Podcast
Questions and Answers
Which term refers to a drug that induces a state of calm or sleep?
Which term refers to a drug that induces a state of calm or sleep?
- Hypnotic
- Sedative (correct)
- Anxiolytic
- Sedativehypnotic
What is the chemical composition of propofol?
What is the chemical composition of propofol?
- Soybean oil
- Purified egg phosphatide
- Isopropylphenol (correct)
- Glycerol
Which class of pharmacologic agents is central to the practice of anesthesiology?
Which class of pharmacologic agents is central to the practice of anesthesiology?
- Antibiotics
- Inhaled anesthetics
- Intravenous sedatives and hypnotics (correct)
- Opioids
What is the dose of propofol for rapid IV injection?
What is the dose of propofol for rapid IV injection?
Which drug is commonly used to attenuate the frequency of myoclonic-like movements during the induction period?
Which drug is commonly used to attenuate the frequency of myoclonic-like movements during the induction period?
After a single IV dose, which drug has a similar awakening time to etomidate?
After a single IV dose, which drug has a similar awakening time to etomidate?
Which drug has a slower full recovery of psychomotor function compared to etomidate?
Which drug has a slower full recovery of psychomotor function compared to etomidate?
Which drug is commonly used to blunt the hemodynamic responses evoked by direct laryngoscopy and tracheal intubation?
Which drug is commonly used to blunt the hemodynamic responses evoked by direct laryngoscopy and tracheal intubation?
Which of the following is a potential adverse effect of propofol sedation in children in the ICU?
Which of the following is a potential adverse effect of propofol sedation in children in the ICU?
What is the recommended course of action if unexpected tachycardia occurs during propofol anesthesia?
What is the recommended course of action if unexpected tachycardia occurs during propofol anesthesia?
What is the potential mechanism for propofol-induced metabolic acidosis?
What is the potential mechanism for propofol-induced metabolic acidosis?
What is the recommended timeframe for discarding an opened ampule of propofol if it is not used?
What is the recommended timeframe for discarding an opened ampule of propofol if it is not used?
Which of the following is a property of propofol that contributes to its neuroprotective effect?
Which of the following is a property of propofol that contributes to its neuroprotective effect?
What is the most commonly reported adverse event associated with propofol administration to awake patients?
What is the most commonly reported adverse event associated with propofol administration to awake patients?
What is the effect of subhypnotic concentrations of propofol, isoflurane, and sevoflurane on pharyngeal contraction force?
What is the effect of subhypnotic concentrations of propofol, isoflurane, and sevoflurane on pharyngeal contraction force?
What is the original formulation of etomidate and what was it changed to?
What is the original formulation of etomidate and what was it changed to?
Which of the following statements about the effects of etomidate on myocardial contractility is most accurate?
Which of the following statements about the effects of etomidate on myocardial contractility is most accurate?
Which of the following statements about the effects of etomidate on ventilation is most accurate?
Which of the following statements about the effects of etomidate on ventilation is most accurate?
Which of the following statements about the effects of etomidate on pain on injection is most accurate?
Which of the following statements about the effects of etomidate on pain on injection is most accurate?
Which of the following statements about the effects of etomidate on myoclonus is most accurate?
Which of the following statements about the effects of etomidate on myoclonus is most accurate?
Which of the following statements is true about the mechanism of etomidate-induced myoclonus?
Which of the following statements is true about the mechanism of etomidate-induced myoclonus?
When does excitatory movements typically occur in relation to the EEG during etomidate-induced myoclonus?
When does excitatory movements typically occur in relation to the EEG during etomidate-induced myoclonus?
Which enzyme does etomidate inhibit to cause adrenocortical suppression?
Which enzyme does etomidate inhibit to cause adrenocortical suppression?
How long does the inhibition of the enzyme by etomidate last after an induction dose?
How long does the inhibition of the enzyme by etomidate last after an induction dose?
In what situation could suppression of adrenocortical function be considered desirable?
In what situation could suppression of adrenocortical function be considered desirable?
Was there a difference in the plasma concentrations of cortisol, corticosterone, or adrenocorticotrophic hormone in patients receiving a single dose of etomidate?
Was there a difference in the plasma concentrations of cortisol, corticosterone, or adrenocorticotrophic hormone in patients receiving a single dose of etomidate?
Etomidate is unique among injected and inhaled anesthetics in being administered as a single isomer. The anesthetic effect of etomidate resides predominantly in the R(+) isomer, which is approximately 5 times as potent as the S(−) isomer. Which of the following statements is true about the isomers of etomidate?
Etomidate is unique among injected and inhaled anesthetics in being administered as a single isomer. The anesthetic effect of etomidate resides predominantly in the R(+) isomer, which is approximately 5 times as potent as the S(−) isomer. Which of the following statements is true about the isomers of etomidate?
Which of the following is true about the distribution of etomidate in the body?
Which of the following is true about the distribution of etomidate in the body?
What is the main reason for the prompt awakening after a single dose of etomidate?
What is the main reason for the prompt awakening after a single dose of etomidate?
What is responsible for the hydrolysis of etomidate in the body?
What is responsible for the hydrolysis of etomidate in the body?
Which drug is chemically distinct from all other drugs that act as IV sedative-hypnotics?
Which drug is chemically distinct from all other drugs that act as IV sedative-hypnotics?
What is the recommended dose of propofol for rapid IV injection?
What is the recommended dose of propofol for rapid IV injection?
Which term refers to a drug that induces hypnosis or sleep?
Which term refers to a drug that induces hypnosis or sleep?
Which class of pharmacologic agents is central to the practice of anesthesiology?
Which class of pharmacologic agents is central to the practice of anesthesiology?
Which of the following is a potential adverse effect of propofol sedation in children in the ICU?
Which of the following is a potential adverse effect of propofol sedation in children in the ICU?
Which of the following is a potential mechanism for propofol-induced metabolic acidosis?
Which of the following is a potential mechanism for propofol-induced metabolic acidosis?
Which of the following is true about the growth of bacteria in propofol?
Which of the following is true about the growth of bacteria in propofol?
What is the recommended timeframe for discarding an opened ampule of propofol if it is not used?
What is the recommended timeframe for discarding an opened ampule of propofol if it is not used?
Which of the following is true about the pharmacokinetics of etomidate?
Which of the following is true about the pharmacokinetics of etomidate?
What is the mechanism of action of etomidate on GABAA receptors?
What is the mechanism of action of etomidate on GABAA receptors?
Which of the following is true about the metabolism of etomidate?
Which of the following is true about the metabolism of etomidate?
In what situation could etomidate be considered as an alternative to propofol or barbiturates for the IV induction of anesthesia?
In what situation could etomidate be considered as an alternative to propofol or barbiturates for the IV induction of anesthesia?
Which of the following statements about the effects of etomidate on cerebral blood flow (CBF) is most accurate?
Which of the following statements about the effects of etomidate on cerebral blood flow (CBF) is most accurate?
Which of the following statements about the effects of etomidate on heart rate and blood pressure is most accurate?
Which of the following statements about the effects of etomidate on heart rate and blood pressure is most accurate?
Which of the following statements about the effects of etomidate on adrenocortical function is most accurate?
Which of the following statements about the effects of etomidate on adrenocortical function is most accurate?
Which of the following statements about the effects of etomidate on postoperative nausea and vomiting (PONV) is most accurate?
Which of the following statements about the effects of etomidate on postoperative nausea and vomiting (PONV) is most accurate?
Which of the following is a potential mechanism for etomidate-induced myoclonus?
Which of the following is a potential mechanism for etomidate-induced myoclonus?
What is the main reason for the prompt awakening after a single dose of etomidate?
What is the main reason for the prompt awakening after a single dose of etomidate?
Which enzyme does etomidate inhibit to cause adrenocortical suppression?
Which enzyme does etomidate inhibit to cause adrenocortical suppression?
When does excitatory movements typically occur in relation to the EEG during etomidate-induced myoclonus?
When does excitatory movements typically occur in relation to the EEG during etomidate-induced myoclonus?
What is the effect of subhypnotic concentrations of propofol, isoflurane, and sevoflurane on pharyngeal contraction force?
What is the effect of subhypnotic concentrations of propofol, isoflurane, and sevoflurane on pharyngeal contraction force?
What is the recommended timeframe for discarding an opened ampule of propofol if it is not used?
What is the recommended timeframe for discarding an opened ampule of propofol if it is not used?
Which of the following statements about etomidate-induced negative inotropic effects is most accurate?
Which of the following statements about etomidate-induced negative inotropic effects is most accurate?
Which of the following statements about the effects of etomidate on ventilation is most accurate?
Which of the following statements about the effects of etomidate on ventilation is most accurate?
Which of the following statements about pain on injection of etomidate is most accurate?
Which of the following statements about pain on injection of etomidate is most accurate?
Which of the following statements about myoclonus associated with etomidate administration is most accurate?
Which of the following statements about myoclonus associated with etomidate administration is most accurate?
Which of the following statements about the antioxidant properties of propofol is most accurate?
Which of the following statements about the antioxidant properties of propofol is most accurate?
What is the most commonly reported adverse event associated with propofol administration to awake patients?
What is the most commonly reported adverse event associated with propofol administration to awake patients?
Which of the following statements about the effects of etomidate on pain on injection is most accurate?
Which of the following statements about the effects of etomidate on pain on injection is most accurate?
Which of the following statements about the effects of propofol on lipid peroxidation during coronary artery bypass graft surgery is most accurate?
Which of the following statements about the effects of propofol on lipid peroxidation during coronary artery bypass graft surgery is most accurate?
Propofol is a γ-Aminobutyric Acid Agonist.
Propofol is a γ-Aminobutyric Acid Agonist.
Propofol is administered orally.
Propofol is administered orally.
Propofol can be used to induce general anesthesia.
Propofol can be used to induce general anesthesia.
Propofol is chemically similar to other drugs that act as IV sedative-hypnotics.
Propofol is chemically similar to other drugs that act as IV sedative-hypnotics.
Propofol sedation can cause severe and fatal bradycardia in children in the ICU.
Propofol sedation can cause severe and fatal bradycardia in children in the ICU.
Short-term infusions of propofol for surgical anesthesia have been associated with the development of metabolic acidosis.
Short-term infusions of propofol for surgical anesthesia have been associated with the development of metabolic acidosis.
Propofol-induced metabolic acidosis can be reversed with discontinuation of propofol administration.
Propofol-induced metabolic acidosis can be reversed with discontinuation of propofol administration.
Propofol administration can lead to the growth of Escherichia coli and Pseudomonas aeruginosa.
Propofol administration can lead to the growth of Escherichia coli and Pseudomonas aeruginosa.
True or false: Propofol has antioxidant properties similar to vitamin E.
True or false: Propofol has antioxidant properties similar to vitamin E.
True or false: Propofol can suppress phagocytosis due to its peroxynitrite-scavenging activity.
True or false: Propofol can suppress phagocytosis due to its peroxynitrite-scavenging activity.
True or false: Propofol can cause pain on injection in awake patients.
True or false: Propofol can cause pain on injection in awake patients.
True or false: Etomidate is water-soluble at an acidic pH and lipid-soluble at physiologic pH.
True or false: Etomidate is water-soluble at an acidic pH and lipid-soluble at physiologic pH.
True or false: Involuntary myoclonic movements are a common side effect of etomidate during the induction period.
True or false: Involuntary myoclonic movements are a common side effect of etomidate during the induction period.
True or false: Etomidate has analgesic properties.
True or false: Etomidate has analgesic properties.
True or false: Etomidate can be used as an alternative to drugs that decrease the duration of seizures in patients undergoing electroconvulsive therapy.
True or false: Etomidate can be used as an alternative to drugs that decrease the duration of seizures in patients undergoing electroconvulsive therapy.
True or false: Etomidate has minimal effects on the duration of electrically induced seizures.
True or false: Etomidate has minimal effects on the duration of electrically induced seizures.
Etomidate causes dose-dependent decreases in myocardial contractility.
Etomidate causes dose-dependent decreases in myocardial contractility.
Etomidate has minimal negative inotropic effects at concentrations used for anesthesia.
Etomidate has minimal negative inotropic effects at concentrations used for anesthesia.
Etomidate-induced decreases in tidal volume are offset by compensatory increases in breathing frequency.
Etomidate-induced decreases in tidal volume are offset by compensatory increases in breathing frequency.
Etomidate may stimulate ventilation independently of the medullary centers that respond to carbon dioxide.
Etomidate may stimulate ventilation independently of the medullary centers that respond to carbon dioxide.
True or false: Etomidate is administered as a single isomer, with the R(+) isomer being more potent than the S(-) isomer.
True or false: Etomidate is administered as a single isomer, with the R(+) isomer being more potent than the S(-) isomer.
True or false: 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.
True or false: 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.
True or false: Etomidate is known to modulate other ligand-gated ion channels in the brain at clinically relevant concentrations.
True or false: Etomidate is known to modulate other ligand-gated ion channels in the brain at clinically relevant concentrations.
True or false: Etomidate is rapidly metabolized by hydrolysis of the ethyl ester side chain to its carboxylic acid ester, resulting in a water-soluble, pharmacologically inactive compound.
True or false: Etomidate is rapidly metabolized by hydrolysis of the ethyl ester side chain to its carboxylic acid ester, resulting in a water-soluble, pharmacologically inactive compound.
True or false: Etomidate-induced myoclonus is caused by disinhibition of subcortical structures that normally suppress extrapyramidal motor activity.
True or false: Etomidate-induced myoclonus is caused by disinhibition of subcortical structures that normally suppress extrapyramidal motor activity.
True or false: Excitatory movements during etomidate-induced myoclonus are often observed during the early slow phase of the EEG, which corresponds to the beginning of deep anesthesia.
True or false: Excitatory movements during etomidate-induced myoclonus are often observed during the early slow phase of the EEG, which corresponds to the beginning of deep anesthesia.
True or false: Etomidate-induced myoclonus can occur upon awakening if the extrapyramidal system emerges more quickly than the cortex that inhibits it.
True or false: Etomidate-induced myoclonus can occur upon awakening if the extrapyramidal system emerges more quickly than the cortex that inhibits it.
True or false: Seizure-like activity on the EEG has been documented in association with etomidate-induced myoclonus.
True or false: Seizure-like activity on the EEG has been documented in association with etomidate-induced myoclonus.
True or false: Etomidate causes adrenocortical suppression by inhibiting the conversion of cholesterol to cortisol through the enzyme 11-β-hydroxylase.
True or false: Etomidate causes adrenocortical suppression by inhibiting the conversion of cholesterol to cortisol through the enzyme 11-β-hydroxylase.
True or false: Adrenocortical suppression caused by etomidate lasts for 4 to 8 hours after an induction dose.
True or false: Adrenocortical suppression caused by etomidate lasts for 4 to 8 hours after an induction dose.
Which of the following is a potential adverse effect of propofol sedation in children in the ICU?
Which of the following is a potential adverse effect of propofol sedation in children in the ICU?
What is the recommended timeframe for discarding an opened ampule of propofol if it is not used?
What is the recommended timeframe for discarding an opened ampule of propofol if it is not used?
True or false: Etomidate has analgesic properties.
True or false: Etomidate has analgesic properties.
Which of the following statements about the effects of etomidate on heart rate and blood pressure is most accurate?
Which of the following statements about the effects of etomidate on heart rate and blood pressure is most accurate?
Which of the following statements about the duration of action of etomidate is most accurate?
Which of the following statements about the duration of action of etomidate is most accurate?
True or false: Etomidate provides analgesia.
True or false: Etomidate provides analgesia.
Which of the following statements about the effects of etomidate on cerebral blood flow is most accurate?
Which of the following statements about the effects of etomidate on cerebral blood flow is most accurate?
Which of the following statements about the cardiovascular effects of etomidate is most accurate?
Which of the following statements about the cardiovascular effects of etomidate is most accurate?
Which of the following is a potential adverse effect of propofol sedation in children in the ICU?
Which of the following is a potential adverse effect of propofol sedation in children in the ICU?
What is the recommended course of action if unexpected tachycardia occurs during propofol anesthesia?
What is the recommended course of action if unexpected tachycardia occurs during propofol anesthesia?
True or false: Propofol has antioxidant properties similar to vitamin E.
True or false: Propofol has antioxidant properties similar to vitamin E.
Which drug is commonly used to blunt the hemodynamic responses evoked by direct laryngoscopy and tracheal intubation?
Which drug is commonly used to blunt the hemodynamic responses evoked by direct laryngoscopy and tracheal intubation?
Which term refers to a drug that induces a state of calm or sleep?
Which term refers to a drug that induces a state of calm or sleep?
What is the chemical composition of propofol?
What is the chemical composition of propofol?
Which drug can be used to allay anxiety with minimal sedation or produce varying degrees of sedation?
Which drug can be used to allay anxiety with minimal sedation or produce varying degrees of sedation?
What is the recommended dose of propofol for rapid IV injection?
What is the recommended dose of propofol for rapid IV injection?
Which of the following statements about the effects of etomidate on myocardial contractility is most accurate?
Which of the following statements about the effects of etomidate on myocardial contractility is most accurate?
Which of the following statements about the effects of etomidate on ventilation is most accurate?
Which of the following statements about the effects of etomidate on ventilation is most accurate?
Which of the following statements about pain on injection of etomidate is most accurate?
Which of the following statements about pain on injection of etomidate is most accurate?
Which of the following statements about etomidate-induced myoclonus is most accurate?
Which of the following statements about etomidate-induced myoclonus is most accurate?
What is the main reason for the prompt awakening after a single dose of etomidate?
What is the main reason for the prompt awakening after a single dose of etomidate?
Which of the following statements about the effects of etomidate on myoclonus is most accurate?
Which of the following statements about the effects of etomidate on myoclonus is most accurate?
Which of the following statements about the effects of etomidate on pain on injection is most accurate?
Which of the following statements about the effects of etomidate on pain on injection is most accurate?
Which of the following best describes the mechanism of etomidate-induced myoclonus?
Which of the following best describes the mechanism of etomidate-induced myoclonus?
What is the main reason for the prompt awakening after a single dose of etomidate?
What is the main reason for the prompt awakening after a single dose of etomidate?
What is the specific enzyme inhibited by etomidate that causes adrenocortical suppression?
What is the specific enzyme inhibited by etomidate that causes adrenocortical suppression?
How long does adrenocortical suppression caused by etomidate last after an induction dose?
How long does adrenocortical suppression caused by etomidate last after an induction dose?
Which of the following statements about the effects of etomidate on cerebral blood flow (CBF) is most accurate?
Which of the following statements about the effects of etomidate on cerebral blood flow (CBF) is most accurate?
Which of the following statements about the effects of propofol on lipid peroxidation during coronary artery bypass graft surgery is most accurate?
Which of the following statements about the effects of propofol on lipid peroxidation during coronary artery bypass graft surgery is most accurate?
Which of the following terms refers to a drug that induces a state of calm or sleep?
Which of the following terms refers to a drug that induces a state of calm or sleep?
What is the chemical composition of propofol?
What is the chemical composition of propofol?
What is the recommended dose of propofol for rapid IV injection?
What is the recommended dose of propofol for rapid IV injection?
Which of the following is a potential adverse effect of propofol sedation in children in the ICU?
Which of the following is a potential adverse effect of propofol sedation in children in the ICU?
Which of the following is a potential mechanism for propofol-induced metabolic acidosis?
Which of the following is a potential mechanism for propofol-induced metabolic acidosis?
What is the effect of subhypnotic concentrations of propofol, isoflurane, and sevoflurane on pharyngeal contraction force?
What is the effect of subhypnotic concentrations of propofol, isoflurane, and sevoflurane on pharyngeal contraction force?
Which drug is commonly used to attenuate the frequency of myoclonic-like movements during the induction period?
Which drug is commonly used to attenuate the frequency of myoclonic-like movements during the induction period?
What is the dose of propofol for rapid IV injection?
What is the dose of propofol for rapid IV injection?
Which of the following statements about the effects of etomidate on cerebral blood flow is most accurate?
Which of the following statements about the effects of etomidate on cerebral blood flow is most accurate?
What is the recommended dose of propofol for rapid IV injection?
What is the recommended dose of propofol for rapid IV injection?
Which drug is commonly used to blunt the hemodynamic responses evoked by direct laryngoscopy and tracheal intubation?
Which drug is commonly used to blunt the hemodynamic responses evoked by direct laryngoscopy and tracheal intubation?
After a single IV dose, which drug has a similar awakening time to etomidate?
After a single IV dose, which drug has a similar awakening time to etomidate?
Which of the following statements about the effects of etomidate on myocardial contractility is most accurate?
Which of the following statements about the effects of etomidate on myocardial contractility is most accurate?
Which of the following statements about the effects of etomidate on ventilation is most accurate?
Which of the following statements about the effects of etomidate on ventilation is most accurate?
Which of the following statements about the effects of etomidate on pain on injection is most accurate?
Which of the following statements about the effects of etomidate on pain on injection is most accurate?
Which of the following statements about the effects of etomidate on myoclonus is most accurate?
Which of the following statements about the effects of etomidate on myoclonus is most accurate?
Which of the following statements about etomidate is most accurate?
Which of the following statements about etomidate is most accurate?
What is the effect of hepatic blood flow changes during cardiopulmonary bypass on etomidate metabolism?
What is the effect of hepatic blood flow changes during cardiopulmonary bypass on etomidate metabolism?
Which of the following statements about the pharmacokinetics of etomidate is most accurate?
Which of the following statements about the pharmacokinetics of etomidate is most accurate?
What is the main reason for the prompt awakening after a single dose of etomidate?
What is the main reason for the prompt awakening after a single dose of etomidate?
Which of the following is the most likely mechanism for etomidate-induced myoclonus?
Which of the following is the most likely mechanism for etomidate-induced myoclonus?
What is the potential disadvantage of administering etomidate to patients experiencing sepsis or hemorrhage?
What is the potential disadvantage of administering etomidate to patients experiencing sepsis or hemorrhage?
How long does the inhibition of adrenocortical function last after an induction dose of etomidate?
How long does the inhibition of adrenocortical function last after an induction dose of etomidate?
What is the specific enzyme inhibited by etomidate that causes adrenocortical suppression?
What is the specific enzyme inhibited by etomidate that causes adrenocortical suppression?
What is the potential advantage of adrenocortical suppression caused by etomidate?
What is the potential advantage of adrenocortical suppression caused by etomidate?
What has not been documented on the EEG in association with etomidate-induced myoclonus?
What has not been documented on the EEG in association with etomidate-induced myoclonus?
Which of the following statements about the antioxidant properties of propofol is most accurate?
Which of the following statements about the antioxidant properties of propofol is most accurate?
Which of the following statements about pain on injection of propofol is most accurate?
Which of the following statements about pain on injection of propofol is most accurate?
Which of the following statements about the effects of propofol on airway protection is most accurate?
Which of the following statements about the effects of propofol on airway protection is most accurate?
Which of the following statements about the effects of etomidate on pain on injection is most accurate?
Which of the following statements about the effects of etomidate on pain on injection is most accurate?
Study Notes
Pharmacology of Propofol: Key Facts and Considerations
- Intravenous (IV) sedatives and hypnotics are crucial in anesthesiology for anxiety reduction, sedation, and general anesthesia.
- Sedative-hypnotics are drugs that depress the central nervous system (CNS) and induce calmness or sleep.
- Propofol is an IV sedative-hypnotic that is chemically distinct from other drugs in its class.
- Propofol is administered as a 1% solution in an aqueous solution of soybean oil, glycerol, and egg phosphatide.
- Prolonged use of propofol sedation can lead to severe bradycardia in children and metabolic acidosis in surgical patients.
- Propofol-induced metabolic acidosis may be reversible by discontinuing the drug, but can lead to cardiogenic shock in rare cases.
- Propofol does not produce seizure activity in patients with epilepsy and is safe for use in patients with known seizures.
- Propofol has addictive potential and has been associated with intense dreaming, hallucinations, and amorous behavior.
- Propofol supports the growth of certain bacteria, leading to postoperative surgical infections if not handled aseptically.
- Propofol has potent antioxidant properties, which contribute to its neuroprotective effects and ability to suppress phagocytosis.
- Pain on injection is a common adverse event with propofol, but can be reduced by using lidocaine or a short-acting opioid beforehand.
- Propofol does not trigger malignant hyperthermia and can be used safely in patients with hereditary coproporphyria.
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Test your knowledge on the effects of etomidate on myocardial contractility and its implications for anesthesia induction in patients with limited cardiac reserve. Explore the challenges of documenting anesthetic-induced negative inotropic effects in vivo.