Benzo Quiz 1
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Questions and Answers

Which term refers to a drug that induces a state of calm or sleep?

  • Anxiolytic
  • Sedative (correct)
  • Hypnotic
  • Sedative-hypnotic

    • What is the chemical composition of propofol?

  • 1% solution
  • 10% soybean oil
  • 2,6-diisopropylphenol (correct)
  • 1.2% purified egg phosphatide

    • What is the dose of propofol for intravenous administration?

  • 2.25% glycerol
  • 1.5 to 2.5 mg/kg IV (correct)
  • 4-5 mg/kg IV
  • 1 mg/kg IV

    • Which of the following best describes the mechanism of etomidate-induced myoclonus?

    <p>Etomidate inhibits subcortical structures that suppress extrapyramidal motor activity (A)</p> Signup and view all the answers

    When does etomidate-induced myoclonus typically occur?

    <p>During the early slow phase of the EEG (B)</p> Signup and view all the answers

    Which enzyme inhibition is responsible for adrenocortical suppression caused by etomidate?

    <p>11-βhydroxylase (A)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of long-term propofol sedation in children in the ICU?

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

    What laboratory evaluation is recommended if unexpected tachycardia occurs during propofol anesthesia?

    <p>Measurement of arterial blood gases and serum lactate concentrations (A)</p> Signup and view all the answers

    What is the potential mechanism for sporadic propofol-induced metabolic acidosis?

    <p>Poisoning of the electron transport chain and impaired oxidation of long chain fatty acids (C)</p> Signup and view all the answers

    What is the recommended handling technique for propofol to minimize the risk of bacterial growth?

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

    Which isomer of etomidate is approximately 5 times as potent as the other?

    <p>R(+) isomer (B)</p> Signup and view all the answers

    What is the mechanism of action of etomidate?

    <p>Modulation of GABAA receptors (C)</p> Signup and view all the answers

    What is the main factor contributing to the prompt awakening after a single dose of etomidate?

    <p>Redistribution of the drug from brain to inactive tissue sites (C)</p> Signup and view all the answers

    How does etomidate differ from propofol in terms of clearance and volume of distribution?

    <p>Etomidate has slower clearance and smaller volume of distribution than propofol (A)</p> Signup and view all the answers

    Which of the following statements about etomidate is true?

    <p>Etomidate has minimal effects on the duration of electrically induced seizures. (C)</p> Signup and view all the answers

    What is the effect of etomidate on cerebral blood flow and CMRO2?

    <p>Etomidate decreases cerebral blood flow and CMRO2. (C)</p> Signup and view all the answers

    What is the recommended dose of etomidate for induction of anesthesia?

    <p>0.1 to 0.3 mg/kg IV (C)</p> Signup and view all the answers

    Which drug causes a greater decline in mean arterial pressure (MAP) during induction of patients undergoing elective cardiac surgery?

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

    Which of the following is true about the effects of etomidate on myocardial contractility?

    <p>Etomidate has minimal negative inotropic effects on myocardial contractility at concentrations needed for anesthesia. (A)</p> Signup and view all the answers

    Which of the following statements about the depressant effects of etomidate on ventilation is true?

    <p>Etomidate-induced decreases in tidal volume are offset by compensatory increases in the frequency of breathing. (B)</p> Signup and view all the answers

    Which of the following is a common side effect of etomidate administration?

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

    Which of the following is true about the incidence and intensity of myoclonus associated with etomidate administration?

    <p>Myoclonus associated with etomidate administration is suppressed by pretreatment with small doses of etomidate. (C)</p> Signup and view all the answers

    Which of the following is true about propofol's antioxidant properties?

    <p>Propofol reacts with lipid peroxyl radicals and inhibits lipid peroxidation. (A)</p> Signup and view all the answers

    Which adverse event is commonly associated with propofol administration to awake patients?

    <p>Pain on injection (B)</p> Signup and view all the answers

    What effect do subhypnotic concentrations of propofol, isoflurane, and sevoflurane have on pharyngeal function?

    <p>Decrease pharyngeal contraction force (C)</p> Signup and view all the answers

    What change in the carrier fat emulsion for propofol decreases the incidence of pain on injection?

    <p>Changing the composition to long and medium chain triglycerides (C)</p> Signup and view all the answers

    Which term refers to a drug that induces hypnosis or sleep?

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

    What is the chemical composition of propofol?

    <p>2,6-diisopropylphenol (B)</p> Signup and view all the answers

    What is the recommended dose of propofol for intravenous administration?

    <p>1.5 to 2.5 mg/kg IV (equivalent to thiopental) (D)</p> Signup and view all the answers

    Which subcortical structures are thought to be disinhibited by etomidate, leading to myoclonus?

    <p>Basal ganglia (C)</p> Signup and view all the answers

    What is the potential mechanism for etomidate-induced adrenocortical suppression?

    <p>Inhibition of 11-β hydroxylase (D)</p> Signup and view all the answers

    How long does the adrenocortical suppression caused by etomidate typically last?

    <p>6-8 hours (C)</p> Signup and view all the answers

    Which of the following statements about propofol's antioxidant properties is true?

    <p>Propofol's antioxidant properties are similar to those of vitamin E. (B)</p> Signup and view all the answers

    What change in the carrier fat emulsion for propofol decreases the incidence of pain on injection?

    <p>Changing the composition to long and medium chain triglycerides (B)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of long-term propofol sedation in children in the ICU?

    <p>Metabolic acidosis (C)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of long-term propofol sedation in children in the ICU?

    <p>Development of metabolic acidosis (C)</p> Signup and view all the answers

    What is the mechanism for sporadic propofol-induced metabolic acidosis?

    <p>Impaired oxidation of long chain fatty acids (A)</p> Signup and view all the answers

    What is the recommended handling technique for propofol to minimize the risk of bacterial growth?

    <p>Disinfect the ampule neck surface or vial rubber stopper with 70% isopropyl alcohol (A)</p> Signup and view all the answers

    What laboratory evaluation is recommended if unexpected tachycardia occurs during propofol anesthesia?

    <p>Measurement of serum lactate concentrations (D)</p> Signup and view all the answers

    Which of the following statements about the duration of action of etomidate is true?

    <p>Increasing the dose of etomidate prolongs its duration of action. (D)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of etomidate administration?

    <p>Activation of seizure foci in patients with focal epilepsy (B)</p> Signup and view all the answers

    Which of the following statements about etomidate's effect on adrenocortical function is true?

    <p>Etomidate transiently depresses adrenocortical function. (A)</p> Signup and view all the answers

    Which of the following statements about the cardiovascular effects of etomidate is true?

    <p>Etomidate decreases systemic vascular resistance. (D)</p> Signup and view all the answers

    Which of the following statements about the effects of etomidate on myocardial contractility is true?

    <p>Etomidate has minimal effects on myocardial contractility at concentrations needed for anesthesia. (D)</p> Signup and view all the answers

    Which of the following statements about the effects of etomidate on ventilation is true?

    <p>Etomidate may be useful when maintenance of spontaneous ventilation is not desirable. (B)</p> Signup and view all the answers

    Which of the following statements about the incidence of myoclonus associated with etomidate administration is true?

    <p>Etomidate-induced myoclonus can be suppressed by pretreatment with an opioid or a benzodiazepine. (A)</p> Signup and view all the answers

    Which of the following statements about the administration of etomidate in a lipid emulsion vehicle is true?

    <p>Etomidate in a lipid emulsion vehicle virtually eliminates pain on injection and venous irritation. (D)</p> Signup and view all the answers

    Which of the following is true about the metabolism of etomidate?

    <p>Etomidate is metabolized by hydrolysis of the ester side chain. (B)</p> Signup and view all the answers

    What is the volume of distribution (Vd) for etomidate compared to propofol?

    <p>Etomidate has a smaller Vd than propofol. (B)</p> Signup and view all the answers

    What is the clearance of etomidate compared to propofol?

    <p>Etomidate has a slower clearance than propofol. (B)</p> Signup and view all the answers

    Which of the following statements about the effects of etomidate on GABAA receptors is true?

    <p>Etomidate does not bind directly to GABAA receptors. (D)</p> Signup and view all the answers

    Which of the following statements about etomidate-induced myoclonus is true?

    <p>It is associated with seizure-like activity on the EEG (B)</p> Signup and view all the answers

    What is the potential mechanism for etomidate-induced adrenocortical suppression?

    <p>Inhibition of cholesterol conversion to cortisol (C)</p> Signup and view all the answers

    Which enzyme is inhibited by etomidate in adrenocortical suppression?

    <p>11-βhydroxylase (C)</p> Signup and view all the answers

    Which of the following statements about propofol is true?

    <p>Propofol is metabolized by the liver. (A)</p> Signup and view all the answers

    Which of the following is true about the pharmacology of propofol?

    <p>Propofol is highly protein bound. (B)</p> Signup and view all the answers

    Which of the following statements about sedative-hypnotics is true?

    <p>Sedative-hypnotics can induce varying degrees of sedation. (A)</p> Signup and view all the answers

    Which of the following is a potential benefit of propofol's antioxidant properties?

    <p>Inhibition of lipid peroxidation (D)</p> Signup and view all the answers

    What is the most commonly reported adverse event associated with propofol administration to awake patients?

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

    Which of the following drugs alter pharyngeal function and pose a risk of impaired upper airway protection and pulmonary aspiration?

    <p>Both etomidate and propofol (B)</p> Signup and view all the answers

    What is the effect of changing the composition of the carrier fat emulsion for propofol to long and medium chain triglycerides?

    <p>Decrease in pain on injection (A)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of long-term propofol sedation in children in the ICU?

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

    What is the mechanism for sporadic propofol-induced metabolic acidosis?

    <p>Impaired oxidation of long chain fatty acids (A)</p> Signup and view all the answers

    What is the recommended handling technique for propofol to minimize the risk of bacterial growth?

    <p>Disinfect the ampule neck surface or vial rubber stopper with 70% isopropyl alcohol (C)</p> Signup and view all the answers

    What is the clearance of etomidate compared to propofol?

    <p>Etomidate has slower clearance than propofol (C)</p> Signup and view all the answers

    Which of the following is true about the pharmacokinetics of etomidate?

    <p>Etomidate has a longer terminal elimination half-life compared to propofol. (D)</p> Signup and view all the answers

    What is the mechanism of action of etomidate?

    <p>Etomidate enhances the affinity of the inhibitory neurotransmitter GABA for GABAA receptors. (D)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of etomidate administration?

    <p>Respiratory depression (C)</p> Signup and view all the answers

    What is the clinical use of etomidate?

    <p>Etomidate is primarily used for induction of anesthesia in patients with unstable cardiovascular systems. (D)</p> Signup and view all the answers

    Which of the following is true about the effects of etomidate on the duration of electrically induced seizures in patients undergoing electroconvulsive therapy?

    <p>Etomidate has no effect on the duration of seizures (A)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of etomidate administration?

    <p>Adrenocortical suppression (C)</p> Signup and view all the answers

    What is the main factor contributing to the prompt awakening after a single dose of etomidate?

    <p>Minimal cumulative drug effect (B)</p> Signup and view all the answers

    Which of the following is true about the cardiovascular effects of etomidate?

    <p>Etomidate has minimal changes in mean arterial blood pressure (A)</p> Signup and view all the answers

    Which of the following is true about the effects of etomidate on myocardial contractility?

    <p>Etomidate has minimal effects on myocardial contractility at clinical concentrations. (A)</p> Signup and view all the answers

    Which of the following statements about the depressant effects of etomidate on ventilation is true?

    <p>Etomidate stimulates ventilation independently of the medullary centers that normally respond to carbon dioxide. (A)</p> Signup and view all the answers

    What is the most commonly reported adverse event associated with etomidate administration?

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

    Which of the following statements about pain on injection and venous irritation is true?

    <p>Pain on injection and venous irritation are virtually eliminated with the use of a lipid emulsion vehicle for etomidate. (C)</p> Signup and view all the answers

    Which of the following is NOT one of the main pharmacologic effects of benzodiazepines?

    <p>Retrograde amnesia (C)</p> Signup and view all the answers

    Which benzodiazepine is most commonly used in the perioperative period?

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

    What is the mechanism of action of benzodiazepines?

    <p>Enhancement of GABA actions without activating GABAA receptors (C)</p> Signup and view all the answers

    Which of the following statements about midazolam is true?

    <p>Midazolam is not commonly used for inducing anesthesia (A)</p> Signup and view all the answers

    What is the recommended dose of midazolam for anesthesia induction?

    <p>0.1 to 0.2 mg/kg IV over 30 to 60 seconds (A)</p> Signup and view all the answers

    What is the effect of administering a small opioid dose before midazolam injection?

    <p>It facilitates the onset of unconsciousness (C)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of chronic benzodiazepine use?

    <p>Respiratory depression (B)</p> Signup and view all the answers

    Which of the following is true about the prevalence of benzodiazepine use for chronic insomnia?

    <p>It has been on the decline (C)</p> Signup and view all the answers

    Which of the following is a specific antagonist for benzodiazepines?

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

    Which of the following is true about the mechanism of action of benzodiazepines?

    <p>They enhance the affinity of GABAA receptors for GABA (A)</p> Signup and view all the answers

    Which of the following is a potential side effect of chronic benzodiazepine use?

    <p>Fatigue and drowsiness (B)</p> Signup and view all the answers

    What is the effect of benzodiazepines on the EEG?

    <p>Shift from α to β activity (A)</p> Signup and view all the answers

    Which of the following is true about benzodiazepine dependence?

    <p>Dependence can emerge after 6 months of use (A)</p> Signup and view all the answers

    What is the potential interaction between benzodiazepines and opioids?

    <p>Benzodiazepines increase all-cause mortality in patients on long-term opioid therapy (C)</p> Signup and view all the answers

    Which of the following statements about midazolam's effect on ventilation is true?

    <p>Midazolam decreases resting ventilation in healthy volunteers. (A)</p> Signup and view all the answers

    Which metabolic pathway is less impacted by aging and liver disease compared to oxidative metabolic pathways?

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

    What is the main side effect of midazolam during sedation?

    <p>Ventilation depression (C)</p> Signup and view all the answers

    Which benzodiazepines are solely metabolized via glucuronidation and lack active metabolites?

    <p>Lorazepam, oxazepam, and temazepam (A)</p> Signup and view all the answers

    Which of the following statements about midazolam's impact on systemic blood pressure is true?

    <p>Midazolam's impact on systemic blood pressure is directly linked to its dose. (B)</p> Signup and view all the answers

    Which type of benzodiazepines might be preferred in elderly patients over those metabolized by hepatic microsomal enzymes?

    <p>Glucuronidation-metabolized benzodiazepines (D)</p> Signup and view all the answers

    What is the recommended dose of oral midazolam syrup for sedation and anxiolysis in children?

    <p>0.25 mg/kg (C)</p> Signup and view all the answers

    What is a potential symptom of benzodiazepine withdrawal in elderly patients?

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

    Which enzyme is responsible for the metabolism of midazolam?

    <p>Cytochrome P450 3A4 (A)</p> Signup and view all the answers

    What is the main metabolite of midazolam?

    <p>1-hydroxymidazolam (A)</p> Signup and view all the answers

    Which statement about the clearance of midazolam is true?

    <p>Midazolam's clearance is faster than diazepam's (B)</p> Signup and view all the answers

    What effect does renal failure have on the pharmacokinetics of midazolam?

    <p>Renal failure does not alter the elimination half-time, volume of distribution (Vd), or clearance of midazolam (D)</p> Signup and view all the answers

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