CH-23 Anesthetic Drugs – Understanding Pharmacology for Health Professionals : Exam Guide

Chapter 23: Anesthetic Drugs Multiple Choice Questions 1. Ether is no longer used for all of the following reasons EXCEPT which one? a. It caused severe postoperative vomiting. b. It had an unpleasant odor. c. It was given intravenously. d. It was highly explosive Answer: c. It was given intravenously. Correct Feedback: From its first use in 1846, ether enjoyed great popularity as an inhaled general anesthetic drug. However, it had an extremely unpleasant odor, was highly explosive, and frequently produced severe postoperative vomiting a. It caused severe postoperative vomiting. Incorrect Feedback: This is one of the reasons. b. It had an unpleasant odor. Incorrect Feedback: This is one of the reasons. d. It was highly explosive Incorrect Feedback: This is one of the reasons. 2. The first three inhaled general anesthetic drugs introduced were ______. a. ether, nitrous oxide, chloroform b. atropine, Pentothal, Ethrane c. Xylocaine, ether, thiopental d. nitrous oxide, lidocaine, Vistaril Answer: a. ether, nitrous oxide, chloroform Correct Feedback: Within the scope of 17 years, the first three inhaled general anesthetic drugs—ether, chloroform, and nitrous oxide—were introduced. b. atropine, Pentothal, Ethrane Incorrect Feedback: These were not the first inhaled general anesthetic drugs. c. Xylocaine, ether, thiopental Incorrect Feedback: These were not the first inhaled general anesthetic drugs. d. nitrous oxide, lidocaine, Vistaril Incorrect Feedback: These were not the first inhaled general anesthetic drugs. 3. Drugs for the induction of anesthesia are ______. a. given intravenously b. provide a rapid loss of consciousness c. are used to relax the abdominal muscles d. a and b Answer: d. a and b Correct Feedback: Drugs for the induction of anesthesia are generally given intravenously. Intravenous drugs provide a rapid loss of consciousness. a. given intravenously Incorrect Feedback: This is true, but it is not the only correct answer. b. provide a rapid loss of consciousness Incorrect Feedback: This is true, but it is not the only correct answer. c. are used to relax the abdominal muscles Incorrect Feedback: Drugs for the induction of anesthesia do not relax the abdominal muscles. 4. Which anticholinergic drug is given preoperatively to decrease oral secretions and facilitate endotracheal intubation? a. halothane b. pentobarbital c. atropine d. morphine Answer: c. atropine Correct Feedback: Atropine is an anticholinergic drug given preoperatively to block the action of acetylcholine and decrease oral secretions to facilitate endotracheal intubation. a. halothane Incorrect Feedback: Halothane is not an anticholinergic drug. b. pentobarbital Incorrect Feedback: Pentobarbital is not an anticholinergic drug. d. morphine Incorrect Feedback: Morphine is not an anticholinergic drug. 5. Narcotic drugs are used ________. a. preoperatively to relieve pain and provide sedation b. to induce general anesthesia c. in combination with other drugs to help maintain general anesthesia d. all of the above Answer: d. all of the above Correct Feedback: Narcotic drugs are given preoperatively to relieve pain and provide sedation. Narcotic drugs are used to induce general anesthesia or are used in combination with other drugs to help maintain general anesthesia. a. preoperatively to relieve pain and provide sedation Incorrect Feedback: This is true, but it is not the only correct answer. b. to induce general anesthesia Incorrect Feedback: This is true, but it is not the only correct answer. c. in combination with other drugs to help maintain general anesthesia Incorrect Feedback: This is true, but it is not the only correct answer. 6. Regional anesthesia is also known as ____ anesthesia. a. spinal b. nerve block c. general d. all of the above Answer: b. nerve block Correct Feedback: Regional anesthesia is used during surgery on an extremity to provide anesthesia for just that region. This is also known as nerve block anesthesia. a. spinal Incorrect Feedback: Regional anesthesia is not the same as spinal anesthesia. c. general Incorrect Feedback: Regional anesthesia is not the same as general anesthesia. d. all of the above Incorrect Feedback: Only one answer is correct. 7. Which of the following statements about the use of an intravenous drug for the induction of general anesthesia is FALSE? a. It provides a rapid loss of consciousness. b. It helps the anesthesiologist initiate anesthesia quickly. c. It uses barbiturate drugs that can be addicting. d. It minimizes patient anxiety. Answer: c. It uses barbiturate drugs that can be addicting. Correct Feedback: Intravenous drugs for the induction of general anesthesia provide a rapid loss of consciousness. This helps the anesthesiologist to initiate anesthesia quickly while minimizing patient anxiety. a. It provides a rapid loss of consciousness. Incorrect Feedback: This is a true statement. b. It helps the anesthesiologist initiate anesthesia quickly. Incorrect Feedback: This is a true statement. d. It minimizes patient anxiety. Incorrect Feedback: This is a true statement. 8. The most widely used topical, local, regional, and spinal anesthetic drug is _____. a. procaine (Novocaine) b. bupivacaine (Marcaine, Sensorcaine) c. thiopental (Pentothal) d. lidocaine (Xylocaine) Answer: d. lidocaine (Xylocaine) Correct Feedback: Lidocaine (Xylocaine), the most widely used topical, local, regional, and spinal anesthetic drug, was introduced in 1948. a. procaine (Novocaine) Incorrect Feedback: This is not the most widely used anesthetic drug. b. bupivacaine (Marcaine, Sensorcaine) Incorrect Feedback: This is not the most widely used anesthetic drug. c. thiopental (Pentothal) Incorrect Feedback: This is not the most widely used anesthetic drug. 9. The local anesthetic drugs bupivacaine and lidocaine are available with or without the vasoconstrictor ______ in the solution. a. atropine b. curare c. epinephrine d. all of the above Answer: c. epinephrine Correct Feedback: The local anesthetic drugs bupivacaine and lidocaine are available with or without epinephrine in the solution. a. atropine Incorrect Feedback: These drugs do not contain atropine in the solution. b. curare Incorrect Feedback: These drugs do not contain curare in the solution. d. all of the above Incorrect Feedback: Only one answer is correct. 10. Which of the following statements is FALSE? a. The South American Indians chewed coca bush leaves for their euphoric effect. b. Cocaine is derived from coca bush leaves. c. Cocaine, the first topical anesthetic drug, was introduced in 1880. d. Cocaine is no longer in use today as a topical anesthetic drug. Answer: d. Cocaine is no longer in use today as a topical anesthetic drug. Correct Feedback: For centuries, the South American Indians chewed the leaves of the coca bush for their euphoric effect. Cocaine, which is derived from these leaves, was recognized as a topical anesthetic drug in 1880 and is still used as a topical anesthetic and vasoconstrictor drug for ENT procedures. a. The South American Indians chewed coca bush leaves for their euphoric effect. Incorrect Feedback: This is a true statement. b. Cocaine is derived from coca bush leaves. Incorrect Feedback: This is a true statement. c. Cocaine, the first topical anesthetic drug, was introduced in 1880. Incorrect Feedback: This is a true statement. 11. If a local anesthetic drug that contained epinephrine for vasoconstriction was used to do surgery on the tip of the nose, that might result in ______. a. excessive local vasoconstriction b. necrosis c. skin sloughing d. all of the above Answer: d. all of the above Correct Feedback: The use of epinephrine is contraindicated in certain areas of the body, such as the tip of the nose, and the fingers, toes, and ears, because the blood supply there is limited and excessive local vasoconstriction could lead to necrosis and skin sloughing. In those areas, an anesthetic drug without epinephrine is used for local anesthesia. a. excessive local vasoconstriction Incorrect Feedback: This is true, but it is not the only correct answer. b. necrosis Incorrect Feedback: This is true, but it is not the only correct answer. c. skin sloughing Incorrect Feedback: This is true, but it is not the only correct answer. 12. Which of the following is NOT a definition of anesthesia: Anesthesia is the absence of ______. a. feeling b. pain c. perception d. sensation Answer: c. perception Correct Feedback: Anesthesia is defined as the absence of feeling, sensation, or pain. Perception is not a part of the definition of anesthesia. a. feeling Incorrect Feedback: Anesthesia is the absence of feeling. b. pain Incorrect Feedback: Anesthesia is the absence of pain. d. sensation Incorrect Feedback: Anesthesia is the absence of sensation. 13. Which of the following drugs is used to reverse the effects of neuromuscular blocker drugs used during general anesthesia? a. atracurium (Tracrium) b. edrophonium (Reversol, Tensilon) c. succinylcholine (Anectine, Quelicin) d. vecuronium (Norcuron) Answer: b. edrophonium (Reversol, Tensilon) Correct Feedback: Edrophonium (Reversol, Tensilon, and combination drug Enlon-Plus) are used to reverse the effects of neuromuscular blocker drugs used during general anesthesia. a. atracurium (Tracrium) Incorrect Feedback: This is a neuromuscular blocker drug. c. succinylcholine (Anectine, Quelicin) Incorrect Feedback: This is a neuromuscular blocker drug. d. vecuronium (Norcuron) Incorrect Feedback: This is a neuromuscular blocker drug. 14. Topical anesthetic drugs do NOT come in which of the following drug forms? a. creams b. gas c. gels d. ointments Answer: b. gas Correct Feedback: Anesthetic drugs available in the form of creams, gels, ointments, and sprays are applied to the skin to produce topical anesthesia. a. creams Incorrect Feedback: Topical anesthetic drugs are available in the form of a cream. c. gels Incorrect Feedback: Topical anesthetic drugs are available in the form of a gel. d. ointments Incorrect Feedback: Topical anesthetic drugs are available in the form of an ointment. 15. The combination drug Duocaine contains the generic anesthetic drugs ______. a. bupivacaine and lidocaine b. atracurium and succinylcholine c. MFP and ENT d. diazepam and lorazepam Answer: a. bupivacaine and lidocaine Correct Feedback: The combination drug Duocaine contains the anesthetic drugs bupivacaine and lidocaine b. atracurium and succinylcholine Incorrect Feedback: These are not generic anesthetic drugs. c. MFP and ENT Incorrect Feedback: These are not generic anesthetic drugs. d. diazepam and lorazepam Incorrect Feedback: These are not generic anesthetic drugs. 16. Which of the following is the most widely used topical, local, regional, and spinal anesthetic drug? a. lidocaine b. mepivacaine c. ropivacaine d. tetracaine Answer: a. lidocaine Correct Feedback: Lidocaine is the most widely used topical, local, regional, and spinal anesthetic drug. b. mepivacaine Incorrect Feedback: Mepivacaine is not the most widely used anesthetic drug. c. ropivacaine Incorrect Feedback: Ropivacaine is not the most widely used anesthetic drug. d. tetracaine Incorrect Feedback: Tetracaine is not the most widely used anesthetic drug. 17. The addition of epinephrine to some local anesthetic drugs ______. a. binds to dopamine receptors in the cell wall b. prolongs the anesthetic effect of the drug c. decreases blood pressure and heart rate d. inhibits the release of prostaglandins to decrease pain Answer: b. prolongs the anesthetic effect of the drug Correct Feedback: Epinephrine is a powerful vasoconstrictor that decreases blood flow to the tissue where it is injected. This therapeutic effect prolongs the anesthetic effect of the drug. a. binds to dopamine receptors in the cell wall Incorrect Feedback: Epinephrine does not bind to dopamine receptors. c. decreases blood pressure and heart rate Incorrect Feedback: Epinephrine does not decrease the heart rate and blood pressure. d. inhibits the release of prostaglandins to decrease pain Incorrect Feedback: Epinephrine has no effect on the release of prostaglandins. 18. To achieve local anesthesia, the anesthetic drug is injected through a needle that is inserted ______. a. into the subcutaneous tissue b. at a 45-degree or 90-degree angle depending on the patient c. into the muscle layer d. at a 15-degree angle Answer: a. into the subcutaneous tissue Correct Feedback: To achieve local anesthesia via subcutaneous injection of an anesthetic drug, the needle is inserted at a 45-degree angle, and the anesthetic drug is injected into the fatty subcutaneous tissue, but not into the muscle layer. b. at a 45-degree or 90-degree angle depending on the patient Incorrect Feedback: A local anesthesia injection is inserted only at a 45-degree angle. c. into the muscle layer Incorrect Feedback: A local anesthesia injection is not inserted into the muscle layer. d. at a 15-degree angle Incorrect Feedback: A local anesthetic injection is not inserted at a 15-degree angle. 19. For many years, synthetic substitutes for the topical anesthetic drug cocaine were sought. This ultimately led to the discovery of what drug that was the prototype of local anesthetic drugs? a. chlorpromazine (Thorazine) b. fentanyl (Sublimaze) c. procaine (Novacaine) d. thiopental (Pentothal) Answer: c. procaine (Novacaine) Correct Feedback: For many years, synthetic substitutes for cocaine were sought. This led to the discovery of procaine (Novacaine), the prototype of local anesthetic drugs. a. chlorpromazine (Thorazine) Incorrect Feedback: Chlorpromazine is not a local anesthetic drug. b. fentanyl (Sublimaze) Incorrect Feedback: Fentanyl is not a local anesthetic drug. d. thiopental (Pentothal) Incorrect Feedback: Thiopental is not a local anesthetic drug. 20. In 1920, what technique was perfected that allowed greater control of patient ventilation and anesthetic administration during surgical procedures? a. anesthetic reversal drugs b. endotracheal intubation c. inhalation route of administration d. subcutaneous administration of local anesthesia Answer: b. endotracheal intubation Correct Feedback: In 1920, the technique of endotracheal intubation was perfected. This allowed greater control of patient ventilation and anesthetic administration during surgical procedures. a. anesthetic reversal drugs Incorrect Feedback: Anesthetic reversal drugs are not a technique. c. inhalation route of administration Incorrect Feedback: The inhalation route of anesthesia was not perfected in 1920. d. subcutaneous administration of local anesthesia Incorrect Feedback: The subcutaneous administration of local anesthesia was not perfected in 1920. 21. In 1935 which barbiturate drug, which is still used today, was found to rapidly induce general anesthesia when given intravenously? a. meperidine (Demerol) b. morphine (Duramorph) c. pentazocine (Talwin) d. thiopental (Pentothal) Answer: d. thiopental (Pentothal) Correct Feedback: In 1935, thiopental (Pentothal), a barbiturate drug, was found to rapidly induce general anesthesia when given intravenously. It is still used today. a. meperidine (Demerol) Incorrect Feedback: Meperidine (Demoral) is not a barbiturate drug. b. morphine (Duramorph) Incorrect Feedback: Morphine (Duramorph) is not a barbiturate drug. c. pentazocine (Talwin) Incorrect Feedback: Pentazocine (Talwin) is not a barbiturate drug. 22. Used by South American Indians to dip their arrows in, what drug introduced in the 1940s was the first neuromuscular blocker drug to be used during general anesthesia and was especially helpful in performing abdominal surgery? a. atropine b. curare c. halothane d. pentobarbital Answer: b. curare Correct Feedback: Until the use of curare, the first neuromuscular blocking drug, abdominal surgery presented a challenge to both the surgeon and anesthesiologist because the abdominal muscles remained taut and unyielding except with the deeper level of general anesthesia. With curare, the anesthesiologist could maintain a lighter level of general anesthesia while still obtaining complete abdominal wall relaxation. a. atropine Incorrect Feedback: Atropine is not a neuromuscular blocker drug. c. halothane Incorrect Feedback: Halothane is not a neuromuscular blocker drug. d. pentobarbital Incorrect Feedback: Pentobarbital is not a neuromuscular blocker drug. 23. Some liquid anesthetic drugs contain methylparaben, which is a/an _______. a. anesthetic drug with antibiotic and antifungal effects b. neuromuscular drug with antibiotic and antifungal effects c. preservative with antibiotic and antifungal effects d. barbiturate drug with antibiotic and antiviral effects Answer: c. preservative with antibiotic and antifungal effects Correct Feedback: Some liquid drugs contain methylparaben, a preservative with antibiotic and antifungal effects. a. anesthetic drug with antibiotic and antifungal effects Incorrect Feedback: Methylparaben is not an anesthetic drug. b. neuromuscular drug with antibiotic and antifungal effects Incorrect Feedback: Methylparaben is not a neuromuscular drug. d. barbiturate drug with antibiotic and antiviral effects Incorrect Feedback: Methylparaben is not a barbiturate drug. 24. Which of the following types of drugs are NOT used preoperatively to decrease anxiety and produce sedation? a. anticholinergic drugs b. antihistamine drugs c. barbiturate drugs d. neuromuscular blocker drugs Answer: d. neuromuscular blocker drugs Correct Feedback: Neuromuscular blocker drugs do not provide a decrease in anxiety nor produce sedation. a. anticholinergic drugs Incorrect Feedback: Anticholinergic drugs are used preoperatively to decrease anxiety and produce sedation. b. antihistamine drugs Incorrect Feedback: Antihistamine drugs are used preoperatively to decrease anxiety and produce sedation. c. barbiturate drugs Incorrect Feedback: Barbiturate drugs are used preoperatively to decrease anxiety and produce sedation. 25. While most of the narcotic drugs given preoperatively to relieve pain and provide sedation are Schedule II drugs, which of the following is a Schedule IV narcotic drug? a. meperidine (Demerol) b. morphine (Duramorph) c. oxymorphone (Numorphan, Opana) d. pentazocine (Talwin) Answer: d. pentazocine (Talwin) Correct Feedback: Narcotic drugs are given preoperatively to relieve pain and provide sedation. They are Schedule II drugs, except for pentazocine, which is a Schedule IV drug. a. meperidine (Demerol) Incorrect Feedback: Meperidine (Demerol) is a Schedule II drug. b. morphine (Duramorph) Incorrect Feedback: Morphine (Duramorph) is a Schedule II drug. c. oxymorphone (Numorphan, Opana) Incorrect Feedback: Oxymorphone (Numorphan, Opana) is a Schedule II drug. 26. A local anesthetic drug with epinephrine can be used during surgery to repair a laceration on the ________. a. ear b. finger c. forearm d. tip of the nose Answer: c. forearm Correct Feedback: The use of an anesthetic drug with epinephrine is contraindicated in certain areas of the body, such as the tip of the nose, and the fingers, toes, and ears, because the blood supply there is limited and excessive local vasoconstriction would lead to necrosis and skin sloughing. a. ear Incorrect Feedback: The use of an anesthetic drug with epinephrine is contraindicated in the ear. b. finger Incorrect Feedback: The use of an anesthetic drug with epinephrine is contraindicated in the finger. d. tip of the nose Incorrect Feedback: The use of an anesthetic drug with epinephrine is contraindicated in the tip of the nose. 27. All of the following are inhaled general anesthetic gases EXCEPT ______. a. Suprane b. fentanyl (Sublimaze) c. Ethrane d. Ultane Answer: b. fentanyl (Sublimaze) Correct Feedback: Fentanyl (Sublimaze) is a narcotic drug used to induce general anesthesia in combination with other drugs to help maintain general anesthesia. a. Suprane Incorrect Feedback: Suprane is an inhaled general anesthetic gas. c. Ethrane Incorrect Feedback: Ethrane is an inhaled general anesthetic gas. d. Ultane Incorrect Feedback: Ultane is an inhaled general anesthetic gas. True/False Questions 28. Antihistamine drugs are given preoperatively to provide sedation as well as to dry up oral secretions. Answer: True Feedback: These antihistamine drugs are given preoperatively to provide sedation as well as to dry up oral secretions. 29. Anticholinergic drugs are given preoperatively to block the action of acetylcholine and relax the abdominal muscles prior to abdominal surgery. Answer: False Feedback: Anticholinergic drugs are given preoperatively to block the action of acetylcholine and decrease oral secretions to facilitate endotracheal intubation. 30. Narcotic drugs are given preoperatively to relieve pain and provide sedation. Answer: True Feedback: Narcotic drugs are given preoperatively to relieve pain and provide sedation. 31. Drugs used for the induction of anesthesia are generally given by inhalation; drugs used to maintain general anesthesia may be given by inhalation or intravenously. Answer: False Feedback: Drugs for the induction of anesthesia are generally given intravenously; drugs used to maintain general anesthesia may be given intravenously or by inhalation. 32. Neuromuscular blocker drugs used during general anesthesia are given intramuscularly to block nerve transmissions throughout the body. Answer: False Feedback: Neuromuscular blocker drugs are given intravenously to block nerve transmissions throughout the body. 33. Local anesthesia is used during minor procedures, such as biopsies or during dental surgery. Answer: True Feedback: Local anesthesia is used during minor surgical procedures, such as biopsies or during dental surgery. 34. Regional anesthesia is used during surgery on an extremity to provide anesthesia for just that region. Answer: True Feedback: Regional anesthesia is used during surgery on an extremity to provide anesthesia for just that region. 35. Sedative and benzodiazepine antianxiety drugs are used to induce general anesthesia or are used in combination with other drugs to maintain general anesthesia. Answer: True Feedback: Sedative and benzodiazepine antianxiety drugs are used to induce general anesthesia or are used in combination with other drugs to maintain general anesthesia. 36. Inhaled drugs for anesthesia are used to induce or maintain general anesthesia, and they are schedule drugs. Answer: False Feedback: Inhaled general anesthesia drugs are in the form of a gas that is inhaled to induce or maintain general anesthesia. They are not schedule drugs. 37. The drug Enlon-Plus is used to reverse the effect of narcotic drugs given during general anesthesia. Answer: False Feedback: Edrophonium (Reversol, Tensilon, Enlon-Plus) is used to reverse the effects of neuromuscular blocker drugs used during general anesthesia 38. Skeletal muscle relaxation is particularly important during abdominal surgery when the muscles of the abdominal wall must relax in order to allow adequate visualization of the operative field that is within the abdominal cavity. Answer: True Feedback: Skeletal muscle relaxation is particularly important during abdominal surgery when the muscles of the abdominal wall must relax in order to allow adequate visualization of the operative field that is within the abdominal cavity. 39. For __________ anesthesia, an anesthetic drug is given by subcutaneous injection into the skin to anesthetize a small area of skin and adjacent tissue. Answer: local Feedback: For local anesthesia, an anesthetic drug is given by subcutaneous injection into the skin to anesthetize a small area of skin and adjacent tissue. 40. For __________ anesthesia, an anesthetic drug is given by subcutaneous injection near a nerve plexus (group of nerves) and its branches. Answer: regional Feedback: For regional anesthesia, an anesthetic drug is given by subcutaneous injection near a nerve plexus (group of nerves) and its branches. 41. For __________ anesthesia, an anesthetic drug is given by injection into the subarachnoid space between the vertebrae of the lumbar region of the back. Answer: spinal Feedback: For spinal anesthesia, an anesthetic drug is given by injection into the subarachnoid space between the vertebrae of the lumbar region of the back. 42. For ___________ anesthesia, an anesthetic drug is given by injection into the epidural space; the drug then moves into the subarachnoid space to provide anesthesia. Answer: epidural Feedback: For epidural anesthesia, an anesthetic drug is given by injection into the subepidural space; the drug then moves into the subarachnoid space to produce anesthesia. 43. The suffix __________ is common to anesthetic drugs used to produce local, regional, spinal, or epidural anesthetic drugs. Answer: –caine Feedback: The suffix –caine is common to anesthetic drugs used to produce local, regional, spinal or epidural anesthetic drugs. 44. The drugs hydroxyzine (Vistaril) and promethazine (Phenergan) are __________ drugs given preoperatively to provide sedation as well as to dry up oral secretions. Answer: antihistamine Feedback: The drugs hydroxyzine (Vistaril) and promethazine (Phenergan) are antihistamine drugs given preoperatively to provide sedation as well as to dry up oral secretions. 45. The drugs atropine and glycopyrrolate (Robinul) are __________ drugs given preoperatively to block the action of acetylcholine and decrease oral secretions to facilitate endotracheal intubation. Answer: antianxiety Feedback: The drugs diazepam, lorazepam (Ativan), and midazalom are benzodiazepine antianxiety drugs given preoperatively to relive anxiety and provide sedation. 46. The drugs diazepam, lorazepam (Ativan), and midazalom are benzodiazepine __________ drugs given preoperatively to relieve anxiety and provide sedation. Answer: antianxiety Feedback: The drugs diazepam, lorazepam (Ativan), and midazalom are benzodiazepine antianxiety drugs given preoperatively to relive anxiety and provide sedation. 47. The drugs pentobarbital and secobarbital (Seconal) are __________ drugs given preoperatively to produce sedation. Answer: barbiturate Feedback: The drugs pentobarbital and secobarbital (Seconal) are barbiturate drugs given preoperatively to produce sedation. 48. The trade name of the generic name drug lidocaine is _____. Answer: Xylocaine Feedback: Lidocaine (Xylocaine) is the most widely used topical, local, regional, and spinal anesthetic drug. 49. Name three areas of the body where the use of epinephrine in local anesthetic drugs is contraindicated: ______ , _______, and _______. Answer: (only need to name three) tip of the nose, fingers, toes, ears. Feedback: The use of epinephrine with a local anesthetic drug is contraindicated in certain areas of the body, such as the tip of the nose, and the fingers, toes, and ears. 50. 1. Anesthesia in one body part. A. epidural or spinal anesthesia 2. Anesthesia in the entire body B. general anesthesia 3. Anesthesia in the skin and deeper tissues C. regional nerve block 4. Anesthesia in the trunk and lower extremities D. subcutaneous injection 5. Anesthesia on the skin E. topical application of an anesthetic drug Answer: C Answer: B Answer: D Answer: A Answer: E Feedback: Anesthesia can be obtained on the skin (by topical application of anesthetic drugs), in the skin and deeper tissues (by topical application of anesthetic drugs), in the skin and deeper tissues (by subcutaneous local injection), in one body part (by regional nerve block), in the trunk and lower extremities (by epidural or spinal anesthesia), or in the entire body (by general anesthesia that produces unconsciousness). 51. 1. alfentanil (Alfenta) A. inhaled general anesthetic drug 2. methohexital (Brevital) B. narcotic drug 3. propofol (Diprivan) C. neuromuscular blocker drug 4. rocuronium (Zemuron) D. sedative and benzodiazepine antianxiety drug 5. sevoflurane (Ultane) E. ultra-short acting barbiturate drug Answer: B Answer: E Answer: D Answer: C Answer: A Feedback: These drugs and their categories are found throughout the chapter. 52. Briefly explain the mechanism by which an anesthetic drug produces topical, local, regional, epidural, or spinal anesthesia. (Note: The mechanism is the same for all of these types of anesthesia.) Answer: Topical, local, regional, epidural, or spinal anesthesia is obtained when an anesthetic drug blocks the flow of sodium ions across the membranes of nerve cells, thereby blocking the production of nerve impulses that convey the message of pain. 53. A larger dose of diazepam will produce amnesia during minor surgical/dental procedures and endoscopic procedures. Explain how this amnesia affects the patient physically and mentally. Answer: A larger does of diazepam will produce amnesia during minor surgical/dental procedures and endoscopic procedures; the patient is able to respond to commands to facilitate the procedure but has little memory of events upon awakening. 54. Why is epinephrine sometimes combined with lidocaine (Xylocaine) when it is used as a local anesthetic drug? Answer: Epinephrine (Adrenalin) is a powerful vasoconstrictor that decreases blood flow to the tissue where it is injected. This therapeutic effect prolongs the anesthetic action of the drug. 55. What is the significance of the abbreviation MPF when seen in the trade names of some anesthetic drugs? Answer: Some patients have an immediate and severe allergic reaction to methylparaben (a preservative in some liquid anesthetic drugs), and so it has been eliminated from some anesthetic drugs. Those anesthetic drugs that do not contain methylparaben are labeled MPF for methyparaben-free. Test Bank for Understanding Pharmacology for Health Professionals Susan M. Turley 9780135145708, 9780133911268