40 Questions
Which type of receptor is associated with the G protein-regulated inwardly rectifying potassium channels (GIRKs)?
Muscarinic M2
What is the primary excitatory neurotransmitter in the central nervous system?
Glutamate
Which drug increases the sensitivity of the GABAA receptor to endogenous GABA?
Propofol
Which ion channel is affected by multiple drugs such as droperidol and volatile anesthetics?
Inward rectifying K+ channel
What activates the Gα protein in G protein-coupled receptors?
Ligand binding
What is considered the best measure of renal function?
Glomerular filtration rate
Which type of receptor is the largest family of receptors and acts through activation or inhibition of an enzyme, ion channel, or other target?
G protein-coupled
What provides a more useful guideline for determining proper bolus dosing at the time of peak effect?
Volume of distribution at time of peak effect (Vdpe)
What is emphasized by the wide interpatient variability in pharmacokinetics?
Need for individualizing and titrating dosing
Which measure is dependent on liver blood flow for the clearance of high hepatic extraction ratio drugs?
Liver blood flow
What is the primary inhibitory neurotransmitter in the brain?
GABA
Which receptor activation results in influx of chloride and hyperpolarization of the cell?
GABAA receptor
What is the primary mechanism of termination of action of a bolus dose of an anesthetic induction agent?
Redistribution to the vessel intermediate group
What is efficacy of a drug a function of?
The nature of the drug as a full, partial, or inverse agonist
What does volume of distribution represent?
The dosage divided by the initial plasma concentration of the drug
Which factor can result in varying concentration of a basic drug in compartments with different pHs?
Ion trapping
Which route of administration bypasses the liver?
Intravenous
What is the most rapid equilibrating tissue for drug distribution?
Brain
What does the volume of distribution (Vd) represent?
Number of liters of blood required to dissolve a dose of drug
What decreases the concentration of plasma proteins and can affect the protein binding of drugs?
Renal failure
Which enzyme is responsible for the metabolism of the majority of drugs?
CYP3A4
What type of reactions increase the drugs' polarity and prepare it for phase II reactions?
Oxidation
What is the hepatic extraction ratio (ER) defined as?
Fraction of drug entering the liver which is removed
Which drugs are considered 'flow-limited' in metabolism?
Propofol, lidocaine, sufentanil
What is considered the best measure of renal function?
Glomerular filtration rate (GFR)
Which process is NOT a part of the 5 millisecond period of synaptic transmission?
Potency Defined by the dose (or concentration) needed to produce a defined effect
In the context of receptor theory, what characterizes an agonist?
Reflects the agonist's ability to activate the receptor
What distinguishes a noncompetitive antagonist from a competitive antagonist?
Can be overcome by large doses of agonist
What is an example of the concept of spare receptors in pharmacology?
Existence of a maximal tissue response in the absence of 100% receptor binding by an agonist
What affects the diffusion of drugs across cell membranes such as the blood-brain barrier and renal tubular epithelium?
pKa (acid dissociation constant) of the drug
Which of the following best describes the term 'Potency' in concentration-response relationships?
The dose required to produce a given effect
What factor is the most important determinant of metabolic rate according to the text?
Genetic
What does 'ED50' represent in terms of dosage?
Dose required to produce a specific effect in 50% of patients
What is the primary focus of 'RESPONSE SURFACE MODELS' according to the text?
Designed to look at the net effect of combining two drugs
What is the 'Therapeutic index' defined as according to the text?
Ratio of LD50/ED50
In pharmacokinetic models, which process involves a rate of change that is constant and a fixed amount of drug removed per unit time?
Zero-order process
What is the average time a molecule of drug spends in the body before being eliminated known as?
Mean residence time (MRT)
Which dosing guideline equation accounts for the target concentration, central compartment volume, clearance from the central compartment, and redistribution between the central and peripheral compartments?
Maintenance infusion rate = CT × V1 × (k10 + k12e−k21t + k13e−k31t)
What is the mechanism of patient controlled postoperative sedation using propofol?
An infusion rate is established, and lack of patient demand allows the rate to slowly fall.
What is the primary use of closed-loop infusions in the context of anesthetic purposes?
Drug delivery is controlled by 'output' from the patient.
Test your understanding of pharmacokinetic models including zero and first-order processes, compartment models, stochastic dosing guidelines, and response surface models. This quiz also covers dosing guidelines such as bolus dosing, maintenance dosing, and target-controlled infusions.
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