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Pharmacology > Anesthesia > Flashcards

Anesthesia Flashcards

1
Q

What is evaluated preanesthetically?

A

work-up, pain, stress

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2
Q

What might be administered preanesthetically?

A

antibiotics, fluids, oxygen

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3
Q

What 5 things are monitored during anesthesia?

A

circulation, oxygenation, ventilation, temperature, depth of anesthesia

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4
Q

What anticholinergics are used to premedicate?

A

atropine, glycopyrrolate

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5
Q

1 MAC

A

light anesthesia

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6
Q

local anesthetics mechanism of action

A

disrupt impulse generation or propagation

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7
Q

two classes of local anesthetics

A

esters and amides

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8
Q

resting membrane potential between

A

-30 and -90

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9
Q

nonmyelinated nerves

A

autonomic postganglionic efferents and nociceptive afferent C fibers

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10
Q

A ____ myelinated fibers that conduct pain

A

delta

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11
Q

sharp pain conducted by, dull pain conducted by

A

A delta, C

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12
Q

unmyelinated fibers that conduct dull pain

A

C

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13
Q

differential blockade of neurons

A

analgesia without affecting motor strength or autonomics

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14
Q

local anesthetic that produces differential blockade

A

bupivacaine

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15
Q

local anesthetic more effective in acidic/alkaline environment

A

alkaline

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16
Q

states of ion channel that bind to local anesthetics more

A

open and inactivated

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17
Q

block _____ with more frequent nerve firing

A

intensifies

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18
Q

systemic uptake of local anesthetics

A

decreases activity and increases systemic toxicity

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19
Q

general structure of local anesthetics

A

aromatic ring, intermediate linkage, terminal amine

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20
Q

primary factor of potency

A

hydrophobicity

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21
Q

Nocita diffusion from injection site

A

minimal

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22
Q

possible injection reaction to Nocita

A

mild granulomatous inflammation

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23
Q

volume will influence _____ of local anesthesia

A

spread

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24
Q

epinephrine co-administered with local anesthetic

A

increase duration by decreasing removal

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25
Q

alpha-2 agonists co-administered with local anesthetic

A

speed onset and increase duration of action

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26
Q

buprenorphine co-administered with local anesthetics

A

prolong blockade

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27
Q

dexamethasone co-administered with local anesthetics

A

increase duration of blockade

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28
Q

sodium bicarbonate co-administered with local anesthetic

A

speed onset, decreases concentration required, decrease injection pain

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29
Q

mixtures of local anesthetics

A

toxicities additive, may lose benefits (rapid onset/long duration)

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30
Q

EMLA cream

A

eutectic mixture of local anesthetics (lidocaine/prilocaine, dressing, long onset

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31
Q

cats vs dogs sensitivity to toxicity

A

cats more sensitive

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32
Q

standard treatment for systemic toxicity with local anesthetics

A

intralipid infusion

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33
Q

main systems affected by local anesthetic toxicity

A

CNS, cardiovascuar

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34
Q

local tissue toxicity due to local anesthetics

A

reversible myonecrosis

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35
Q

allergic reactions to local anesthetics more common in esters/amides

A

esters

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36
Q

inhaled anesthetic mechanism general effects

A

increase inhibitory transmission, decrease excitatory transmission, EEG modification

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37
Q

minimum alveolar concentration

A

minimum concentration of an anesthetic at 1 atm that prevents a response to a painful stimulus in 50% of individuals

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38
Q

elimination of inhalant anesthetics is primarily through

A

lungs

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39
Q

inhaled anesthetic potency increases with

A

lipid solubility and protein targets

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40
Q

inhaled anesthetics likely affect

A

neurotransmitter-gated ion channels

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41
Q

all inhaled anesthetics potentiate ____ signaling

A

GABAA

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42
Q

presynaptic release machinery

A

inhaled anesthetics affect presynaptic neurotransmitter release

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43
Q

MACimmobility

A

prevention of movement (likely reflects peripheral targets)

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44
Q

MAC measured as

A

end-tidal concentration

45
Q

1.5 MAC

A

moderate surgical anesthesia

46
Q

older patients require _____ concentrations of inhaled anesthetics

A

lower

47
Q

smaller patients require _____ concentrations of inhaled anesthetics

A

higher

48
Q

hypothermia _____ anesthetic requirements

A

lowers

49
Q

0.5 MAC

A

MAC awake

50
Q

effects of inhalant anesthesia

A

amnesia, sedation, unconsciousness, immobility

51
Q

physical properties of inhalant anesthetic to consider

A

volatility and boiling point

52
Q

anesthetic system determines

A

concentration patient exposed to, rate of change of concentration

53
Q

sevoflurane and CO2 absorbent results in

A

compound A

54
Q

N2O toxicity

A

demyelination due to inhibition of B12

55
Q

opioid effect on biliary system

A

increased biliary muscle tone/biliary pressure

56
Q

opioid effect on GI system

A

increased GI muscle tone, increased pyloric sphincter, constipation

57
Q

treatment of peripheral opioid effects

A

peripheral antagonist (methylnaltrexone)

58
Q

opioid effect on body temperature

A

dogs decreased, cats increased

59
Q

apomorphine action

A

dopamine agonist

60
Q

opioid-induced hyperalgia

A

increased sensitivity to pain after opioid therapy

61
Q

drugs that reverse opioid-induced hyperalgia

A

NMDA receptor antagonists

62
Q

opioid effects limited by

A

p-glycoprotein efflux pump

63
Q

most metabolites of opioids more/less potent

A

less

64
Q

AT-121 acts at

A

nociceptin and mu receptor (partial)

65
Q

opioids ______ inhaled anesthesia requirement

A

decreases, except horses

66
Q

etorphine acts at which receptors

A

mu, delta, kappa

67
Q

opioids that work at kappa receptors

A

morphine, etorphine, butorphanol, nalbuphine

68
Q

partial mu agonists

A

butrophanol, buprenorphine

69
Q

reasons tramadol doesn’t work in dogs

A

extensive metabolism, rapid elimination

70
Q

tramadol contraindicated drugs

A

serotonin reuptake/metabolism drugs

71
Q

propofol allergy

A

egg/soy proteins (intradermal)

72
Q

propofol action

A

enhance GABA effects at GABAA

73
Q

propofol effect on dopamine

A

increase dopamine release

74
Q

propofol redistribution and metabolism

A

rapid; glucuronide synthase, clearance exceeds hepatic blood flow

75
Q

propofol cardiovascular effects

A

decreased resistance, negative inotrope, decreased BP

76
Q

propofol respiratory effects

A

hypoxemia, ventilatory response depressed

77
Q

alfaxalone structure

A

neurosteroid

78
Q

alfaxalone mechanism

A

GABAA receptors

79
Q

alfaxalone recovery

A

better with sedatives/tranquilizers/analgesics

80
Q

cough suppressant opioids

A

codeine, butorphanol, dextromethorphan

81
Q

pupil appearance smallies opioids

A

dogs: miosis
cats: mydriasis

82
Q

nausea/vomiting associated with _____ (opioids)

A

dopamine or serotonin receptors

83
Q

immune effect of opioids

A

immunosuppression

84
Q

high doses of opioids can result in

A

seizures

85
Q

tramadol interaction with NSAIDs

A

increase GI side effects

86
Q

uses of general anesthesia

A

humane restraint, control convulsions, euthanasia

87
Q

slow administration of propofol decreases

A

dose required and respiratory depression

88
Q

etomidate feature

A

rapid induction/recovery

89
Q

etomidate minimal effects on

A

CV and respiratory systems

90
Q

etomidate transient effects

A

myoclonus, pain on injection

91
Q

etomidate negative effects

A

inhibition of steroidogenesis, hemolysis

92
Q

C2 of barbituric acid defines

A

thio vs oxy

93
Q

C5 of barbituric acid defines

A

hypnotic and sedative activity

94
Q

pentobarbital _____ duration than thiopental

A

longer

95
Q

pentobarbital uses

A

anesthesia in laboratory rodents, euthanasia

96
Q

breed sensitivity to thiopental

A

sighthounds

97
Q

guaifenesin

A

centrally acting skeletal muscle relaxant, drowsiness and potentiates other agents

98
Q

guaifenesin risk at high concentrations

A

hemolysis

99
Q

guaifenesin, xylazine, ketamine used for

A

prolonging anesthesia in field

100
Q

NMDA receptor drugs

A

ketamine, tiletamine, amantadine

101
Q

ketamine elimination in cats

A

kidney; unchanged

102
Q

ketamine analgesic use

A

opioid hyperalgia, neuropathic pain

103
Q

ketamine effect on CBF, cerebral metabolic rate, ICP, HR, BP

A

increase

104
Q

ketamine directly _____ inotrope

A

negative, but CNS effects make indirect stimulant

105
Q

ketamine respiratory effects

A

change breathing pattern, bronchodilation, increased airway secretions, maintain laryngeal reflexes

106
Q

chloralose use

A

nonsurvival physiological investigation for CV

107
Q

urethane use

A

nonsurvival laboratory animal anesthesia

108
Q

tricaine methanesulfonate

A

fish and amphibian anesthetic, dissolved in water

109
Q

eugenol

A

fish anesthesia, not approved

Pharmacology (7 decks)

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