Coming in an aesthetically pleasing little orange container, glucagon is a drug anaesthetists administer infrequently. Funnily enough the most common indication that we give glucagon for has nothing to do with hypoglycaemia. Rather it is given to treat suspected spasm of the sphincter of Oddi demonstrated on an intraoperative cholangiogram when performed during a lap chole. The second most common indication in our sphere of influence is probably the management of impacted food boluses. Both of these indications relate to the smooth muscle relaxant action of glucagon.
Glucagon is an anabolic hormone TRUE/FALSE
Glucagon is synthesized by the alpha cells of the islets of Langerhans TRUE/FALSE
Glucagon is effective in the management of beta blocker overdose because it firmly binds to adrenoceptors TRUE/FALSE
Glucagon is an inotrope and chronotrope TRUE/FALSE
Glucagon binds to a G protein coupled receptor and inhibits adenylate cyclase activity and thus reduces cAMP TRUE/FALSE
Insulin preparations are synthesized using recombinant technology TRUE/FALSE
If injected intravenously, long acting insulins will still have a long duration of action TRUE/FALSE
Insulins are metabolized by the liver TRUE/FALSE
Measurement of C-peptide levels can differentiate endogenous from exogenous insulin TRUE/FALSE
Glargine insulin (Lantus) forms microprecipitates when injected subcutaneously* TRUE/FALSE
* Lantus commonly stings when injected- my diabetic father will attest to this! This is related to its formulation. Can you hazard a guess at its pH and why it is formulated like that?
Although insulin will degrade at room temperature, it is similar to suxamethonium in that it will be retain adequate activity for well over a month if left out on your anaesthetic trolley.
Describe the pharmacology of * insulin preparations *oral hypoglycaemic *corticosteroid drugs.
Intravenous dexamethasone has a slow onset of action. TRUE/FALSE
Prednisone and dexamethasone are synthetic corticosteroids with predominantly mineralocorticoid effects. TRUE/FALSE
The anti-inflammatory response of corticosteroids is a mineralocorticoid effect. TRUE/FALSE
Mineralocorticoid effects of synthetic corticosteroids are less than the natural hormones. TRUE/FALSE
Dexamethasone lacks mineralocorticoid effects. TRUE/FALSE