Anesthetic Pharmacology Flashcards

Midazolam is preferred over diazepam for IV sedation primarily because it:

Answer: Causes superior amnesia and has a shorter half-life

Midazolam produces reliable anterograde amnesia and has a shorter half-life (approximately 2 hours) compared to diazepam (approximately 24 to 48 hours), reducing prolonged sedation.

Flumazenil (Romazicon) reverses benzodiazepine sedation by:

Answer: Competitively blocking GABA-A receptor benzodiazepine sites

Flumazenil competitively antagonizes benzodiazepines at the GABA-A receptor benzodiazepine binding site, reversing sedation without affecting opioid effects.

Which opioid is most commonly used for IV conscious sedation in the dental office due to its rapid onset and short duration?

Answer: Fentanyl

Fentanyl has an onset of approximately 2 minutes and peak effect at 5 minutes with a short duration (approximately 30 to 60 min), making it ideal for procedural sedation.

Nitrous oxide exerts its clinical effects primarily through:

Answer: NMDA receptor antagonism and endogenous opioid release

Nitrous oxide anxiolytic and analgesic effects are mediated largely by NMDA antagonism and endogenous opioid system activation.

A patient receiving IV ketamine for sedation is most likely to exhibit which distinctive clinical finding?

Answer: Dissociative anesthesia with preserved airway reflexes

Ketamine produces a dissociative state where the patient appears awake but is unresponsive to pain, while maintaining airway tone and protective reflexes.

The maximum recommended dose of epinephrine in a local anesthetic for a healthy adult per appointment is:

Answer: 0.2 mg (200 mcg)

The maximum epinephrine dose for a healthy adult is 0.2 mg (200 mcg) per appointment to avoid cardiovascular adverse effects.