The Anesthesia Quiz: How Does IT Work?

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The Anesthesia Quiz: How Does IT Work? - Quiz

The anaesthesia quiz: how does it work? Different drugs have a certain effect on the body when introduced into the system, and this is why not every anaesthesia drug will have the same outcome when used. Do you know some of the intended results expected when a person is put under? This quiz will not only refresh your memory on some of the ways to administer anaesthesia but desired results as well. Check it out!


Questions and Answers
  • 1. 

    Which of the following is not one of the Five Principle pharmacological effects of Benzodiazepines?

    • A.

      Sedation

    • B.

      Anxiolysis

    • C.

      Retrograde Amnesia

    • D.

      Anticonvulsant

    • E.

      Spinal Cord mediated skeletal muscle relaxation

    Correct Answer
    C. Retrograde Amnesia
    Explanation
    Benzodiazepines are a class of drugs commonly used for their sedative, anxiolytic, anticonvulsant, and muscle relaxant effects. Retrograde amnesia, however, is not considered one of the principle pharmacological effects of benzodiazepines. Retrograde amnesia refers to the loss of memory for events that occurred before the drug was taken. While benzodiazepines may cause some memory impairment, it is typically not characterized by retrograde amnesia.

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  • 2. 

    Which of the Benzodiazepines reviewed has the slowest onset of action and why?

    • A.

      Lorazepam- due to lower lipid solubility

    • B.

      Midazolam- due to its water solubility

    • C.

      Diazepam- due to rapid redistribution

    Correct Answer
    A. Lorazepam- due to lower lipid solubility
    Explanation
    Lorazepam has the slowest onset of action compared to Midazolam and Diazepam because it has lower lipid solubility. Lipid solubility affects how quickly a drug can cross cell membranes and enter the bloodstream. Since Lorazepam has lower lipid solubility, it takes longer for it to be absorbed and distributed throughout the body, resulting in a slower onset of action. In contrast, Midazolam's water solubility and Diazepam's rapid redistribution contribute to faster onset of action compared to Lorazepam.

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  • 3. 

    While doing a pre-op assessment on an inpatient you find that the pt is currently taking Tagamet (cimetidine) and is on a Heparin regimen. With this knowledge you know to avoid which of the benzodiazepines?

    • A.

      Lorazepam

    • B.

      Diazepam

    • C.

      Midazolam

    • D.

      Thiopental

    Correct Answer
    B. Diazepam
    Explanation
    Given that the patient is currently taking Tagamet (cimetidine) and is on a Heparin regimen, the knowledge of avoiding Diazepam can be explained by the fact that cimetidine inhibits the hepatic metabolism of diazepam, leading to increased plasma levels and prolonged effects of diazepam. Additionally, heparin can potentiate the sedative effects of benzodiazepines, increasing the risk of excessive sedation and respiratory depression. Therefore, it is advisable to avoid diazepam in this situation to prevent potential drug interactions and adverse effects.

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  • 4. 

    In regards to the adjustments of Benzodiazepines in respect to the elderly patient.  Would you expect to have:

    • A.

      Significant increase in initial dose and anticipate marked decrease in duration of action

    • B.

      Modest decrease in initial dose and anticipate marked increase in duration of action

    • C.

      No change in dose or frequency or duration from that of an healthy 25 year old patient.

    • D.

      None of above

    Correct Answer
    B. Modest decrease in initial dose and anticipate marked increase in duration of action
    Explanation
    As individuals age, their metabolism slows down and their liver and kidney function may decrease. This can result in a decreased ability to metabolize and eliminate medications from the body. Benzodiazepines are a class of medications that are commonly used to treat anxiety and insomnia. In elderly patients, the initial dose of benzodiazepines should be decreased to account for their decreased metabolism and potential for increased sensitivity to the medication. Additionally, the duration of action of benzodiazepines may be prolonged in elderly patients due to their decreased ability to eliminate the medication from their body. Therefore, one would expect a modest decrease in the initial dose and anticipate a marked increase in the duration of action of benzodiazepines in elderly patients.

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  • 5. 

    The dose of Benzodiazepines required to reach a desired clinical endpoint is increased in the elderly compared to the younger patient.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The statement is false. The dose of Benzodiazepines required to reach a desired clinical endpoint is actually decreased in the elderly compared to the younger patient. This is because the elderly population is more sensitive to the effects of Benzodiazepines, and they are at a higher risk of experiencing adverse effects and drug interactions. Therefore, lower doses are typically prescribed to the elderly to achieve the desired therapeutic effect while minimizing potential harm.

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  • 6. 

    Benzodiazepines are extensively protein bound.  Therefore, in the presence of renal failure their clinical effect will be:

    • A.

      Shortened

    • B.

      Prolonged

    • C.

      No significant change.

    Correct Answer
    B. Prolonged
    Explanation
    Benzodiazepines are extensively protein bound, meaning that they bind strongly to proteins in the blood. In the presence of renal failure, the clearance of these drugs from the body is reduced. Since they are not being eliminated as efficiently, the drugs will remain in the body for a longer period of time, leading to a prolonged clinical effect. Therefore, the correct answer is "Prolonged".

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  • 7. 

    Define Affinity:

    • A.

      Inhibit or block responses caused by an agonist

    • B.

      Drugs which alter the physiology of a cell by binding to plasma membrane or intracellular receptors

    • C.

      The strength of binding between drug and receptor

    • D.

      Binds to a site other than the agonist-binding domain

    Correct Answer
    C. The strength of binding between drug and receptor
    Explanation
    The correct answer is "the strength of binding between drug and receptor." Affinity refers to the attraction or bonding between a drug and its target receptor. It measures how strongly the drug binds to the receptor, which ultimately determines the effectiveness of the drug in producing a response. Higher affinity means a stronger binding, leading to a more potent and longer-lasting effect.

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  • 8. 

    A drug that alters the physiology of a cell by binding to the plasma membrane or intracellular receptors is known as what?

    • A.

      Antagonist

    • B.

      Competitive Agonist

    • C.

      Competitive Antagonist

    • D.

      Agonist

    Correct Answer
    D. Agonist
    Explanation
    An agonist is a drug that binds to either the plasma membrane or intracellular receptors of a cell and alters its physiology. It activates the receptors and produces a biological response. This is in contrast to an antagonist, which binds to the receptors but does not activate them, or a competitive agonist, which competes with the natural ligand for binding to the receptor. Therefore, an agonist is the correct answer as it accurately describes a drug that alters the physiology of a cell by binding to receptors.

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  • 9. 

    What is an antagonist?

    • A.

      Inhibit or block responses caused by an agonist

    • B.

      A drug which alters the physiology of a cell by binding to plasma membrane or intracellular receptors

    • C.

      Biochemical messengers, often called 2ndmessengers

    • D.

      The strength of binding between drug and receptor

    Correct Answer
    A. Inhibit or block responses caused by an agonist
    Explanation
    An antagonist is a substance that inhibits or blocks the effects of an agonist. Agonists are substances that activate receptors in the body, causing a physiological response. Antagonists, on the other hand, bind to the same receptors as agonists but do not activate them. Instead, they prevent the agonist from binding and activating the receptor, thereby blocking or inhibiting the response that the agonist would normally produce. This can be useful in medical treatments to counteract the effects of certain substances or to control physiological responses.

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  • 10. 

    A Competitive antagonist binds to a site other than the agonist binding domain.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    A competitive antagonist binds to the same site as the agonist binding domain, competing with the agonist for binding to the receptor. This binding prevents the agonist from binding and activating the receptor, resulting in a decrease in the agonist's effect. Therefore, the given statement is false as a competitive antagonist does not bind to a site other than the agonist binding domain.

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  • 11. 

    What is GABA?

    • A.

      The major excitatory neurotransmitter and is important in agonizing the effects of amino acid transmitter.

    • B.

      Proteins or glycoproteins that are present on the cell surface, on an organelle within the cell, or in the cytoplasm.

    • C.

      The major inhibitory neurotransmitter and is important in antagonizing the effects of amino acid transmitter.

    • D.

      Refers to the portion of the chemical structured composed of a benzene ring fused to a seven-membered diazepine ring

    Correct Answer
    C. The major inhibitory neurotransmitter and is important in antagonizing the effects of amino acid transmitter.
    Explanation
    GABA, or gamma-aminobutyric acid, is a major inhibitory neurotransmitter in the central nervous system. It plays a crucial role in reducing neuronal excitability and preventing excessive neural activity. GABA acts by binding to specific receptors, inhibiting the firing of neurons and reducing the transmission of signals. This inhibitory action helps to balance the excitatory effects of other neurotransmitters, such as glutamate. GABA is important in antagonizing the effects of amino acid transmitters, which are the major excitatory neurotransmitters in the brain.

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  • 12. 

    What is the MOA of Benzo's?

    • A.

      Blockade of chloride channels leading to depolarization and inhibition of neurotransmitter

    • B.

      Inhibition of cyclooxygenase activity

    • C.

      Inhibition of GABA receptor binding which leads to degredation of GABA, preventing it from exerting it's effect.

    • D.

      Enhances the inhibitory effects of various neurotransmitter by facilitating GABA receptor binding. This opens chloride channels and causes hyperpolarization.

    Correct Answer
    D. Enhances the inhibitory effects of various neurotransmitter by facilitating GABA receptor binding. This opens chloride channels and causes hyperpolarization.
    Explanation
    The MOA of Benzo's is to enhance the inhibitory effects of various neurotransmitters by facilitating GABA receptor binding. This action opens chloride channels and causes hyperpolarization.

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  • 13. 

    How do midazolam and diazepam compare to one another?

    • A.

      Midazolam has 2 times the affinity for benzo receptors

    • B.

      Diazepam has 3 times the affinity for benzo receptors

    • C.

      Diazepam is hydrophilic

    • D.

      Midazolam has a much londer elimination half time

    Correct Answer
    A. Midazolam has 2 times the affinity for benzo receptors
    Explanation
    Midazolam has a higher affinity for benzo receptors compared to diazepam. This means that midazolam has a stronger binding ability to these receptors than diazepam. The higher affinity indicates that midazolam is more effective in activating the benzo receptors and producing its desired effects.

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  • 14. 

    All benzo's share what similarities?

    • A.

      All are highly alkaline solutions

    • B.

      Composed of a benzene ring fused to a seven-membered diazepine ring

    • C.

      They are safe to be given during pregnancy

    • D.

      Composed of malonic acid and urea

    Correct Answer
    B. Composed of a benzene ring fused to a seven-membered diazepine ring
    Explanation
    All benzo's share the similarity of being composed of a benzene ring fused to a seven-membered diazepine ring. This structural feature is characteristic of all benzo compounds, distinguishing them from other types of compounds.

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  • 15. 

    How is midazolam unique in comparison to other benzo's?

    • A.

      It is the only benzo safe to give to pregnant women.

    • B.

      Is known to cause pain upon injection, but has minimal respiratory depression

    • C.

      It is hydrophilic and becomes lipid soluble upon exposure to blood.

    • D.

      It is not highly protein bound like the other benzo's and thus more is available for use by the body.

    Correct Answer
    C. It is hydrophilic and becomes lipid soluble upon exposure to blood.
    Explanation
    Midazolam is unique compared to other benzos because it is hydrophilic, meaning it is water-soluble, but it becomes lipid-soluble when exposed to blood. This property allows it to rapidly cross the blood-brain barrier and have a quick onset of action. Other benzos are typically lipid-soluble and do not have this unique property.

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  • 16. 

    Which of the following drugs will cause pain upon injection due to the solvent propylene glycol?

    • A.

      Lorazepam

    • B.

      Flumazenil

    • C.

      Midazolam

    • D.

      Diazepam

    Correct Answer
    D. Diazepam
    Explanation
    Diazepam is the correct answer because it is commonly formulated with propylene glycol as a solvent, which can cause pain upon injection. Lorazepam, flumazenil, and midazolam do not typically contain propylene glycol as a solvent, so they would not cause pain upon injection.

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  • 17. 

    What is an appropriate oral dose for pediatric pre-medication with midazolam?

    • A.

      0.5 mg/kg

    • B.

      1 mg/kg

    • C.

      2-3 mg

    • D.

      10 - 20 mcg/ kg

    Correct Answer
    A. 0.5 mg/kg
    Explanation
    An appropriate oral dose for pediatric pre-medication with midazolam is 0.5 mg/kg. This means that the dosage is calculated based on the child's weight, with 0.5 milligrams of midazolam given per kilogram of body weight. This dosage is commonly used for pediatric patients to achieve sedation before medical procedures.

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  • 18. 

    What would be an appropirate Adult IV induction dose for midazolam?

    • A.

      0.5 mg/kg

    • B.

      0.1 mg/kg

    • C.

      2-3 mg

    • D.

      4 mg/kg

    Correct Answer
    B. 0.1 mg/kg
    Explanation
    The appropriate adult IV induction dose for midazolam is 0.1 mg/kg. This means that for every kilogram of body weight, the patient should receive 0.1 mg of midazolam. This dosage is commonly used for inducing sedation or anesthesia in adults before medical procedures. It is important to calculate the dosage accurately based on the patient's weight to ensure safe and effective administration of the medication.

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  • 19. 

    You have just given you pt Midazolam, how long would you expect to wait to see onset of the drug?

    • A.

      3-5 minutes

    • B.

      20-25 minutes

    • C.

      30-60 seconds

    • D.

      2 minutes

    Correct Answer
    C. 30-60 seconds
    Explanation
    After administering Midazolam, the onset of the drug can be expected to occur within 30-60 seconds. This means that the effects of the drug will start to be noticeable within this time frame. It is important to monitor the patient closely during this period to assess the effectiveness of the drug and to ensure that any desired sedative or anxiolytic effects are achieved.

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  • 20. 

    When doing a pre-op evaluation for a pt you notice the pt has low albumin levels. How would this effect the amount of Midazolam given to the pt for pre-medication?

    • A.

      You would need to increase the amount given in order to reach the desired effect

    • B.

      You would not change the dose at all.

    • C.

      You would decrease the amount of drug given since this pt may be at risk for overdose.

    Correct Answer
    C. You would decrease the amount of drug given since this pt may be at risk for overdose.
    Explanation
    Low albumin levels can affect the distribution of drugs in the body. Albumin is a protein that helps transport drugs in the bloodstream. When albumin levels are low, there is less protein available to bind to drugs, leading to an increased concentration of free, unbound drug in the bloodstream. This means that the same dose of a drug can have a stronger effect in a patient with low albumin levels compared to a patient with normal levels. Therefore, to avoid the risk of overdose, the amount of Midazolam given to a patient with low albumin levels should be decreased.

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  • 21. 

    Put these medications in order of shortest elimination half time to longest: Midazolam, Diazepam, Lorazepam

    • A.

      Midazolam < Diazepam < Lorazepam

    • B.

      Diazepam < Lorazepam < Midazolam

    • C.

      Lorazepam < Midazolam < Diazepam

    • D.

      Midazolam < Lorazepam < Diazepam

    Correct Answer
    D. Midazolam < Lorazepam < Diazepam
    Explanation
    Midazolam has the shortest elimination half-time, followed by Lorazepam, and then Diazepam.

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  • 22. 

    What is the elimination half time of Midazolam?

    • A.

      21-37 hours

    • B.

      1-4 hours

    • C.

      10-20 hours

    • D.

      5-10 hours

    Correct Answer
    B. 1-4 hours
    Explanation
    The elimination half-time of Midazolam is 1-4 hours. This means that it takes 1-4 hours for the concentration of Midazolam in the body to decrease by half. After this time, half of the drug has been eliminated from the body. This information is important for determining the dosing frequency and duration of action of Midazolam.

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  • 23. 

    What is the elimination half time of Lorazepam?

    • A.

      1-4 hours

    • B.

      21-37 hours

    • C.

      10-20 hours

    • D.

      5-10 hours

    Correct Answer
    C. 10-20 hours
    Explanation
    The elimination half-life of a drug refers to the time it takes for half of the drug to be eliminated from the body. In the case of Lorazepam, the correct answer is 10-20 hours. This means that it takes between 10 to 20 hours for half of the Lorazepam dose to be eliminated from the body. After several half-lives, the drug is considered to be effectively eliminated from the body.

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  • 24. 

    What is the elimination half time of Diazepam?

    • A.

      5-10 hours

    • B.

      1-4 hours

    • C.

      10-20 hours

    • D.

      21-37 hours

    Correct Answer
    D. 21-37 hours
    Explanation
    The elimination half-time of Diazepam is the time it takes for the concentration of the drug in the body to decrease by half. The given answer of 21-37 hours suggests that it takes between 21 and 37 hours for Diazepam to be eliminated from the body. This indicates that Diazepam is eliminated relatively slowly, compared to the other options provided.

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  • 25. 

    What effects do benzodiazepines exert upon the cardiovascular system?

    • A.

      No effect on cardiovascular system, even at high doses.

    • B.

      Decrease BP & PVR, especially in hypovolemic pt

    • C.

      Decrease ABP, CO & HR

    • D.

      Increase HR and decrease SV

    Correct Answer
    B. Decrease BP & PVR, especially in hypovolemic pt
    Explanation
    Benzodiazepines, specifically in hypovolemic patients, have the effect of decreasing blood pressure (BP) and peripheral vascular resistance (PVR). This means that they can cause a decrease in the force exerted on the blood vessel walls and the resistance to blood flow, resulting in a lower BP. However, it is important to note that this effect may not be observed in all patients and may vary depending on individual factors.

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  • 26. 

    Benzodiazepines are preferred as a pre-medication for anesthesia because they do not cause any respiratory depression in patients.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Benzodiazepines are not preferred as a pre-medication for anesthesia because they can cause respiratory depression in patients.

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  • 27. 

    Which of the following is not a cerebral effect of benzodiazepines?

    • A.

      Reduce CMRO2 & CBF

    • B.

      Increase the seizure threshold to prevent seizure

    • C.

      Anti-anxiety & sedative effects

    • D.

      Direct Analgesic Effects

    Correct Answer
    D. Direct Analgesic Effects
    Explanation
    Benzodiazepines are a class of drugs that are commonly used for their sedative, anxiolytic (anti-anxiety), and anticonvulsant properties. They work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which leads to a decrease in neuronal activity. However, benzodiazepines do not have direct analgesic effects, meaning they do not directly relieve pain. This is why the correct answer is "Direct Analgesic Effects."

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  • 28. 

    Where would you find benzodiazepine receptors?

    • A.

      Primarily on the postsynaptic nerve endings in the cerebral cortex

    • B.

      Pre-synaptic nerve endings in the brain stem and spinal cord.

    • C.

      Brain, spinal cord and peripheral tissue: pre-synaptic and post synaptic.

    Correct Answer
    A. Primarily on the postsynaptic nerve endings in the cerebral cortex
    Explanation
    Benzodiazepine receptors are primarily found on the postsynaptic nerve endings in the cerebral cortex. This means that these receptors are located on the receiving end of the synapse in the outer layer of the brain. They play a role in the regulation of neurotransmitters and are involved in processes such as sleep, anxiety, and muscle relaxation. While benzodiazepine receptors may also be found in other areas such as pre-synaptic nerve endings in the brain stem and spinal cord, the primary location is in the cerebral cortex.

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  • 29. 

    What is a non-competitive antagonist?

    • A.

      A drug which alters the physiology of a cell by binding to plasma membrane or intracellular receptors

    • B.

      Binds to a site other than the agonist-binding domain

    • C.

      A drug which really hates playing sports, and instead takes a bunch of art classes.

    • D.

      A drug which inhibits a normal cellular function by competing with agonists for receptors

    Correct Answer
    B. Binds to a site other than the agonist-binding domain
    Explanation
    A non-competitive antagonist is a drug that binds to a site other than the agonist-binding domain. This means that it does not compete with agonists for the same binding site on a receptor. Instead, it binds to a different site on the receptor, causing a conformational change that prevents the agonist from binding and activating the receptor. As a result, the non-competitive antagonist inhibits the normal cellular function that would have been activated by the agonist.

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  • 30. 

    Why should you be cautious when giving both an opioid and a benzo together?

    • A.

      You increase risk for arrythmias

    • B.

      Patient may lose respiratory drive

    • C.

      You may increase ICP & SVR

    • D.

      You may severely reduce ABP

    Correct Answer
    D. You may severely reduce ABP
    Explanation
    When giving both an opioid and a benzo together, you should be cautious because it may severely reduce ABP (arterial blood pressure). Opioids and benzodiazepines both have sedative effects and can cause respiratory depression. When used together, they can potentiate each other's effects, leading to excessive sedation and potentially causing a severe drop in blood pressure. This can be dangerous and may result in hypotension and inadequate perfusion to vital organs. Therefore, it is important to closely monitor the patient's blood pressure and respiratory status when administering these medications concurrently.

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  • 31. 

    What drug would you choose to treat a pt with a benzodiazepine overdose?

    • A.

      Flumazenil, slow titration of 0.2 mg doses IV

    • B.

      Narcan, slow titration of 1-4mcg/kg

    • C.

      Flurazepam 15-30 mg

    • D.

      Just wait it out.

    Correct Answer
    A. Flumazenil, slow titration of 0.2 mg doses IV
    Explanation
    Flumazenil is the correct answer for treating a patient with a benzodiazepine overdose because it is a specific benzodiazepine receptor antagonist. By administering slow titration of 0.2 mg doses intravenously, Flumazenil can competitively inhibit the effects of benzodiazepines, reversing their sedative and respiratory depressant effects. This helps to restore the patient's consciousness and respiratory function. It is important to administer Flumazenil slowly to avoid precipitating withdrawal symptoms or seizures in patients who are physically dependent on benzodiazepines.

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  • 32. 

    Which benzo would be used to treat panic attacks?

    • A.

      Lorazepam

    • B.

      Alprazolam

    • C.

      Flurazepam

    • D.

      Diazepam

    Correct Answer
    B. Alprazolam
    Explanation
    Alprazolam would be used to treat panic attacks because it is a benzodiazepine that acts on the central nervous system to produce a calming effect. It is commonly prescribed for the treatment of anxiety disorders, including panic disorder. Alprazolam works by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which helps to reduce excessive neuronal activity and promote relaxation.

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  • 33. 

    How much oral midazolam would you give to a child weighing 40 kg?

    • A.

      40 mg

    • B.

      4 mg

    • C.

      20 mg

    • D.

      60 mg

    Correct Answer
    C. 20 mg
    Explanation
    Based on the question, the correct answer is 20 mg. This suggests that for a child weighing 40 kg, the appropriate dose of oral midazolam would be 20 mg.

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  • 34. 

    Which of the following is true regarding Barbituates?

    • A.

      Composed of a benzene ring fused to a seven-membered diazepine ring, and highly acidic

    • B.

      Composed of malonic acid & urea and highly acidic

    • C.

      Derived from poppy and highly alkaline

    • D.

      Composed of malonic acid & urea and highly alkaline

    Correct Answer
    D. Composed of malonic acid & urea and highly alkaline
  • 35. 

    How long can Methohexital be refrigerated and stable for after mixing?

    • A.

      2 weeks

    • B.

      6 weeks

    • C.

      6 days

    • D.

      1 month

    Correct Answer
    B. 6 weeks
    Explanation
    Methohexital can be refrigerated and remain stable for up to 6 weeks after mixing. This means that the medication can be prepared in advance and stored in the refrigerator for a relatively long period of time before it starts to lose its potency or effectiveness. This is important information for healthcare professionals who need to prepare and store Methohexital for future use.

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  • 36. 

    Substitutions on the carbon atoms of barbituates determine all of the following except:

    • A.

      Hypnotic potency

    • B.

      Anti-convulsant properties

    • C.

      Protein binding

    • D.

      Duration of action

    Correct Answer
    C. Protein binding
    Explanation
    The substitutions on the carbon atoms of barbiturates have an impact on various properties of the drug, such as hypnotic potency, anti-convulsant properties, and duration of action. However, protein binding is not affected by these substitutions. Protein binding refers to the degree to which a drug binds to proteins in the bloodstream, and it is determined by factors other than the carbon atom substitutions in barbiturates.

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  • 37. 

    A  barbituate with an oxygen atom on the #2 carbon would be called a...

    • A.

      Thiobarbituates

    • B.

      Malobarbituates

    • C.

      Pentabarbituates

    • D.

      Oxybarbituate

    Correct Answer
    D. Oxybarbituate
    Explanation
    An oxybarbituate would be a barbituate compound that contains an oxygen atom on the #2 carbon. The prefix "oxy-" indicates the presence of an oxygen atom. Therefore, the correct answer is oxybarbituate.

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  • 38. 

    A Barbituate with a sulfur atom on the #2 carbon is called a...

    • A.

      Thiobarbituates

    • B.

      Oxybarbituates

    • C.

      Pentabarbituate

    • D.

      Sulbarbituates

    Correct Answer
    A. Thiobarbituates
    Explanation
    A barbiturate with a sulfur atom on the #2 carbon is called a thiobarbiturate. The prefix "thio-" indicates the presence of a sulfur atom, and "barbiturate" refers to the class of drugs that act as central nervous system depressants. Therefore, a barbiturate with a sulfur atom on the #2 carbon is specifically known as a thiobarbiturate.

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  • 39. 

    What is the MOA of barbituates?

    • A.

      Act at stereospecific receptors at presynaptic and postsynaptic sites in the central nervous system– brain(periaqueductal gray, amygdala, corpus striam, and hypothalmus) and spinal cord(substanstantia geltinosa) and in the peripheral tissues.

    • B.

      Depression of the reticulcar activating system, suppression of excitatory neurotranmitters and enhancement of inhibitory neurotransmitters.

    • C.

      Receptor binding enhances the inhibitory effects of various neurotransmitter by facilitating GABA receptor binding. This opens chloride gating channels, producing hyperpolarization of post synaptic cell membranes and rendering post synaptic neurons more resistant to excitation.

    Correct Answer
    B. Depression of the reticulcar activating system, suppression of excitatory neurotranmitters and enhancement of inhibitory neurotransmitters.
    Explanation
    Barbiturates act by depressing the reticular activating system, which is responsible for maintaining wakefulness and arousal. They also suppress excitatory neurotransmitters, which are involved in transmitting signals that promote alertness and activity. Additionally, barbiturates enhance inhibitory neurotransmitters, such as gamma-aminobutyric acid (GABA), which help to regulate neuronal activity and reduce excessive excitation. This combination of effects leads to sedation, relaxation, and a decrease in overall brain activity.

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  • 40. 

    Distribution of barbituates depends on all of the following except...

    • A.

      Lipid Solubility

    • B.

      Protein binding

    • C.

      Hepatic oxidation

    • D.

      Degree of ionization

    Correct Answer
    C. Hepatic oxidation
    Explanation
    Barbiturates are primarily metabolized in the liver through hepatic oxidation, so it is incorrect to say that the distribution of barbiturates depends on hepatic oxidation. The correct answer is hepatic oxidation.

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  • 41. 

    Duration of action of highly lipid soluble barbituates is determined by...

    • A.

      Hepatic Oxidation

    • B.

      Lipid Solubility

    • C.

      Renal Excretion

    • D.

      Redistribution

    Correct Answer
    D. Redistribution
    Explanation
    ppt slide 10

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  • 42. 

    How much methohexital would you expect to find excreted unchanged in the urine?

    • A.

      < 1%

    • B.

      1-3 %

    • C.

      5-10 %

    • D.

      95%

    Correct Answer
    A. < 1%
    Explanation
    Methohexital is a short-acting barbiturate used as an anesthetic. The given answer suggests that less than 1% of methohexital would be excreted unchanged in the urine. This indicates that the majority of the drug is metabolized and eliminated from the body through other routes, such as metabolism in the liver and excretion in the feces.

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  • 43. 

    The elimination half time of Methohexital is ~4 hours.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The statement is true because the elimination half-time of Methohexital is approximately 4 hours. This means that it takes around 4 hours for half of the drug to be eliminated from the body.

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  • 44. 

    What is the respiratory pattern associated with barbituates upon awakening?

    • A.

      Decrease Tv and Increase RR

    • B.

      Increase Tv and RR

    • C.

      Increase Tv and decrease RR

    • D.

      Decrease Tv and RR

    Correct Answer
    D. Decrease Tv and RR
    Explanation
    Upon awakening from barbiturate use, the respiratory pattern is characterized by a decrease in tidal volume (Tv) and an increase in respiratory rate (RR). Barbituates are central nervous system depressants that can suppress the respiratory drive and decrease the depth of breathing. As a result, the tidal volume, which is the amount of air inspired and expired during each breath, decreases. To compensate for the decreased tidal volume, the body increases the respiratory rate, which is the number of breaths taken per minute. This pattern helps maintain an adequate level of oxygenation and removal of carbon dioxide in the body.

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  • 45. 

    How are barbituate metabolized?

    • A.

      Hepatic Oxidation

    • B.

      Renal oxidation

    • C.

      Glomerular filtration

    • D.

      Broken down in small intestines and excreted in feces

    Correct Answer
    A. Hepatic Oxidation
    Explanation
    Barbiturates are metabolized through hepatic oxidation, which means that they are broken down in the liver through a process of oxidation. This is the primary method by which barbiturates are metabolized in the body. Renal oxidation and glomerular filtration refer to processes that occur in the kidneys, and are not involved in the metabolism of barbiturates. Additionally, barbiturates are not broken down in the small intestines and excreted in feces. Therefore, the correct answer is hepatic oxidation.

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  • 46. 

    Is Thiopental safe to give during pregnancy?

    • A.

      No!

    • B.

      Up to 4mg/kg, yes

    • C.

      Yes, it does not cross the placental barrier and even a high dose will not effect the fetus

    • D.

      Only minimal dose of 0.5 mg/kg.

    Correct Answer
    B. Up to 4mg/kg, yes
    Explanation
    Thiopental is safe to give during pregnancy up to a dose of 4mg/kg. This means that it can be administered without significant harm to the fetus as it does not cross the placental barrier. However, it is important to note that higher doses may have potential risks and should be avoided.

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  • 47. 

    Unlike the benzo's, Barbituates are known to increase CBF and ICP.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Barbiturates are not known to increase CBF (cerebral blood flow) and ICP (intracranial pressure). In fact, they have the opposite effect and are often used to decrease both CBF and ICP in certain medical conditions. Therefore, the statement is false.

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  • 48. 

    How much methohexital should be given to a pt undergoing ECT?

    • A.

      0.5 mg/kg IV

    • B.

      20 mg/kg via rectal suppository

    • C.

      5 mg/kg PO

    • D.

      > 1mg/kg IV

    Correct Answer
    D. > 1mg/kg IV
    Explanation
    The correct answer is "> 1mg/kg IV." This means that a dosage of methohexital greater than 1mg per kilogram of body weight should be administered intravenously to a patient undergoing ECT. This dosage is typically determined by the healthcare provider based on factors such as the patient's weight, age, and medical condition. It is important to note that this answer is specific to the given scenario and may not be applicable in other situations.

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  • 49. 

    What is the MOA of opioids?

    • A.

      Act at stereospecific receptors at presynaptic and postsynaptic sites in the central nervous system. mimic the endogenous endorphines to inhibit pain transmission.

    • B.

      Receptor binding enhances the inhibitory effects of various neurotransmitter by facilitating GABA receptor binding.

    • C.

      Depression of the reticulcar activating system, suppression of excitatory neurotranmitters and enhancement of inhibitory neurotransmitters.

    Correct Answer
    A. Act at stereospecific receptors at presynaptic and postsynaptic sites in the central nervous system. mimic the endogenous endorphines to inhibit pain transmission.
    Explanation
    Opioids act at stereospecific receptors at presynaptic and postsynaptic sites in the central nervous system. They mimic the endogenous endorphins to inhibit pain transmission. This means that opioids bind to specific receptors in the nervous system, both before and after the synapse, and imitate the natural pain-relieving substances produced by the body. By doing so, opioids are able to block the transmission of pain signals, providing analgesic effects.

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  • 50. 

    Which of the following is NOT an endogenous peptide?

    • A.

      Endorphin

    • B.

      Ekephalin

    • C.

      Dynorphine

    • D.

      Epinorphin

    Correct Answer
    D. Epinorphin
    Explanation
    Epinorphin is not an endogenous peptide because it is a synthetic opioid peptide derived from morphine, rather than being naturally produced within the body. Endorphin, enkephalin, and dynorphin are all examples of endogenous peptides, which are naturally occurring peptides that are produced by the body and play a role in various physiological processes. Epinorphin, on the other hand, is a synthetic peptide that is not naturally produced in the body.

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