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MED CHEM II TUTORING ANESTHETICS Brandy Hollums [email protected] LOCAL ANESTHETICS • 1. Identify drugs by chemical class • 2. Effect of physicochemical properties on the a.) aqueous solubility or the drugs (e.g. lidocaine vs. benzocaine) b.)stability and DOA of the drugs • 3. SAR • 4. Side effects (i.e. toxicity of Las) WHICH CLASS DOES THE FOLLOWING STRUCTURE BELONG TO? • A. Amino Esters • B. Amino Amides • C. Amino ethers • D. Alcohols • E. Phenol WHICH CLASS DOES THE FOLLOWING STRUCTURE BELONG TO? • A. Amino Esters • B. Amino Amides • C. Amino ethers • D. Alcohols • E. Phenol WHICH CLASS DOES THE FOLLOWING STRUCTURE BELONG TO? • A. Amino Esters • B. Amino Amides • C. Amino ethers • D. Alcohols • E. Phenol WHICH CLASS DOES THE FOLLOWING STRUCTURE BELONG TO? • A. Amino Esters • B. Amino Amides • C. Amino ethers • D. Alcohols • E. Phenol WHICH CLASS DOES THE FOLLOWING STRUCTURE BELONG TO? • A. Amino Esters • B. Amino Amides • C. Amino ethers • D. Alcohols • E. Phenol WHICH STATEMENT IS TRUE? • A. Benzocaine is more stable than lidocaine due to the ester group. • B. Lidocaine is more stable than benzocaine due to the ester group. • C. Lidocaine is more stable that benzocaine due to the amide group. • D. Benzocaine is more stable that lidocaine due to the ester group. LIDOCAINE VS. BENZOCAINE WHICH OF THE FOLLOWING IS TRUE? • A. Electron donating groups at the meta and para position increase activity of local anesthetics. • B. Electron withdrawing groups at the ortho and para position increase activity of local anesthetics. • C. Electron donating groups at the ortho and para positions increase activity of local anesthetics. • D. Electron donating groups at the ortho and para positions decrease activity of local anesthetics. WHICH OF THE FOLLOWING DRUGS C AN HELP MAINTAIN LOC AL CONCENTRATIONS OF LIDOC AINE? • A. Albuterol • B. Epinephrine • C. Dobutamine • D. Diazepam HYDROLYSIS OF THE AMIDE BOND IN WHICH LA PRODUCES METHEMOGLOBINEMIA? • A. Benzocaine • B. Pramoxine • C. Alcohol • D. Prilocaine INHALATION OF GENERAL ANESTHETICS • 1. Effect of blood solubility on induction of anesthesia, recovery from anesthesia, and toxicity of GAs. • 2. Ability to produce analgesia and/or muscle relaxation. • 3. Side effects: hepatotoxicity, nephrotoxicity, and malignant hyperthermia. MATCH GAME • 1. GA w/high blood solubility • 2. GA w/medium blood solubility • 3. GA w/low blood solubility a. Intermediate induction and recovery b. Fast induction and fast recovery c. Slow induction and slow recovery WHAT SIDE EFFECT IS ASSOCIATED WITH THE FOLLOWING GA? • A. arrhythmias • B. nephrotoxicity • C. neurotoxicity • D. ototoxicity WHICH OF THE FOLLOWING GA HAVE LIMITED SKELETAL MUSCLE RELAXATION? A B C WHICH OF THE FOLLOWING IS A TOXICITY OF GA DUE TO HYPERMETABOLIC REACTIONS IN SKELETAL MUSCLES? • A. Hepatotoxicity • B. Nephrotoxicity • C. Malignant Hyperthermia • D. Congenital birth defects INTRAVENOUS ANESTHETICS • 1. Recognize the drugs by structure • 2. Advantages over inhalation anesthetics • 3. Effect of physicochemical properties on aqueous solubility (e.g. propofol) • 4. Effect on the cardiovascular and respiratory systems as ability to produce analgesia and muscle relaxation • 5. Side effects (e.g. dissociative anesthesia, hallucinations) WHICH OF THE FOLLOWING IS ACCOMPANIED WITH HALLUCINATIONS? WHICH OF THE FOLLOWING IS USED TO PREVENT HALLUCINATIONS C AUSED BY KETAMINE? WHICH OF THE FOLLOWING IS NOT AN ADVANTAGE OF IV ANESTHETICS OVER GA? • A. more convenient dosage form • B. ease of administration • C. lack of flammability • D. Rapid onset and prolonged DOA WHAT CLASS DOES THE FOLLOWING STRUCTURE BELONG TO? A. B. C. D. Barbiturates Benzodiazepines Opioids Anti-emetics WHICH OF THE FOLLOWING IS WATER SOLUBLE? • A. Propofol • B. Fospropofol WHICH IV ANESTHETIC PRODUCES DISSOCIATIVE ANESTHESIA? • A. ketamine • B. etomidate • C. midazolam • D. fentanyl WHICH IV ANESTHETIC HAS CV STIMULATION? • A. propofol • B. thiopental • C. ketamine • D. etomidate WHICH IS A MAJOR SIDE EFFECT OF OPIOID MEDICATIONS • A. diarrhea • B. nausea and vomiting • C. CNS stimulant • D. pruritus