Surgical Pharmacology and Anesthesia Flashcards

Which reversal agent is used to antagonize the effects of non-depolarizing neuromuscular blocking agents?

Answer: Neostigmine

Neostigmine is an acetylcholinesterase inhibitor that reverses non-depolarizing NMBAs by increasing acetylcholine at the neuromuscular junction.

A patient receives succinylcholine and develops jaw rigidity combined with a rapid rise in end-tidal CO2. The CSFA should prepare for which emergency?

Answer: Malignant hyperthermia

Masseter spasm combined with rising end-tidal CO2 after succinylcholine is a classic early warning sign of malignant hyperthermia.

Which local anesthetic has the LONGEST duration of action and is commonly used for postoperative pain blocks?

Answer: Bupivacaine

Bupivacaine is an amide local anesthetic with a long duration of action (4–12 hours), making it ideal for postoperative regional analgesia.

Ketamine's primary mechanism of action as an anesthetic involves blocking which receptor?

Answer: NMDA

Ketamine produces dissociative anesthesia by blocking NMDA (N-methyl-D-aspartate) glutamate receptors in the CNS.

When assisting with a case requiring heparin anticoagulation, which agent is used for reversal of heparin?

Answer: Protamine sulfate

Protamine sulfate binds and neutralizes heparin, reversing its anticoagulant effect within minutes.

Which volatile anesthetic agent is CONTRAINDICATED in patients with a known or suspected susceptibility to malignant hyperthermia?

Answer: Sevoflurane

Sevoflurane (and all halogenated volatile agents) can trigger malignant hyperthermia in susceptible patients and must be avoided.

A patient develops bronchospasm during anesthesia induction. Which drug class is the FIRST-LINE bronchodilator used intraoperatively?

Answer: Beta-2 agonists

Beta-2 agonists such as albuterol are first-line agents for acute bronchospasm because they rapidly relax bronchial smooth muscle.