Sunday, July 29, 2012

BARBITURATES: THIOPENTAL

QUESTION 1: Thiopental is contraindicated in:
A. porphyria congenita
B. porphyria cutanea tarda
C. acute intermittent porphyria
D. myotonia
E. chorea

QUESTION 2: Propofol compared to thiopental:
A. is less likely to provoke bronchospasm
B. if administered in equipotent doses for induction of anesthesia causes less reduction in systemic blood pressure
C. causes adrenal suppression after prolonged infusion
D. has no effect on cerebral metabolic rate
E. does not cause excitatory motor activity

QUESTION 3: The action of thiopental after injection is terminated by:
A. its elimination unchanged by the kidneys
B. its biotransformation by the liver
C. its being bound to proteins
D. its redistribution
E. being taken up in fatty tissues




ANSWER 1: (C) Thiopental is contraindicated in patients with acute intermittent porphyria.  The other porphyrias listed as options are not associated with enzyme induction

ANSWER 2: (A) excitatory phenomena after propofol induction occur at about the same frequency as with thiopental, however, bronchospasm appears to occur less frequently.  In equipotent doses, propofol produces a dose-dependent decrease in blood pressure that is more pronounced than with thiopental administration.  Propofol and thiopental cause a similar decrease in cerebral metabolic rate.  Adrenal suppression occurs after the administration of etomidate.

ANSWER 3: (D) The action of thiopental is terminated by redistribution.  The drug is bound to protein, and various concomitant drugs may interfere with binding.  It is taken up in fatty tissues, but that is not the mechanism of terminating its effect.

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