11/12: Induction Agents & Techniques Flashcards
What is stage I of anesthetic depth?
Stage of voluntary movement; from initial admin of drugs to loss of consciousness
What is stage II of anesthetic depth?
Stage of delirium and involuntary movement; disinhibition; react to stimuli, struggle, vocalize
T/F: Intubation should be attempted at stage II of anesthetic depth
False;
There is risk of vomiting/regurgitation
What is stage III of anesthetic depth?
Progressive loss of reflexes/muscle tone (light, medium, deep)
Where are eyes located in the light plane of stage III?
Where are eyes located in the medium plane of stage III?
Where are eyes located in the deep plane of stage III?
What is a good way to check if an animal is too light or too deep?
Check palpebral reflexes
Which is the most important stage and where do you want your patient to be?
Stage III;
Want to be somewhere between plane 1 and plane 2
What is stage IV of anesthetic depth?
Extreme CNS depression;
Pulses weak/not palpable, resp may cease;
eyes central, pupils dilated
What are the 5 criteria of general anesthesia?
- Analgesia (loss of response to pain)
- Amnesia (loss of memory)
- Immobility (loss of motor reflexes)
- Hypnosis (unconsciousness)
- Paralysis (skeletal m relaxation and normal m relaxation)
What is pharmacokinetics?
What the body does to the drugs
What is pharmacodynamics?
What drugs do to the body
Why does it take some time for a drug to circulate to the brain after it is given?
Depends on circulation time and equilibrium time;
Has to cross BBB and interstitium
What is the % CO to the brain?
14%
What is the % CO to the kidney?
23%
What is the % CO to the liver?
5.8%
What is the % CO to the muscles?
16%
What is the % CO to the skin?
5%
What is the % CO to the fat?
2%
Why does drug [] decrease over time (after initial increase)?
Because it is distributed to the fat and muscle and away from the brain
What is the ideal administration rate?
Not too fast, not too slow
What can happen if a drug is administered too fast?
Overdose
What can happen if a drug is administered too slowly?
Stage 2 or not anesthetized at all
Concentration = solute/solution = _____/_____
Drug (X) / Volume of distribution (Vd)
Why is the apparent volume of a drug not the actual volume?
Due to distribution
What drug characteristics influence distribution?
Lipophilicity, protein binding, tissue binding, charge, pKa, size
What patient characteristics influence distribution?
Age, breed, body composition, pH, plasma protein, tissue inflammation
Larger Vd = _____ _____
longer duration
Which of these drugs have the largest Vd?
C > A > B
How do you calculate the loading dose?
C x Vd
Calculate the loading dose of propofol in dogs:
Vd = 0.78 L/kg, Induction [] = 8 µg/mL
Dose = C x Vd
Dose = 8 µg/mL x 0.78 L/kg
Dose = 8 mg/L x 0.78 L/kg
Dose = 6.14 mg/kg
What does this graph represent?
First-order kinetics
What does this graph represent?
Zero-order kinetics
What is plasma/blood clearance?
Volume of a totally cleared substance per unit of time
What is the equation for clearance?
Clearance = k x Vd
(k = elimination constant)
What are the phases of half life?
Distribution and elimination
What is the equation for half life?
t1/2 = 0.693/K
How is infusion rate calculated?
C (ss) x K x Vs (ss)
= C (ss) x Cl
Calculate infusion rate of propofol in dogs:
Vd (ss) = 4.5 L/kg, Cl = 54 ml/kg/min, t1/2 = 57 minutes, K = 0.012 minute-1, maint [] = 4 µg/ml
IR = C (ss) Cl
IR = 4 µg/ml x 54 ml/kg/min
IR = 208 µg/kg/min
What does one vial of propofol contain?
1% propofol, soybean oil, egg phasphatide, glycerol, NaOH
Propofol is ____ at room temp and is not tissue ____.
stable, irritating
How long after opening does propofol have to be discarded and why?
6 hours - adjuvant promotes bacterial growth
What does Propofol 28 contain and why is it problematic?
Benzyl alcohol - toxic to cats;
Can cause hemolysis, may be able to use for a single injection only
What is the shelf life of propofol 28?
28 days from opening
Propofol 28 is bacterio_____.
static