ATI RN
Peripheral Nervous System Drugs Questions
Question 1 of 5
Which of the following drugs would be contraindicated for inclusion in his anesthetic protocol?
Correct Answer: A
Rationale: The correct answer is A: Halothane. Halothane is contraindicated in patients with a history of malignant hyperthermia, a rare but life-threatening condition triggered by certain anesthetics. Using halothane in such patients can lead to a dangerous reaction. Fentanyl (B), Lorazepam (C), and Thiopental (D) do not have the same risk of triggering malignant hyperthermia and are commonly used in anesthesia protocols. Therefore, Halothane is the only drug in the options that would be contraindicated in this scenario.
Question 2 of 5
Which of the following drugs was most likely administered to achieve muscle relaxation in the 74-year-old man with impaired hepatic and renal function undergoing abdominal surgery?
Correct Answer: C
Rationale: The correct answer is C: Vecuronium. This drug was most likely administered to achieve muscle relaxation in the 74-year-old man with impaired hepatic and renal function undergoing abdominal surgery because it is primarily eliminated through the liver and does not require renal excretion. This makes it a safer choice in patients with impaired hepatic and renal function. Succinylcholine (A) can cause hyperkalemia in renal failure patients. Tubocurarine (B) is eliminated through the kidneys, which can be problematic in renal impairment. Mivacurium (D) is metabolized by plasma cholinesterase, which can be affected in liver dysfunction.
Question 3 of 5
Which of the following muscle relaxants would be contraindicated in a patient with Tubocurarine deficiency of plasma cholinesterase?
Correct Answer: A
Rationale: The correct answer is A: Tubocurarine. Tubocurarine is a non-depolarizing muscle relaxant that works by blocking the action of acetylcholine at the neuromuscular junction. In a patient with Tubocurarine deficiency of plasma cholinesterase, using Tubocurarine as a muscle relaxant would be contraindicated because it would exacerbate the deficiency and lead to prolonged effects. Summary of other choices: B: Cisatracurium - Not contraindicated in a patient with Tubocurarine deficiency of plasma cholinesterase. C: Baclofen - Acts on spinal cord neurons, not related to neuromuscular junction function. D: Mivacurium - A short-acting non-depolarizing muscle relaxant, not contraindicated in this scenario.
Question 4 of 5
Which of the following molecular actions most likely mediated the therapeutic effect of botulinum toxin in the patient's disorder?
Correct Answer: D
Rationale: The correct answer is D: Inhibition of acetylcholine exocytosis from cholinergic terminals. Botulinum toxin works by blocking the release of acetylcholine at the neuromuscular junction, leading to muscle paralysis. This inhibition prevents the communication between nerve cells and muscles, resulting in the therapeutic effect. Choices A, B, and C are incorrect as they do not directly relate to the mechanism of action of botulinum toxin in blocking acetylcholine release.
Question 5 of 5
Which of the following was most likely the primary reason for the use of cisatracurium instead of tubocurarine in this patient?
Correct Answer: C
Rationale: The correct answer is C: Propofol induction. Cisatracurium is preferred over tubocurarine for patients undergoing propofol induction due to its faster onset and shorter duration of action, aligning with propofol's rapid onset and short duration. This minimizes the risk of prolonged muscle paralysis and respiratory depression. Liver insufficiency (A) and renal insufficiency (D) would not affect the choice between cisatracurium and tubocurarine. Advanced age (B) alone is not a primary factor for choosing cisatracurium over tubocurarine.