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

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

<p>It decreases significantly (D)</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 (A)</p> Signup and view all the answers

What is the maximum decrease in CMRO2 achievable with barbiturates?

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

In which scenario have barbiturates been found to be contraindicated?

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

What is a paradoxical effect of barbiturates at lower doses?

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

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

<p>Blockade of excitatory amino acids (C)</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 (C)</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 (A)</p> Signup and view all the answers

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

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

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

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

Which medication reduces vagally mediated and methacholine-induced bronchoconstriction?

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

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

<p>Induction agent (C)</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 (A)</p> Signup and view all the answers

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

<p>Treatment of hypertension (A)</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 (B)</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 (B)</p> Signup and view all the answers

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

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

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

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

What is the primary effect of ketamine in inducing analgesia?

<p>Activation of NMDA receptors (C)</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 (D)</p> Signup and view all the answers

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

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

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

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

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

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

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

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

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