Anesthesia and Inhaled Anesthetics
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Questions and Answers

What factor can make acidic tissues difficult to anesthetize with local anesthetic?

  • Ester hydrolysis
  • Increased lipid solubility
  • Alkaline pH (correct)
  • Vasoconstriction

How does small doses of epinephrine added to local anesthetic affect duration of anesthesia?

  • Increases blood flow to the site
  • Decreases lipid solubility
  • Prolongs duration through vasoconstriction (correct)
  • Enhances ester hydrolysis

Which type of metabolism do ester local anesthetics predominantly undergo?

  • Ester hydrolysis (correct)
  • Reduction
  • Oxidation
  • Glycosylation

How does cocaine affect vasoconstriction?

<p>Potentiates adrenergic effects (C)</p> Signup and view all the answers

How does increased lipid solubility influence the onset time of local anesthetics?

<p>Shortens the onset time (D)</p> Signup and view all the answers

What characteristic of local anesthetics is influenced by lipid solubility?

<p>Duration of action (C)</p> Signup and view all the answers

Which of the following is the most important factor affecting the speed of onset of an inhaled anesthetic?

<p>The partial pressure of the anesthetic in the lungs (A)</p> Signup and view all the answers

How does the solubility of an inhaled anesthetic affect its pharmacokinetics?

<p>High solubility requires more drug to be absorbed into the body to achieve the desired partial pressure, leading to slower onset of action (A)</p> Signup and view all the answers

How does the solubility of an inhaled anesthetic affect its elimination from the body?

<p>High solubility correlates with slower elimination because more drug had to be dissolved into the body initially to achieve the desired partial pressure (B)</p> Signup and view all the answers

How can vessel-poor tissues affect the pharmacokinetics of an anesthetic during a long procedure?

<p>Vessel-poor tissues act as a sink, slowly absorbing drug at the start and then releasing it at the end, prolonging elimination (C)</p> Signup and view all the answers

Which of the following is the most important factor affecting the distribution of an intravenous anesthetic in the body?

<p>The volume of distribution of the anesthetic in the body (D)</p> Signup and view all the answers

How does the rate of hepatic metabolism affect the pharmacokinetics of an intravenous anesthetic?

<p>Rapid hepatic metabolism leads to a faster onset of action and faster elimination of the anesthetic (D)</p> Signup and view all the answers

Which enzyme is responsible for the metabolism of amide-type local anesthetics?

<p>Microsomal P-450 enzymes (A)</p> Signup and view all the answers

What is the main pathway of metabolism for amide-type local anesthetics?

<p>N-dealkylation and hydroxylation by microsomal P-450 enzymes (B)</p> Signup and view all the answers

Which local anesthetic is associated with methemoglobinemia and is typically used only topically?

<p>Benzocaine (D)</p> Signup and view all the answers

Why is chloroprocaine not used in spinal anesthesia?

<p>Neurotoxicity (C)</p> Signup and view all the answers

Which local anesthetic has a butyl group attached to its aromatic group, allowing it to stay in the tissue surrounding a nerve for an extended period of time?

<p>Tetracaine (C)</p> Signup and view all the answers

What is the main reason for the low potency, slow onset, and short duration of action observed in ester-type local anesthetics?

<p>Rapid hydrolysis by circulating esterases (C)</p> Signup and view all the answers

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