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Chapter 4. Pharmacology of Drugs Used in Airway Management

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

A. It is metabolized by hepatic enzymes.

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

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

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

E. It is metabolized primarily by plasma pseudocholinesterases.

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

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

A. immediately after the burn

B. more than 1 day after the burn

C. more than 2 days after the burn

D. more than 3 days after the burn

E. more than 4 days after the burn

(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.

Which of the following statements is NOT true about Sugammadex?

A. Sugammadex is a modified g-cyclodextrin.

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

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

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

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

(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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