33 Questions
What is the incidence of emergence reactions in adults when ketamine is a major part of the anesthetic?
10-30%
What is the proposed neuroprotective effect of ketamine?
NMDA receptor antagonism
Which personality type is associated with a higher incidence of emergence reactions when ketamine is used as an anesthetic in adults?
High psychotism score
What effect does ketamine have on the EEG at high doses?
Burst suppression
What effect does ketamine have on the seizure threshold in epileptic patients?
No change in threshold
What is the duration of increased systemic blood pressure caused by ketamine?
10-20 minutes
What effect does ketamine have on minute ventilation following a bolus dose?
Brief decrease
What is a rare side effect of ketamine related to platelet aggregation?
Inhibition of platelet aggregation
Which receptor does dexmedetomidine act as an agonist on?
Alpha2 receptor
What effect does alpha2 agonism have on the respiratory drive?
Minimal effect on respiratory drive
What is the primary site of action for dexmedetomidine?
Spinal cord
Which organ system is affected by dexmedetomidine, leading to decreased salivation and minimal depression of ventilation?
Respiratory system
What is the clinical use of dexmedetomidine in reducing the minimum alveolar concentration (MAC) of isoflurane?
Adjunct to general anesthesia
Which organ system experiences hypotension and bradycardia due to the central and peripheral mechanisms of dexmedetomidine?
Cardiovascular system
What is the primary clinical use of scopolamine?
Antiemetic
What is the side effect associated with scopolamine that could lead to restlessness, hallucinations, or somnolence?
Central anticholinergic syndrome
What is the primary organ affected by droperidol to achieve the goal of detached, pain-free state of immobilization?
Nervous system
What is the main effect of droperidol on the respiratory system when used alone?
Minimal effect on respiration
What is the primary clinical use of droperidol in combination with an opioid such as fentanyl?
Prophylaxis for postoperative nausea and vomiting (PONV)
Which receptor inhibition by droperidol leads to CNS depression, sedation, and occasional extrapyramidal symptoms?
GABAA receptors and α2 -acetylcholine receptors
What is the main effect of droperidol on myocardial repolarization and the QT interval?
Prolongation of the QT interval
What was the 2007 International Consensus Panel's recommended primary use for droperidol?
Prophylaxis for postoperative nausea and vomiting (PONV)
What is the primary mechanism of action of ketamine?
Inhibits binding of glutamate with NMDA receptors
What is the significant difference between the S(+) isomer and R(-) isomer of ketamine?
The S(+) isomer has a greater affinity for phencyclidine binding site on NMDA receptor than R(-) isomer
What is the major pathway of metabolism for ketamine?
Metabolism by hepatic microsomal enzymes leading to norketamine
What is the effect of ketamine on cerebral blood flow (CBF)?
Increases CBF which speeds delivery of drug to the brain
At what doses does ketamine achieve analgesia without causing anesthesia?
0.2 - 0.5 mg/kg IV
What is a concern associated with increased psychomimetic reactions when using ketamine for postoperative sedation and analgesia?
Increased risk of emergence reactions
What is the onset of action for intravenous (IV) administration of ketamine for induction of anesthesia?
30-60 seconds
What is a potential concern with chronic dosing of ketamine?
Induction of enzymes responsible for its metabolism
What effect does ketamine have on spinal nocioceptive pathways?
Excitation via activation of NMDA receptors
What contributes to the rapid onset of action of ketamine?
High lipid solubility
What effect does the S(+) isomer of ketamine have on muscarinic receptors?
It acts as an antagonist at muscarinic receptors
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
