CST Surgical Pharmacology 3 — Questions and Answers
Question 1: Which inhalation agent is known to sensitize the myocardium to catecholamine-induced arrhythmias?
- Isoflurane
- Sevoflurane
- Halothane (Correct answer)
- Desflurane
Correct answer: Halothane
Halothane sensitizes the myocardium to epinephrine, making arrhythmias more likely when catecholamines are used.
Question 2: Tranexamic acid (TXA) reduces surgical bleeding primarily by:
- Activating platelets at the wound site
- Inhibiting fibrinolysis by blocking plasminogen activation (Correct answer)
- Reversing the effects of anticoagulants
- Stimulating thrombin production
Correct answer: Inhibiting fibrinolysis by blocking plasminogen activation
Tranexamic acid is an antifibrinolytic that blocks lysine binding sites on plasminogen, preventing fibrin clot breakdown.
Question 3: Which opioid is commonly delivered via epidural infusion for postoperative pain management and has high lipid solubility?
- Morphine
- Codeine
- Fentanyl (Correct answer)
- Hydromorphone
Correct answer: Fentanyl
Fentanyl's high lipid solubility allows rapid onset and segmental analgesia when delivered epidurally.
Question 4: A patient develops malignant hyperthermia intraoperatively. Which drug is the definitive treatment?
- Dantrolene (Correct answer)
- Succinylcholine
- Propofol
- Neostigmine
Correct answer: Dantrolene
Dantrolene inhibits calcium release from the sarcoplasmic reticulum, directly treating the hypermetabolic crisis of malignant hyperthermia.
Question 5: What class of drugs is ketorolac (Toradol), frequently used for postoperative pain?
- Opioid analgesic
- COX-2 selective inhibitor
- Non-selective NSAID (Correct answer)
- Alpha-2 agonist
Correct answer: Non-selective NSAID
Ketorolac is a parenteral NSAID that non-selectively inhibits both COX-1 and COX-2 enzymes to reduce inflammation and pain.
Question 6: Which drug is used intraoperatively to reduce secretions and prevent bradycardia during general anesthesia?
- Metoprolol
- Glycopyrrolate (Correct answer)
- Atropine sulfate applied topically
- Neostigmine
Correct answer: Glycopyrrolate
Glycopyrrolate is an anticholinergic agent that reduces oral and airway secretions and helps prevent vagally mediated bradycardia.
Question 7: Vasopressin (ADH) may be administered during cardiac surgery primarily to:
- Increase urine output
- Treat vasodilatory shock by causing vasoconstriction (Correct answer)
- Reverse anticoagulation
- Reduce myocardial oxygen demand
Correct answer: Treat vasodilatory shock by causing vasoconstriction
Vasopressin acts on V1 receptors in vascular smooth muscle to cause vasoconstriction and raise blood pressure in vasodilatory shock.
CST Surgical Pharmacology 3
Which inhalation agent is known to sensitize the myocardium to catecholamine-induced arrhythmias?