EXAM 3 1996
<Q 1-8> <Q 17-24> <Q 25-32> <Q 33-40>
Select the letter of the BEST single answer.
9. All of the long-acting non-depolarizing neuromuscular blockers share the following characteristics:
a. onset of 2-4 min; duration of 30-40 min; elimination by ester hydrolysis
b. onset of 3-5 min; duration of 30-40 min; elimination by hepatic mechanisms mostly
c. onset of 1-2 min; duration of 60-70 min; elimination by renal excretion mostly
d. onset of 3-5 min; duration of 60-90 min; elimination by renal excretion mostly
10. Side effects associated with administration of pancuronium include:
A. B. C. D.
a. modest increase in heart rate; absence of histamine release
b. severe increase in heart rate; autonomic ganglia stimulation
c. modest decrease in heart rate; mild histamine release
d. none of the above
11. Vecuronium differs from pancuronium in chemical structure only by lacking a quaternary ammonium methyl group in the steroid nucleus. Because vecuronium is monoquaternary and pancuronium is bisquaternary, vecuronium exhibits ______ and _______.
a. more acetylcholine-like characteristics, including more vagolytic activity; instability in solution, thus prepared as a powder
b. more acetylcholine-like characteristics, including autonomic ganglia blockade; increased lipid solubility, facilitating uptake into hepatocytes
c. more acetylcholine-like characteristics, including histamine release activity; less renal excretion
d. none of the above
12. The elimination of atracurium is via ester hydrolysis and ______, which are effected by temperature and _____.
a. Haldemann elimination; blood pressure
b. Erlichmann elimination; carbonic anhydrase elimination
c. Hofmann elimination; pH
d. none of the above
13. Two muscle relaxants that are eliminated via plasma cholinesterase (pseudocholinesterase) hydrolysis are _______ and _______; two muscle relaxants that are eliminated largely by hepatic metabolism are _______ and _______.
a. succinylcholine, cis atracurium; pancuronium, vecuronium
b. succinylcholine, mivacurium; rocuronium, vecuronium
c. succinylcholine, atracurium; gallamine, rocuronium
d. succinylcholine, mivacurium; atracurium, cis atracurium
14. Rocuronium differs from all the other intermediate-acting non-depolarizing neuromuscular blockers by exhibiting ______; mivacurium differs from all the other intermediate-acting non-depolarizing neuromuscular blockers by exhibiting ______.
a. duration of 40-60 min; low cost
b. absence of histamine release; onset of 1-2 min
c. primarily hepatic elimination; moderate histamine release
d. onset 1-2 min; duration 12-18 min
15. Resistance to the effects of non-depolarizing neuromuscular blockers can occur with:
a. phenytoin therapy; burn injury
b. decreased serum potassium; hypothermia
c. administration of combinations of non-depolarizing neuromuscular blockers
d. none of the above
16. Are neuromuscular blockers anesthetic agents?
a. Yes
b. No
c. with intubating doses only, not maintenance doses
d. with 2 or less of 4 twitches on the train-of-four
