120 Questions
Which drug is associated with a significant decrease in intraocular pressure?
Propofol
Which drug is NOT known to affect hepatic or renal function?
Thiopental
Which drug is associated with a high incidence of pain on injection?
Propofol
Which drug is a selective modulator of GABAA receptors?
Propofol
Which drug is chemically unrelated to any other drug used for IV induction?
Etomidate
What is the chemical structure of propofol?
2,6-diisopropyl phenol
Which of the following best describes a sedative?
A drug that induces a state of calm or sleep
Why is mixing propofol with lidocaine not recommended?
It may result in droplets that pose a risk of pulmonary embolism
Which of the following is an alternative to propofol?
Aquavan & fospropofol: prodrug
What is the mechanism of action of propofol?
Selective modulator of GABAA receptors
Which factor determines the differences in onset and duration among benzodiazepines?
Pharmacokinetics (uptake, distribution, metabolism and elimination)
Which of the following drugs can exert synergistic sedative effects with benzodiazepines?
Alcohol
Which of the following symptoms may occur after more than 6 months of use of low-potency benzodiazepines?
All of the above
Which of the following benzodiazepines is preferred in elderly patients?
Temazepam
Which of the following factors contribute to the water solubility of midazolam?
Buffering to pH 3.5
Which of the following is true about the administration of Diazepam for sedation during regional and brief therapeutic procedures?
It is recommended to be given up to 10 minutes before surgery.
What is the protein binding characteristic of Diazepam?
It has a high degree of protein binding.
How is Diazepam metabolized in the body?
It is metabolized by hepatic microsomal enzymes.
What is the elimination half-time of Diazepam in healthy volunteers?
Between 20 and 30 hours
How does the elimination half-time of Diazepam change with age?
It increases with age.
Which of the following is a characteristic of etomidate metabolism?
It is metabolized by hepatic microsomal enzymes and plasma esterases.
Which of the following is a side effect of etomidate on the cardiovascular system?
Minimal changes in heart rate, stroke volume, and cardiac output.
What is the principal limiting aspect of etomidate's clinical usefulness?
Its ability to suppress adrenocortical function.
Which of the following is a characteristic of etomidate's effects on ventilation?
Stimulates ventilation independent of medullary centers.
What is a principal pharmacologic effect of benzodiazepines?
Anticonvulsant effects.
Which of the following is NOT a clinical use of propofol?
Treatment of bronchoconstriction
Propofol administration can result in a decrease in which of the following?
Systemic blood pressure
What is the recommended dose of propofol for induction of anesthesia in children?
1.5 to 2.5 mg/kg IV
How does propofol affect cerebral metabolic rate for oxygen (CMRO2)?
Decreases CMRO2
What effect does propofol have on the cardiovascular system?
Decreases systemic blood pressure
Which drug is associated with a high incidence of pain on injection?
Propofol
Which drug is NOT known to affect hepatic or renal function?
Propofol
Which of the following drugs can potentiate respiratory depression when combined with opioids?
Propofol
Which drug is a selective modulator of GABAA receptors?
Propofol
Which drug is associated with a significant decrease in intraocular pressure?
Propofol
Which of the following drugs induces hypnosis or sleep?
Hypnotic
What is the chemical structure of propofol?
2,6-diisopropyl phenol
Which of the following drugs is a low-lipid emulsion that does not require preservative but has higher pain on injection?
Ampofol
What is the mechanism of action of propofol?
Selective modulator of GABAA receptors
Why is mixing propofol with lidocaine not recommended?
Risk of pulmonary embolism
Which of the following is a characteristic of Diazepam's protein binding?
It is highly lipid-soluble
What is the onset time for intravenous sedation with Diazepam?
30 - 60 seconds
What is the recommended timing for administration of Diazepam before surgery?
20 minutes
What is the elimination half-time of Diazepam in healthy volunteers?
21 - 37 hours
How is Diazepam metabolized in the body?
By hepatic microsomal enzymes
Which of the following factors contributes to the differences in onset and duration among benzodiazepines?
Pharmacokinetics (uptake, distribution, metabolism and elimination)
Which of the following symptoms may occur after more than 6 months of use of low-potency benzodiazepines?
All of the above
Which of the following drugs can exert synergistic sedative effects with benzodiazepines?
Opioids
What is the preferred benzodiazepine in elderly patients?
Lorazepam
What is the principal pharmacologic effect of benzodiazepines on the cardiovascular system?
Anticonvulsant
Which of the following is the equation of a line in slope-intercept form?
$y = mx + b$
Which of the following is the quadratic formula?
$x = \frac{-b \pm \sqrt{b^2 - 4ac}}{2a}$
What is the value of $\sin(90°)$?
1
What is the derivative of $f(x) = 3x^2 - 2x + 1$?
$f'(x) = 6x - 2$
What is the value of $\log_{10}(1000)$?
3
Which of the following is a characteristic of etomidate metabolism?
Etomidate is metabolized by hepatic microsomal enzymes and plasma esterases.
What is the principal limiting aspect of etomidate's clinical usefulness?
Etomidate can cause adrenocortical suppression.
Which of the following is a side effect of etomidate on the cardiovascular system?
Etomidate causes a decrease in blood pressure.
How does propofol affect cerebral metabolic rate for oxygen (CMRO2)?
Propofol decreases CMRO2.
How does the elimination half-time of Diazepam change with age?
The elimination half-time of Diazepam increases with age.
Which drug is associated with a higher incidence of pain on injection?
Propofol
Which drug is NOT known to affect hepatic or renal function?
Thiopental
What is the principal pharmacologic effect of propofol on the cardiovascular system?
Bradycardia
What is the chemical structure of propofol?
Phenyl nucleus and diisopropyl side chain
What is the mechanism of action of propofol?
Selective modulator of GABAA receptors
Which of the following equations represents a line with a slope of 2 and a y-intercept of -3?
$y = 2x - 3$
What is the value of x in the equation $3x + 7 = 22$?
$x = 5$
What is the area of a rectangle with length 6 units and width 4 units?
$24$ square units
What is the value of $(-2)^3$?
$-8$
What is the solution to the equation $2x + 5 = 3x - 1$?
$x = 6$
Which of the following is true about the protein binding characteristic of Diazepam?
Diazepam has a high degree of protein binding
What is the elimination half-time of Diazepam in healthy volunteers?
21 to 37 hours
Which of the following drugs is recommended for sedation during regional as well as brief therapeutic procedures?
Diazepam
What is the recommended timing for administration of Diazepam before surgery?
20 minutes before surgery
What is the commercial preparation of Diazepam?
Dissolved in organic solvents
Which of the following factors contribute to the differences in onset and duration among benzodiazepines?
Pharmacokinetics (uptake, distribution, metabolism and elimination)
Which of the following drugs can potentiate the ventilatory depressant effects of opioids?
Opioids
Which of the following drugs is capable of producing an isoelectric EEG?
Midazolam
Which of the following drugs is preferred in elderly patients due to its metabolism by glucuronidation?
Lorazepam
Which of the following drugs has a short duration of action due to redistribution and rapid hepatic clearance?
Midazolam
Which of the following is a characteristic of propofol's mechanism of action?
It selectively modulates GABAA receptors.
Which of the following is a characteristic of propofol administration?
It can result in a decrease in cerebral metabolic rate for oxygen (CMRO2).
Which of the following is NOT a characteristic of propofol alternatives?
They are prodrugs.
Which of the following is a characteristic of propofol's chemical structure?
It is a non-lipid formulation.
Which of the following is a characteristic of propofol's administration medium?
It maintains isotonicity with blood.
Which of the following is a characteristic of etomidate's metabolism?
Metabolized by hydrolysis of the ethyl ester side chain
Which of the following is a side effect of etomidate on the cardiovascular system?
Minimal changes in heart rate and cardiac output
Which of the following is a side effect of etomidate on ventilation?
Stimulates ventilation independent of medullary centers
Which of the following is a characteristic of etomidate's adrenocortical suppression?
Lasts for 4 to 8 hours after an induction dose
Which of the following is NOT a principal pharmacologic effect of benzodiazepines?
Muscle relaxation
Propofol has a longer half-life in elderly patients compared to children
False
Propofol is primarily metabolized by hepatic oxidative metabolism
True
Propofol is commonly used for intravenous sedation
True
Propofol can attenuate bronchoconstriction in asthmatic patients
True
Propofol increases cerebral blood flow
False
Propofol is associated with significant decrease in intraocular pressure.
True
Propofol does not affect hepatic or renal function.
True
Bradycardia is a potential side effect of propofol.
True
Propofol is chemically unrelated to any other drug used for IV induction.
True
Propofol has potent antioxidant properties.
True
Etomidate is rapidly metabolized by hydrolysis of the ethyl ester side chain to its carboxylic acid ester
True
Etomidate is highly protein bound to albumin
False
Etomidate is known to produce analgesia
False
Etomidate is associated with adrenocortical suppression
True
Etomidate has minimal effects on cardiovascular stability
True
Diazepam is commonly used as part of the anesthesia care plan.
False
Diazepam is highly protein-bound.
True
Diazepam is dissolved in water.
False
Diazepam has a rapid absorption from the GI tract.
True
The elimination half-time of Diazepam is shorter than lorazepam.
False
Propofol is a sedative-hypnotic drug.
True
Anxiolytics are drugs that induce hypnosis or sleep.
False
Propofol is administered intravenously.
True
Mixing propofol with lidocaine is not recommended.
True
Propofol is a non-lipid formulation.
False
True or false: Benzodiazepines have a built-in ceiling effect that prevents them from exceeding the physiologic maximum of GABA inhibition.
True
True or false: Differences in onset and duration among benzodiazepines reflect differences in potency, lipid solubility, and pharmacokinetics.
True
True or false: Benzodiazepines decrease adenosine degradation, which can lead to a reduction in cardiac oxygen demand.
True
True or false: Benzodiazepines exert synergistic sedative effects with alcohol, inhaled anesthetics, opioids, and α2 agonists.
True
True or false: Benzodiazepines can accelerate cognitive decline in elderly patients.
True
Study Notes
Anesthesia and Sedation
- Etomidate is associated with a significant decrease in intraocular pressure.
- Propofol is a selective modulator of GABAA receptors.
- Etomidate is chemically unrelated to any other drug used for IV induction.
- Propofol has a chemical structure that is a 2,6-diisopropylphenol.
- A sedative is a drug that reduces anxiety, stress, and excitement, but does not induce sleep.
Propofol
- Propofol is associated with a high incidence of pain on injection.
- Propofol is not known to affect hepatic or renal function.
- Propofol can induce hypnosis or sleep.
- The mechanism of action of propofol is through modulation of GABAA receptors.
- Mixing propofol with lidocaine is not recommended due to increased pain on injection.
- Ketamine is an alternative to propofol.
- Propofol administration can result in a decrease in systemic vascular resistance.
- The recommended dose of propofol for induction of anesthesia in children is 2.5-3.5 mg/kg.
- Propofol decreases cerebral metabolic rate for oxygen (CMRO2).
- Propofol has a negative inotropic effect on the cardiovascular system.
Diazepam
- Diazepam is a benzodiazepine that can exert synergistic sedative effects with opioids.
- Diazepam is preferred in elderly patients due to its metabolism by glucuronidation.
- The protein binding characteristic of Diazepam is 99%.
- The onset time for intravenous sedation with Diazepam is 1-2 minutes.
- The recommended timing for administration of Diazepam before surgery is 10-15 minutes.
- The elimination half-time of Diazepam in healthy volunteers is 20-30 hours.
- Diazepam is metabolized in the body through glucuronidation.
- The commercial preparation of Diazepam is Valium.
Etomidate
- Etomidate is associated with a high incidence of pain on injection.
- Etomidate is not known to affect hepatic or renal function.
- Etomidate has a characteristic of adrenocortical suppression.
- The principal limiting aspect of etomidate's clinical usefulness is adrenocortical suppression.
- Etomidate has a side effect on the cardiovascular system, causing hypertension.
- Etomidate has a side effect on ventilation, causing respiratory depression.
- Etomidate's metabolism is primarily through ester hydrolysis.
Benzodiazepines
- The principal pharmacologic effect of benzodiazepines is anxiolysis.
- The principal pharmacologic effect of benzodiazepines on the cardiovascular system is a decrease in systemic vascular resistance.
- The factor that contributes to the differences in onset and duration among benzodiazepines is lipid solubility.
- The symptoms that may occur after more than 6 months of use of low-potency benzodiazepines include rebound anxiety and insomnia.
Test your knowledge on the pharmacokinetics of Etomidate. Learn about its unionization, protein binding, metabolism, and more. Find out how this drug is rapidly metabolized and its effects on the body.
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