Otterbein/Grant CRNA Pharm Final Review

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About This Quiz

The 'Otterbein\/Grant CRNA Pharm Final Review' quiz assesses knowledge on pharmacology relevant to anesthesia. It covers topics such as MAC of common agents, contraindications for induction agents in specific medical conditions, and the impact of drugs on the cardiovascular system and adrenal function.

Otterbein/Grant CRNA Pharm Final Review - Quiz

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  • 2. 

    Cocaine is special because it has vasoconstrictive properties related to its ability to block the reuptake of norepinephrine.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Cocaine is indeed special because it has vasoconstrictive properties. This means that it can narrow or constrict blood vessels, leading to a decrease in blood flow. This property is related to its ability to block the reuptake of norepinephrine, a neurotransmitter involved in regulating blood vessel size. By blocking the reuptake of norepinephrine, cocaine increases its levels in the body, causing vasoconstriction and various physiological effects. Therefore, the statement "Cocaine is special because it has vasoconstrictive properties related to its ability to block the reuptake of norepinephrine" is true.

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  • 3. 

    Systemic absorption of injected local anesthetics depends on the blood flow to the site.  IV>tracheal>intrapleural, intercostal>Caudal>paracervical>epidural>brachial plexus>subarachnoid,sciatic,femoral>subcutaneous

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Mnemonic=In Time I Can Please Everyone But Susie & Sally

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  • 4. 

    Levobupivacaine is the isomer of bupivacaine that is less cardiotoxic.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Ropivacaine is mentioned in the ppt to have less cardiotoxicity than bupivacaine - it is "the propyl analogue of, bupivacaine having a butyl group in the same position."

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  • 5. 

    Epinephrine _________ myocardial oxygen demand.

    • Increases

    • Decreases

    Correct Answer
    A. Increases
    Explanation
    Epinephrine increases myocardial oxygen demand. Epinephrine is a hormone that is released during times of stress or excitement. It acts on the heart by increasing heart rate and contractility, which in turn increases the amount of oxygen that the heart muscle needs to function properly. This increased demand for oxygen can be beneficial in certain situations, such as during exercise when the body needs more oxygen to meet the increased energy demands. However, in individuals with heart disease or other cardiac conditions, this increased demand for oxygen can be detrimental and may lead to chest pain or heart attack.

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  • 6. 

    Which of the following antimuscarinics crosses the BBB?

    • Atropine

    • Glycopyrrolate

    Correct Answer
    A. Atropine
    Explanation
    Atropine is able to cross the blood-brain barrier (BBB), allowing it to exert its effects on the central nervous system. This is due to its lipophilic nature, which enables it to pass through the lipid-rich barrier. On the other hand, glycopyrrolate is a quaternary ammonium compound, which means it carries a positive charge and is therefore unable to cross the BBB. Hence, atropine is the correct answer as it is the antimuscarinic that can penetrate the BBB.

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  • 7. 

    Which drug is a centrally acting dopamine antagonist that causes selective GI cholinergic stimulation, increases LES/fundal smooth muscle tension, increases gastric & small intestine motility, relaxes pylorus/duodenum during contraction?

    • Metoclopramide

    • Zantac

    • Prilosec

    • Succinylcholine

    Correct Answer
    A. Metoclopramide
    Explanation
    Metoclopramide is a centrally acting dopamine antagonist that stimulates cholinergic receptors in the gastrointestinal (GI) tract. It increases the tension of the lower esophageal sphincter (LES) and fundal smooth muscles, which helps prevent reflux. It also increases the motility of the gastric and small intestine, aiding in digestion. Additionally, metoclopramide relaxes the pylorus and duodenum during contraction, allowing for the smooth passage of food through the GI tract.

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  • 8. 

    Hypotension, bradycardia, dysrhythmias and akathisia (restlessness/uneasiness) are common side effects of Reglan.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The statement is true because hypotension, bradycardia, dysrhythmias, and akathisia are indeed common side effects of Reglan. Hypotension refers to low blood pressure, bradycardia is a slow heart rate, dysrhythmias are abnormal heart rhythms, and akathisia is a condition characterized by restlessness or uneasiness. These side effects can occur when taking Reglan, a medication commonly used to treat gastrointestinal issues such as acid reflux and gastroparesis. It is important for patients to be aware of these potential side effects and discuss them with their healthcare provider.

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  • 9. 

    Ancef is an example of a cephalosporin that is commonly used because it offers broad spectrum coverage and is inexpensive.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Ancef is indeed an example of a cephalosporin that is commonly used. It is known for its broad spectrum coverage, meaning that it can effectively treat a wide range of bacterial infections. Additionally, it is also relatively inexpensive, making it a cost-effective choice for many healthcare providers. Therefore, the statement that Ancef offers broad spectrum coverage and is inexpensive is true.

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  • 10. 

    Serotonin is an endogenous vasoactive autocoid.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Serotonin is a neurotransmitter that is involved in various physiological processes, including the regulation of blood vessels. As an endogenous vasoactive autocoid, it means that serotonin is produced within the body and acts as a signaling molecule to regulate blood vessel constriction and dilation. This helps in maintaining blood pressure and blood flow to different tissues and organs. Therefore, the statement that serotonin is an endogenous vasoactive autocoid is true.

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  • 11. 

    Aldosterone secretion causes the reabsorption of Na+, the loss of hydrogen ions and which electrolyte?

    • K+

    • Ca+

    • Glucose

    • Plasma

    Correct Answer
    A. K+
    Explanation
    Aldosterone secretion causes the reabsorption of Na+ and the loss of hydrogen ions. This hormone also stimulates the reabsorption of potassium ions (K+) in the kidneys. Therefore, the correct answer is K+.

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  • 12. 

    Prostaglandins cause bronchial muscle relaxation, uterus contraction, inhibit gastric acid secretion, and prevent platelet aggregation.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Prostaglandins are lipid compounds that play a role in various physiological processes. They are known to cause bronchial muscle relaxation, which helps in widening the airways and facilitating breathing. Prostaglandins also stimulate uterine contractions during labor and delivery. Additionally, they inhibit gastric acid secretion, which can help in reducing stomach acid levels and preventing gastric ulcers. Lastly, prostaglandins prevent platelet aggregation, which is important for maintaining normal blood flow and preventing the formation of blood clots. Therefore, the statement is true as prostaglandins do indeed cause all of these effects.

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  • 13. 

    HITT stands for __________ induced thrombocytopenia and thrombosis caused by drug induced platelet aggregation.

    Correct Answer
    heparin
    Explanation
    HITT stands for heparin induced thrombocytopenia and thrombosis caused by drug induced platelet aggregation. Heparin is a medication commonly used as an anticoagulant to prevent blood clots. However, in some individuals, heparin can cause an immune response that leads to a decrease in platelet count (thrombocytopenia) and the formation of blood clots (thrombosis). This condition is known as HITT. It is important to identify and manage HITT promptly to prevent serious complications.

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  • 14. 

    A, D, E, and K are the only fat soluble vitamins, therefore all other vitamins must be water soluble.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The explanation for the given correct answer is that fat soluble vitamins are only absorbed and stored in the body with the help of dietary fat. A, D, E, and K are the only vitamins that fall under this category. Since all other vitamins are not fat soluble, they must be water soluble, meaning they can dissolve in water and are easily absorbed and excreted by the body. Therefore, the statement is true.

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  • 15. 

    Deficiencies in ______ acid cause neural tube defect in utero.

    Correct Answer
    folic
    Explanation
    Deficiencies in folic acid can lead to neural tube defects in the developing fetus. Folic acid is crucial for the proper development of the neural tube, which eventually becomes the brain and spinal cord. Insufficient levels of folic acid during pregnancy can result in incomplete closure of the neural tube, leading to conditions such as spina bifida or anencephaly. It is therefore important for pregnant women to ensure an adequate intake of folic acid through diet or supplements to prevent these defects.

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  • 16. 

    Parkinson's treatment consists of anticholinergic and _______ drugs.

    • Dopaminergic

    • Antidopaminergic

    • Chemotherapeautic

    • Antimicrobial

    Correct Answer
    A. Dopaminergic
    Explanation
    Parkinson's disease is characterized by a deficiency of dopamine in the brain. Dopaminergic drugs are used to increase the levels of dopamine in the brain, which helps to alleviate the symptoms of the disease. These drugs work by either replacing dopamine or by stimulating the dopamine receptors in the brain. Therefore, the use of dopaminergic drugs is a crucial part of the treatment for Parkinson's disease.

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  • 17. 

    Levodopa for Parkinson's treatment is associated with GI dysfunction, hypotension, dyskinesias, and psychosis.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Levodopa, a medication commonly used for the treatment of Parkinson's disease, is indeed associated with various side effects. GI dysfunction refers to gastrointestinal problems such as nausea, vomiting, and constipation. Hypotension refers to low blood pressure, which can lead to dizziness and fainting. Dyskinesias are abnormal involuntary movements that can occur as a side effect of levodopa treatment. Lastly, psychosis, which includes symptoms such as hallucinations and delusions, can also be a potential side effect of levodopa therapy. Therefore, the statement "Levodopa for Parkinson's treatment is associated with GI dysfunction, hypotension, dyskinesias, and psychosis" is true.

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  • 18. 

    I can't remember what Greg believes is the most potent vasoconstrictor - angiotensin II??

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The given answer is true because angiotensin II is indeed considered to be one of the most potent vasoconstrictors. It is a hormone that constricts blood vessels, leading to an increase in blood pressure. Angiotensin II plays a crucial role in regulating blood pressure and fluid balance in the body.

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  • 19. 

    Angiotensin converting enzyme is responsible for the production of the vasoconstrictor angiotensin II as well as the destruction of the vasodilator bradykinin.  ACE inhibitors therefore prevent the production of angiotensin II and increase the amount of circulation bradykinin causing vasodilation.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Angiotensin converting enzyme (ACE) is responsible for the production of angiotensin II, which is a vasoconstrictor. ACE inhibitors work by blocking the action of ACE, thereby preventing the production of angiotensin II. This leads to vasodilation, or the widening of blood vessels, which helps to lower blood pressure. Additionally, ACE is also responsible for the destruction of bradykinin, which is a vasodilator. By inhibiting ACE, ACE inhibitors also increase the amount of circulating bradykinin, further promoting vasodilation. Therefore, the statement that ACE inhibitors prevent the production of angiotensin II and increase the amount of circulating bradykinin causing vasodilation is true.

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  • 20. 

    Kayexelate is indicated for ____________, it binds with potassium in exchange for sodium or calcium ions and is excreted via poops.

    • Hyperkalemia

    • Hypokalemia

    Correct Answer
    A. Hyperkalemia
    Explanation
    Kayexelate is indicated for hyperkalemia, a condition characterized by high levels of potassium in the blood. It works by binding with potassium in exchange for sodium or calcium ions, which helps to lower the potassium levels in the body. Once bound, it is excreted through the stool, thereby aiding in the removal of excess potassium from the body.

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  • 21. 

    When redosing an induction agent you should use 10% of the original dose you gave.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    When redosing an induction agent, it is recommended to use 10% of the original dose that was given. This is because the initial dose of the induction agent is usually higher to achieve the desired effect quickly. Redosing with a smaller amount helps maintain the desired level of sedation or anesthesia without overdosing the patient. Using a smaller dose also allows for better control and adjustment of the medication as needed. Therefore, the statement "When redosing an induction agent you should use 10% of the original dose you gave" is true.

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  • 22. 

    Which of the following induction agents is contraindicated with an intracranial hemorrhage?

    • Ketamine

    • Propofol

    • Midazolam

    • Dexmedatomidine

    Correct Answer
    A. Ketamine
    Explanation
    Increases CPP, CMRO2, ICP, and IOP

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  • 23. 

    Patients with end stage renal disease do not need reduced dosing for benzodiazepines or morphine.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Patients with end stage renal disease do need reduced dosing for benzodiazepines or morphine. This is because their kidneys are not functioning properly, leading to a decreased ability to eliminate these medications from the body. Therefore, lower doses are required to prevent potential toxicity or adverse effects.

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  • 24. 

    Local anesthetics that are more lipid soluble also tend to have a higher degree of protein binding.  Local anesthetics bind mostly to:

    • Alpha 1-acid glycoproteins

    • Albumin

    Correct Answer
    A. Alpha 1-acid glycoproteins
    Explanation
    Local anesthetics that are more lipid soluble tend to have a higher degree of protein binding. In this case, the correct answer is Alpha 1-acid glycoproteins. This means that local anesthetics with higher lipid solubility have a greater affinity for binding to Alpha 1-acid glycoproteins rather than albumin.

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  • 25. 

    The lower the pKa of a local anesthetic, the faster the onset of action will be, with the only exception being chloroprocaine which has a high pKa but a rapid onset.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The explanation for the given correct answer is that the pKa of a local anesthetic determines its ability to penetrate the nerve membrane and become ionized, which affects its onset of action. A lower pKa means that the anesthetic is more likely to be in its non-ionized form, allowing it to easily cross the nerve membrane and reach its target site. This results in a faster onset of action. However, chloroprocaine is an exception to this rule. Despite having a high pKa, it still has a rapid onset of action due to its unique chemical properties.

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  • 26. 

    Methyldopa, clonidine, and dexmedetomidine are all _______ agonists, they are considered to be sympatholytic, abrupt discontinuation can cause acute withdrawal syndrome leading to hypertensive crisis.

    • Alpha 2

    • Alpha 1

    • Beta 1

    • Beta 2

    Correct Answer
    A. Alpha 2
    Explanation
    Methyldopa, clonidine, and dexmedetomidine are all alpha 2 agonists. Alpha 2 agonists work by stimulating alpha 2 adrenergic receptors in the body, leading to a decrease in sympathetic outflow from the central nervous system. This results in a decrease in sympathetic activity and a reduction in blood pressure. These drugs are considered sympatholytic because they inhibit the release of norepinephrine, which is responsible for activating the sympathetic nervous system. Abrupt discontinuation of alpha 2 agonists can cause acute withdrawal syndrome, which can lead to a sudden increase in sympathetic activity and hypertensive crisis.

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  • 27. 

    Which of the following are the naturally occuring adrenergic agonists?

    • Epinephrine

    • Norepinephrine

    • Dopamine

    • Dobutamine

    • Isoproterenol

    Correct Answer(s)
    A. Epinephrine
    A. Norepinephrine
    A. Dopamine
    Explanation
    Epinephrine, norepinephrine, and dopamine are naturally occurring adrenergic agonists. Adrenergic agonists are substances that activate adrenergic receptors in the sympathetic nervous system, leading to various physiological responses. Epinephrine, also known as adrenaline, is released by the adrenal glands and plays a role in the "fight or flight" response. Norepinephrine, also known as noradrenaline, is a neurotransmitter that is released by sympathetic nerve endings. Dopamine is a neurotransmitter that has various functions in the brain and body. These three substances have adrenergic effects and can bind to adrenergic receptors to stimulate the sympathetic nervous system.

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  • 28. 

    It is okay for patients on monoamine oxidase inhibitors to receive ephedrine.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    NE is in abundance - will cause htn crisis

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  • 29. 

    Phenylephrine is a non-catecholamine predominantly ______ agonist.

    • Alpha1

    • Alpha2

    • Beta1

    • Beta2

    Correct Answer
    A. Alpha1
    Explanation
    Phenylephrine is a non-catecholamine that primarily acts as an agonist on alpha1 adrenergic receptors. This means that it stimulates these receptors, leading to vasoconstriction and increased blood pressure. Alpha1 agonists are commonly used to treat conditions such as nasal congestion, hypotension, and shock.

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  • 30. 

    Beta blockers are generally avoided in asthmatics due to the potential to trigger severe asthma attacks.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Beta blockers are medications that can block the effects of adrenaline, which can cause bronchial constriction and narrowing of the airways. This can be particularly dangerous for individuals with asthma, as it can potentially trigger severe asthma attacks. Therefore, it is generally recommended to avoid using beta blockers in asthmatics to minimize the risk of exacerbating their condition.

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  • 31. 

    Verapamil is a calcium channel blocker used to prevent cerebral vasospasms because it is the only Ca++ channel blocker that crosses the BBB.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Nimodipine

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  • 32. 

    The dose of sodium nitroprusside is 0.5-10 mcg/kg/min.  It can cause what type of toxicity if ran at high doses?

    • Cyanide

    • Arsenic

    • Food

    • Stingray

    Correct Answer
    A. Cyanide
    Explanation
    Sodium nitroprusside, when administered at high doses, can cause cyanide toxicity. Cyanide is a highly toxic substance that inhibits cellular respiration by binding to cytochrome oxidase, preventing the utilization of oxygen by cells. Symptoms of cyanide toxicity include headache, confusion, dizziness, seizures, respiratory distress, and cardiac arrest. Prompt recognition and treatment are essential in managing cyanide toxicity.

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  • 33. 

    An allergy to penicillins implies an 8% likelihood of an allergy to:

    • Cephalosporins (ancef)

    • Aminoglycosides

    • Antivirals

    • Vancomycin

    Correct Answer
    A. Cephalosporins (ancef)
    Explanation
    An allergy to penicillins implies an 8% likelihood of an allergy to cephalosporins (ancef). This means that there is a relatively high chance of cross-reactivity between penicillins and cephalosporins, as both are beta-lactam antibiotics and have a similar chemical structure. However, there is no significant evidence to suggest a similar cross-reactivity with aminoglycosides, antivirals, or vancomycin. Therefore, the correct answer is cephalosporins (ancef).

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  • 34. 

    H2 receptors relax bronchial smooth muscles, therefore patients on H2 antagonists are at an increased risk for bronchial constriction. 

    • True

    • False

    Correct Answer
    A. True
    Explanation
    H2 receptors are found in the bronchial smooth muscles, and when these receptors are activated by H2 antagonists, they cause relaxation of the muscles. This relaxation can lead to bronchial constriction, which is a narrowing of the airways. Therefore, patients on H2 antagonists are indeed at an increased risk for bronchial constriction.

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  • 35. 

    What stimulates renin secretion?

    • Decreased renal perfusion

    • Hypercapnia

    • Hypoxia

    • Decreased pH

    Correct Answer
    A. Decreased renal perfusion
    Explanation
    Decreased renal perfusion refers to a reduction in blood flow to the kidneys. When the kidneys sense a decrease in blood flow, they release renin, an enzyme that plays a crucial role in regulating blood pressure. Renin acts on angiotensinogen to convert it into angiotensin I, which is further converted to angiotensin II. Angiotensin II causes vasoconstriction and stimulates the release of aldosterone, leading to increased blood volume and blood pressure. Therefore, decreased renal perfusion stimulates renin secretion as a compensatory mechanism to restore blood pressure.

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  • 36. 

    Toradol is safe to use on patients with a history of asthma.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    NSAID-induced bronchospasms appear to be caused by the inhibition of cyclooxygenase-1 (Cox-1); this in turn activates the lipoxygenase pathway, which eventually increases the release of cysteinyl leukotrienes (Cys-LTs) that induces bronchospasm and nasal obstruction.

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  • 37. 

    Which steroid is commonly used to treat cerebral edema?

    • Dexamethasone

    • Betamethasone

    • Prednisone

    • Prednisolone

    Correct Answer
    A. Dexamethasone
    Explanation
    Dexamethasone is commonly used to treat cerebral edema. It is a steroid that helps reduce inflammation and swelling in the brain, which can occur in conditions such as brain tumors, infections, or traumatic brain injury. Dexamethasone works by suppressing the immune response and reducing the release of substances that cause inflammation. This helps to alleviate the symptoms of cerebral edema and improve the patient's condition.

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  • 38. 

    Which medication was originally advertised as an antiepileptic but is now commonly used to manage neuropathic pain?

    • Gabapentin

    • Levetiracetam

    • Phenobarbital

    • Topiramate

    Correct Answer
    A. Gabapentin
    Explanation
    Gabapentin was originally advertised as an antiepileptic medication but is now commonly used to manage neuropathic pain. It works by reducing the abnormal electrical activity in the brain that can cause seizures, and also helps to relieve nerve pain by affecting certain chemicals in the brain and nerves that are involved in pain signals.

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  • 39. 

    Gingko, ginseng, and garlic are all associated with?

    • Bleeding

    • Immunosuppression

    • Sedation

    • Arrhythmias

    Correct Answer
    A. Bleeding
    Explanation
    Gingko, ginseng, and garlic are all associated with bleeding. These three substances have anticoagulant properties, meaning they can thin the blood and increase the risk of bleeding. They can interfere with blood clotting mechanisms and may interact with certain medications, such as blood thinners, leading to excessive bleeding. It is important to be cautious when using these substances, especially before surgeries or if already taking medications that affect blood clotting.

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  • 40. 

    Antiretrovirals can cause pancreatitis, lactic acidosis, and inhibition of cytochrome P-450 enzymes.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Antiretrovirals, which are used to treat HIV, can indeed cause pancreatitis, lactic acidosis, and inhibition of cytochrome P-450 enzymes. Pancreatitis is inflammation of the pancreas, lactic acidosis is a buildup of lactic acid in the body, and inhibition of cytochrome P-450 enzymes can affect the metabolism of other drugs. Therefore, the statement is true.

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  • 41. 

    With epinephrine added, the max dose of lidocaine and mepivacaine are both _ mg/kg.

    Correct Answer
    7
    Explanation
    With epinephrine added, the maximum dose of lidocaine and mepivacaine is both 7 mg/kg.

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  • 42. 

    Which of the following induction agents is associated with adrenal corticoid suppression and should be used cautiously or avoided with patients on chronic steroids/Addison's disease?

    • Etomidate

    • Propofol

    • Ketamine

    • Fentanyl

    Correct Answer
    A. Etomidate
    Explanation
    Etomidate is associated with adrenal corticoid suppression and should be used cautiously or avoided with patients on chronic steroids/Addison's disease. This is because etomidate inhibits the production of cortisol, a hormone produced by the adrenal glands. Patients with chronic steroid use or Addison's disease already have compromised adrenal function, and the use of etomidate can further suppress cortisol production, leading to adrenal insufficiency. Therefore, it is important to exercise caution and consider alternative induction agents in these patients to prevent adrenal crisis.

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  • 43. 

    Which of the following agents should be avoiding in patients with coronary artery disease, uncontrolled HTN, or CHF due to its ability to increase myocardial workload?

    • Ketamine

    • Etomidate

    • Propofol

    • Versed

    Correct Answer
    A. Ketamine
    Explanation
    Ketamine should be avoided in patients with coronary artery disease, uncontrolled hypertension, or congestive heart failure due to its ability to increase myocardial workload. Ketamine is a dissociative anesthetic that can cause an increase in heart rate and blood pressure, leading to increased myocardial oxygen demand. This can be dangerous in patients with pre-existing cardiovascular conditions as it may exacerbate their symptoms and potentially lead to cardiovascular complications. Therefore, it is recommended to avoid using ketamine in these patients to minimize the risk of cardiovascular events.

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  • 44. 

    The addition of epinephrine to a local anesthetic leads to vessel vasoconstriction and _______ absorption/metabolism of the local anesthetic.

    • Less

    • More

    Correct Answer
    A. Less
    Explanation
    The addition of epinephrine to a local anesthetic leads to vessel vasoconstriction, which means that the blood vessels in the area constrict or narrow. This constriction reduces blood flow to the area, resulting in less absorption and metabolism of the local anesthetic. As a result, the anesthetic stays in the area for a longer duration, providing prolonged pain relief.

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  • 45. 

    The duration of action is ________ for local anesthetics that exhibit the greatest protein binding and the highest lipid solubility. 

    • Longest

    • Shortest

    Correct Answer
    A. Longest
    Explanation
    Local anesthetics that exhibit the greatest protein binding and highest lipid solubility have a longer duration of action. This is because these properties allow the anesthetic to stay bound to proteins and remain within the lipid-rich environment for a longer period of time, resulting in a slower release and metabolism of the drug. As a result, the effects of the anesthetic are prolonged, leading to a longer duration of action.

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  • 46. 

    Which of the following antimuscarinics do NOT cross the placenta?

    • Atropine

    • Glycopyrrolate

    Correct Answer
    A. Glycopyrrolate
    Explanation
    Glycopyrrolate is the correct answer because it is a quaternary ammonium compound that does not easily cross the placenta due to its large molecular size and positive charge. This makes it a safer choice during pregnancy compared to atropine, which is a tertiary amine and can cross the placenta more readily.

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  • 47. 

    Which of the following would you NOT consider using for treating a hypertensive crisis intraoperatively?

    • Dobutamine

    • Nitroprusside

    • Esmolol

    • Hydralazine

    Correct Answer
    A. Dobutamine
    Explanation
    Dobutamine is a medication that is primarily used to increase cardiac output in patients with heart failure. It works by stimulating the heart to beat more forcefully. However, in the context of a hypertensive crisis, where blood pressure is dangerously high, the goal is to lower blood pressure. Therefore, using dobutamine, which can increase blood pressure, would not be appropriate in this situation.

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  • 48. 

    Aldosterone, desoxycorticosterone, cortisol (hydrocortisone), corticosterone, and cortisone are endogenous corticosteroids.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The statement is true because aldosterone, desoxycorticosterone, cortisol (hydrocortisone), corticosterone, and cortisone are indeed endogenous corticosteroids. These hormones are produced naturally in the body by the adrenal glands and play important roles in regulating various physiological processes, including salt and water balance, metabolism, and immune responses.

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  • 49. 

    Insulin is metabolized by the liver and the:

    • Kidneys

    • Lungs

    • Tonsils

    • Spleen

    Correct Answer
    A. Kidneys
    Explanation
    Insulin is primarily metabolized by the liver, but a small portion is also metabolized by the kidneys. The kidneys play a role in the elimination of insulin from the body. They filter the blood and excrete any excess or unused insulin through urine. While the liver is the main organ responsible for insulin metabolism, the kidneys also contribute to its elimination.

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  • Current Version
  • Mar 17, 2023
    Quiz Edited by
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  • Apr 25, 2015
    Quiz Created by
    Alainad3

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