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f93094ae-4a43-5df3-bf52-6475c1db7aef
Whta is MOA of Ketamine?
Selective modulation of GABA receptors
Non-competitive antagonist binding to the phencyclidine recognition site on the NMDA receptor & acts on opioid receptors
Through binding to and activating alpha subunit receptors to cause sustained depolarization.
Inhibition of acetycholinesterase
4
B
1
null
null
null
null
null
57c945f5-a5b6-5789-b38d-2a3868a9b696
Which of the non-barbituate agents has the lowest amount of protein binding & works on NMDA receptors?
Propofol
Ketamine
Etomidate
Thiopental
4
B
1
null
null
null
null
null
956cc563-f8d0-510d-85a2-e68f83bda3e0
Which of the following is not at an increased risk for Malignant Hyperthermia?
Patient with Muscular Dystrophy
Patient who is immunosuppressed
Patient who had a heat stroke last year while playing outdoors
Patients whose mother has MH.
4
B
1
null
null
null
null
null
d83f4f04-7112-52b1-aabf-3aff1610c7d4
What is the incidence of Malignant hyperthermia in adults?
1: 50,000
1: 100,000
1: 15,000
1: 250,000
4
A
1
null
null
null
null
null
c5a32c89-8287-5255-acc4-b9d1dc923564
How much atropine would you give to a patient receiving 40mg Edrophoinium?
0.28 mg
0.56 mg
0.8 mg
4 mg
4
B
2
null
null
null
null
null
c9ee1620-6173-5c11-a23d-46d8bafac821
What is an appropriate induction dose of propofol for a 50 yr old male who is 5’10” and weighs 80 kg?
80 mg
160 mg
16 mg
400 mg
4
B
2
null
null
null
null
null
92036d0d-450c-5217-8888-c187dcd43b69
How do we prevent the muscarinic effects of cholinesterase inhibitors?
By delivering small doses calculated on patient weight
By pre-medication with an opioid
Through inactivation of acetylcholinesterase
By concurrently administering an anticholinergic drug
4
D
1
null
null
null
null
null
1268fc00-0a07-5dd6-8b83-54e47164ac8f
Regaining 4/4 twitches after administration of a non-depolarizing muscle relaxant means that you no longer need to administer a reversal agent.
True
False
null
null
2
B
2
null
null
null
null
null
cafaf1b2-4da2-5584-9095-dbfce49810b0
When caring for children you should ALWAYS give the anticholinergic and the cholinesterase inhibitor together  in one syringe.
True
False
null
null
2
B
1
null
null
null
null
null
18847cbd-93de-5ec8-a131-46a33bb3362f
What would be an appropriate starting dose of dantrolene to give to a 2 yr old child weighing 14 kg?
14 mg
140 mg
35 mg
280 mg
4
C
2
null
null
null
null
null
edc0ab7f-94ff-5b29-91f9-9a8c04d4260c
You have a patient in the PACU who has been receiving morphine and is now itching from the pain medications. What might you give to help relieve the itching?
Ketamine 0.2 mg/kg
Propofol 10 mg
Etomidate 0.1 mg/kg
Propofol 50 mg
4
B
2
null
null
null
null
null
3c81ff92-3355-53f6-b206-72b609a79c84
What is an appropriate intubating dose of Rocuronium?
1-1.5 mg/kg
.08-0.1 mg/kg
0.6-1.2 mg/kg
0.15-0.2 mg/kg
5
C
1
0.4-0.5 mg/kg
null
null
null
null
13a99971-4bd2-50f4-96ff-5a8640694b04
Propofol is metabolized extensively in the liver, as well as in the lungs and other sites. How will hepatic disease affect the half life of Propofol?
Effects can be prolonged
Decrease the half life
Contraindicated in liver disease
null
3
A
2
null
null
null
null
null
f0ed30a0-b7b6-59b4-b975-e8b861df8f39
What is the purpose of giving lidocaine prior to administration of propofol?
To make the propofol slightly more acidic
To prevent allergic reaction to egg lecithin
To prevent burning upon injection
To decrease ability of bacteria to grow in propofol
4
C
1
null
null
null
null
null
7dd2c400-b856-57dd-9a83-5103c99fe427
What is an appropriate dose of propofol sedation during a MAC case?
25-100 mcg/kg/min
1.5-2.5 mg/kg
100-300 mcg/kg/min
3-5 mg/kg
4
A
1
null
null
null
null
null
ab770253-7ccb-5a6b-8bee-1bfc12a39611
What is the mechanism of action of the cholinesterase inhibitors?
Attenuate the peripheral muscarinic effects of NMBA's.
Inhibition of the hydrolysis of acetylcholine resulting in greater availability at its sites of action
Through binding to and activating alpha subunit receptors to cause sustained depolarization.
Selective inhibition of GABA
4
B
1
null
null
null
null
null
d96c6b91-08c3-5a61-a465-5c2a01707a24
Which of the following muscle relaxants allows you to skip use of a reversal agent?
Mivacurium
Vecuronium
Pancuronium
Rocuronium
4
A
1
null
null
null
null
null
11f72922-24d4-56e6-81cb-4e71085ddef3
When can your reversal agents be administered?
When you have 0/4 twitches
When you have at least 1 /4 twitches
You must have 4/4 twitches prior to administration
After your anesthetic agent has been turned off.
4
B
1
null
null
null
null
null
fbc50605-97e6-544e-9e95-bb0275117aff
Which opioid receptor causes dysphoria, miosis, diuresis & sedation?
Mu1
Mu2
Kappa
Delta
4
C
1
null
null
null
null
null
fc770dd3-3374-57f6-8386-a95eb0dd3487
You are caring for Mr. X who is currently having a Left BKA. You notice his HR increasing and take a quick glance at his pupils to see they are normal size. His train of four is currently 0/4. What does this tell you?
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.
4
B
2
null
null
null
null
null
cc956756-d615-50b1-baf9-5bcd745c1821
What is the onset of action for Morphine?
2 hours
30-60 seconds
15-30 minutes
5-10 minutes
4
C
1
null
null
null
null
null
550a41ef-c4ec-5982-ba46-d99717a70c23
Which of the following effects is NOT associated with morphine.
Facial Redness
Stop Shivering
Hypotension
All of the above
4
B
1
null
null
null
null
null
96d1fbf1-1ce3-5831-ab9b-d3ebbf451d73
Which of the opioids will NOT cause miosis?
Morphine
Fentanyl
Meperidine
Narcan
4
C
1
null
null
null
null
null
b39f27f1-7405-5227-bf8c-a5cd5e405003
Which opioid has the highest degree of lipid solubility?
Sufentanil
Remifentanil
Fentanyl
Morphine
4
C
1
null
null
null
null
null
568deac3-febe-5b30-a319-a83117511fcd
You are caring for Mrs. Tica who has a past history of A-fib, DM, pancreatitis & asthma. Which drug would you choose to relieve her pain?
Toradol
Morphine
Ethanol
Fentanyl
4
D
3
null
null
null
null
null
7c8ad3dd-3f5c-5741-998f-30d78eed62b9
Why is remifentanil unique among the opioids?
Can be safely given to asthmatics and those on MAOI's
Does not cause miosis
Context sensitive half time independent of infusion time.
Most rapid onset with large Vd.
4
C
1
null
null
null
null
null
1d6b1166-5636-5e26-bee4-4b2eee990063
Fentanyl has a much more rapid onset but a longer elimination half time than Morphine. Why?
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.
4
A
1
null
null
null
null
null
59b3690b-7c69-5c64-a46b-52c55f029abb
Which medication would you give to reliev post-op itching caused by Morphine?
Narcan 1-4 mcg/kg IV
Flumazenil, titrate by doses of 0.2 mg
Nubain 10-20 mg IV
Meperidine
4
C
2
null
null
null
null
null
9114db64-e294-5b5b-9abf-12cb74148b90
Which of the following benzodiazepines is most commonly used during the preoperative period and for IV conscious sedation?
Diazepam
Lorazepam
Midazolam
Alprazolam
4
C
1
null
null
null
null
null
3821c09a-0648-5ebe-a01b-362ecfb1c82c
Which adverse reaction is a patient most likely to experience after receiving general anesthesia?
Nauseau & Vomiting
Seizures
Cyanosis
Increased HR
4
A
1
null
null
null
null
null
6d87489e-0f64-57fb-889e-42f24df8ad8a
What is responsible for the pain reaction elicited when diazepam is given IM?
Any IM injection is painful
Ethyl alcohol component
Propylene glycol component
Solubility component
4
C
1
null
null
null
null
null
8473d9d5-042f-5114-a363-18c3254e80f7
Which of the following is not one of the Five Principle pharmacological effects of Benzodiazepines?
Sedation
Anxiolysis
Retrograde Amnesia
Anticonvulsant
5
C
1
Spinal Cord mediated skeletal muscle relaxation
null
null
null
null
773f100d-92cf-5148-9d9f-7db08f66a71f
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?
Lorazepam
Diazepam
Midazolam
Thiopental
4
B
2
null
null
null
null
null
5015fb3b-f571-5df3-982f-815c8ca71784
In regards to the adjustments of Benzodiazepines in respect to the elderly patient.  Would you expect to have:
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
4
B
2
null
null
null
null
null
e8bca84d-bb57-50b0-a895-8a47ad7ca930
The dose of Benzodiazepines required to reach a desired clinical end point is increased in the elderly compared to the younger patient.
True
False
null
null
2
B
1
null
null
null
null
null
91f7b8e1-a099-5779-8339-fb4db0dc90cf
Benzodiazepines are extensively protein bound.  Therefore, in the presence of renal failure their clinical effect will be:
Shortened
Prolonged
No significant change.
null
3
B
2
null
null
null
null
null
9aa91ec0-5546-5e47-be41-0d2f736c5e85
A drug that alters the physiology of a cell by binding to the plasma membrane or intracellular receptors is known as what?
Antagonist
Competitive Agonist
Competitive Antagonist
Agonist
4
D
1
null
null
null
null
null
7f87ba2e-3a41-54ec-9e52-2d128a069d85
What is an antagonist?
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
4
A
1
null
null
null
null
null
0ab33f4d-bf06-540e-9910-58879406e5e7
What is the MOA of Benzos?
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.
4
D
1
null
null
null
null
null
357a17e4-443e-5b3a-b277-41b6ef9b1d55
All benzos share what similarities?
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
4
B
1
null
null
null
null
null
89f05e21-88ce-59e5-afe9-e42a81706922
How is midazolam unique in comparison to other benzos?
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.
4
C
1
null
null
null
null
null
36d134d4-cf0b-5371-83b9-6af036a8e57e
Which of the following drugs will cause pain upon injection due to the solvent propylene glycol?
Lorazepam
Flumazenil
Midazolam
Diazepam
4
D
1
null
null
null
null
null
8d12d7c2-228d-55b2-9010-23fd96675870
What would be an appropirate Adult IV induction dose for midazolam?
0.5 mg/kg
0.1 mg/kg
2-3 mg
4 mg/kg
4
B
1
null
null
null
null
null
c585f8b9-5484-5762-a307-1f20f611ab8b
What is the elimination half time of Midazolam?
21-37 hours
1-4 hours
10-20 hours
5-10 hours
4
B
1
null
null
null
null
null
747468b2-6765-577d-be37-dc14ca79a624
What is the elimination half time of Diazepam?
5-10 hours
1-4 hours
10-20 hours
21-37 hours
4
D
1
null
null
null
null
null
76b8c0e9-d2e3-5a1d-b896-638d60ae3a56
Describe the metabolism and excretion of the benzodiazepines?
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
4
A
1
null
null
null
null
null
a8198545-da9e-51f8-a90e-429be2f0d846
What effects do benzodiazepines exert upon the cardiovascular system?
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
4
B
1
null
null
null
null
null
d65ff90d-1ca6-5c2a-be33-f9c845008248
Which of the following is not a cerebral effect of benzodiazepines?
Reduce CMRO2 & CBF
Increase the seizure threshold to prevent seizure
Anti-anxiety & sedative effects
Direct Analgesic Effects
4
D
1
null
null
null
null
null
25f2f4cf-b955-5b02-84e8-6e21554c9be3
Where would you find benzodiazepine receptors?
Primarily on the postsynaptic nerve endings in the cerebral cortex
Pre-synaptic nerve endings in the brain stem and spinal cord.
Brain, spinal cord and peripheral tissue: pre-synaptic and post synaptic.
null
3
A
1
null
null
null
null
null
f64badad-21d4-5c13-8d5f-64485ab52f7c
What is a non-competitive antagonist?
A drug which alters the physiology of a cell by binding to plasma membrane or intracellular receptors
Binds to a site other than the agonist-binding domain
A drug which really hates playing sports, and instead takes a bunch of art classes.
A drug which inhibits a normal cellular function by competing with agonists for receptors
4
B
1
null
null
null
null
null
e8a0dd46-5175-5d80-8174-f3be61fc1512
What drug would you choose to treat a pt with a benzodiazepine overdose?
Flumazenil, slow titration of 0.2 mg doses IV
Narcan, slow titration of 1-4mcg/kg
Flurazepam 15-30 mg
Just wait it out.
4
A
1
null
null
null
null
null
0c01de2d-2e67-5485-9ebd-dca92118b4d9
Which benzo would be used to treat panic attacks?
Lorazepam
Alprazolam
Flurazepam
Diazepam
4
B
1
null
null
null
null
null
9cf178f3-0b10-5f0b-a906-1885eb2a307c
How much oral midazolam would you give to a child weighing 40 kg?
40 mg
4 mg
20 mg
60 mg
4
C
2
null
null
null
null
null
0e69aae9-08e5-5bf8-9c2a-ef8f34193ffe
You are holding a room temperature bottle of thiopental that was mixed 5 days ago. Can you still use it?
Yes, still good!
Nope, it is only stable for 2 days
If it had been refrigerated it would be good, but now it is not. Don't use.
null
3
A
1
null
null
null
null
null
d2ed33c8-8b86-5998-9fb3-fabbe409b76a
A Barbituate with a sulfur atom on the #2 carbon is called a...
Thiobarbituates
Oxybarbituates
Pentabarbituate
Sulbarbituates
4
A
1
null
null
null
null
null
296a5893-d98e-58c3-83ed-bdca13329b49
What is the MOA of barbituates?
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.
Depression of the reticulcar activating system, suppression of excitatory neurotranmitters and enhancement of inhibitory neurotransmitters.
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.
null
3
B
1
null
null
null
null
null
ef347e06-8405-5d91-86a6-d02a77c7c235
Duration of action of highly lipid soluble barbituates is determined by...
Hepatic Oxidation
Lipid Solubility
Renal Excretion
Redistribution
4
D
1
null
null
null
null
null
ff127121-6c5f-5f20-88cf-470aed6df2d0
The elimination half time of Methohexital is ~4 hours.
True
False
null
null
2
A
1
null
null
null
null
null
55eaaf89-b6e2-53c4-a345-a270ebfa034d
What is responsible for the quick awakening associated with a single dose of thiopental?
Rapid hepatic oxidation
Rapid renal excretion
Redistribution
Patient respiratory rate
4
C
1
null
null
null
null
null
b4abb820-f0d8-597b-b326-750b651f8daf
Unlike the benzo's, Barbituates are known to increase CBF and ICP.
True
False
null
null
2
B
1
null
null
null
null
null
92280ffb-4481-5ee8-b9c3-f40075ae4ffa
How much methohexital should be given to a pt undergoing ECT?
0.5 mg/kg IV
20 mg/kg via rectal suppository
5 mg/kg PO
> 1mg/kg IV
4
D
1
null
null
null
null
null
3a5922c2-09c3-5e77-9979-1da83eb3d319
What is the MOA of opioids?
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.
null
3
A
1
null
null
null
null
null
ba4422c4-0ff2-5ea3-a1f6-15bbf8aa78b4
Which of the following is NOT an endogenous peptide?
Endorphin
Ekephalin
Dynorphine
Epinorphin
4
D
1
null
null
null
null
null
b91cb59b-88e0-5535-be68-de7648bd5688
Which opioid receptor produces ONLY spinal analgesia.
Mu2
Kappa
Mu1
Delta
4
A
1
null
null
null
null
null
32c39b6d-3c89-5e96-a0bb-40918ad2950c
What are the metabolites of morphine?
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
4
C
1
null
null
null
null
null
a50c7caa-fbd5-5481-86df-0b215296523b
30mg of Ketorolac would be equivalent to how much morphine?
1 mg
30 mg
15 mg
10 mg
4
D
1
null
null
null
null
null
ba9d9317-179e-5beb-8395-c067ce4bad12
Put these medications in order of shortest elimination half time to longest: Midazolam, Diazepam, Lorazepam
Midazolam < Diazepam < Lorazepam
Diazepam < Lorazepam < Midazolam
Lorazepam < Midazolam < Diazepam
Midazolam < Lorazepam < Diazepam
4
D
1
null
null
null
null
null
eea2956f-9c9a-5188-8527-244527257dcb
Which opioid receptors are responsible for physical dependence?
Mu1 & Mu2
Mu2 & Delta
Mu1 & Kappa
Kappa & Delta
4
B
1
null
null
null
null
null
d942e7f5-2491-5395-ab9d-8cc420622540
What is the respiratory pattern associated with barbituates upon awakening?
Decrease Tv and Increase RR
Increase Tv and RR
Increase Tv and decrease RR
Decrease Tv and RR
4
D
1
null
null
null
null
null
ab0b5120-5aa1-5c3e-9dd4-8718b2a4b255
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?
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.
null
3
C
2
null
null
null
null
null
d312e61a-01ce-553b-aaaa-c52203bde507
What is GABA?
The major excitatory neurotransmitter and is important in agonizing the effects of amino acid transmitter.
Proteins or glycoproteins that are present on the cell surface, on an organelle within the cell, or in the cytoplasm.
The major inhibitory neurotransmitter and is important in antagonizing the effects of amino acid transmitter.
Refers to the portion of the chemical structured composed of a benzene ring fused to a seven-membered diazepine ring
4
C
1
null
null
null
null
null
1946abb2-552f-584b-b6f7-f460cdbd2bf6
How does Sufentanil compare to Morphine?
1/10 as potent
10 times as potent
100 times as potent
1,000 as potent
4
D
1
null
null
null
null
null
6d75c970-2b1c-5c13-887b-46530dd4f375
Which benzodiazepine is primarily used for induction of anesthesia?
Midazolam
Propofol
Thiopental
Etomidate
4
A
1
null
null
null
null
null
1fd46658-3ada-5cae-b597-4c220ec5c08f
Which of the following is not an effect of opiods?
Chest wall rigidity
Fetal respiratory depression
Anterograde Amnesia
Constipation
4
C
1
null
null
null
null
null
8bd9ba5c-b64e-55d3-a014-ee345c484534
Which of the following is not a factor which increases risk of respiratory depression with opioids?
High opioid dose
High lipid solubility
Administration of other sedatives
Lack of tolerance
5
B
1
Advanced age
null
null
null
null
dcc7cad1-cf8b-5461-878b-32965d9f73cc
How is remifentanil different than other opioids?
Shortest acting opioid
Stronger acting than Fentanyl
Structurally unique due to ester linkage
Few side effects
4
C
1
null
null
null
null
null
465938ed-19df-5bad-a437-ad3254c8dc05
Substitutions on the carbon atoms of barbituates determine all of the following except:
Hypnotic potency
Anti-convulsant properties
Protein binding
Duration of action
4
C
1
null
null
null
null
null
eaadfcb9-138d-5418-aa29-c43e98128240
What would be an appropriate loading dose for remifentanil?
5-20 microgram
1 mcg/kg
0.5 mg/kg
5 mcg/kg
4
B
1
null
null
null
null
null
5f898723-e0de-5c56-bd73-a8861a97e113
Is Thiopental safe to give during pregnancy?
No!
Up to 4mg/kg, yes
Yes, it does not cross the placental barrier and even a high dose will not effect the fetus
Only minimal dose of 0.5 mg/kg.
4
B
1
null
null
null
null
null
ea601da0-3d77-5146-9a29-cb01ff06251a
A  barbituate with an oxygen atom on the #2 carbon would be called a...
Thiobarbituates
Malobarbituates
Pentabarbituates
Oxybarbituate
4
D
1
null
null
null
null
null
19a320af-699f-5ca4-b2b8-40b04d8a732b
Sodium Thiopental is a contraindication in which patients?
History of neurologic distrubances
History of hemolytic amenia
Acute intermittent porphyria
Immunosuppression
4
C
1
null
null
null
null
null
c79c49eb-7cab-5b5c-8e8f-dee1ce484a5a
Which opioid receptor causes depression of ventilation, physical dependence, minimal constipation & urinary retention?
Mu1
Mu2
Kappa
Delta
4
D
1
null
null
null
null
null
e40d163a-bf9c-5137-beee-a73edcad95b1
How is midazolam unique in comparison to other benzo's?
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.
4
C
1
null
null
null
null
null
8d5e280a-2e1f-57c5-80ef-debc16cabd47
Benzodiazepines are preferred as a pre-medication for anesthesia because they do not cause any respiratory depression in patients.
True
False
null
null
2
B
1
null
null
null
null
null
3f3bde22-a38a-5cea-ae48-f44a7acc5e53
How do midazolam and diazepam compare to one another?
Midazolam has 2 times the affinity for benzo receptors
Diazepam has 3 times the affinity for benzo receptors
Diazepam is hydrophilic
Midazolam has a much londer elimination half time
4
A
1
null
null
null
null
null
dd9aadf8-d9ec-584b-913f-6a811d951de5
What is the MOA of Benzo's?
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.
4
D
1
null
null
null
null
null
2f825960-94d1-5973-ba51-5a64494402aa
Which of the Benzodiazepines reviewed has the slowest onset of action and why?
Lorazepam- due to lower lipid solubility
Midazolam- due to its water solubility
Diazepam- due to rapid redistribution
null
3
A
1
null
null
null
null
null
bdf0f8f2-9787-57bc-9704-df783841293d
What is Substance P?
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?
4
C
1
null
null
null
null
null
f2da649e-ae0c-5ac9-891f-bbc37e84fa4c
A Competitive antagonist binds to a site other than the agonist binding domain.
True
False
null
null
2
B
1
null
null
null
null
null
f817846f-6736-5d23-b43f-7dc734999f79
How does meperidine compare to morphine?
1/10 as potent
10 times as potent
100 time as potent
1,000 times as potent
4
A
1
null
null
null
null
null
4a0833f1-e61a-5d08-8a7f-f1601fc72a97
Which of the following is true regarding benzodiazepines?
Amnesitic effects are greater than sedative effects
Produce sufficient skeletal muscle relaxation for surgery
Have a high tendency of tolerance compared to barbiturates
Longer duration of sedation than amnesia
4
A
1
null
null
null
null
null
6708492a-04e5-56e6-867a-b915c3f11dc1
Which of the following is NOT a pharmacological effect of benzodiazepines?
Amnesia
Anxiolysis
Analgesia
Anticonvulsant
4
C
1
null
null
null
null
null
3947f0e1-574f-5c9c-87ba-8658fe995031
How is remifentanil metabolized?
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
4
B
1
null
null
null
null
null
8dfa4aa3-1282-55f9-b7ee-2c706bc0c71a
Endorphin stimulates which opioid receptor?
Mu
Kappa
Delta
null
3
A
1
null
null
null
null
null
dba1b1f8-07d3-5050-a1fc-7a306e0580f1
Distribution of barbituates depends on all of the following except...
Lipid Solubility
Protein binding
Hepatic oxidation
Degree of ionization
4
C
1
null
null
null
null
null
bd4ecc93-bfa5-5650-ac00-702f9d4ed957
Which benzodiazepine is primarily used to treat anxiety?
Lorazepam
Midazolam
Diazepam
Temazepam
4
A
1
null
null
null
null
null
b868440d-d858-50e2-852c-a37217501a84
How does fentanyl compare to morphine?
1/10 as potent
10 times as potent
100 times as potent
1000 times as potent
4
C
1
null
null
null
null
null
30e67074-ffaa-50df-8be7-1430dd919d76
Why should you be cautious when giving both an opioid and a benzo together?
You increase risk for arrythmias
Patient may lose respiratory drive
You may increase ICP & SVR
You may severely reduce ABP
4
D
2
null
null
null
null
null
87788817-1cff-5141-b623-ae3ac003fea0
Epidural or subarachnoid placement of opioids is based on activation of which receptors?
Kappa
Mu
Delta
All the above
4
B
1
null
null
null
null
null
2bd18367-c09f-5f20-abd4-c462f65cef55
What is the half life of Narcan?
60-90 minutes
30-45 minutes
3 hours
4-6 hours
4
A
1
null
null
null
null
null