FANZCA Clinical Pharmacology and Anesthesia Flashcards
6 cards from real FANZCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 FANZCA Clinical Pharmacology and Anesthesia flashcards as text
Which opioid analgesic has an active metabolite (morphine-6-glucuronide) that accumulates in renal failure and can cause prolonged respiratory depression?
Answer: Morphine
Morphine-6-glucuronide, a potent metabolite of morphine, is renally excreted and accumulates in patients with renal impairment, prolonging analgesic and respiratory depressant effects.
What is neostigmine's mechanism for reversing non-depolarizing neuromuscular blockade?
Answer: Inhibition of acetylcholinesterase, increasing synaptic acetylcholine to compete with the blocker
Neostigmine inhibits acetylcholinesterase, allowing acetylcholine to accumulate at the neuromuscular junction and competitively displace non-depolarizing blockers from nicotinic receptors.
Which benzodiazepine is preferred for procedural sedation in anesthesia due to its short duration, amnesic properties, and water solubility?
Answer: Midazolam
Midazolam is the preferred benzodiazepine in anesthesia because of its water solubility (preventing phlebitis), rapid onset, anterograde amnesia, and short duration of action.
What is the primary advantage of remifentanil over other opioids for total intravenous anesthesia (TIVA)?
Answer: It is metabolized by plasma esterases, giving a predictably short context-sensitive half-time regardless of infusion length
Remifentanil is hydrolyzed by non-specific tissue and plasma esterases, resulting in a context-sensitive half-time of approximately 3–5 minutes regardless of infusion duration.
Which drug is used as a specific reversal agent for benzodiazepine-induced sedation and respiratory depression in the perioperative setting?
Answer: Flumazenil
Flumazenil competitively antagonizes benzodiazepines at GABA-A receptors, reversing sedation and respiratory depression, though its duration is shorter than most benzodiazepines, requiring monitoring for re-sedation.
Which vasopressor used in anesthesia acts primarily through alpha-1 adrenoceptor agonism to treat anesthesia-induced hypotension without causing significant tachycardia?
Answer: Phenylephrine
Phenylephrine is a pure alpha-1 agonist that increases systemic vascular resistance to treat vasodilatory hypotension under anesthesia, and it typically causes a reflex bradycardia rather than tachycardia.