Pharmacology Fundamentals Flashcards

Sugammadex reverses neuromuscular blockade by which mechanism?

Answer: Encapsulating and binding rocuronium or vecuronium

Sugammadex is a modified gamma-cyclodextrin that encapsulates steroidal NMB agents (rocuronium, vecuronium), forming a tight complex that renders them inactive.

A PACU patient develops shivering post-anesthesia. Which medication is most commonly used to treat postoperative shivering?

Answer: Meperidine 25 mg IV

Low-dose meperidine (25 mg IV) is the most effective pharmacologic treatment for postoperative shivering, acting on kappa-opioid and alpha-2 receptors in the hypothalamus.

Which of the following correctly describes the mechanism of ondansetron in preventing postoperative nausea and vomiting (PONV)?

Answer: Serotonin 5-HT3 receptor antagonist

Ondansetron blocks 5-HT3 (serotonin) receptors in the gut and CTZ, making it one of the most effective agents for PONV prophylaxis and treatment.

A patient has a known allergy to sulfa drugs. Which non-opioid analgesic should be used with caution or avoided?

Answer: Celecoxib

Celecoxib is a COX-2 inhibitor containing a sulfonamide group and may cross-react in patients with sulfa drug allergies.

Propofol infusion syndrome (PRIS) is most associated with which clinical finding?

Answer: Severe metabolic acidosis with cardiac failure

PRIS is characterized by severe metabolic (lactic) acidosis, rhabdomyolysis, cardiac failure, and renal failure, typically occurring with high-dose prolonged propofol infusions.

A patient received intrathecal morphine for postoperative pain. What delayed complication requires monitoring up to 24 hours later?

Answer: Delayed respiratory depression

Intrathecal morphine is hydrophilic and can migrate rostrally to brainstem respiratory centers, causing delayed respiratory depression 6–24 hours post-administration.

Which inhalational anesthetic is known to trigger malignant hyperthermia in susceptible patients?

Answer: Sevoflurane

All volatile halogenated anesthetics, including sevoflurane, can trigger malignant hyperthermia by causing uncontrolled calcium release from the sarcoplasmic reticulum in genetically susceptible patients.