CGRN Pharmacology and Sedation 2

Question 1

What is the mechanism of action of propofol used for endoscopic sedation?

Accepted Answer

GABA-A receptor potentiation

Answer

Opioid receptor agonist

Answer

NMDA receptor antagonist

Answer

Serotonin receptor modulation

Question 2

A patient receiving fentanyl and midazolam becomes unresponsive. Which medication should be given first?

Accepted Answer

Naloxone 0.04-0.1 mg IV titrated

Answer

Flumazenil 0.2 mg IV

Answer

Naloxone 0.4 mg IV

Answer

Epinephrine 1 mg IV

Question 3

Which PPI has the strongest CYP2C19 inhibition and highest drug interaction potential?

Accepted Answer

Omeprazole

Answer

Pantoprazole

Answer

Esomeprazole

Answer

Rabeprazole

Question 4

What is the primary advantage of CO2 insufflation over room air during endoscopy?

Accepted Answer

CO2 is absorbed 150 times faster than nitrogen, reducing post-procedure bloating

Answer

Better visualization

Answer

CO2 is less expensive

Answer

CO2 eliminates the need for sedation

Question 5

What antibiotic prophylaxis is recommended before endoscopy in a patient with a prosthetic heart valve?

Accepted Answer

No antibiotic prophylaxis is recommended

Answer

Amoxicillin 2g IV

Answer

Ampicillin-sulbactam IV

Answer

Vancomycin 1g IV

Question 6

What is the onset time and peak effect of IV midazolam for endoscopic sedation?

Accepted Answer

Onset 1-2 minutes, peak 3-5 minutes

Answer

Onset 30 seconds, peak 1 minute

Answer

Onset 5 minutes, peak 15 minutes

Answer

Onset 10 minutes, peak 30 minutes