Pharmacology for Nurse Anesthetists Flashcards

Which inhalation anesthetic has the lowest blood-gas partition coefficient, resulting in the fastest induction and emergence?

Answer: Desflurane

Desflurane has the lowest blood-gas partition coefficient (0.42) among currently used volatile agents, enabling the most rapid alveolar equilibration.

What is the primary mechanism of action of propofol?

Answer: GABA-A receptor potentiation

Propofol produces hypnosis primarily by enhancing GABA-mediated inhibitory neurotransmission at GABA-A receptors.

Which neuromuscular blocking agent is reversed specifically by sugammadex?

Answer: Rocuronium

Sugammadex is a modified gamma-cyclodextrin that encapsulates rocuronium (and vecuronium) to reverse neuromuscular blockade.

The MAC of an inhalation anesthetic is defined as the minimum alveolar concentration that prevents movement in what percentage of patients exposed to a surgical skin incision?

Answer: 50%

MAC is the median effective dose (ED50), representing the alveolar concentration at which 50% of patients do not move in response to a surgical skin incision.

Which opioid has the fastest onset due to its high lipid solubility and is most commonly used for intraoperative analgesia infusions?

Answer: Remifentanil

Remifentanil is an ultra-short-acting opioid with rapid onset and offset due to ester hydrolysis metabolism, making it ideal for continuous intraoperative infusions.

Ketamine produces dissociative anesthesia primarily through which receptor mechanism?

Answer: NMDA receptor antagonism

Ketamine blocks NMDA (N-methyl-D-aspartate) glutamate receptors, producing dissociative anesthesia, analgesia, and amnesia.