Hypnotics PP
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Questions and Answers

Which of the following statements about ketamine is true?

  • Ketamine produces direct myocardial depression in vivo.
  • Ketamine does not produce significant depression of ventilation. (correct)
  • Ketamine increases the amplitude of SSEP's.
  • Ketamine enhances dysrhythmogenicity of epinephrine.

Which of the following is a potential adverse effect of ketamine?

  • Tissue damage from repeated use
  • Allergic reactions
  • Both tissue damage and allergic reactions (correct)
  • None of the above

What is the incidence of emergence delirium with ketamine?

  • 5 to 10%
  • 10 to 15%
  • 20 to 30% (correct)
  • 15 to 20%

Which of the following is NOT a risk factor for emergence delirium with ketamine?

<p>Age older than 15 years (B)</p> Signup and view all the answers

How do barbiturates differ from benzodiazepines in terms of their clinical applications?

<p>Barbiturates are used for induction of anesthesia. (B)</p> Signup and view all the answers

What is the relative potency of thiopental compared to thiamylal?

<p>Thiopental is 61% more potent than thiamylal. (B)</p> Signup and view all the answers

Which of the following is a benefit of propofol compared to barbiturates for inducing anesthesia?

<p>Both less nausea and faster recovery (C)</p> Signup and view all the answers

Which of the following statements about ketamine is true?

<p>Ketamine is a derivative of phencyclidine. (B)</p> Signup and view all the answers

What is the characteristic feature of dissociative anesthesia produced by ketamine?

<p>Dissociation between the thalamocortical and limbic systems (B)</p> Signup and view all the answers

Which isomer of ketamine is used for treatment resistant depression?

<p>S (-) ketamine (B)</p> Signup and view all the answers

What is the most frequently used form of ketamine in the US?

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

What is a limitation of ketamine as a sole agent?

<p>High risk for abuse potential (A)</p> Signup and view all the answers

Which isomer of ketamine has a lower incidence of emergence reactions?

<p>S (-) ketamine (C)</p> Signup and view all the answers

What is the mechanism of action of ketamine?

<p>Inhibition of re-uptake of catecholamines (A)</p> Signup and view all the answers

Which receptors does ketamine bind to?

<p>N-methyl-D-aspartate receptors (A)</p> Signup and view all the answers

What is the mechanism of action of ketamine-induced analgesia and dissociative anesthesia?

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

What is the rapid onset of action, duration of action, and lipid solubility of ketamine?

<p>Rapid onset, relatively short duration, and high lipid solubility (C)</p> Signup and view all the answers

What is the main metabolite of ketamine and how potent is it compared to ketamine?

<p>Norketamine, 1/5 - 1/3 as potent as ketamine (B)</p> Signup and view all the answers

What is a clinical use of ketamine?

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

What are the central nervous system side effects of ketamine?

<p>Increases cerebral blood flow and cerebral metabolic rate of oxygen consumption (B)</p> Signup and view all the answers

What is a potential neuroprotective effect of ketamine?

<p>Antagonistic effect on NMDA receptors (B)</p> Signup and view all the answers

Which of the following is a side effect of Thiopental?

<p>Increased heart rate (D)</p> Signup and view all the answers

What is the main function of Dexmetomidine?

<p>Decrease plasma catecholamine concentration (A)</p> Signup and view all the answers

What is the elimination half-life of Dexmetomidine?

<p>3 hours (C)</p> Signup and view all the answers

What is the clinical use of Dexmetomidine?

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

What is the main difference between Dexmetomidine and Clonidine?

<p>Dexmetomidine is more selective for alpha-2 receptors (B)</p> Signup and view all the answers

What is the dose-dependent change in SSEP's and BAEP's caused by Thiopental?

<p>Change in somatosensory and brainstem auditory evoked potentials (C)</p> Signup and view all the answers

What is the main side effect of intra-arterial injection of Thiopental?

<p>Gangrene and permanent damage (B)</p> Signup and view all the answers

What is the main function of Atipamezole?

<p>Reverse the sedative and cardiovascular effects of Dexmetomidine (C)</p> Signup and view all the answers

What is the effect of Dexmetomidine on ventilation?

<p>Mild depression of ventilation (B)</p> Signup and view all the answers

Which of the following statements about ketamine is true?

<p>Ketamine does not precipitate generalized convulsions in patients with seizure disorders. (D)</p> Signup and view all the answers

Which of the following is a side effect of ketamine?

<p>Allergic reactions. (A)</p> Signup and view all the answers

Which of the following is a risk factor for emergence delirium with ketamine?

<p>Dose greater than 2 mg/kg. (D)</p> Signup and view all the answers

Which of the following is a drug interaction with ketamine?

<p>Ketamine administered in the presence of inhaled anesthetics may result in hypotension. (A)</p> Signup and view all the answers

Which of the following is a characteristic feature of dissociative anesthesia produced by ketamine?

<p>Visual, auditory, proprioceptive and confusional illusions which may progress to delirium. (B)</p> Signup and view all the answers

Which of the following is a clinical use of thiopental?

<p>Induction of anesthesia. (D)</p> Signup and view all the answers

Which of the following is a pharmacokinetic characteristic of barbiturates?

<p>Hangover type CNS effects that may persist after administration. (A)</p> Signup and view all the answers

Which of the following is a potential clinical use of ketamine?

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

What is the main metabolite of ketamine and how potent is it compared to ketamine?

<p>Norketamine, 1/5 - 1/3 as potent as ketamine (C)</p> Signup and view all the answers

What is the rapid onset of action, duration of action, and lipid solubility of ketamine?

<p>Rapid onset, short duration, high lipid solubility (A)</p> Signup and view all the answers

What is the mechanism of action of ketamine-induced analgesia and dissociative anesthesia?

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

What are the central nervous system side effects of ketamine?

<p>Increased cerebral blood flow and metabolism (A)</p> Signup and view all the answers

Which receptors does ketamine bind to?

<p>N-methyl-D-aspartate receptors (A)</p> Signup and view all the answers

What is the most correct statement about ketamine's induction of anesthesia?

<p>Useful in burn patients for dressing changes (B)</p> Signup and view all the answers

Which of the following is a potential side effect of thiopental?

<p>Laryngeal and cough reflex depression (C)</p> Signup and view all the answers

What is the main function of dexmedetomidine?

<p>To produce sedation by decreasing sympathetic nervous system activity (D)</p> Signup and view all the answers

What is a potential neuroprotective effect of ketamine?

<p>Attenuation of postoperative delirium effects (C)</p> Signup and view all the answers

What is a clinical use of ketamine?

<p>To decrease perioperative requirements of opioids and inhaled anesthetics (B)</p> Signup and view all the answers

What is the main side effect of intra-arterial injection of thiopental?

<p>Gangrene and permanent damage (A)</p> Signup and view all the answers

What is the effect of dexmedetomidine on ventilation?

<p>Mild depression of ventilation (D)</p> Signup and view all the answers

What is the mechanism of action of ketamine-induced analgesia and dissociative anesthesia?

<p>Binding to alpha-2 receptors (D)</p> Signup and view all the answers

What is the main difference between dexmedetomidine and clonidine?

<p>Dexmedetomidine has a higher selectivity for alpha-2 receptors (B)</p> Signup and view all the answers

Which of the following statements about ketamine is true?

<p>It has a high incidence of emergence reactions (C)</p> Signup and view all the answers

Which of the following is a characteristic feature of dissociative anesthesia produced by ketamine?

<p>Patient is amnesic and analgesia is intense (B)</p> Signup and view all the answers

Which of the following is true about ketamine's resemblance to phencyclidine?

<p>Ketamine has two optical isomers (D)</p> Signup and view all the answers

Which of the following statements about esketamine is true?

<p>Esketamine is the R (-) isomer of ketamine (B)</p> Signup and view all the answers

What is the main limitation of ketamine as a sole agent?

<p>It has a high incidence of emergence delirium (D)</p> Signup and view all the answers

Which of the following is a potential adverse effect of ketamine?

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

What is the main clinical use of dexmedetomidine?

<p>Sedation in the intensive care unit (A)</p> Signup and view all the answers

Which of the following is NOT a risk factor for emergence delirium with ketamine?

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

Propofol clearance from plasma exceeds hepatic blood flow.

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

Propofol is commonly used for induction of anesthesia in children.

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

Propofol has a short context-sensitive half-time and site equilibrium.

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

Propofol decreases cerebral blood flow.

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

Propofol is a sedative-hypnotic drug that induces rapid drug-induced unconsciousness.

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

Propofol is typically mixed with other drugs, such as lidocaine, to enhance its effects.

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

Propofol acts as a selective modulator of GABAA receptors and may potentiate glycine receptors.

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

True or false: Diazepam is commonly used as part of the anesthesia care plan.

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

True or false: Diazepam has a high degree of protein binding.

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

True or false: Diazepam has a longer elimination half-life compared to lorazepam.

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

Propofol increases the risk of oculocardiac reflex during pediatric strabismus surgery repair.

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

Propofol does not alter tests of coagulation or platelet function.

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

Thiopental can cause hepatocellular injury and lactic acidosis.

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

Propofol has potent antioxidant properties similar to Vitamin E.

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

Etomidate is primarily metabolized by hepatic microsomal enzymes and plasma esterases.

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

Etomidate is 99% protein bound to albumin.

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

Etomidate has a longer terminal elimination half-life compared to propofol.

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

Etomidate can cause adrenocortical suppression.

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

True or false: Benzodiazepines have a built-in ceiling effect that prevents them from exceeding the physiologic maximum of GABA inhibition.

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

True or false: Differences in onset and duration among benzodiazepines reflect differences in potency (receptor binding affinity), lipid solubility (ability to cross the BBB), and pharmacokinetics (uptake, distribution, metabolism, and elimination).

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

True or false: Benzodiazepines decrease adenosine degradation by inhibiting the nucleoside transporter.

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

True or false: Benzodiazepines exert synergistic sedative effects with alcohol, inhaled anesthetics, opioids, and α2 agonists.

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

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