DAANCE Drug Interactions and Contraindications in Anesthesia

Question 1

A patient taking a monoamine oxidase inhibitor (MAOI) for depression is scheduled for oral surgery under sedation.
Which anesthetic agent combination poses the greatest risk of a life-threatening interaction?

Accepted Answer

Meperidine and an MAOI

Answer

Nitrous oxide and midazolam

Answer

Lidocaine and epinephrine

Answer

Propofol and fentanyl

Question 2

A patient chronically taking beta-blockers presents for sedation. Which effect should the anesthesia team anticipate?

Accepted Answer

Blunted heart rate response to laryngoscopy, hypoxia, and epinephrine

Answer

Exaggerated tachycardia in response to hypotension

Answer

Increased sensitivity to benzodiazepines

Answer

Elevated minimum alveolar concentration (MAC) for inhalation agents

Question 3

Which combination of drugs synergistically potentiates CNS and respiratory depression and requires significant dose reduction to avoid overdose?

Accepted Answer

Benzodiazepines and opioids

Answer

Local anesthetics and corticosteroids

Answer

Antihistamines and beta-blockers

Answer

Nitrous oxide and lidocaine

Question 4

A patient's medical history reveals they take warfarin. The primary concern for the anesthesia team during a procedure is:

Accepted Answer

Prolonged bleeding and difficulty achieving hemostasis

Answer

Increased risk of malignant hyperthermia

Answer

Resistance to benzodiazepine sedation

Answer

Enhanced uptake of inhaled anesthetic agents

Question 5

Epinephrine-containing local anesthetics should be used with extreme caution or avoided in a patient currently taking which medication?

Accepted Answer

Non-selective beta-blockers (e.g., propranolol)

Answer

Acetaminophen

Answer

Proton pump inhibitors

Answer

Selective serotonin reuptake inhibitors (SSRIs)

Question 6

Which of the following best describes 'tachyphylaxis' in the context of drug interactions during anesthesia?

Accepted Answer

Diminishing response to a drug with repeated dosing over a short time period

Answer

A rapid, severe allergic reaction to an anesthetic agent

Answer

An abnormally fast heart rate caused by an anesthetic overdose

Answer

Cross-reactivity between two chemically similar local anesthetics