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

Propofol potentiates GABA-A receptor activity, producing rapid-onset sedation with very short duration.

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

Start with low-dose naloxone (0.04-0.1 mg) titrated to reverse respiratory depression while minimizing pain reversal.

Question 3

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

Accepted Answer

Omeprazole

Answer

Omeprazole has the strongest CYP2C19 inhibitory effect, particularly affecting clopidogrel.

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

CO2 is absorbed 150 times faster than nitrogen, dramatically reducing post-procedure distention and pain.

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

Current guidelines do NOT recommend routine antibiotic prophylaxis for GI endoscopy solely for cardiac conditions.

CGRN - Certified Gastroenterology Registered Nurse Practice Test