Anesthesia Flashcards
1
Q
What is evaluated preanesthetically?
A
work-up, pain, stress
2
Q
What might be administered preanesthetically?
A
antibiotics, fluids, oxygen
3
Q
What 5 things are monitored during anesthesia?
A
circulation, oxygenation, ventilation, temperature, depth of anesthesia
4
Q
What anticholinergics are used to premedicate?
A
atropine, glycopyrrolate
5
Q
1 MAC
A
light anesthesia
6
Q
local anesthetics mechanism of action
A
disrupt impulse generation or propagation
7
Q
two classes of local anesthetics
A
esters and amides
8
Q
resting membrane potential between
A
-30 and -90
9
Q
nonmyelinated nerves
A
autonomic postganglionic efferents and nociceptive afferent C fibers
10
Q
A ____ myelinated fibers that conduct pain
A
delta
11
Q
sharp pain conducted by, dull pain conducted by
A
A delta, C
12
Q
unmyelinated fibers that conduct dull pain
A
C
13
Q
differential blockade of neurons
A
analgesia without affecting motor strength or autonomics
14
Q
local anesthetic that produces differential blockade
A
bupivacaine
15
Q
local anesthetic more effective in acidic/alkaline environment
A
alkaline
16
Q
states of ion channel that bind to local anesthetics more
A
open and inactivated
17
Q
block _____ with more frequent nerve firing
A
intensifies
18
Q
systemic uptake of local anesthetics
A
decreases activity and increases systemic toxicity
19
Q
general structure of local anesthetics
A
aromatic ring, intermediate linkage, terminal amine
20
Q
primary factor of potency
A
hydrophobicity
21
Q
Nocita diffusion from injection site
A
minimal
22
Q
possible injection reaction to Nocita
A
mild granulomatous inflammation
23
Q
volume will influence _____ of local anesthesia
A
spread
24
Q
epinephrine co-administered with local anesthetic
A
increase duration by decreasing removal
25
alpha-2 agonists co-administered with local anesthetic
speed onset and increase duration of action
26
buprenorphine co-administered with local anesthetics
prolong blockade
27
dexamethasone co-administered with local anesthetics
increase duration of blockade
28
sodium bicarbonate co-administered with local anesthetic
speed onset, decreases concentration required, decrease injection pain
29
mixtures of local anesthetics
toxicities additive, may lose benefits (rapid onset/long duration)
30
EMLA cream
eutectic mixture of local anesthetics (lidocaine/prilocaine, dressing, long onset
31
cats vs dogs sensitivity to toxicity
cats more sensitive
32
standard treatment for systemic toxicity with local anesthetics
intralipid infusion
33
main systems affected by local anesthetic toxicity
CNS, cardiovascuar
34
local tissue toxicity due to local anesthetics
reversible myonecrosis
35
allergic reactions to local anesthetics more common in esters/amides
esters
36
inhaled anesthetic mechanism general effects
increase inhibitory transmission, decrease excitatory transmission, EEG modification
37
minimum alveolar concentration
minimum concentration of an anesthetic at 1 atm that prevents a response to a painful stimulus in 50% of individuals
38
elimination of inhalant anesthetics is primarily through
lungs
39
inhaled anesthetic potency increases with
lipid solubility and protein targets
40
inhaled anesthetics likely affect
neurotransmitter-gated ion channels
41
all inhaled anesthetics potentiate ____ signaling
GABAA
42
presynaptic release machinery
inhaled anesthetics affect presynaptic neurotransmitter release
43
MACimmobility
prevention of movement (likely reflects peripheral targets)
44
MAC measured as
end-tidal concentration
45
1.5 MAC
moderate surgical anesthesia
46
older patients require _____ concentrations of inhaled anesthetics
lower
47
smaller patients require _____ concentrations of inhaled anesthetics
higher
48
hypothermia _____ anesthetic requirements
lowers
49
0.5 MAC
MAC awake
50
effects of inhalant anesthesia
amnesia, sedation, unconsciousness, immobility
51
physical properties of inhalant anesthetic to consider
volatility and boiling point
52
anesthetic system determines
concentration patient exposed to, rate of change of concentration
53
sevoflurane and CO2 absorbent results in
compound A
54
N2O toxicity
demyelination due to inhibition of B12
55
opioid effect on biliary system
increased biliary muscle tone/biliary pressure
56
opioid effect on GI system
increased GI muscle tone, increased pyloric sphincter, constipation
57
treatment of peripheral opioid effects
peripheral antagonist (methylnaltrexone)
58
opioid effect on body temperature
dogs decreased, cats increased
59
apomorphine action
dopamine agonist
60
opioid-induced hyperalgia
increased sensitivity to pain after opioid therapy
61
drugs that reverse opioid-induced hyperalgia
NMDA receptor antagonists
62
opioid effects limited by
p-glycoprotein efflux pump
63
most metabolites of opioids more/less potent
less
64
AT-121 acts at
nociceptin and mu receptor (partial)
65
opioids ______ inhaled anesthesia requirement
decreases, except horses
66
etorphine acts at which receptors
mu, delta, kappa
67
opioids that work at kappa receptors
morphine, etorphine, butorphanol, nalbuphine
68
partial mu agonists
butrophanol, buprenorphine
69
reasons tramadol doesn't work in dogs
extensive metabolism, rapid elimination
70
tramadol contraindicated drugs
serotonin reuptake/metabolism drugs
71
propofol allergy
egg/soy proteins (intradermal)
72
propofol action
enhance GABA effects at GABAA
73
propofol effect on dopamine
increase dopamine release
74
propofol redistribution and metabolism
rapid; glucuronide synthase, clearance exceeds hepatic blood flow
75
propofol cardiovascular effects
decreased resistance, negative inotrope, decreased BP
76
propofol respiratory effects
hypoxemia, ventilatory response depressed
77
alfaxalone structure
neurosteroid
78
alfaxalone mechanism
GABAA receptors
79
alfaxalone recovery
better with sedatives/tranquilizers/analgesics
80
cough suppressant opioids
codeine, butorphanol, dextromethorphan
81
pupil appearance smallies opioids
dogs: miosis
cats: mydriasis
82
nausea/vomiting associated with _____ (opioids)
dopamine or serotonin receptors
83
immune effect of opioids
immunosuppression
84
high doses of opioids can result in
seizures
85
tramadol interaction with NSAIDs
increase GI side effects
86
uses of general anesthesia
humane restraint, control convulsions, euthanasia
87
slow administration of propofol decreases
dose required and respiratory depression
88
etomidate feature
rapid induction/recovery
89
etomidate minimal effects on
CV and respiratory systems
90
etomidate transient effects
myoclonus, pain on injection
91
etomidate negative effects
inhibition of steroidogenesis, hemolysis
92
C2 of barbituric acid defines
thio vs oxy
93
C5 of barbituric acid defines
hypnotic and sedative activity
94
pentobarbital _____ duration than thiopental
longer
95
pentobarbital uses
anesthesia in laboratory rodents, euthanasia
96
breed sensitivity to thiopental
sighthounds
97
guaifenesin
centrally acting skeletal muscle relaxant, drowsiness and potentiates other agents
98
guaifenesin risk at high concentrations
hemolysis
99
guaifenesin, xylazine, ketamine used for
prolonging anesthesia in field
100
NMDA receptor drugs
ketamine, tiletamine, amantadine
101
ketamine elimination in cats
kidney; unchanged
102
ketamine analgesic use
opioid hyperalgia, neuropathic pain
103
ketamine effect on CBF, cerebral metabolic rate, ICP, HR, BP
increase
104
ketamine directly _____ inotrope
negative, but CNS effects make indirect stimulant
105
ketamine respiratory effects
change breathing pattern, bronchodilation, increased airway secretions, maintain laryngeal reflexes
106
chloralose use
nonsurvival physiological investigation for CV
107
urethane use
nonsurvival laboratory animal anesthesia
108
tricaine methanesulfonate
fish and amphibian anesthetic, dissolved in water
109
eugenol
fish anesthesia, not approved
