Pharmacology and Anesthesia Overview

Questions and Answers

What is the definition of an antagonist?

Enhances receptor sensitivity

Attaches to a specific receptor to block the neurotransmitter from stimulating the receptor (correct)

Attaches to specific receptors to stimulate them

Increases neurotransmitter production

What are the goals of therapy for a patient experiencing malignant hyperthermia?

Prompt administration of dantrolene, treatment of hyperkalemia, rapid cooling, and hyperventilation.

What drug class does dantrolene belong to?

Skeletal muscle relaxant.

What are the effects of sevoflurane?

Respiratory depression and rapid emergence Signup and view all the answers

What is the most definitive test for malignant hyperthermia?

Caffeine-halothane contracture test. Signup and view all the answers

What does inhalation agents disrupt in the body?

Regulation of body temperature by depressing the effect of the hypothalamus. Signup and view all the answers

What condition does alkalosis increase the risk for prior to anesthesia?

Occurrence of apnea. Signup and view all the answers

What is the maintenance IV rate for an infant weighing 0 to 10 kg?

4 mL/kg/hr. Signup and view all the answers

How is perioperative hypothermia defined?

Core body temperature less than 36° C. Signup and view all the answers

What are the Phase I priorities for patients having an esophagogastrectomy?

Pain management with low thoracic epidural or patient-controlled analgesia and maintaining nasogastric tube patency and position. Signup and view all the answers

Which anesthetic agent may cause photosensitivity in the Phase I PACU?

Glycopyrrolate. Signup and view all the answers

What does Triple-H therapy stand for?

Hypertension, hemodilution, hypervolemia. Signup and view all the answers

What are common complications related to brachial plexus block?

Hoarse or weak voice, upper eyelid ptosis, anhidrosis. Signup and view all the answers

What drug class do thiazide diuretics belong to?

Diuretics that act on the distal tubule of the loop of Henle. Signup and view all the answers

What side effect is associated with metoclopramide?

Tardive dyskinesia. Signup and view all the answers

Tonic seizures are characterized by ____.

increased muscle tone and rigidity. Signup and view all the answers

What characterizes clonic seizures?

Jerking movements that gradually slow and then stop. Signup and view all the answers

How long do petit mal seizures typically last?

Short, 5 to 20 seconds. Signup and view all the answers

What are the four key elements of medical malpractice?

Causation Signup and view all the answers

What does causation refer to in medical malpractice?

Direct cause of negligence. Signup and view all the answers

What is an epidural leak characterized by?

Searing headache with movement, sitting, or standing, diminished by lying down. Signup and view all the answers

What classic indicators suggest early respiratory distress in an adult with septic shock?

Hyperventilation with respiratory alkalosis and elevated lactate Signup and view all the answers

What does the interscalene block provide?

Paresthesia to upper, middle, and lower trunks of the brachial plexus. Signup and view all the answers

What can cause hypotension if a patient is warmed too rapidly?

Vasodilation. Signup and view all the answers

What is hetastarch known for?

Less expensive than blood products; minimal coagulation effects. Signup and view all the answers

What effect does hydrochlorothiazide have on urine output?

Increases urine output without the loss of potassium. Signup and view all the answers

How can burns affect the body?

Can cause dehydration due to the loss of fluids from the injury. Signup and view all the answers

What characterizes steal syndrome?

Ischemic pain related to vascular insufficiency due to fistula formation. Signup and view all the answers

What does the skin of a patient with venous insufficiency look like?

Warm, with reddish-brown pigmentation; scaly, scarred, and thick. Signup and view all the answers

What describes the skin of patients with arterial insufficiency?

Pale, cyanotic, often cool, shiny, dry, and thin. Signup and view all the answers

What is the normal urine output for a baby?

2-3 mL/kg/hr. Signup and view all the answers

What is autonomic hyperreflexia?

Abnormal overreaction of the nervous system to stimulation, common in patients with spinal cord injuries above T6. Signup and view all the answers

What is Horner's syndrome?

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What is sympathetic dysreflexia?

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What is an anaphylactic reaction?

Signup and view all the answers

What are the signs of hyponatremia due to water intoxication during TURP?

Shortness of breath, hypoxemia, confusion, nausea, vomiting, muscle twitches, tachycardia, and/or hypotension. Signup and view all the answers

What is proprioception?

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What are prostaglandins produced in the renal medulla responsible for?

Maintaining several renal functions. Signup and view all the answers

What do NSAIDs block?

Block the production of prostaglandins. Signup and view all the answers

Where does the distal tubule act in the kidney?

Site for aldosterone action, acid-base regulation, hydrogen ion secretion, and bicarbonate reabsorption. Signup and view all the answers

What is desmopressin used for?

Synthetic replacement for vasopressin to help minimize bleeding. Signup and view all the answers

What is the primary function of the proximal tubule in the glomerulus?

Reabsorb 65% of filtered solute and water. Signup and view all the answers

What is the function of the loop of Henle?

Reabsorbs 25% of glomerular filtrate, controls urine concentration and conservation. Signup and view all the answers

What is local anesthetic systemic toxicity (LAST)?

Agitation, metallic taste in mouth, circumoral numbness, can lead to CNS depression. Signup and view all the answers

What is a longitudinal fracture?

Fracture line runs parallel to the axis of the bone. Signup and view all the answers

What is an oblique fracture?

Fracture line runs at a 45-degree angle to the axis of the bone. Signup and view all the answers

What is a spiral fracture?

Fracture twists around the bone shaft. Signup and view all the answers

What is a transverse fracture?

Fracture occurs at a 90-degree angle to the longitudinal axis of the bone. Signup and view all the answers

What is a comminuted fracture?

Multiple fracture lines that divide the bone into multiple fragments. Signup and view all the answers

How do you test sensory function of the radial nerve?

Touch the web space between the thumb and index finger. Signup and view all the answers

How do you test sensory function of the median nerve?

Touch the tip of the index finger. Signup and view all the answers

How do you test sensory function of the ulnar nerve?

Touch the tip of the small finger. Signup and view all the answers

What condition involves hyposecretion of anti-diuretic hormone?

Diabetes insipidus. Signup and view all the answers

What lab values are associated with Addison's disease?

Decrease sodium, increase potassium. Signup and view all the answers

What is conduction in terms of heat loss?

Heat loss through direct contact. Signup and view all the answers

How does pituitary surgery affect body temperature regulation?

Causes hyperthermia due to hypothalamus and hypothermia due to decreased TSH. Signup and view all the answers

What is convection in terms of heat transfer?

Transfer of heat to the surrounding cooler air. Signup and view all the answers

What is the normal infant response to hypoxia?

Bradycardia. Signup and view all the answers

What cardiac effect is associated with droperidol?

Prolonged QT interval. Signup and view all the answers

What causes red man syndrome?

Vancomycin. Signup and view all the answers

What common side effect can occur from magnesium sulfate?

Decreased or absent deep tendon reflexes, respiratory depression, cardiac arrest. Signup and view all the answers

What area of the respiratory tract is affected by asthma?

Lower airway. Signup and view all the answers

What area does laryngeal edema affect?

Upper airway. Signup and view all the answers

What condition makes premature babies prone to obstruction and apnea?

Premature birth. Signup and view all the answers

What can dehydration during pregnancy cause?

Preterm labor. Signup and view all the answers

What effect can intraoperative uterine manipulation have?

Preterm labor. Signup and view all the answers

What is the recommended dose of ondansetron for a child?

0.15 mg/kg. Signup and view all the answers

What effect does isoflurane have on coronary blood flow?

"Coronary steal", increased coronary blood flow. Signup and view all the answers

What is the most important element of effective pulmonary care?

Inspiratory hold. Signup and view all the answers

Study Notes

Pharmacology and Anesthesia

Antagonist: Blocks neurotransmitter stimulation at specific receptors.
Dantrolene: A skeletal muscle relaxant used for malignant hyperthermia treatment; goals include rapid cooling and hyperventilation.
Sevoflurane: Causes respiratory depression and enables rapid patient emergence from anesthesia.
Caffeine-halothane contracture test: Most definitive test for malignant hyperthermia.
Inhalation agents: Disrupt temperature regulation by depressing hypothalamic function.

Patient Management and Conditions

Malignant Hyperthermia Therapy Goals: Timely dantrolene administration, hyperkalemia treatment, and maintaining optimal body temperature.
Epidural headache: Resulting from an epidural leak, characterized by pain exacerbated by movement.
Perioperative hypothermia: Defined by core temperature falling below 36° C.
Triple-H therapy: Involves hypertension, hemodilution, and hypervolemia, effective postoperatively against cerebral vasospasm.

Seizure Types and Their Characteristics

Tonic Seizures: Marked by increased muscle tone and rigidity.
Clonic Seizures: Characterized by rhythmic jerking movements that gradually slow down.
Petit Mal Seizures: Brief episodes (5-20 seconds) occurring multiple times daily.

Diuretics and Fluid Management

Thiazide Diuretics: Work on distal tubule, impairing sodium, chloride, and potassium reabsorption.
Hydrochlorothiazide: Increases urine output without causing potassium loss.
Desmopressin: A synthetic vasopressin used to reduce bleeding.

Complications and Anesthesia Effects

Brachial Plexus Block Complications: Can lead to hoarseness, upper eyelid ptosis, and anhidrosis.
Local Anesthetic Systemic Toxicity (LAST): Symptoms include agitation and metallic taste; treat with lipid emulsion.
Glycopyrrolate: An anesthetic agent linked to photosensitivity in PACU.

Vascular Concerns

Steal Syndrome: Ischemic pain due to vascular insufficiency from fistula formation.
Skin Characteristics:
- Arterial insufficiency presents pale, cyanotic, shiny, and thin skin.
- Venous insufficiency shows warmth, reddish-brown pigmentation, and scaling.

Neurological and Endocrine Insights

Autonomic Hyperreflexia: Results in exaggerated nervous system responses, common above T6 spinal cord injuries.
Addison's Disease: Marked by decreased sodium and increased potassium levels.
Diabetes Insipidus: Caused by hyposecretion of vasopressin leading to excessive urine production.

Temperature Regulation

Heat Loss Mechanisms:
- Conduction: Direct contact heat loss.
- Convection: Transfer of heat to cooler air.
Hyperthermia/Hypothermia: Pituitary surgery can disrupt bodily temperature regulation.

Urological and Pregnancy Complications

TURP Irrigation: Early respiratory distress indicators include confusion, nausea, and muscle twitching from hyponatremia.
Dehydration during Pregnancy: Can trigger preterm labor, alongside intraoperative uterine manipulation.

Pediatric Anesthesia Dosage

Ondansetron Dosage: Recommended dose for children is 0.15 mg/kg.

Important Anesthetic Agents

Isoflurane: Associated with "coronary steal," increasing coronary blood flow.
Droperidol: Linked to prolonged QT interval.

Respiratory Considerations

Common Asthma Sites: Lower airways affected during an asthma exacerbation.
Laryngeal Edema: Affects the upper airway, potentially leading to obstruction.

General Observations

Urine Output for Infants: Expected to be around 2-3 mL/kg/hr.
Fainting due to Hypoxia in Infants: Bradycardia is a common response.
Magnesium Sulfate Effects: May cause reduced reflexes, respiratory depression, and cardiac arrest.

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Description

This quiz covers key concepts related to pharmacology and anesthesia, including antagonist mechanisms, the use of Dantrolene in malignant hyperthermia, and various inhalation agents. Additionally, it explores patient management strategies for conditions like perioperative hypothermia and epidural headaches.