Anesthesia Flashcards

1
Q

What are the four classes of opioids and give an example of each.

A
  • Full agonists - Morphine, hydromorphone, oxymorphone, fentanyl, alfentanyl, sufentanyl, remifentanyl, methadone
  • Partial agonist- Buprenorphine
  • Agonist/antagonist- Butorphanol
  • Antagonist- Naloxone
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2
Q

What are the uses of Anticholinergics (2)

A

a. Prevention and/or treatment of bradycardia.
b. During cardiopulmonary resuscitation (CPR).

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3
Q

What is the mechanism of action of anticholinergics?

A

a. Competitive antagonist of acetylcholine at the muscarinic postganglionic
receptors in the autonomic nervous system.

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4
Q

What are the contraindications of anticholinergics? (4)

A

a. Patients with preexisting tachycardia or cardiac diseases where increase
in heart rate is contraindicated (e. g., hypertrophic cardiomyopathy)
b. When the existent bradycardia was caused by an alpha-2 agonist
c. Animals with narrow angle glaucoma and synechia
d. In Horses UNLESS severe bradycardia (HR < 20) is present and
unresponsive to other treatment options.

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5
Q

Anticholinergics should be avoided in horses EXCEPT in what SPECIFIC circumstance.

A

d. In Horses UNLESS severe bradycardia (HR < 20) is present and
unresponsive to other treatment options.

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6
Q

What systems does Atropine sulfate effect

A

Cardiovascular, Respiratory, and CNS

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7
Q

What are the cardiovascular effects of Atropine (5)

A
  • Increases heart rate
  • Increases myocardial work
  • Decreases myocardial perfusion if degree of tachycardia significantly reduces ventricular filling time
  • +/- affect blood pressure
  • Low doses may cause transient bradycardia & 1st or 2nd degree AV block due to presynaptic muscarinic receptor blockade that normally inhibit release of acetylcholine
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8
Q

What are the respiratory effects of Atropine

A

Decreases oral, pharyngeal, and respiratory tract secretions. and * Bronchodilation

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9
Q

What are the CNS effects of Atropine

A
  • Crosses the blood brain barrier
  • Overdosage can stimulate the CNS and cause seizures
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10
Q

What special considerations need to be taken for horses when administering atropine sulfate

A

Decreases motility and secretory activity of the gastrointestinal tract. Can result in gastrointestinal stasis (Colic) in horses.

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11
Q

What is the duration of atropine when given IV and IM

A

Duration: IV: 30 min, IM: 1 – 1.5 hours

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12
Q

What is the use of Tranquilizers / Sedatives

A

Commonly used to induce sedation and decrease anxiety before the induction of
anesthesia. They can also be used prior to physical examination, diagnostic
procedures, or to transport animals.

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13
Q

What are some uses for Acepromazine

A
  • Sedation
  • Antiemetic
  • Anti arrhythmogenic
  • Antihistaminic
  • Antipruritic
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14
Q

What is the mechanism of action of Acepromazine

A
  • Block post synaptic dopamine receptors in the basal ganglia and limbic system
  • May also inhibit the release of, and increase the turnover rate of dopamine
  • Block the action of serotonin
  • Block alpha-1 adrenergic receptors
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15
Q

What are the cardiovascular effects of Acepromazine

A
  • Causes dose dependent vasodilation, that may lead hypotension, due to depression of vasomotor reflexes mediated by the hypothalamus and brainstem, peripheral alpha-1 adrenergic blockade, direct relaxing effect on vascular smooth muscle, and direct cardiac depression (negative inotrope)
  • Hypotension may lead to a reflex sinus tachycardia
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16
Q

What are the respiratory effects of acepromazine

A

The respiratory effects are minimal

17
Q

What CNS affects does acepromazine have

A

-CNS depression and sedation by affecting the basal ganglia, hypothalamus, limbic system, brain stem, and reticular activating system
-Depresses the thermoregulation center
-Potentiates the sedative effects of opioids

18
Q

What is the duration of acepromazine in dogs, cats, and horses

A

3 – 6 hours in dogs and cats
1-2 hours in horses.

19
Q

2 Benzodiazepines
Reasons for administration of benzodiazepines are what?

A

Mild sedation, muscle relaxation, and anxiolysis,
and as an anticonvulsant

20
Q

What is the mechanism of action of Benzodiazepines?

A

Binds to specific benzodiazepines GABAA receptor in
the brainstem reticular formation and spinal cord.

21
Q

What are the two systems that see minimal effects from Diazepam?

A

Cardiovascular and Respiratory

22
Q

What happens if you rapidly administer diazepam IV?

A

When infused rapidly, it can cause hypotension due to the high concentration of propylene glycol.
* Rapid intravenous infusion may cause pain and venous thrombosis

23
Q

What is diazepam dissolved in and why?

A

It is dissolved in 40% propylene glycol because it is not water soluble.

24
Q

What organ metabolizes diazepam?

A

Liver