Nagelhout Pharm 2-Final Exam questions with correct answers

Nagelhout Pharm 2-Final Exam questions with
correct answers


Ultra |short |acting |Depolarizing |neuromuscular |blocker

(Length |of |duration) |- |CORRECT |ANSWER✔✔-Succinylcholine

(5 |- |15 |minutes)



Short |Acting |Nondepolarizing |NMBs

(Length |of |duration) |- |CORRECT |ANSWER✔✔-Mivacurium

(20-30 |minutes)



Intermediate |Acting |Nondepolarizing |NMBs |(4)

(Length |of |duration) |- |CORRECT |ANSWER✔✔-Atracurium

Cisatracurium

Vecuronium

Rocuromium

(30-60 |minutes)



Long |Acting |Nondepolarizing |NMB

(Length |of |duration) |- |CORRECT |ANSWER✔✔-Pancuronium

(60-90 |minutes)



NMB |Reversal |Agents |(3) |- |CORRECT |ANSWER✔✔-Neostigmine

Edrophonium

Sugammadex

,NMBs |work |at |____ |receptors |- |CORRECT |ANSWER✔✔-Nicotinic |Cholinergic |(sub-m)



Nicotinic |Cholinergic |(sub-m) |use |positive |or |negative |feedback? |- |CORRECT |ANSWER✔✔-
Positive |feedback. |This |explains |fade |with |NDMBs.



Neurotransmitter |of |the |NM |junction |- |CORRECT |ANSWER✔✔-acetylcholine



Breaks |down |acetylcholine |at |the |NM |synapse/junction |- |CORRECT |ANSWER✔✔-
acetylcholinesterase



Phase |2, |Non-depolarizing |agents |are: |agonists |or |antagonists |- |CORRECT |ANSWER✔✔-
Antagonist



Phase |1, |Depolarizing |agents |act |as: |agonist |or |antagonist?? |- |CORRECT |ANSWER✔✔-Agonist |
then |antagonist



Train |of |Four |Ratio |- |CORRECT |ANSWER✔✔-Strength |of |4th |twitch:Strength |of |1st |twitch |
(when |it |is |90% |patient |considered |recovered)



Best |nerve/muscle |to |measure |onset |of |NMB |- |CORRECT |ANSWER✔✔-Facial |Nerve

Orbicularis |Oculi |(Corrugator |supercilii |= |best)

(reflects |diaphragm |blockade)

(negative-black |electrode |over |nerve)



Best |nerve/muscle |to |measure |emergence |from |NMB |- |CORRECT |ANSWER✔✔-Ulnar |Nerve

Adductor |Pollicis

Measures |thumb |adduction |(Red |proximal)

,Single |Twitch |Test |- |CORRECT |ANSWER✔✔-1.0 |Hz

Single |stimulus

Compares |pre |(baseline) |and |post |NMB |hand |twitch



Train |of |Four |Test |- |CORRECT |ANSWER✔✔-4 |- |2 |Hz |twitches

Compares |4th |twitch |to |1st |twitch |(fade)

Reflects |70-100% |blockade

*Succ |has |no |fade, |all |4 |twitches |equal*



Double |Burst |Simulation |(DBS) |Test |- |CORRECT |ANSWER✔✔-2 |- |50 |Hz |twitches

0.75 |seconds |apart

Compares |2 |twitches |to |monitor |for |fade



Tetanus |Test |- |CORRECT |ANSWER✔✔-100 |Hz |twitch |for |5 |seconds

Painful



Posttetanic |Count |Test |- |CORRECT |ANSWER✔✔-50 |Hz |stimulus |for |5 |sec |→ |3 |sec |pause |→ |1 |
Hz |single |twitch |every |second

Only |used |when |patient |is |100% |paralyzed

0 |= |call |for |ventilator |(>9 |minutes |til |TOF)

4 |= |4 |minutes |until |TOF |possible

8= |0-2 |minutes |until |TOF



Sequence |of |muscle |paralysis |- |CORRECT |ANSWER✔✔-1. |Eyelids |(Protective |muscles |of |
pharynx)

2. |Extremities

, 3. |Chest |(neck |downward)

4. |Abdominal |muscles

5. |Diaphragm



Muscles |not |affected |by |NMBs |(4) |- |CORRECT |ANSWER✔✔-1. |Cardiac |muscle

Smooth |muscle:

2. |Bronchi |(can't |treat |bronchospasm |with |NMBs)

3. |Uterus

4. |GI/bowels



Sequence |of |muscle |recovery |from |NMB |- |CORRECT |ANSWER✔✔-1. |Diaphragm

2. |Abdominal |muscles

3. |Chest |(upward)

4. |Extremities

5. |Eyelids

*6. |Protective |muscles |reflexes |of |pharynx



1/4 |Train |of |Four |will |take |___ |minutes |for |recovery |- |CORRECT |ANSWER✔✔-30 |minutes



2-3/4 |Train |of |Four |will |take |___ |minutes |for |recovery |- |CORRECT |ANSWER✔✔-4-15 |minutes |
(intermediate |acting |relaxant)

30 |minutes |(Pancuronium)



4/4 |Train |of |Four |will |take |___ |minutes |for |recovery |- |CORRECT |ANSWER✔✔-5 |minutes |with |
Neostigmate

2-3 |minutes |with |Edrophonium