NGR 6460 PHARMACOLOGY EXAM 1 UPDATED ACTUAL
QUESTIONS AND CORRECT ANSWERS
Question:
What is context sensitive half-time?
Answer:
The time required for blood or plasma concentrations of a drug to decrease by 50%
after discontinuation of drug infusion. Cannot be predicted by elimination half-life
because it also depends on drug distribution.
Question:
What are the two major mechanisms by which drugs are removed from the blood?
Answer:
Distribution: where the drug moves from the blood into the tissues, e.g., fat. Excretion:
where the drug is either metabolized (e.g., by the liver) or excreted from the body
unchanged (e.g., in urine).
Question:
What makes up an anesthetic?
Answer:
•Amnesia •Analgesia •Homeostasis (ANS management) •Wake up/Emergence •Post
anesthesia recovery
Question:
What is included in a preop interview?
Answer:
•Review the medical record •Review current medications •Discuss anesthetic plan
(general/regional/MAC) •Get informed consent •Assign ASA status
Question:
Chemoreceptive trigger zone is? the BBB. The vomiting center is? the BBB.
Answer:
CTZ is outside the BBB Vomiting Center is inside the BBB
Question:
Where is the chemoreceptor trigger zone located?
Answer:
area postrema of medulla oblongata
Question:
The vomiting center responds to input from:
Answer:
1. Higher cortical center (CNS)
2. Chemoreceptor trigger zone (CTZ)
3. Disturbances of the vestibular system
4. Peripheral via sensory system
, Question:
The CTZ contains which kinds of receptors?
Answer:
D2 receptors 5-HT3 receptor Opioid receptors Histamine receptors
Question:
Risk factors for PONV include:
Answer:
Female Previous history of PONV/motion sickness Non-smoker Use of post-op opioids
Question:
What is the PONV risk based on risk factors (in%)
Answer:
None: 10% One risk factor: 21% Two risk factors: 39% Three risk factors: 61% Four risk
factors: 79%
Question:
What is the reduction in PONV incidence by # of interventions performed?
Answer:
Question:
What procedures increase the risk of PONV?
Answer:
Gynecological (peritoneal/organ retraction) Opthalmic (centrally mediated) ENT (d/t
blood in mouth/stomach) Laproscopic (d/t CO2 insufflation) Intraabdominal
(peritoneal/organ retraction) Dental/Oral (d/t blood in mouth/stomach) Testicular
(vagally mediated) Breast (d/t anxiety) Neuro (d/t vestibular stimulation)
Question:
Ondansetron (Zofran): class, when to administer, peak, 1/2 life, metabolization,
pros/cons
Answer:
Serotonin receptor (5HT3) antagonist Indicated for moderate/high risk of PONV
Administer before emergence Peak of 30-60min 60% bioavailability, 3-4hr plasma
1/2-life Hepatic metabolization Pros: very selecting/potent antiemetic, non-sedating,
generally well tolerated Cons: better for vomiting than nausea, can cause QT
prolongation
Question:
Ondansetron
(Zofran) dosing
Answer:
•Adults: 0.15 mg/kg (usually 4 mg dose) •Pediatrics: 0.05-0.15 mg/kg (use 0.1 mg/kg)
•Safety not established in children < two years old •Not more efficacious after 4 mg,
max 8 mg •Give over 2-5 mins
QUESTIONS AND CORRECT ANSWERS
Question:
What is context sensitive half-time?
Answer:
The time required for blood or plasma concentrations of a drug to decrease by 50%
after discontinuation of drug infusion. Cannot be predicted by elimination half-life
because it also depends on drug distribution.
Question:
What are the two major mechanisms by which drugs are removed from the blood?
Answer:
Distribution: where the drug moves from the blood into the tissues, e.g., fat. Excretion:
where the drug is either metabolized (e.g., by the liver) or excreted from the body
unchanged (e.g., in urine).
Question:
What makes up an anesthetic?
Answer:
•Amnesia •Analgesia •Homeostasis (ANS management) •Wake up/Emergence •Post
anesthesia recovery
Question:
What is included in a preop interview?
Answer:
•Review the medical record •Review current medications •Discuss anesthetic plan
(general/regional/MAC) •Get informed consent •Assign ASA status
Question:
Chemoreceptive trigger zone is? the BBB. The vomiting center is? the BBB.
Answer:
CTZ is outside the BBB Vomiting Center is inside the BBB
Question:
Where is the chemoreceptor trigger zone located?
Answer:
area postrema of medulla oblongata
Question:
The vomiting center responds to input from:
Answer:
1. Higher cortical center (CNS)
2. Chemoreceptor trigger zone (CTZ)
3. Disturbances of the vestibular system
4. Peripheral via sensory system
, Question:
The CTZ contains which kinds of receptors?
Answer:
D2 receptors 5-HT3 receptor Opioid receptors Histamine receptors
Question:
Risk factors for PONV include:
Answer:
Female Previous history of PONV/motion sickness Non-smoker Use of post-op opioids
Question:
What is the PONV risk based on risk factors (in%)
Answer:
None: 10% One risk factor: 21% Two risk factors: 39% Three risk factors: 61% Four risk
factors: 79%
Question:
What is the reduction in PONV incidence by # of interventions performed?
Answer:
Question:
What procedures increase the risk of PONV?
Answer:
Gynecological (peritoneal/organ retraction) Opthalmic (centrally mediated) ENT (d/t
blood in mouth/stomach) Laproscopic (d/t CO2 insufflation) Intraabdominal
(peritoneal/organ retraction) Dental/Oral (d/t blood in mouth/stomach) Testicular
(vagally mediated) Breast (d/t anxiety) Neuro (d/t vestibular stimulation)
Question:
Ondansetron (Zofran): class, when to administer, peak, 1/2 life, metabolization,
pros/cons
Answer:
Serotonin receptor (5HT3) antagonist Indicated for moderate/high risk of PONV
Administer before emergence Peak of 30-60min 60% bioavailability, 3-4hr plasma
1/2-life Hepatic metabolization Pros: very selecting/potent antiemetic, non-sedating,
generally well tolerated Cons: better for vomiting than nausea, can cause QT
prolongation
Question:
Ondansetron
(Zofran) dosing
Answer:
•Adults: 0.15 mg/kg (usually 4 mg dose) •Pediatrics: 0.05-0.15 mg/kg (use 0.1 mg/kg)
•Safety not established in children < two years old •Not more efficacious after 4 mg,
max 8 mg •Give over 2-5 mins
