67 Questions
Which drug is associated with a slower recovery of psychomotor function compared to propofol?
Etomidate
What is the effect of increasing the dose of etomidate or administering it as a continuous infusion?
Prolongs the duration of action
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?
Opioids
What is the principal limiting factor in the clinical use of etomidate for induction of anesthesia?
Transiently depresses adrenocortical function
Which of the following is true about the effects of etomidate on myocardial contractility?
Etomidate has minimal depressive effects on myocardial contractility at concentrations needed for anesthesia.
Which of the following is true about the effects of etomidate on hepatic and renal functions?
Etomidate has no effect on hepatic and renal functions.
Which of the following is true about the effects of etomidate on intraocular pressure?
Etomidate decreases intraocular pressure.
Which of the following is true about the effects of etomidate on ventilation?
Etomidate has transient effects on ventilation lasting only 3 to 5 minutes.
Which of the following statements about propofol is true?
Propofol has been administered to patients with hereditary coproporphyria without incident.
Which of the following is true about the original formulation of etomidate?
It had a high incidence of pain during IV injection.
Which of the following statements about etomidate is true?
It is administered as a mixture of isomers.
According to the text, what is the duration of enzyme inhibition after an induction dose of etomidate?
4 to 8 hours
According to the text, what impact does etomidate have on mortality, length of ICU stay, and duration of mechanical ventilation in trauma patients?
No impact
According to the text, what is the incidence of allergic reactions following administration of etomidate?
Very low
According to the text, what are the five principal pharmacologic effects of benzodiazepines?
Anxiolysis, sedation, anticonvulsant actions, spinal cord–mediated skeletal muscle relaxation, and anterograde amnesia
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?
Etomidate binds to GABAA receptors and enhances the effects of the inhibitory neurotransmitter (GABA).
Which of the following is NOT a characteristic of etomidate's distribution in the body?
Etomidate rapidly penetrates the brain.
What is the primary reason for the prompt awakening after a single dose of etomidate?
Redistribution of etomidate from the brain to inactive tissue sites.
How does etomidate metabolism differ from propofol metabolism?
Etomidate is metabolized by hepatic microsomal enzymes, while propofol is metabolized by plasma esterases.
Which of the following is true about the metabolism of etomidate?
Etomidate is metabolized primarily in the liver.
What is the primary reason for the use of propofol in patients with hereditary coproporphyria?
To influence cortisol secretion.
What is the mechanism of action of etomidate?
Etomidate enhances the affinity of GABA for its receptors.
Which of the following statements about etomidate is true?
Etomidate is highly bound to plasma albumin.
What is the primary reason for the prompt awakening after a single dose of etomidate?
Rapid metabolism
What is the effect of increasing the dose of etomidate or administering it as a continuous infusion?
Increased context-sensitive half-time
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?
Opioids
Which of the following is true about the effects of etomidate on cortisol levels?
Etomidate decreases cortisol levels
Which of the following is true about the incidence of allergic reactions following administration of etomidate?
The incidence of allergic reactions is low
Which of the following is NOT one of the pharmacologic effects of benzodiazepines?
Bronchodilation
Which of the following is true about the effects of etomidate on mortality and morbidity in cardiac surgical patients?
Etomidate has no impact on mortality and morbidity
Which of the following is true about the effects of etomidate on cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2)?
Etomidate decreases CBF and CMRO2 by 35% to 45%
Which of the following is a characteristic of etomidate's effects on the EEG?
Etomidate produces a pattern on the EEG that is similar to propofol, thiopental, and methohexital, but with greater frequency of excitatory spikes
Which of the following statements about the cardiovascular effects of etomidate is true?
Etomidate causes minimal changes in heart rate, stroke volume, or cardiac output
Which of the following is a consideration when using etomidate for induction of anesthesia in patients with little or no cardiac reserve?
Etomidate has dose-dependent negative inotropic effects on myocardial contractility
Which of the following statements about the effects of etomidate on myocardial contractility is true?
Etomidate has minimal depressive effects on myocardial contractility at concentrations needed for anesthesia.
Which of the following statements about the effects of etomidate on ventilation is true?
Etomidate has less depressant effects on ventilation compared to barbiturates and propofol.
Which of the following statements about pain on injection of etomidate is true?
Pain on injection and venous irritation have been eliminated with the use of etomidate in a lipid emulsion vehicle.
Which of the following statements about etomidate-induced myoclonus is true?
Etomidate can cause excitatory effects such as myoclonus in a significant percentage of patients.
True or false: Propofol can trigger malignant hyperthermia.
False
True or false: Propofol can influence the secretion of cortisol.
False
True or false: Etomidate is a carboxylated imidazole–containing compound.
True
True or false: Full recovery of psychomotor function after administration of etomidate is faster than following use of propofol.
False
True or false: Etomidate produces analgesia similar to barbiturates and propofol.
False
True or false: Etomidate has minimal effects on the duration of electrically induced seizures.
True
True or false: Etomidate is a potent direct cerebral vasodilator that increases cerebral blood flow.
False
Etomidate administration can lead to an intact cortisol response in patients with sepsis or hemorrhage.
False
Suppression of adrenocortical function is always desirable during anesthesia.
False
The use of etomidate has been shown to have no impact on mortality or length of ICU stay in trauma patients.
True
Etomidate exposure is associated with longer length of hospital stay in cardiac surgical patients.
False
True or false: Etomidate is more selective as a modulator of GABAA receptors compared to barbiturates.
True
True or false: Etomidate binds directly to GABAA receptors and enhances the affinity of GABA for these receptors.
True
True or false: Etomidate is known to modulate other ligand-gated ion channels in the brain at clinically relevant concentrations.
False
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.
False
True or false: Etomidate has minimal depressive effects on myocardial contractility at concentrations needed for anesthesia.
True
True or false: Etomidate-induced decreases in tidal volume are offset by compensatory increases in the frequency of breathing.
True
True or false: Etomidate can cause excitatory effects such as myoclonus in a high percentage of patients.
True
True or false: Etomidate causes adrenocortical suppression by inhibiting the conversion of cholesterol to cortisol.
True
Which of the following is a potential disadvantage of administering etomidate to patients experiencing sepsis or hemorrhage?
Increased cortisol response
Which of the following statements is supported by at least one report?
Etomidate has no effect on mortality in trauma patients
Which of the following statements is NOT supported by the retrospective study of cardiac surgical patients?
Etomidate exposure is associated with severe hypotension
Which of the following is a potential advantage of administering etomidate for induction of anesthesia?
Suppression of adrenocortical function
Which drug was associated with increased 30-day mortality and cardiovascular morbidity after noncardiac surgery in a large-scale retrospective study?
Propofol
Which of the following statements about allergic reactions to etomidate is true?
The incidence of allergic reactions is very low
Which of the following is NOT a pharmacologic effect of benzodiazepines?
Anticonvulsant actions
Which of the following statements about etomidate's effects on tidal volume and frequency of breathing is true?
Etomidate decreases tidal volume and frequency of breathing
Which drug has a faster recovery of psychomotor function compared to etomidate?
Propofol
Which of the following statements about etomidate's mechanism of action is true?
Etomidate enhances the affinity of GABA for GABAA receptors
Test your knowledge on the recovery time and duration of action of etomidate compared to propofol, as well as its analgesic properties. Learn about the effects of increasing the dose of etomidate and administering it as a continuous infusion. Discover the importance of administering an opioid before anesthesia induction.
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