Anesthesia and Pharmacology Study Notes
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Questions and Answers

What does parental administration of a drug refer to?

Administering with a needle

What is the operative stage of anesthesia?

Third

What is a major side effect of thrombolytics?

Hemorrhage

What is an emergency drug useful in stabilizing ventricular fibrillation?

<p>Propranolol hydrochloride</p> Signup and view all the answers

Dark blood in the operative field is a sign of possible?

<p>Hypoxia</p> Signup and view all the answers

What amount is approximately equal to 500ml?

<p>1 pint</p> Signup and view all the answers

Naloxone (Narcan) is a/an?

<p>Narcotic antagonist</p> Signup and view all the answers

Drugs that draw fluid from the tissues are classified as?

<p>Diuretics</p> Signup and view all the answers

What does oxytocin (Pitocin) cause?

<p>Uterine contractions</p> Signup and view all the answers

Lidocaine (Xylocaine) is used intravenously for?

<p>Treatment of cardiac arrhythmias</p> Signup and view all the answers

Which of the following anesthetics must be augmented with a more potent agent for general abdominal surgery?

<p>Nitrous oxide</p> Signup and view all the answers

What is the heparin reversal agent?

<p>Protamine sulfate</p> Signup and view all the answers

What is commonly given preoperatively to inhibit the production of gastric acid?

<p>Cimetidine</p> Signup and view all the answers

What type of narcotic opioid is given intramuscularly for premedication?

<p>Meperidine hydrochloride (Demerol)</p> Signup and view all the answers

The purpose of administering atropine preoperatively is to?

<p>Inhibit secretions</p> Signup and view all the answers

A benzodiazepine sedative given intramuscularly for premedication is?

<p>Versed (Midazolam)</p> Signup and view all the answers

Under normal circumstances, 0.9% normal saline is an isotonic solution.

<p>True</p> Signup and view all the answers

Mannitol is used in neurosurgery to?

<p>Reduce swelling of brain tissue</p> Signup and view all the answers

In cardiac arrest, atropine might be administered to?

<p>Treat severe bradycardia</p> Signup and view all the answers

Lidocaine 1% is used to treat?

<p>Ventricular dysrhythmias</p> Signup and view all the answers

The test that determines the ratio of red blood cells to whole blood cells is the?

<p>Hematocrit</p> Signup and view all the answers

The universal recipient has blood type:

<p>AB</p> Signup and view all the answers

What vitamin is essential to the synthesis of prothrombin by the liver and is a valuable hemostatic agent?

<p>Vitamin K</p> Signup and view all the answers

An anticholinergic drug given preoperatively to inhibit mucous secretion is?

<p>Atropine</p> Signup and view all the answers

A vasoconstrictor added to a local anesthetic agent to extend the life of the local agent is?

<p>Epinephrine</p> Signup and view all the answers

Common blood product given for blood loss replacement is?

<p>Packed red blood cells</p> Signup and view all the answers

NIOSH recommends that trace gas analysis be performed how often?

<p>Quarterly</p> Signup and view all the answers

Atrial fibrillation is caused by which of the following?

<p>All of the above</p> Signup and view all the answers

What should be the correct action when the recommended time limit for the inflation of a double tourniquet has been reached?

<p>Cuff should be deflated over a 15 minute period to allow reperfusion</p> Signup and view all the answers

This portable device allows blood to be oxygenated outside of the body when long-term cardiac and respiratory support is required:

<p>ECMO</p> Signup and view all the answers

Joint commission requires that crash carts or emergency carts are secured by?

<p>Breakaway locks and under surveillance</p> Signup and view all the answers

This non-depolarizing neuromuscular blocker (NBA) is long acting:

<p>Pancuronium</p> Signup and view all the answers

The minimum concentration of oxygen that can safely be given to a patient is?

<p>21%</p> Signup and view all the answers

What does the average adult electrolyte panel consist of?

<p>Sodium 135-145mEq/L, Potassium 3.5-5.0mEq/L, Ionized calcium 4.4-5.1mg/dL</p> Signup and view all the answers

The central venous pressure catheter tip should be placed into the chambers of the heart.

<p>False</p> Signup and view all the answers

All types of LMA's are safe for use in an MRI machine.

<p>False</p> Signup and view all the answers

The severity of electrical shock is determined by?

<p>Amount of current, Direction of flow</p> Signup and view all the answers

When transducing an arterial line, the ideal placement of the transducer should be?

<p>Attached to the patient's bed</p> Signup and view all the answers

Dantrolene sodium is the drug of choice to treat patients with malignant hyperthermia (MH). It counteracts which of the following?

<p>Ca ions</p> Signup and view all the answers

An antagonist inhibits the function of agonist receptors.

<p>True</p> Signup and view all the answers

The hemoglobin dissociation curve represents the relationship between the?

<p>O2 saturation and the PaO2</p> Signup and view all the answers

Asepsis is described as?

<p>The absence of pathogenic organisms in a clinical setting</p> Signup and view all the answers

What is the amount of blood required to perform a blood patch?

<p>20cc</p> Signup and view all the answers

What is a possible cause of the capnography waveform failing to return to baseline?

<p>Exhausted CO2 absorber</p> Signup and view all the answers

What is the most common size spinal needle used?

<p>25ga</p> Signup and view all the answers

What are the possible causes of the anesthesia machine alarming 'high pressure'?

<p>Hose kinked, Inspiratory/expiatory limb, Malfunction</p> Signup and view all the answers

What is the method for converting lbs to kilos?

<p>Take weight in lbs and divide by 2.2</p> Signup and view all the answers

What safety system on the anesthesia machine prevents gas from exiting when there is no cylinder in the yoke?

<p>Check valve</p> Signup and view all the answers

Which muscle relaxant should not be administered to patients diagnosed with atypical plasma cholinesterase?

<p>Succ</p> Signup and view all the answers

An agonist diminishes the effect of a drug.

<p>False</p> Signup and view all the answers

The ability of the balloon to be fully expanded and contain the full amount of helium for the catheter is the definition of?

<p>Augmentation</p> Signup and view all the answers

Asystole occurs when the ventricles are at a standstill.

<p>True</p> Signup and view all the answers

What device allows the interruption of blood flow so the surgeon may operate on vessels supplying the heart and/or lungs?

<p>Heart/lung bypass machine, Extracorporeal circuit</p> Signup and view all the answers

Which two EKG leads are most often used during anesthesia cases?

<p>Lead II and Lead V</p> Signup and view all the answers

What is the minimum percentage of oxygen flow when nitrous oxide is infusing?

<p>25%</p> Signup and view all the answers

Lidocaine (Xylocaine) works on what specific tissues of the heart?

<p>His Purkinje system</p> Signup and view all the answers

Succinylcholine (Anectine) mimics which neurotransmitter in the synaptic cleft?

<p>ACh-Acetylcholine</p> Signup and view all the answers

The determination of tissue damage on an individual that has sustained an electrical accident depends on?

<p>Current density and resistance</p> Signup and view all the answers

What happens if an air bubble of significant size is left in a venous blood sample?

<p>This will increase PvO2</p> Signup and view all the answers

The measure of the volatility of the liquid anesthetic in carrier gas is called?

<p>Vapor pressure</p> Signup and view all the answers

The associate responsible for publishing guidelines for the use of an auto transfusion is?

<p>AABB American Association of Blood Banks</p> Signup and view all the answers

What effect does an air bubble of significant size have in an arterial blood gas syringe?

<p>The air bubble will decrease PaCO2</p> Signup and view all the answers

This law states that within gases, pressure and volume are related:

<p>Boyle's Law</p> Signup and view all the answers

ASTM mandates that the vapor output cannot increase by more than what percentage with flush?

<p>10%</p> Signup and view all the answers

What can decrease breathing system resistance?

<p>Reducing the circuit's length, increasing diameter, and maximizing laminar flow</p> Signup and view all the answers

Which of the following agents may use a variable bypass vaporizer for delivery?

<p>All volatile agents but Desflurane</p> Signup and view all the answers

The line isolation monitor is a device that?

<p>Continuously monitors the integrity of the isolated power system</p> Signup and view all the answers

When using an electrosurgical unit, it cannot be safely used unless?

<p>The energy is routed from the unit through the patient and back to the unit via a dispersive pad</p> Signup and view all the answers

Desiccated carbon dioxide absorbent in the presence of which agent may result in a fire?

<p>Sevoflurane</p> Signup and view all the answers

What is allogenic blood?

<p>Blood that is donated by one individual to be transfused to another</p> Signup and view all the answers

What is autologous blood?

<p>The patient's own blood</p> Signup and view all the answers

What are the three different types of auto transfusion?

<p>Intraoperative salvage, Predonation, Acute normovolemic hemodilution</p> Signup and view all the answers

There are two types of anticoagulants that may be used with auto transfusion: Citrate and Heparin solution containing 10,000 units of heparin to a liter bag of normal saline.

<p>False</p> Signup and view all the answers

The harness tubing employed by an auto transfusion device connects the?

<p>Cardiotomy reservoir, centrifuge bowl, waste bag, wash solution, and reinfusion bag</p> Signup and view all the answers

During the full mode of an auto transfusion device, what is the normal trip point to generate the wash cycle?

<p>1/4 inch above the shoulder of the bowl</p> Signup and view all the answers

Why should the transfer bag of an auto transfusion system be purged of air?

<p>To maintain stable oxygen concentration in the blood</p> Signup and view all the answers

One of the benefits of collecting salvaged blood from the surgical site is to improve?

<p>Oxygen transportation</p> Signup and view all the answers

To determine the proficiency of the auto transfusion device, where must blood samples be drawn from?

<p>Cardiotomy bag and reinfusion bag</p> Signup and view all the answers

Hemolysis can be caused by small bore suction tips and co-aspiration of air with blood increasing turbulence during aspiration.

<p>True</p> Signup and view all the answers

The AABB recommends that a 40-micron filter be used when transfusing blood collected and processed from an auto transfusion device.

<p>True</p> Signup and view all the answers

If the roller pump speed of an auto transfusion device is lowered during the fill/prime cycle, what will occur?

<p>Higher Hct</p> Signup and view all the answers

Dantrolene sodium is the drug of choice to treat MH. This drug counteracts which of the following?

<p>Calcium ion release within the muscle cells</p> Signup and view all the answers

A pop-off valve in the closed position during mechanical ventilation can result in?

<p>Barotrauma</p> Signup and view all the answers

Possible pharmacological treatment for a latex-sensitive patient would be?

<p>All of the above</p> Signup and view all the answers

What is the maximum amount of current leakage allowed in the OR?

<p>10mcA</p> Signup and view all the answers

When floating a PA catheter, where is the PA entered?

<p>40 cm Mark</p> Signup and view all the answers

Which of the flow meters is fluted?

<p>Oxygen</p> Signup and view all the answers

What is a specific consideration related to ENT surgery?

<p>High risk of airway fire, often the airway is shared and a special ET tube is required</p> Signup and view all the answers

Abnormal blood flow between the aorta and the pulmonary arteries is defined as?

<p>Patent ductus arteriosus</p> Signup and view all the answers

In a 'flash' sterilizer, what is the typical sterilization time once the chamber reaches the appropriate temperature?

<p>4 min</p> Signup and view all the answers

Which supply item may the anesthetist ask for if a patient has a venous air embolism?

<p>Central venous pressure kit</p> Signup and view all the answers

What are the three elements needed to produce a fire in the OR?

<p>Fuel supply, Source of ignition, Oxygen 21% or more</p> Signup and view all the answers

An ultrasound machine probe contains a piezoelectric crystal that deflects a reflection by emitting and receiving sound back as an image.

<p>True</p> Signup and view all the answers

NIOSH mandates that trace gas analysis be monitored with?

<p>An infrared analyzer</p> Signup and view all the answers

CAP guidelines state that POC instrumentation needs to have quality controls performed every?

<p>8 hours</p> Signup and view all the answers

What neurotransmitter causes contraction of skeletal muscle?

<p>Acetylcholine</p> Signup and view all the answers

The amount of pressure the left ventricle must work against to pump blood into circulation is called?

<p>Afterload</p> Signup and view all the answers

When inserting a PAC percutaneously, the shortest and straightest path to the heart is via?

<p>Right internal jugular</p> Signup and view all the answers

Epidural catheters are inserted with a blunt needle.

<p>True</p> Signup and view all the answers

What is the minimum concentration of oxygen with nitrous oxide use?

<p>25%</p> Signup and view all the answers

Study Notes

Anesthesia and Pharmacology Study Notes

  • Parental administration of drug involves using a needle for drug delivery.
  • The operative stage of anesthesia is categorized as the third stage.
  • Thrombolytics can lead to major side effects, notably hemorrhage.
  • Propranolol hydrochloride stabilizes ventricular fibrillation in emergencies.
  • Dark blood in the operative field indicates potential hypoxia.
  • Approximately 500ml is equivalent to 1 pint.
  • Naloxone (Narcan) serves as a narcotic antagonist.
  • Diuretics draw fluids from body tissues.
  • Oxytocin (Pitocin) is responsible for inducing uterine contractions.
  • Lidocaine (Xylocaine) is utilized intravenously for cardiac arrhythmias.

Anesthesia Practice Insights

  • Nitrous oxide requires augmentation with a more potent anesthetic for general abdominal procedures.
  • Protamine sulfate is the reversal agent for heparin.
  • Cimetidine is often administered preoperatively to reduce gastric acid production.
  • Meperidine hydrochloride (Demerol) is a short-acting narcotic opioid used intramuscularly for premedication.
  • Atropine is given preoperatively to inhibit secretions.
  • Versed (Midazolam) is an intramuscular benzodiazepine sedative used for premedication.
  • 0.9% normal saline is classified as an isotonic solution.
  • Mannitol is used to reduce brain tissue swelling during neurosurgery.
  • Atropine may be given in cardiac arrest to treat severe bradycardia.

Blood and Fluid Management

  • Lidocaine 1% is effective for treating ventricular dysrhythmias.
  • Hematocrit determines the ratio of red blood cells to whole blood.
  • Blood type AB is known as the universal recipient.
  • Vitamin K is essential for prothrombin synthesis, acting as a valuable hemostatic agent.
  • Atropine, an anticholinergic drug, is used to reduce mucous secretion preoperatively.

Equipment and Safety Protocols

  • A vasoconstrictor like epinephrine is added to local anesthetics to prolong their effects.
  • Packed red blood cells are a common substitute for blood loss during surgeries.
  • NIOSH recommends quarterly trace gas analysis for safety in medical environments.
  • Atrial fibrillation can arise from conditions such as mitral regurgitation, mitral stenosis, or acute myocardial infarction.
  • The application of a double tourniquet requires deflation over 15 minutes for safe reperfusion.
  • ECMO (Extracorporeal Membrane Oxygenation) provides long-term cardiac and respiratory support for ICU patients.
  • Crash carts must be secured with breakaway locks and monitored according to Joint Commission standards.

Anesthesia Techniques and Medications

  • Pancuronium is a long-acting non-depolarizing neuromuscular blocker.
  • 21% represents the minimum safe concentration of oxygen for administration.
  • The average electrolyte panel for adults includes sodium (135-145 mEq/L), potassium (3.5-5.0 mEq/L), and ionized calcium (4.4-5.1 mg/dL).
  • Misplacement of the central venous pressure catheter can lead to erroneous readings; the correct position is in the superior vena cava above its junction with the right atrium.

Special Considerations and Emergencies

  • Electrical shock severity is influenced by the amount of current and its direction of flow.
  • For arterial line transducing, the transducer should ideally be attached to the patient’s bed.
  • Dantrolene sodium is critical in treating malignant hyperthermia by counteracting calcium ion release.
  • An antagonist inhibits agonist receptor functions, impacting pharmacological responses.
  • The hemoglobin dissociation curve shows the relationship between oxygen saturation and partial pressure of oxygen (PaO2).

Infection Control and Sterilization

  • Asepsis is defined as the absence of pathogenic organisms in healthcare settings.
  • A blood patch requires 20cc of blood for effective operation.
  • An incomplete capnography waveform can indicate an exhausted CO2 absorber.
  • The most frequently used spinal needle is 25 gauged.
  • High-pressure alarms on anesthesia machines can arise from kinks in hoses or equipment malfunctions.

Anesthesia Safety and Regulations

  • Check valves on anesthesia machines prevent gas from escaping when not in use.
  • Succinylcholine should not be used in patients with atypical plasma cholinesterase.
  • Agonists enhance drug effects, while antagonists restrict them.
  • Helium balloon expansion is referred to as augmentation.
  • Asystole indicates a total absence of ventricular contraction.

Emergency Procedures and Responses

  • Heart/lung bypass machines allow the surgeon to operate on vessels supplying blood to the heart/lungs.
  • Lead II and lead V are commonly utilized EKG leads in anesthesia.
  • A minimum of 25% oxygen flow is required when nitrous oxide is in use.
  • Specific tissues like His-Purkinje system are targeted by Lidocaine (Xylocaine).

Physiological and Technical Knowledge

  • Acetylcholine is the neurotransmitter responsible for skeletal muscle contraction.
  • The afterload describes the pressure the left ventricle encounters during blood pumping.
  • For pulmonary artery catheter insertion, the shortest route is via the right internal jugular vein.
  • Epidural catheters are inserted using blunt needles.

Blood Transfusion Practices

  • Allogenic blood is blood donated for use in another patient, while autologous blood is the patient's own blood.
  • Auto transfusion methods include intraoperative salvage, predonation, and acute normovolemic hemodilution.
  • Ongoing quality control for auto transfusion devices involves blood sample analysis from both the cardiotomy and reinfusion bags.

Regulatory Compliance and Fire Safety

  • The maximum allowable current leakage in operating rooms is set at 10µA.
  • High-risk surgeries, particularly ENT procedures, necessitate cautious fire safety measures.
  • A "flash" sterilizer typically requires a sterilization time of 4 minutes after reaching the necessary temperature.

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Description

This quiz covers essential concepts in anesthesia and pharmacology, including drug administration methods, anesthetic stages, and specific medications used in surgical settings. It also addresses the side effects of certain drugs and their pharmacological actions. Test your knowledge on these critical medical topics!

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