Pharmacology for Nurse Anesthetists Flashcards

Which local anesthetic is most associated with cardiac toxicity due to its high protein binding and sodium channel blocking properties?

Answer: Bupivacaine

Bupivacaine has a high affinity for cardiac sodium channels and dissociates very slowly, making cardiotoxicity severe and difficult to treat.

What is the reversal agent for benzodiazepine-induced sedation?

Answer: Flumazenil

Flumazenil is a competitive benzodiazepine receptor antagonist that reverses sedation, amnesia, and respiratory depression caused by benzodiazepines.

Dexmedetomidine produces sedation and analgesia primarily through which mechanism?

Answer: Alpha-2 adrenergic receptor agonism

Dexmedetomidine acts on alpha-2 adrenergic receptors in the locus coeruleus and spinal cord to produce sedation, anxiolysis, and analgesia without respiratory depression.

Which volatile anesthetic is contraindicated in patients at risk for malignant hyperthermia?

Answer: All potent volatile agents

All potent volatile anesthetic agents (halothane, isoflurane, desflurane, sevoflurane) are known triggers for malignant hyperthermia in susceptible individuals.

What is the primary mechanism by which neostigmine reverses non-depolarizing neuromuscular blockade?

Answer: Acetylcholinesterase inhibition

Neostigmine inhibits acetylcholinesterase, increasing the concentration of acetylcholine at the neuromuscular junction to competitively overcome the non-depolarizing blockade.

Succinylcholine is contraindicated in patients with burn injuries because it can cause life-threatening what?

Answer: Hyperkalemia

Burn, crush, and denervation injuries cause upregulation of extrajunctional acetylcholine receptors, and succinylcholine-induced depolarization can release lethal amounts of potassium.