Surgical Pharmacology Flashcards

Which neuromuscular blocking agent has the fastest onset and shortest duration, making it ideal for rapid sequence intubation?

Answer: Succinylcholine

Succinylcholine has the fastest onset (approximately 60 seconds) and shortest duration (5-10 minutes), making it the classic choice for RSI.

Neostigmine is administered at the end of surgery to:

Answer: Reverse non-depolarizing neuromuscular blockade

Neostigmine inhibits acetylcholinesterase, increasing acetylcholine at the neuromuscular junction to overcome non-depolarizing blockade.

Which vasoactive drug is a first-line vasopressor for septic shock and acts on alpha and beta adrenergic receptors?

Answer: Norepinephrine

Norepinephrine is the first-line vasopressor for septic shock, acting primarily on alpha-1 receptors to increase systemic vascular resistance.

What is the maximum safe dose of lidocaine WITHOUT epinephrine for local infiltration?

Answer: 5 mg/kg

The maximum recommended dose of plain lidocaine for infiltration is 4-5 mg/kg to avoid systemic toxicity.

Ondansetron prevents postoperative nausea and vomiting by blocking which receptor?

Answer: Serotonin 5-HT3 receptor

Ondansetron is a selective 5-HT3 antagonist that blocks serotonin receptors in the chemoreceptor trigger zone and vagal afferents.

Which drug used in surgery can cause 'red man syndrome' if infused too rapidly?

Answer: Vancomycin

Rapid infusion of vancomycin causes histamine release resulting in flushing, erythema, and hypotension known as red man syndrome.

Sodium bicarbonate is sometimes added to local anesthetic solutions before injection in order to:

Answer: Raise the pH and speed onset of the block

Alkalinizing the solution with sodium bicarbonate shifts more drug to the uncharged base form, which crosses nerve membranes faster and accelerates onset.