
Published	12/13/2023	Etomidate {{c1::lacks::has/lacks}} analgesic properties.
Published	12/13/2023	What allergies contraindicate the use of propofol?{{c1::None}}
Published	12/13/2023	Propofol has a rapid onset of action and awakening due to its very short {{c1::distribution}} half-life.
Published	12/13/2023	Propofol is primarily cleared through {{c1::hepatic}} metabolism and excreted by the {{c2::kidneys}}.
Published	12/13/2023	Use of propofol infusions for long-term sedation in the PICU or young adult neurosurgical patients has been associated with {{c1::propofol infusi…
Published	12/13/2023	Propofol causes a {{c1::decrease::increase/decrease}} in arterial blood pressure and a {{c2::decrease::increase/decrease}} in heart rate.
Published	12/13/2023	Propofol markedly impairs the {{c1::baroreceptor}} response to hypotension.
Published	12/13/2023	Propofol causes a profound respiratory depressant because it inhibits {{c1::hypoxic}} ventilatory drive and depresses the normal response to {{c1::hyp…
Published	12/13/2023	Which IV anesthetic suppresses airway reflexes the most?{{c1::Propofol}}
Published	12/13/2023	Propofol {{c1::decreases::increases/decreases}} cerebral blood flow, cerebral blood volume, and intracranial pressure
Published	12/13/2023	Low doses of propofol may cause {{c1::excitatory/myoclonic}} effects due to disinhibition of subcortical centers.
Published	12/13/2023	Propofol {{c1::decreases::increases/decreases}} intraocular pressure.
Published	12/13/2023	At low doses, barbiturates potentiate the action of {{c1::GABA::neurotransmitter}} by increasing the {{c2::duration::duration/intensity}} of openings …
Published	12/13/2023	Barbiturates are primarily metabolized in {{c2::hepatocytes}} and excreted in the {{c1::urine}}.
Published	12/13/2023	Intravenous bolus induction doses of barbiturates cause a {{c1::decrease::increase/decrease}} in blood pressure and a {{c2::increase::increase/decreas…
Published	12/13/2023	Barbiturates may cause broncho{{c1::constriction}}.
Published	12/13/2023	Benzodiazepines produce respiratory {{c2::depression}}, especially in patients with {{c1::COPD}}.
Published	12/13/2023	Benzodiazepines are effective in controlling {{c1::grand mal}} seizures.
Published	12/13/2023	Benzodiazepines produce {{c1::antero::antero/retro}}grade amnesia.
Published	12/13/2023	The antianxiety, amnestic, and sedative effects of benzodiazepines are seen at {{c1::lower::higher/lower}} doses.
Published	12/13/2023	{{c2::Ketamine::IV anesthetic}} functionally “dissociates” sensory impulses from the {{c1::limbic cortex}}.
Published	12/13/2023	What are the respiratory effects of ketamine?{{c1::None - if anything, ventilation is increased}}
Published	12/13/2023	Ketamine is used off-label to treat severe, treatment-resistant {{c1::depression}}
Published	12/13/2023	{{c1::Ketamine}} is the preferred induction agent in patients with severe hypotension or bronchoconstriction.
Published	12/13/2023	One adverse side effect of ketamine is {{c1::delirium/hallucinations}} on emergence.
Published	12/13/2023	Do patient who recieve repeated doses of ketamine develop tolerance?{{c1::Yes}}
Published	12/13/2023	Norketamine is a metabolite of ketamine with {{c1::¼}} the potency, and is excreted {{c2::renally}}.
Published	12/13/2023	Ketamine can cause increased {{c1::salivation}}, which can be attenuated with anticholinergic agents.
Published	12/13/2023	Ketamine {{c1::increases::increases/decreases}} cerebral oxygen consumption, cerebral blood flow, and intracranial pressure
Published	12/13/2023	Emergence delirium from ketamine is most effectively prevented with {{c1::midazolam}}.
Published	12/13/2023	Etomidate depresses the {{c1::reticular activating}} system by mimicking the inhibitory effects of {{c2::GABA::neurotransmitter}}.
Published	12/13/2023	What induction agent is most highly associated with postoperative nausea and vomiting (PONV)?{{c1::Etomidate}}
Published	12/13/2023	Propofol acts by {{c1::allosterically}} increasing the {{c1::binding affinity}} of GABA for the GABAA receptor complex.
Published	12/13/2023	Does terminal CKD affect the metabolism of propofol?{{c1::No}}
Published	12/13/2023	Dexmedetomidine is a α2 -adrenergic agonist that can be used for anxiolysis, sedation, and analgesia. However, it does not produce {{c1::amnesia}}.&nb…
Published	12/13/2023	What are the respiratory side effects of propofol?{{c1::profound respiratory depression}}
Published	12/13/2023	The induction dose of propofol is {{c1::1}} - {{c1::2.5}} mg/kg.
Published	12/13/2023	The induction agents {{c3::propofol}} and {{c3::etomidate}} can cause {{c1::pain}} on injection, which can be attenuated with concomitant administrati…
Published	12/13/2023	The structure of etomidate is a {{c1::carboxylated imidazole ring}}.
Published	12/13/2023	Etomidate is {{c1::less::more/less}} of a cardiovascular depressant than propofol.
Published	12/13/2023	The standard induction dose of midazolam is {{c1::0.1}} to {{c1::0.4}} mg/kg.
Published	12/13/2023	The induction dose of IV ketamine is {{c1::1}} to {{c1::4}} mg/kg.
Published	12/13/2023	The induction dose of etomidate is {{c1::0.2}} to {{c1::0.5}} mg/kg.
Published	12/13/2023	The standard premedication dose of midazolam is {{c1::0.025}} to {{c1::0.1}} mg/kg.
Published	12/13/2023	Propofol is {{c1::98}}% protein-bound.
Published	12/13/2023	In a 70 kg patient, a normal plasma fluid volume is {{c1::4}} L.
Published	12/13/2023	In a 70 kg patient, a normal interstitial fluid volume is {{c1::10}} L.
Published	12/13/2023	In a 70 kg patient, a normal intracellular fluid volume is {{c1::28}} L.
Published	12/13/2023	In a 70 kg patient, a normal total fluid volume is {{c1::42}} L.
Published	12/13/2023	Voltage changes in the NMDA receptor displace {{c1::Mg2+}} from the {{c2::Ca2+}} channel pore.
Published	12/13/2023	Ketamine antagonizes {{c1::glutamate}} by binding to the phencyclidine recognition site on {{c2::NMDA}} receptors.
Published	12/13/2023	Barbiturates are derived from {{c1::barbituric acid}}.
Published	12/13/2023	{{c3::Thio}}barbiturates contain a {{c1::sulfur}} molecule at {{c2::C-2}}, which increases the {{c4::lipid solubility}}.
Published	12/13/2023	{{c3::Oxy}}barbiturates contain a {{c1::oxygen}} molecule at {{c2::C-2}}.
Published	12/13/2023	{{c3::N-Methyl }}barbiturates contain a {{c1::methyl group}} at N-1 or N-2, which lowers the {{c4::seizure threshold}}.
Published	12/13/2023	The induction dose of methohexital is {{c1::1}}-{{c1::2}} mg/kg IV.
Published	12/13/2023	Porphyrias are a group of enzymatic deficiencies in the {{c1::heme}} synthesis pathway that leads to an accumulation of {{c2::porphyrins}}.
Published	12/13/2023	What induction agents are known to precipitate acute porphyria?{{c1::Barbiturates}}, {{c1::etomidate}}, and {{c1::ketamine}}
Published	12/13/2023	Treatment for acute intermittent porphyria includes {{c1::heme}} and {{c1::glucose}}, which inhibit ALA synthesis
Published	12/13/2023	What antihypertensive/anti-arrhythmic medications are contraindicated in patients with acute porphyria?{{c3::Calcium channel blockers}}, {{c2::am…
Published	12/13/2023	What antihistamine medications are contraindicated in patients with acute porphyria?{{c1::Hydroxyzine}}
Published	12/13/2023	What antimicrobial medications are contraindicated in patients with acute porphyria?{{c1::sulfonamides}}, {{c3::fluconazole}}, and {{c2::metronid…
Published	12/13/2023	Propofol is a {{c4::2,6-diisopropyl phenol}} compound prepared as a 1% solution in a lipid emulsion of 10% {{c3::soybean oil}}, 2.25% {{c2::glycerol}}…
Published	12/13/2023	The Diprivan formulation of propofol contains 0.005% {{c1::disodium edetate}} as a preservative.
Published	12/13/2023	The generic formulation of propofol contains 0.025% {{c1::sodium metabisulfite}} or {{c2::benzyl alcohol}} as a preservative.
Published	12/13/2023	Which formulation of propofol is problematic in asthmatics?{{c1::Generic}}
Published	12/13/2023	When used as a continuous intravenous infusion, propofol bottles should be discarded after {{c1::12}} hours.
Published	12/13/2023	Propofol has a onset of {{c1::30}} to {{c1::45}} seconds, and a duration of action of {{c2::5}} to {{c2::10}} minutes.
Published	12/13/2023	Propofol clearance exceeds {{c1::hepatic blood flow}}. This extrahepatic metabolism of propofol occurs primarily in the {{c2::lungs}}.
Published	12/13/2023	The dose of propofol for the maintenance of general anesthesia is {{c1::100}} to {{c1::200}} mcg/kg/min as a continuous infusion.
Published	12/13/2023	The dose of propofol for the maintenance of conscious sedation is {{c1::25}} to {{c1::75}} mcg/kg/min as a continuous infusion.
Published	12/13/2023	In patients with morbid obesity, induction doses of propofol should be dosed on {{c1::lean}} body weight.
Published	12/13/2023	The risk of propofol infusion syndrome is increased in critically-ill patients receiving > {{c1::4}} mg/kg/hr of propofol for > {{c2::48}} hours…
Published	12/13/2023	The risk of propofol infusion syndrome is increased in critically-ill patients with a high-{{c1::fat}} low-{{c1::carb}} nutritional intake.
Published	12/13/2023	The risk of propofol infusion syndrome is increased in critically-ill patients receiving {{c1::catecholamine}} infusions and {{c2::steroids}}.
Published	12/13/2023	Propofol infusion syndrome can cause refractory {{c1::bradycardia}}, which can be treated with {{c2::cardiac pacing}}.
Published	12/13/2023	Etomidate is typically prepared in a solvent of 35% {{c1::propylene glycol}}.
Published	12/13/2023	Etomidate is {{c1::75}}% protein bound.
Published	12/13/2023	The onset of action of etomidate is {{c1::1}} minute(s).
Published	12/13/2023	The duration of action of etomidate is {{c1::3}} to {{c1::12}} minutes. .
Published	12/13/2023	Midazolam is compounded with 0.8% {{c1::sodium chloride}}. It is preserved with and 0.01% {{c2::disodium edetate}} and 1% {{c2::benzyl alcohol}}.&nbsp…
Published	12/13/2023	The onset of action for midazolam is {{c1::1}} minute(s).
Published	12/13/2023	The duration of action for midazolam is {{c1::20}} to {{c1::80}} minutes.
Published	12/13/2023	Ketamine is a white crystalline salt prepared in a {{c1::1}}%, {{c1::5}}%, or {{c1::10}}% aqueous solution.
Published	12/13/2023	At sub-hypnotic doses, ketamine produces {{c2::analgesic}} effects at the {{c1::μ, κ, and δ}} opioid receptors.
Published	12/13/2023	Ketamine is {{c1::12}}% protein-bound.
Published	12/13/2023	Ketamine has a {{c1::slower::faster/slower}} onset than propofol and etomidate.
Published	12/13/2023	Ketamine undergoes {{c1::N-demethylation}} via {{c3::P450}} enzymes in the liver to {{c2::norketamine}}.
Published	12/13/2023	What pupillary signs does ketamine produce?{{c1::horizontal nystagmus}}
Published	12/13/2023	ID: {{c1::Ketamine}}
Published	12/13/2023	ID: {{c1::Etomidate}}
Published	12/13/2023	ID: {{c1::Thiopental}}
Published	12/13/2023	ID: {{c1::Methohexital}}
Published	12/13/2023	Propofol infusion syndrome can cause {{c1::rhabdomyolysis}} leading to {{c2::renal}} failure.
Published	12/13/2023	Propofol infusion syndrome can cause a {{c1::high}} anion gap metabolic acidosis.
Published	12/13/2023	Propofol infusion syndrome can cause a {{c1::enlarged/fatty}} liver and {{c2::hyperlipidemia}}.
Published	12/13/2023	What medications can be given to treat propofol infusion syndrome?{{c1::Glucagon}} and {{c1::PDE inhibitors}}
Published	12/13/2023	Rapid awakening from etomidate is due to {{c1::redistribution}}.
Published	12/13/2023	Etomidate causes cerebral vaso{{c1::constriction}} and decreased intracranial pressure, with an overall {{c2::no change}} in cerebral perfusion p…
Published	12/13/2023	Etomidate causes a transient adrenal suppression for {{c1::8}} to {{c1::24}} hours.
Published	12/13/2023	At higher doses, barbiturates work by {{c1::direct stimulation}} of the GABAA receptor.
Published	12/13/2023	What analgesic medications are contraindicated in patients with acute porphyria?{{c1::ketorolac}}
Published	12/13/2023	Ketamine decreases presynaptic release of {{c1::glutamate}}.
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