A practice test on anaesthesia trivia quiz! There are different types of drugs given to a patient so that they can be unconscious or some parts of their body made numb of feeling. In some instances, not drugs but gasses are used. As an aspiring anaesthetic, how much do you know about different benzodiazepines, their effect as well as consumption in different types of patients? This quiz will help you find out!
Flumazenil, slow titration of 0.2 mg doses
Nubain 10-20 mg
Lithium
Narcan 1-4 mcg/kg
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Flumazenil
Nalbuphine
Naloxone
Butorphanol
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Rapid hepatic oxidation
Rapid renal excretion
Redistribution
Patient respiratory rate
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Significant increase in initial dose and anticipate marked decrease in duration of action
Modest decrease in initial dose and anticipate marked increase in duration of action
No change in dose or frequency or duration from that of an healthy 25 year old patient.
None of above
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Inhibit or block responses caused by an agonist
Drugs which alter the physiology of a cell by binding to plasma membrane or intracellular receptors
The strength of binding between drug and receptor
Binds to a site other than the agonist-binding domain
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Nauseau & Vomiting
Seizures
Cyanosis
Increased HR
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Flumazenil, slow titration of 0.2 mg doses IV
Narcan, slow titration of 1-4mcg/kg
Flurazepam 15-30 mg
Just wait it out.
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Shortened
Prolonged
No significant change.
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You would need to increase the amount given in order to reach the desired effect
You would not change the dose at all.
You would decrease the amount of drug given since this pt may be at risk for overdose.
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21-37 hours
1-4 hours
10-20 hours
5-10 hours
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Amnesia
Anxiolysis
Analgesia
Anticonvulsant
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True
False
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Inhibit or block responses caused by an agonist
A drug which alters the physiology of a cell by binding to plasma membrane or intracellular receptors
Biochemical messengers, often called 2ndmessengers
The strength of binding between drug and receptor
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Reduce CMRO2 & CBF
Increase the seizure threshold to prevent seizure
Anti-anxiety & sedative effects
Direct Analgesic Effects
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Midazolam
Propofol
Thiopental
Etomidate
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History of neurologic distrubances
History of hemolytic amenia
Acute intermittent porphyria
Immunosuppression
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Blockade of chloride channels leading to depolarization and inhibition of neurotransmitter
Inhibition of cyclooxygenase activity
Inhibition of GABA receptor binding which leads to degredation of GABA, preventing it from exerting it's effect.
Enhances the inhibitory effects of various neurotransmitter by facilitating GABA receptor binding. This opens chloride channels and causes hyperpolarization.
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Chest wall rigidity
Fetal respiratory depression
Anterograde Amnesia
Constipation
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Thiobarbituates
Malobarbituates
Pentabarbituates
Oxybarbituate
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He is too light, Increase the sevo.
Maybe he could use some more opioids, to relieve pain.
Maybe he could use some more paralytic.
He needs a little more midazolam, to calm him.
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True
False
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Chest wall flaccidity
Increase RR with decrease Tv
Decrease RR and increase Tv
Increased response to CO2
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Any IM injection is painful
Ethyl alcohol component
Propylene glycol component
Solubility component
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All are highly alkaline solutions
Composed of a benzene ring fused to a seven-membered diazepine ring
They are safe to be given during pregnancy
Composed of malonic acid and urea
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Metabolized by liver and excreted in the urine
Metabolized in kidneys and excreted in feces
Metabolized by liver and excreted in feces
Metabolized in kidneys and excreted by urine
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Thiobarbituates
Oxybarbituates
Pentabarbituate
Sulbarbituates
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It is the only benzo safe to give to pregnant women.
Is known to cause pain upon injection, but has minimal respiratory depression
It is hydrophilic and becomes lipid soluble upon exposure to blood.
It is not highly protein bound like the other benzo's and thus more is available for use by the body.
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1/10 as potent
10 times as potent
100 times as potent
1000 times as potent
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Act at stereospecific receptors at presynaptic and postsynaptic sites in the central nervous system. mimic the endogenous endorphines to inhibit pain transmission.
Receptor binding enhances the inhibitory effects of various neurotransmitter by facilitating GABA receptor binding.
Depression of the reticulcar activating system, suppression of excitatory neurotranmitters and enhancement of inhibitory neurotransmitters.
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Hepatic Oxidation
Lipid Solubility
Renal Excretion
Redistribution
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90% metabolized to normeperidine,1/2 as active as a analgesic
By nonspecific plasma esterase inactive metabolites
Metabolized via conjugation with glucuronic acid
Metabolized via hepatic oxidation
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Sedation
Anxiolysis
Retrograde Amnesia
Anticonvulsant
Spinal Cord mediated skeletal muscle relaxation
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True
False
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The major inhibitory neurotransmitter.
An active metabolite of opioid metabolism which relieves pain
An excitatory neurotransmitter presumed to be released by terminals of pain fibers
A rapper?
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5-10 hours
1-4 hours
10-20 hours
21-37 hours
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Lipid Solubility
Protein binding
Hepatic oxidation
Degree of ionization
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Facial Redness
Stop Shivering
Hypotension
All of the above
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Because of fentanyl high lipid solubility
Because fentanyl is highly protein bound
Because Morphine has a much high lipid solubility and thus is excreted more rapidly
Because morphine has a much larger Vd.
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Lorazepam
Flumazenil
Midazolam
Diazepam
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0.5 mg/kg
0.1 mg/kg
2-3 mg
4 mg/kg
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No effect on cardiovascular system, even at high doses.
Decrease BP & PVR, especially in hypovolemic pt
Decrease ABP, CO & HR
Increase HR and decrease SV
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True
False
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Endorphin
Ekephalin
Dynorphine
Epinorphin
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Morphine 3-gluconiride which is active and induces analgesia and resp depression, & Mophine 6-gluconiride which is inactive
Morphine 3-gluconiride & Mophine 6-gluconiride both of which are inactive.
Morphine 3-gluconiride which is inactive, & Mophine 6-gluconiride which is active and induces analgesia and resp depression
Morphine 3-gluconiride & Mophine 6-gluconiride both of which are active and cause respiratory depression and analgesia
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1/10 as potent
10 times as potent
100 times as potent
1,000 as potent
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Midazolam < Diazepam < Lorazepam
Diazepam < Lorazepam < Midazolam
Lorazepam < Midazolam < Diazepam
Midazolam < Lorazepam < Diazepam
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< 1%
1-3 %
5-10 %
95%
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Nalbuphine
Narcan, carefully titrated
Flumazenil
Switch to Meperidine
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