Mechanisms of Action
This induction agent inhibits cortisol synthesis through 11-beta-hydroxylase inhibition.
What is etomidate?
Etomidate suppresses adrenal steroid synthesis. Etomidate suppresses cortisol synthesis by inhibiting 11-β-hydroxylase.
This induction agent is known for profound hypotension caused by venodilation and decreased SVR.
What is propofol?
Propofol commonly decreases BP by 20–40%.
This benzodiazepine becomes lipid soluble at physiologic pH.
What is midazolam?
Closure of the imidazole ring at physiologic pH increases lipid solubility.
This syndrome includes rhabdomyolysis, metabolic acidosis, renal failure, and cardiovascular collapse.
What is Propofol Infusion Syndrome?
PRIS is associated with prolonged high-dose propofol infusions.
This sedative is commonly used to prevent emergence delirium in pediatric patients.
What is dexmedetomidine?
Dexmedetomidine may reduce emergence delirium.
This IV anesthetic primarily antagonizes NMDA receptors.
What is ketamine?
Ketamine’s primary mechanism is NMDA receptor antagonism.
This induction agent is preferred for severe hemodynamic instability.
What is etomidate?
Etomidate minimally affects HR, SVR, and CO.
This long-acting benzodiazepine has active metabolites that may last for days in elderly patients.
What is diazepam?
Diazepam’s active metabolites significantly prolong sedation.
This induction agent commonly causes myoclonus in 50–80% (without premed) of patients.
What is etomidate?
Myoclonus is a classic side effect of etomidate.
This induction agent is preferred in hypovolemic shock and trauma.
What is ketamine?
Ketamine supports sympathetic tone and cardiovascular stability.
This benzodiazepine becomes lipophilic at physiologic pH due to closure of its imidazole ring.
What is midazolam?
Midazolam is water soluble in the vial and lipid soluble in the bloodstream.
This induction agent uniquely increases ICP and cerebral blood flow.
Hint: It also produces bronchodilation and preserves airway reflexes.
What is ketamine?
Ketamine increases CBF, ICP, and CMRO₂.
Ketamine relaxes bronchial smooth muscle and preserves upper airway reflexes.
This induction agent is metabolized by both hepatic and plasma ester hydrolysis.
What is etomidate?
Etomidate metabolism occurs rapidly through liver and plasma esterases.
This sedative commonly causes injection pain because of propylene glycol formulation.
What is etomidate?
Propylene glycol contributes to venous irritation.
This induction agent is preferred for electroconvulsive therapy.
What is methohexital?
Methohexital provides rapid onset and short duration for ECT.
This sedative acts primarily at alpha-2 adrenergic receptors.
What is dexmedetomidine?
Dexmedetomidine is a highly selective alpha-2 agonist.
This sedative-hypnotic preserves respiratory drive better than other agents.
What is dexmedetomidine?
Dexmedetomidine causes minimal respiratory depression.
This benzodiazepine is metabolized by tissue esterases rather than hepatic CYP enzymes.
Hint: context-sensitive half-life of approximately 7–8 minutes.
What is remimazolam?
Remimazolam undergoes tissue carboxylesterase metabolism.
Remimazolam is an ultra-short benzodiazepine has a context-sensitive half-life of approximately 7–8 minutes.
Rapid esterase metabolism allows predictable recovery.
This benzodiazepine reversal agent may precipitate withdrawal seizures.
What is flumazenil?
Flumazenil can abruptly reverse chronic benzodiazepine effects.
This medication is commonly paired with fentanyl in classic neurolept anesthesia.
What is droperidol?
Droperidol + fentanyl formed Innovar for neuroleptanalgesia.
This antiemetic works mainly through dopamine D2 receptor blockade.
What is droperidol?
Droperidol blocks D2 receptors in the CRTZ.
This antiemetic prolongs the QT interval through effects on cardiac repolarization.
What is droperidol?
Droperidol carries an FDA black-box warning for QT prolongation and torsades.
This sedative’s duration may increase 2–3 times with erythromycin administration.
What is midazolam?
Erythromycin inhibits CYP3A4 metabolism of midazolam.
This antiemetic may cause extrapyramidal symptoms because of dopamine blockade.
What is droperidol?
Droperidol may produce dystonia and parkinsonian symptoms.
This benzodiazepine is best when prolonged intense anxiolysis and amnesia are desired.
What is lorazepam?
Lorazepam produces prolonged anxiolysis and amnesia.