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</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.</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.</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</p> Signup and view all the answers

    Which of the following statements about ketamine is true?

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

    Which isomer of ketamine is used for treatment resistant depression?

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

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

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

    What is a limitation of ketamine as a sole agent?

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

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

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

    What is the mechanism of action of ketamine?

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

    Which receptors does ketamine bind to?

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

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

    <p>Unknown</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</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</p> Signup and view all the answers

    What is a clinical use of ketamine?

    <p>Analgesia</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</p> Signup and view all the answers

    What is a potential neuroprotective effect of ketamine?

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

    Which of the following is a side effect of Thiopental?

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

    What is the main function of Dexmetomidine?

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

    What is the elimination half-life of Dexmetomidine?

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

    What is the clinical use of Dexmetomidine?

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

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

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

    What is the main function of Atipamezole?

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

    What is the effect of Dexmetomidine on ventilation?

    <p>Mild depression of ventilation</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.</p> Signup and view all the answers

    Which of the following is a side effect of ketamine?

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

    Which of the following is a clinical use of thiopental?

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

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

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

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

    <p>Unknown</p> Signup and view all the answers

    What are the central nervous system side effects of ketamine?

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

    Which receptors does ketamine bind to?

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

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

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

    What is the main function of dexmedetomidine?

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

    What is a potential neuroprotective effect of ketamine?

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

    What is a clinical use of ketamine?

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

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

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

    What is the effect of dexmedetomidine on ventilation?

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

    Which of the following statements about esketamine is true?

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

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

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

    What is the main clinical use of dexmedetomidine?

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

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

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

    Propofol clearance from plasma exceeds hepatic blood flow.

    <p>True</p> Signup and view all the answers

    Propofol is commonly used for induction of anesthesia in children.

    <p>True</p> Signup and view all the answers

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

    <p>True</p> Signup and view all the answers

    Propofol decreases cerebral blood flow.

    <p>True</p> Signup and view all the answers

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

    <p>True</p> Signup and view all the answers

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

    <p>False</p> Signup and view all the answers

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

    <p>True</p> Signup and view all the answers

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

    <p>False</p> Signup and view all the answers

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

    <p>True</p> Signup and view all the answers

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

    <p>True</p> Signup and view all the answers

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

    <p>True</p> Signup and view all the answers

    Propofol does not alter tests of coagulation or platelet function.

    <p>True</p> Signup and view all the answers

    Thiopental can cause hepatocellular injury and lactic acidosis.

    <p>True</p> Signup and view all the answers

    Propofol has potent antioxidant properties similar to Vitamin E.

    <p>True</p> Signup and view all the answers

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

    <p>True</p> Signup and view all the answers

    Etomidate is 99% protein bound to albumin.

    <p>False</p> Signup and view all the answers

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

    <p>False</p> Signup and view all the answers

    Etomidate can cause adrenocortical suppression.

    <p>True</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</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</p> Signup and view all the answers

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

    <p>True</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</p> Signup and view all the answers

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