Effects of Thiopental and Propofol in Spinal Cord Injury Studies
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Questions and Answers

What is Methohexital used for in low doses?

  • To induce respiratory depression
  • To treat cardiac arrhythmias
  • To sedate patients with COPD
  • To induce seizure discharges in temporal lobe epilepsy (correct)
  • What is the effect of intravenous induction agents on the respiratory system?

  • Dose-dependent respiratory stimulation
  • Dose-dependent respiratory depression (correct)
  • Unchanged respiratory parameters
  • Increased tidal volume and minute ventilation
  • How long does apnea typically last after barbiturate induction?

  • Around 30 seconds or less (correct)
  • 1-2 hours
  • Until the patient is fully awake
  • Several minutes
  • What happens to cardiac index due to anesthetic effects?

    <p>It remains unchanged or is reduced</p> Signup and view all the answers

    What is the effect of anesthetics on sympathetic outflow from the CNS?

    <p>It decreases significantly</p> Signup and view all the answers

    Following acute brain injury, what do barbiturates fail to demonstrate superiority over other techniques in doing?

    <p>Decreasing ICP</p> Signup and view all the answers

    What is the maximum decrease in CMRO2 achievable with barbiturates?

    <p>50-55%</p> Signup and view all the answers

    In which scenario have barbiturates been found to be contraindicated?

    <p>Following resuscitation from cardiac arrest</p> Signup and view all the answers

    What is a paradoxical effect of barbiturates at lower doses?

    <p>Increased seizure activity</p> Signup and view all the answers

    What is a proposed mechanism of the neuroprotective effect of barbiturates?

    <p>Blockade of excitatory amino acids</p> Signup and view all the answers

    Which medication reduced lipid peroxidase but did not spare ultrastructure injury in spinal cord injury studies?

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

    What is the mechanism of action of thiopental and propofol in reducing spinal cord injury?

    <p>Antioxidant activity and free radical scavenging</p> Signup and view all the answers

    Which factor does Propofol-induced hypotension in elderly patients depend on?

    <p>Hypovolemic states</p> Signup and view all the answers

    What is a dose-dependent effect of thiopental and propofol in cardioprotection?

    <p>Myocardial protection</p> Signup and view all the answers

    Which medication reduces vagally mediated and methacholine-induced bronchoconstriction?

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

    Which effect is NOT true about propofol in the context of spinal cord injury?

    <p>Increases sympathetic activity</p> Signup and view all the answers

    Which benzodiazepine has a shorter half-life and increased context-sensitive half-time compared to propofol?

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

    In patients with reduced intracranial compliance, benzodiazepines like midazolam are generally considered acceptable for?

    <p>Induction agent</p> Signup and view all the answers

    Which effect do benzodiazepines like midazolam exhibit by decreasing the ventilatory response to CO2?

    <p>Central respiratory depression</p> Signup and view all the answers

    Which clinical use is NOT associated with benzodiazepines as mentioned in the text?

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

    What is the primary reason for the modest decrease in blood pressure observed with the use of benzodiazepines like midazolam?

    <p>Increased SVR</p> Signup and view all the answers

    According to the information provided, which organ system is negatively impacted by benzodiazepines through decreased muscular tone in the upper airway?

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

    Which receptor does ketamine inhibit the release of glutamate from the presynaptic nerve terminal?

    <p>NMDA receptor</p> Signup and view all the answers

    What is the major active metabolite of ketamine formed via hepatic microsomal enzymes?

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

    What is the primary effect of ketamine in inducing analgesia?

    <p>Activation of NMDA receptors</p> Signup and view all the answers

    Which organ system shows decreased salivation and reduced incidence of emergence reactions with the S(+) isomer of ketamine?

    <p>Digestive system</p> Signup and view all the answers

    What is the primary characteristic of the 'dissociative state' induced by ketamine?

    <p>Consciousness with amnesia</p> Signup and view all the answers

    Which route of administration for ketamine results in the highest bioavailability?

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

    What is the primary concern when using ketamine for induction in patients with known severe cardiac valvular disease?

    <p>Cardiac arrhythmias</p> Signup and view all the answers

    Which aspect of biochemical pharmacokinetics does ketamine exhibit a brief duration of action?

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

    What is the primary concern with ketamine induction in individuals with elevated intracranial pressure (ICP)?

    <p>Cerebral vasodilation</p> Signup and view all the answers

    What is the therapeutic benefit of ketamine in postoperative sedation and analgesia?

    <p>Opioid sparing effect</p> Signup and view all the answers

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