Benzo Quiz 1

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?

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

When does etomidate-induced myoclonus typically occur?

During the early slow phase of the EEG (B) Signup and view all the answers

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

11-βhydroxylase (A) 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?

Bradycardia (D) Signup and view all the answers

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

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

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

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

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

All of the above (D) Signup and view all the answers

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

R(+) isomer (B) Signup and view all the answers

What is the mechanism of action of etomidate?

Modulation of GABAA receptors (C) Signup and view all the answers

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

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

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

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

Which of the following statements about etomidate is true?

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

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

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

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

0.1 to 0.3 mg/kg IV (C) 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?

Propofol (D) Signup and view all the answers

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

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

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

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

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

Myoclonus (B) Signup and view all the answers

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

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

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

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

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

Pain on injection (B) Signup and view all the answers

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

Decrease pharyngeal contraction force (C) Signup and view all the answers

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

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

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

Hypnotic (B) Signup and view all the answers

What is the chemical composition of propofol?

2,6-diisopropylphenol (B) Signup and view all the answers

What is the recommended dose of propofol for intravenous administration?

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

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

Basal ganglia (C) Signup and view all the answers

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

Inhibition of 11-β hydroxylase (D) Signup and view all the answers

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

6-8 hours (C) Signup and view all the answers

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

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

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

Changing the composition to long and medium chain triglycerides (B) 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?

Metabolic acidosis (C) 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?

Development of metabolic acidosis (C) Signup and view all the answers

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

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

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

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

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

Measurement of serum lactate concentrations (D) Signup and view all the answers

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

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

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

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

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

Etomidate transiently depresses adrenocortical function. (A) Signup and view all the answers

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

Etomidate decreases systemic vascular resistance. (D) Signup and view all the answers

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

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

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

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

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

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

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

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

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

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

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

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

What is the clearance of etomidate compared to propofol?

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

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

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

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

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

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

Inhibition of cholesterol conversion to cortisol (C) Signup and view all the answers

Which enzyme is inhibited by etomidate in adrenocortical suppression?

11-βhydroxylase (C) Signup and view all the answers

Which of the following statements about propofol is true?

Propofol is metabolized by the liver. (A) Signup and view all the answers

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

Propofol is highly protein bound. (B) Signup and view all the answers

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

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

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

Inhibition of lipid peroxidation (D) Signup and view all the answers

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

Pain on injection (D) 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?

Both etomidate and propofol (B) 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?

Decrease in pain on injection (A) 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?

Seizures (A) Signup and view all the answers

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

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

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

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

What is the clearance of etomidate compared to propofol?

Etomidate has slower clearance than propofol (C) Signup and view all the answers

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

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

What is the mechanism of action of etomidate?

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

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

Respiratory depression (C) Signup and view all the answers

What is the clinical use of etomidate?

Etomidate is primarily used for induction of anesthesia in patients with unstable cardiovascular systems. (D) 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?

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

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

Adrenocortical suppression (C) Signup and view all the answers

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

Minimal cumulative drug effect (B) Signup and view all the answers

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

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

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

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

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

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

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

Myoclonus (C) Signup and view all the answers

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

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

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

Retrograde amnesia (C) Signup and view all the answers

Which benzodiazepine is most commonly used in the perioperative period?

Midazolam (B) Signup and view all the answers

What is the mechanism of action of benzodiazepines?

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

Which of the following statements about midazolam is true?

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

What is the recommended dose of midazolam for anesthesia induction?

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

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

It facilitates the onset of unconsciousness (C) Signup and view all the answers

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

Respiratory depression (B) Signup and view all the answers

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

It has been on the decline (C) Signup and view all the answers

Which of the following is a specific antagonist for benzodiazepines?

Flumazenil (D) Signup and view all the answers

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

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

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

Fatigue and drowsiness (B) Signup and view all the answers

What is the effect of benzodiazepines on the EEG?

Shift from α to β activity (A) Signup and view all the answers

Which of the following is true about benzodiazepine dependence?

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

What is the potential interaction between benzodiazepines and opioids?

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

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

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

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

Glucuronidation (D) Signup and view all the answers

What is the main side effect of midazolam during sedation?

Ventilation depression (C) Signup and view all the answers

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

Lorazepam, oxazepam, and temazepam (A) Signup and view all the answers

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

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

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

Glucuronidation-metabolized benzodiazepines (D) Signup and view all the answers

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

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

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

Confusion (B) Signup and view all the answers

Which enzyme is responsible for the metabolism of midazolam?

Cytochrome P450 3A4 (A) Signup and view all the answers

What is the main metabolite of midazolam?

1-hydroxymidazolam (A) Signup and view all the answers

Which statement about the clearance of midazolam is true?

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

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

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

Benzo Quiz 1

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Questions and Answers

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

What is the chemical composition of propofol?

What is the dose of propofol for intravenous administration?

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

When does etomidate-induced myoclonus typically occur?

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

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

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

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

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

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

What is the mechanism of action of etomidate?

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

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

Which of the following statements about etomidate is true?

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

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

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

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

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

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

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

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

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

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

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

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

What is the chemical composition of propofol?

What is the recommended dose of propofol for intravenous administration?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What is the clearance of etomidate compared to propofol?

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

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

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

Which enzyme is inhibited by etomidate in adrenocortical suppression?

Which of the following statements about propofol is true?

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

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

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

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

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

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

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

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

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

What is the clearance of etomidate compared to propofol?

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

What is the mechanism of action of etomidate?

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

What is the clinical use of etomidate?

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

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

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

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

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

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

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