Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Opiods/induction
| Question | Answer |
|---|---|
| How many times more potent is fentanyl than morphine? | 100 times |
| How fast does respiratory depression occur after administration of fentanyl? | 5- 15 mins |
| What is the duration of fentanyl? | 30 min- 1 hr |
| What is the half-life of fentanyl? | 219 min |
| What is the volume of distribution of fentanyl? | 4 L/kg |
| What percentage of the first dose undergoes first pass metabolism? | 75% |
| Is fentanyl metabolized into active or inactive metabolites? | inactive |
| What receptors does fentanyl mostly affect? | Mu |
| What is fentanyl's low dose regimen for minor procedures? | 1-3 mcg/kg, titrated to affect |
| What is fentanyl's moderate dose that blunts the response to direct laryngoscopy and sudden changes in the level of surgical stimulation? | 3-10mcg/kg |
| What is the large dose of fentanyl used for cardiac anesthesia? | 50-150mcg/kg |
| What receptors are associated with dysphoria? | |
| What drug is affected least by genetic variability of the CYP system? | Fentanyl |
| What has been shown to be opioid sparing and reduces undesirable opioid side effects? | multimodal therapy |
| What drug is the gold standard of opioids? | Morphine |
| What is the half life of the parent compound of morphine? | 114 min |
| What is the half life of the active metabolite M6G? | 173 min |
| How many times more powerful is sufentanyl than fentanyl? | 10 times |
| What is sufentanyl ideal for? | continuous infusions |
| How is sufentanyl dosed? | mcg/kg/hr |
| True/False: Sufentanyl is the highest lipophilic drug of the family? | True |
| How long before expected wake up should sufentanyl be turned off? | 40 mins |
| What drug is used for infusion only because bolus causes profound apnea? | Remifentanyl |
| How is remi metabolized? | hydrolysis of the ester linkages by blood and tissue esterases |
| What deficiency does not affect Remi? | pseudocholinesterase deficiency |
| What is hydromorphone commonly known as? | dilaudid |
| What is the onset and duration of hydromorphone? | onset- 5 min duration 4-5 hours |
| What is meperidine commonly known as? | demerol |
| What active metabolite is produced by meperidine? | normaperedine |
| What has increasing levels of normaperedine resulted in? | seizures |
| What patients are not recommended to receive meperidine? | sickle cell, CNS disorders, renal failure, or children |
| Meperidine should not be combined with what which could result in respiratory depression, hypotension, circulatory collapse? | MAOIs |
| What opioid receptor has been credited with being responsible for respiratory depression? | mu II |
| What is a subjective phenomenon of unpleasant wavelike sensations in the throat or epigastrium? | nausea |
| What drug is a synthetic opioid agonist/antagonist? | nalbuphine |
| What agonist activity provides analgesia with less risk of respiratory depression? | kappa |
| What partial agonist can cause respiratory depression? | buprenorphine |
| What antagonist is frequently given to patients with respiratory depression or sedation from opioids? | Naloxone (Narcan) |
| What receptors are blocked primarily by narcan? | Mu |
| What is the half life of narcan? | 64 min |
| Narcan can precipitate what untoward effect? | flash pulmonary edemaH |
| One Amp of Narcan (0.4 mg/ml) is diluted in what? | 10 ml syringe of NS to yield 40mcg/ml |
| How is Narcan delivered until the desired effect is achieved? | 0.5 ml q 5 min |
| What is dexmedetomidine also known as? | precedex |
| What drug is a highly selective and potent alpha-2 adrenergic agonist? | precedex |
| Is precedex a narcotic? | NO |
| Precedex is 10 times more selective for alpha 2 receptors than what? | clonidine |
| What kind of cases can precedex be used in? | MAC cases with natural airway and general anesthesia cases |
| What are the loading dose and infusion doses for precedex? | loading: 0.5mcg/kg infusion: 5-10mcg/kg/hr |
| What antagonist rapidly reverses the effects of precedex? | atipamezole |
| Precedex effectively treats emergence delerium in what patient population? | children |
| What is the prototypical alpha 2 agonist that inhibits catecholamine release, renin release with subsequent vsodilation? | clonidine |
| What is utilized in neuro monitoring cases because it does not interfere with signals achieved by the neurophysiologist? | TIVA |
| What is the keystone of barbiturate induction agents? | sodium thiopental |
| Sodium thiopental is derived from what, which by itself lacks CNS activity? | barbituric acid |
| Chmical structure changes to which carbon positions alters barbituric acid to provide sedative hyponotic effects? | # 2 &5 |
| Substitution of a methyl radical at #5 produces a pro-epileptic effect. What drug is created? | Methohexitol or brevitol |
| Addition of the phenol group at number 5 carbon produces enhanced anti convulsive properties. Which drug is this? | Phenobarbitol |
| When sulfur is substituted at the number 2 carbon position, what is formed? | Thiopental |
| What has been used for physician assisted suicide? | Pentobarbitol (Nembuitol) |
| Barbiturates exert their sedative hypnotic effect by interacting with what inhibitory system? | GABA |
| What is the primary determinant of barbiturate distribution? | lipid solubility |
| What accounts for the cessation of the effects associated with the use of barbiturates? | Redistribution away from the CNS |
| What serves as a reservoir for barbiturates, resulting in slow awakening? | fat |
| What barbiturate induces involuntary muscle contractions? | Methohexitol |
| Barbiturates are contraindicated in patients with what problem? | inducible porphyias |
| Sulfur containing thio-barbiturates (thiopental) can evoke what? | Mast cell mediated histamine release |
| T/F Oxybarbiturates do not cause histamine release? | T |
| How are extravasations of barbiturates treated? | procane 1% and local application of heat |
| What kind of compound is contained in etomidate? | carboxylated imidazole |
| What is induced upon induction with etomidate that can be reduced by coadministering a benzo or opioid? | myoclonis |
| Etomidates predominant isomer structure is? | R (+) |
| What is the hallmark of etomidate? | stable cardiovascular profile |
| Dose of etomidate? | 0.3 mcg/kg IV |
| What function dose etomidate suppress even after a single dose? | adrenocortical |
| What are required to prevent hyperdynamic swing with DL? | Opioids |
| How does etomidate inhibit steroidogenesis? | By blocking the conversion of cholesterol to cortisol. |
| Use etomidate (amidate) with extreme caution when administering to an acutely hypovolemic patient = | profound hypotension |
| Administer with caution in patients with what, as this drug increases beta wave activity | focal epilepsy |
| Etomidate is capable of terminating what? | status epilepticus |
| Ketamine is usually provided as what kind of preparation? | Racemic |
| What does receptors does ketamine bind to? | opioid, nicotinic and muscarinic cholinergic receptors |
| De-methylation of ketamine via P450 oxydase pathways yields what? | Nor-ketamine |
| Ketamine increases ________ _______ _____, but does not significantly increase ICP in the presence of mechanically ventillated patients | cerebral blood flow |
| Ketamine is a potent bronchodilator that has been used successfully in ? | status asthmaticus |
| What receptors does propofol exert its sedative hypnotic effect on predominantly? | GABA |
| What patient population requires a larger induction dose due to larger volume of distribution, and an elevated clearance rate? | pediatrics |
| What is the dose of propofol for sedation? | 25-100mcg/min |
| Propofol TIVA dose? | 100-300 mcg/kg/min |
| What reflex is depressed by propofol? | baroreceptor |
Created by:
Jmw015
Popular Pharmacology sets