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Chapter 4. Pharmacology of Drugs Used in Airway Management

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Which of the following is a true statement about the elimination of remifentanil?

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A. It is metabolized by hepatic enzymes.

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B. It is primarily removed from the body unchanged by the kidneys.

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C. It is metabolized primarily by plasma and tissue esterases.

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D. It is primarily removed from the body by Hofmann degradation.

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E. It is metabolized primarily by plasma pseudocholinesterases.

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(C) The ester linkage of remifentanil renders it susceptible to cleavage by nonspecific plasma and tissue esterases.

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To avoid serious hyperkalemia, which of the following is NOT considered a safe period to administer succinylcholine to a burned patient?

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A. immediately after the burn

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B. more than 1 day after the burn

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C. more than 2 days after the burn

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D. more than 3 days after the burn

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E. more than 4 days after the burn

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(E) In burn victims, extrajunctional receptor sensitization becomes clinically significant at 4 to 5 days postburn. It lasts an indefinite period of time, although the “at-risk” period is deemed to have passed at the point healing of the burned area is complete.

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Which of the following statements is NOT true about Sugammadex?

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A. Sugammadex is a modified g-cyclodextrin.

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B. Sugammadex selectively binds and inactivates vecuronium, enhancing neuromuscular recovery.

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C. Sugammadex selectively binds and inactivates rocuronium, enhancing neuromuscular recovery.

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D. Sugammadex interacts with nicotinic receptors by displacing rocuronium and vecuronium.

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E. Sugammadex does not appear to have any significant hemodynamic or respiratory effects.

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(D) Sugammadex encapsulates and inactivates rocuronium and vecuronium; the resultant complex is excreted in the urine. It does not interact with nicotinic receptors by displacing rocuronium and vecuronium.

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