Anesthesia Tutorial of the Week Quiz

1) Remimazolam tosilate belongs to the benzodiazepine class of drugs.

2) Remimazolam is highly protein bound.

3) Remimazolam is licensed for procedural sedation in the UK.

4) Remimazolam was approved in August 2020 for compassionate use in intensive care sedation in Europe.

5) Carboxylesterase-2 is the primary enzyme responsible for metabolising remimazolam into its pharmacologically inactive metabolite CNS 7054.

6) Remimazolam is contraindicated in patients with known hypersensitivity reactions to Dextran 40.

7) Remimazolam works on the γ subunits of the GABAA receptor to induce cell membrane hyperpolarisation and inhibit CNS activity via an increase in chloride ion influx.

8) Remimazolam contains a carboxylic ester group.

9) The remimazolam metabolite CNS 7054 remains active.

10) Flumazenil reverses the effects of remimazolam in all patients.

11) Remimazolam prolongs the QRS duration.

12) Remimazolam has a shorter context sensitive half time than dexmedetomidine.

13) The volume of distribution of remimazolam is greater than midazolam.

14) The elimination clearance of remimazolam is greater than midazolam.

15) Remimazolam has reduced drug elimination in individuals with severe hepatic impairment, Child Pugh class C.

16) The intranasal route for remimazolam has 80% bioavailability.

17) Initial remimazolam dose should be reduced in elderly patients.

18) Remimazolam comes in a 20mg powder formulation which is mixed with 8.2 mL of normal saline.

19) The safety and efficacy of remimazolam in paediatric populations is well established.

20) Clinical effects of remimazolam maybe more pronounced and last longer in patients with severe hepatic impairment.