Etomidate
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Questions and Answers

Which drug is associated with a slower recovery of psychomotor function compared to propofol?

  • Propofol
  • Etomidate (correct)
  • Opioids
  • Barbiturates
  • What is the effect of increasing the dose of etomidate or administering it as a continuous infusion?

  • Shortens the duration of action
  • Prolongs the duration of action (correct)
  • Decreases adrenocortical function
  • Increases analgesia
  • Which drug can be useful to blunt the hemodynamic responses evoked by direct laryngoscopy and tracheal intubation when administered before induction of anesthesia with etomidate?

  • Propofol
  • Thiopental
  • Barbiturates
  • Opioids (correct)
  • What is the principal limiting factor in the clinical use of etomidate for induction of anesthesia?

    <p>Transiently depresses adrenocortical function</p> Signup and view all the answers

    Which of the following is true about the effects of etomidate on myocardial contractility?

    <p>Etomidate has minimal depressive effects on myocardial contractility at concentrations needed for anesthesia.</p> Signup and view all the answers

    Which of the following is true about the effects of etomidate on hepatic and renal functions?

    <p>Etomidate has no effect on hepatic and renal functions.</p> Signup and view all the answers

    Which of the following is true about the effects of etomidate on intraocular pressure?

    <p>Etomidate decreases intraocular pressure.</p> Signup and view all the answers

    Which of the following is true about the effects of etomidate on ventilation?

    <p>Etomidate has transient effects on ventilation lasting only 3 to 5 minutes.</p> Signup and view all the answers

    Which of the following statements about propofol is true?

    <p>Propofol has been administered to patients with hereditary coproporphyria without incident.</p> Signup and view all the answers

    Which of the following is true about the original formulation of etomidate?

    <p>It had a high incidence of pain during IV injection.</p> Signup and view all the answers

    Which of the following statements about etomidate is true?

    <p>It is administered as a mixture of isomers.</p> Signup and view all the answers

    According to the text, what is the duration of enzyme inhibition after an induction dose of etomidate?

    <p>4 to 8 hours</p> Signup and view all the answers

    According to the text, what impact does etomidate have on mortality, length of ICU stay, and duration of mechanical ventilation in trauma patients?

    <p>No impact</p> Signup and view all the answers

    According to the text, what is the incidence of allergic reactions following administration of etomidate?

    <p>Very low</p> Signup and view all the answers

    According to the text, what are the five principal pharmacologic effects of benzodiazepines?

    <p>Anxiolysis, sedation, anticonvulsant actions, spinal cord–mediated skeletal muscle relaxation, and anterograde amnesia</p> Signup and view all the answers

    Etomidate exerts its effects on GABAA receptors by binding directly to a specific site or sites on the protein and enhancing the affinity of the inhibitory neurotransmitter (GABA) for these receptors. Which of the following statements about etomidate is true?

    <p>Etomidate binds to GABAA receptors and enhances the effects of the inhibitory neurotransmitter (GABA).</p> Signup and view all the answers

    Which of the following is NOT a characteristic of etomidate's distribution in the body?

    <p>Etomidate rapidly penetrates the brain.</p> Signup and view all the answers

    What is the primary reason for the prompt awakening after a single dose of etomidate?

    <p>Redistribution of etomidate from the brain to inactive tissue sites.</p> Signup and view all the answers

    How does etomidate metabolism differ from propofol metabolism?

    <p>Etomidate is metabolized by hepatic microsomal enzymes, while propofol is metabolized by plasma esterases.</p> Signup and view all the answers

    Which of the following is true about the metabolism of etomidate?

    <p>Etomidate is metabolized primarily in the liver.</p> Signup and view all the answers

    What is the primary reason for the use of propofol in patients with hereditary coproporphyria?

    <p>To influence cortisol secretion.</p> Signup and view all the answers

    What is the mechanism of action of etomidate?

    <p>Etomidate enhances the affinity of GABA for its receptors.</p> Signup and view all the answers

    Which of the following statements about etomidate is true?

    <p>Etomidate is highly bound to plasma albumin.</p> Signup and view all the answers

    What is the primary reason for the prompt awakening after a single dose of etomidate?

    <p>Rapid metabolism</p> Signup and view all the answers

    What is the effect of increasing the dose of etomidate or administering it as a continuous infusion?

    <p>Increased context-sensitive half-time</p> Signup and view all the answers

    Which drug can be useful to blunt the hemodynamic responses evoked by direct laryngoscopy and tracheal intubation when administered before induction of anesthesia with etomidate?

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

    Which of the following is true about the effects of etomidate on cortisol levels?

    <p>Etomidate decreases cortisol levels</p> Signup and view all the answers

    Which of the following is true about the incidence of allergic reactions following administration of etomidate?

    <p>The incidence of allergic reactions is low</p> Signup and view all the answers

    Which of the following is NOT one of the pharmacologic effects of benzodiazepines?

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

    Which of the following is true about the effects of etomidate on mortality and morbidity in cardiac surgical patients?

    <p>Etomidate has no impact on mortality and morbidity</p> Signup and view all the answers

    Which of the following is true about the effects of etomidate on cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2)?

    <p>Etomidate decreases CBF and CMRO2 by 35% to 45%</p> Signup and view all the answers

    Which of the following is a characteristic of etomidate's effects on the EEG?

    <p>Etomidate produces a pattern on the EEG that is similar to propofol, thiopental, and methohexital, but with greater frequency of excitatory spikes</p> Signup and view all the answers

    Which of the following statements about the cardiovascular effects of etomidate is true?

    <p>Etomidate causes minimal changes in heart rate, stroke volume, or cardiac output</p> Signup and view all the answers

    Which of the following is a consideration when using etomidate for induction of anesthesia in patients with little or no cardiac reserve?

    <p>Etomidate has dose-dependent negative inotropic effects on myocardial contractility</p> Signup and view all the answers

    Which of the following statements about the effects of etomidate on myocardial contractility is true?

    <p>Etomidate has minimal depressive effects on myocardial contractility at concentrations needed for anesthesia.</p> Signup and view all the answers

    Which of the following statements about the effects of etomidate on ventilation is true?

    <p>Etomidate has less depressant effects on ventilation compared to barbiturates and propofol.</p> Signup and view all the answers

    Which of the following statements about pain on injection of etomidate is true?

    <p>Pain on injection and venous irritation have been eliminated with the use of etomidate in a lipid emulsion vehicle.</p> Signup and view all the answers

    Which of the following statements about etomidate-induced myoclonus is true?

    <p>Etomidate can cause excitatory effects such as myoclonus in a significant percentage of patients.</p> Signup and view all the answers

    True or false: Propofol can trigger malignant hyperthermia.

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

    True or false: Propofol can influence the secretion of cortisol.

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

    True or false: Etomidate is a carboxylated imidazole–containing compound.

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

    True or false: Full recovery of psychomotor function after administration of etomidate is faster than following use of propofol.

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

    True or false: Etomidate produces analgesia similar to barbiturates and propofol.

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

    True or false: Etomidate has minimal effects on the duration of electrically induced seizures.

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

    True or false: Etomidate is a potent direct cerebral vasodilator that increases cerebral blood flow.

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

    Etomidate administration can lead to an intact cortisol response in patients with sepsis or hemorrhage.

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

    Suppression of adrenocortical function is always desirable during anesthesia.

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

    The use of etomidate has been shown to have no impact on mortality or length of ICU stay in trauma patients.

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

    Etomidate exposure is associated with longer length of hospital stay in cardiac surgical patients.

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

    True or false: Etomidate is more selective as a modulator of GABAA receptors compared to barbiturates.

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

    True or false: Etomidate binds directly to GABAA receptors and enhances the affinity of GABA for these receptors.

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

    True or false: Etomidate is known to modulate other ligand-gated ion channels in the brain at clinically relevant concentrations.

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

    True or false: Etomidate is rapidly metabolized by hydrolysis of the ethyl ester side chain to its carboxylic acid ester, resulting in a pharmacologically active compound.

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

    True or false: Etomidate has minimal depressive effects on myocardial contractility at concentrations needed for anesthesia.

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

    True or false: Etomidate-induced decreases in tidal volume are offset by compensatory increases in the frequency of breathing.

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

    True or false: Etomidate can cause excitatory effects such as myoclonus in a high percentage of patients.

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

    True or false: Etomidate causes adrenocortical suppression by inhibiting the conversion of cholesterol to cortisol.

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

    Which of the following is a potential disadvantage of administering etomidate to patients experiencing sepsis or hemorrhage?

    <p>Increased cortisol response</p> Signup and view all the answers

    Which of the following statements is supported by at least one report?

    <p>Etomidate has no effect on mortality in trauma patients</p> Signup and view all the answers

    Which of the following statements is NOT supported by the retrospective study of cardiac surgical patients?

    <p>Etomidate exposure is associated with severe hypotension</p> Signup and view all the answers

    Which of the following is a potential advantage of administering etomidate for induction of anesthesia?

    <p>Suppression of adrenocortical function</p> Signup and view all the answers

    Which drug was associated with increased 30-day mortality and cardiovascular morbidity after noncardiac surgery in a large-scale retrospective study?

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

    Which of the following statements about allergic reactions to etomidate is true?

    <p>The incidence of allergic reactions is very low</p> Signup and view all the answers

    Which of the following is NOT a pharmacologic effect of benzodiazepines?

    <p>Anticonvulsant actions</p> Signup and view all the answers

    Which of the following statements about etomidate's effects on tidal volume and frequency of breathing is true?

    <p>Etomidate decreases tidal volume and frequency of breathing</p> Signup and view all the answers

    Which drug has a faster recovery of psychomotor function compared to etomidate?

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

    Which of the following statements about etomidate's mechanism of action is true?

    <p>Etomidate enhances the affinity of GABA for GABAA receptors</p> Signup and view all the answers

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