A1 Antag & A2 Agonist
Doxazosin & Tamsulosin have selectivity of α1____ subtype over the α1____ subtype receptors.
a1A > a1B
Which of the following is NOT an effect of α2 Agonists?
A. Hypotension
B. Rebound Tachycardia
C. Bradycardia
D. Central Sedation
E. Mild Anesthesia
F. Rebound Hypertension
B. Rebound Tachycardia
Select All: Which of the following are TRUE of Clonidine?
A. Worsens intra-op shivering
B. PO route has rapid absorption
C. HL = 12-16 hours
D. Bradycardia related effects may last up to 8 hours
B. PO route has rapid absorption
C. HL = 12-16 hours
A. Worsens intra-op shivering- treats postop shivering
D. Bradycardia related effects may last up to 8 hours- hypotensive effects
Dexmedetomidine has what α2:α1 ratio?
1620:1
Initial loading dose of of Dexmedetomidine (Precedex)
1 mcg/kg over 10 mins
Doxazosin & Tamsulosin relax the bladder neck, prostate capsule, and prostatic urethra to tx _________
BPH
Clonidine (α2 Agonist) has what α2:α1 ratio?
400:1
How is Clonidine metabolized & excreted?
Metabolized in the liver & excreted by the kidneys
Which is correct of Dexmedetomidine?
A. Poor protein binding
B. Excreted unchanged in the urine
C. HL = 2-3 hours
D. 1 vial = 100 mcg
C. HL = 2-3 hours
A. Poor protein binding- highly protein binding
B. Excreted unchanged in the urine- undergoes hepatic metabolism
D. 1 vial = 100 mcg- One vial (2mL; 100 mcg/mL) = 200 mcg
MIV dose of Dexmedetomidine (Precedex)
0.2-0.7 mcg/kg/hr
Most α2 receptors are found in what two areas of the CNS?
A. Diencephalon
B. Medulla
C. Brainstem
D. Locus Ceruleus
C. Brainstem
D. Locus Ceruleus
Clonidine causes a dose dependent decrease in what 2 hemodynamics?
A. HR
B. SVR
C. CO/CI
D. BP
A. HR
D. BP
Rebound HTN from abrupt d/c of Clonidine can occur as soon as _______ hrs and as late as _______ hrs.
8-36 hours
If you dilute a vial of Dexmedetomidine into 48 mL, how many mcg/mL does it make?
2 mL (200 mcg) + 48 mL= 200 mcg in 50 mL
***4 mcg/ mL***
Dexmedetomidine (Precedex): TIVA dose without associated depression of ventilation
5-10 mcg/kg/hr
T/F: Rapid administration α2 Agonists can cause a dramatic increase in SNS outflow, increasing HR/BP to dangerous levels.
FALSE: Withdrawal of α2 Agonists can cause this response
How does Clonidine affect anesthesia induction and MAC?
induces sedation and decreases MAC
You can avoid rebound HTN by introducing what 2 categories of meds when gradually discontinuing Clonidine?
- Vasodilators
- Beta Blockers
How many mL do we add to a vial of Dexmedetomidine to make a final concentration of 4 mcg/ mL?
48 mL
Dexmedetomidine (Precedex) HL
2 hours
Because α2 Agonists decrease NE from presynaptic nerves and reduce SNS outflow they have what effect on BP compared to α1 Antagonists?
A. less decrease in BP
B. the same decrease in BP
C. more decrease in BP
D. no effect on BP
B. the same decrease in BP
Where does Clonidine cause modulation of pain pathways?
spinal cord
Match the doses of Clonidine
- Spinal:
- Epidural:
- Epidural Continuous:
- Premedication:
- HTN:
A. 30 mcg/hr
B. 5 mcg/kg PO
C. 150-450 mcg
D. 0.1 mg up to 0.6 mg PO
E. 75-150 mcg
- Spinal: C. 150-450 mcg
- Epidural: E. 75-150 mcg
- Cont. Epidural: A. 30 mcg/hr
- Premedication: B. 5 mcg/kg PO
- HTN: D. 0.1 mg up to 0.6 mg PO
Which of the following is NOT a clinical use of Precedex?
A. Decrease SNS Response
B. Decrease Catecholamines
C. Decrease MAC requirements
D. Postoperative Sedation
E. Dose Dependent Analgesia
F. Improved Ventilation
F. Improved Ventilation
***mild depression in ventilation***
Choose the BEST possible answer: How much are we going to drink when we pass these finals?
A. 1 shot
B. 2 shots
C. 3 shots
D. 4 shots