Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesia > Anesthesia ch 8 > Flashcards

Anesthesia ch 8 Flashcards

1
Q

Acute Pain

A

Pain of immediate onset after tissue injury. Resolves when healing is complete.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

adaptive pain

A

Pain that promotes survival by preventing injury and by promoting healing of the injured body part. Physiologic pain is an example of adaptive pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

algesia

A

Sensitivity to pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

allodynia

A

A phenomenon in which an uninjured area close to a site of tissue injury is painful if stimulated with a normally non-noxious stimulus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

analgesia

A

sensitive to pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

catabolic state

A

A metabolic state in which the rate of catabolism (the breakdown of body tissues and substances into simple molecules) exceeds the rate of anabolism (the synthesis of body tissues and substances from simple molecules).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

categorical numeric rating scale

A

A tool used to assess pain. Has a series of numeric rating scales with descriptions to rate each of several categories of behavior and or physiologic changes separately, such as appearance, interaction, posture, and response to palpation of the wound. The points for each of the categories are totaled.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

central nervous system hypersensitivity

A

A state, caused by constant nociceptive input from the periphery, in which neurons in the spinal cord become hyperexcitable and sensitive to low intensity stimuli that would not normally elicit a pain response. Also referred to as secondary hyperalgesia or windup.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

chronic pain

A

Pain that lasts weeks, months, or years and persists after the tissues have healed or when they will not heal (such as in cancer patients).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

distress

A

An extreme form of stress that leads to anxiety and suffering.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

emergence delirium

A

Disorientation that occurs during anesthetic recovery as consciousness returns. May be characterized by vocalization, aggression, thrashing, and locomotor activity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

idiopathic pain

A

Pain of unknown or unidentifiable cause.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

inflammatory pain

A

Pain that occurs at the site of tissue injury due to the release of chemical mediators such as prostaglandin and histamine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

locomotor

A

Relating to movement from place to place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

maladaptive pain

A

Pain that is due to malfunction of or damage to the nervous system and that serves no useful function, but causes suffering and is often difficult to treat.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

mediators

A

Chemical substances released from damaged cells or inflammatory cells that cause a response (such as increasing the sensitivity of peripheral pain receptors).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

modulation

A

The third step in nociception, in which sensory nerve impulses are amplified or suppressed by other neurons.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

morbidity

A

The incidence of disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mortality

A

The death rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

multimodal therapy

A

Treatment of pain with analgesics that target two or more types of pain receptors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

neuropathic pain

A

Pain resulting from injury of a nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

numeric rating scale

A

A tool used to assess pain. the intensity of the pain is assigned to one of several levels that are identified by number (no pain =0, mild pain=1, moderate pain =2, severe pain= 3).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

pain

A

An adverse sensory and emotional experience that elicits protective motor actions, results in learned avoidance, and may modify species specific behavior.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

pain scales

A

Any assessment tool used to rate the intensity of pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

pathologic pain

A

pain that is amplified and persistent. This type of pain is due to malfunction of or damage to the nervous system and is maladaptive because it serves no useful function, but causes suffering.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

perception

A

The final step of nociception, in which sensory impulses are transmitted to the brain, where they are processed and recognized.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

perioperative analgesia

A

Pain control before and or after surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

peripheral hypersensitivity

A

Increased sensitivity to a painful stimulus that occurs when the threshold of the peripheral pain receptors is lowered as a result of injury to peripheral tissues, thus increasing their senstitivity. Also known as primary hyperalgesia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

physiologic pain

A

The protective sensation of pain that normally occurs when there is a possibility of or actual tissue injury. Physiologic pain is adaptive because it promotes survival by preventing injury and by promoting healing of the injured body part.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

pre-emptive analgesia

A

provision of analgesia before tissue injury, including surgery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

primary hyperalgesia

A

Increased sensitivity to a painful stimulus that occurs when the threshold of the peripheral pain receptors is lowered as a result of injury to peripheral tissues, thus increasing their senstitivity. Also known as primary hyperalgesia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

secondary hyperalgesia

A

State caused by constant nociceptive input from the periphery, in which neurons in the spinal cord became hyperexcitable and sensitive to low intensity stimuli that would not normally elicit a pain response. Also referred to as secondary hyperalgesia or windup.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

simple descriptive scale

A

a tool used to assess pain by rating its severity (absent, mild, moderate, or severe).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

somatic pain

A

Pain originating from the musculoskeletal or integument system. Subclassifed as superficial (skin) and deep (joints, muscles, bones).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

transdermal patch

A

A reservoir of analgesic or other drug enclosed in plastic that is applied to clipped skin. The drug is released slowly through the back of the patch and absorbed transcutaneously. Especially useful for drugs with a short half life.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

transduction

A

The first step in nociception, in which noxious thermal, chemical, or mechanical stimuli are transformed into electrical signals called action potentials.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

transmission

A

The second step in nociception, in which sensory impulses are conducted to the spinal cord.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

validated

A

A process of evaluating the effectiveness and reliability of something such as a scale used to assess pain in animals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

visceral pain

A

Pain originating from the internal organs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

visual analog scale

A

A tool used to assess pain that consists of a ruler, the left end of which equates to no pain, and the right end to the worst pain imaginable for the specific disease or surgical procedure. The assessor places a mark (usually X) on the ruler corresponding to the level of pain that the assessor feels the animal is experiencing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

wasting

A

A decrease in body mass, energy, or rigor offer caused

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

windup

A

Increased sensitivity to a painful stimulus that occurs when the threshold of the peripheral pain receptors is lowered as a result of injury to peripheral tissues, thus increasing their sensitivity. Also known as primary hyperalgesia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Pain

A

Aversive sensory and emotional experience that elicits protective motor actions, results in learned avoidance, and modify species specific behavior traits, including social behavior.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

If untreated what does pain negatively affect

A

Patient behavior
physiology
metabolism
immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What surgery has both components of somatic pain and visceral pain?

A

Abdominal surgery (skin and abdomen) (organ manipulation and surgery).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Pain scale

A

None
Mild
Moderate
Severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

4 steps of nociception (pain pathway)

A
  1. transduction- the transformation of noxious, mechanical, thermal, or chemical stimuli into electrical signals or action potentials by nociceptors (pain receptors)
  2. Transmission- The sensory impulses from transduction are conducted to the spinal cord via peripheral nerve fibers.
  3. Modulation- Where the impulses can be altered by other neurons which can amplify or suppress them.
  4. perception- impulses are transmitted to the brain where they are processed and recognized.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the goal of pain managment

A

Targeting 2 or more receptors especially with severe pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are the consequences of untreated pain

A

Produces catabolic state leading to wasting.
suppressive immune response
promotes inflammation and delays wound healing
Anesthetic risks higher due to needing higher doses of drugs
causes patient suffering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What can happen with pathologic pain and what does it do to CNS function?

A

Can cause tissue damage. The constant noxious stimulation of the CNS can alter the function of neurons and receptors which can cause hypersensitivity in both acute and chronic pain. Neurons in the periphery (limbs, organs) and central neurons (spinal cord) can be affected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What does peripheral tissue trauma release

A

it releases mediators from damaged cells and attracts inflammatory cells, which also release mediators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What do mediators do?

A

They combine and form a sensitizing soup that lowers the threshold of peripheral pain receptors increasing sensitivity. This leads to windup pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What receptors do Opioids affect?

A

Transduction, modulation, perception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What receptors do NSAIDs affect?

A

transduction, modulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what receptors do local anesthetics affect?

A

transduction, transmission, modulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what receptors do alpha 2 agonists affect?

A

transmission, modulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what receptors do ketamine affect

A

modulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what receptors do corticosteroids affect

A

transduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What receptors do steroids/tranquilizers/general anesthesia affect

A

perception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What receptors do tricyclic antidepressants affect

A

Modulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

when is N-methyl-D-aspartate (NMDA) activated?

A

Its activated by windup pain but not physiologic pain. Drugs like ketamine can block this receptor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What neuroendocrine changes happen due to pain?

A

in response to pain to include the release of adrenocorticotropic hormone (ACTH), elevation in cortisol, norepinephrine, and epinephrine and a decrease in insulin can lead to wasting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

what does Sympathetic stimulation cause?

A

Can lead to vasoconstriction increased myocardial work, increased myocardial oxygen consumption predisposing the patient to arrythmias. Skeletal muscle blood flow increases while GI and urinary tract functions decrease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What are the 5 freedoms?

A

Freedom from hunger, discomfort, disease, injury, and pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What cardiovascular changes does pain cause

A

hypertension
tachycardia, tachyarrhythmia
peripheral vasoconstriction (pale mm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What reparatory changes does pain cause

A

Tachypnea
shallow breathing (abdominal or thoracic guarding)
panting (dogs)
exaggerated abdominal component
open mouth breathing (cats)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What ophthalmic changes does pain make

A

miosis- dogs
mydriasis- cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

How can emergence delirium be differentiated from pain?

A

By the fact it lasts for a short time less than 5 min and responds to sedation, while pian last longer and responds to analgesics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What can be used for perioperative pain?

A

premedication’s-opioids, alpha 2 adrenoceptor 2 agonists (ketamine), in small animals transdermal fentanyl patches, and in large animals NSAIDS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What do opioids do?

A

action on opioid receptors in both the spinal cord, brain, and some peripheral tissues like synovial joints. Centrally inhibit perception in the brain and central sensitization in the spinal cord.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What can stop or reduce windup pain and how long odes it last?

A

Preoperative medications given with tranquilizers like acepromazine or dexmedetomidine and they last 2-4 hours.

70
Q

What can be given in high doses with tranquilizers to induce sedation (neuroleptanalgesia) and offers considerable analgesia through surgery and after?

A

Opioids

71
Q

What drugs can be used on their own or with other agents to provide post op pain control?

A

alpha 2 agonists, NSAIDS, and local anesthetics

72
Q

What are some MU agonists and what do they do?

A

Morphine, fentanyl, hydromorphone, oxymorphone, methadone, and meperidine. They produce the most potent analgesic effects but are equally likely to induce adverse effects and are used to moderate to severe pain.

73
Q

What partial MU agonist and agonist-antagonists are used as preanesthetic or for mild pain relief.

A

Partial (buprenorphine)
agonist-antagonist (nalbuphine, butorphanol) they are less potent analgesics and degree of sedation is less pronounced as well as adverse effects on the cardiovascular systems. Used as preanesthetic or mild pain relief

74
Q

What animals do opioids cause excitement in if given alone or in high doses?

A

horses/cats

75
Q

What are some side effects of opioids?

A

Gi issues caused by GI tract speeding up like vomiting, nausea, and defecation and then the GI tract slows causing ileus, colic, and constipation.

76
Q

What metabolizes opioids?

A

the liver

77
Q

What are some potent opioids

A

Morphine, oxymorphone, hydromorphone, methadone, fentanyl.

78
Q

How long do opioids last given IM/SC for pain?

A

Morphine 2-3 hrs severe pain, 4-6 for moderate to mild pain
hydromorphone 2-4hrs
oxymorphone 1.5-5hrs
fentanyl 20min
butorphanol 1-2 hrs dogs, 4hrs cats
Can repeated doses but will cause peak and trough blood levels instead of having a constant effect on blood levels.

79
Q

What patients should opioids be avoided in?

A

High risk
hypotensive
hepatic diseased
preexisting respiratory issues
CNS disorders (head injury, intracranial pressure)
altered bowel mobility

80
Q

What ways can opioids be given?

A

IM
SC
IV
epidurally
transdermal
intraarticularly

81
Q

Which opioids can be given IV and as a CRI

A

morphine
fentanyl
oxymorphone
hydromorphone
methadone
butorphanol

82
Q

What is MLK

A

a mix of morphine, lidocaine, and ketamine

83
Q

How to use opioids intraarticularly

A

0.1 to 0.3mg/kg of morphine diluted in a volume of saline that is equivalent to 1ml/10kg and instilled into joint with sterile catheter immediately after closure of joint capsule.

84
Q

What can morphine be combined with to provide analgesia after elbow or stifle type surgeries. How long does it last?

A

0.5% bupivacaine and lasts 8-12hrs.

85
Q

Where does an epidural injection go and what are its effects

A

It goes into the LS joint. It give analgesia to hindlimbs, abdomen, caudal thorax, pelvis, and tail.

86
Q

Which medication is commonly used for epidurals and which one is not commonly used?

A

Morphine is commonly used and sometimes with local anesthetics or alpha 2 agonists in large animals
Butorphanol is not used due to the possibility of causing spinal toxicity.

87
Q

What does lidocaine do as an epidural

A

It can impair movement, urination, and defecation and it can cause sympathetic blockage if drug diffuses too cranially.

88
Q

What does an epidural have to be combined with for surgery

A

general anesthesia

89
Q

Why doesn’t morphine reach high concentrations in the blood stream when used as an epidural?

A

because morphine has a low fat solubility and it last longer on pain receptors in the spinal cord

90
Q

What are some rare and some common complications of epidurals

A

Dogs are rarely sedated, cats are rarely excited, and nausea and respiratory depression rarely happen.
urinary retention and puritis can be seen though.

91
Q

When should the epidural be given

A

after induction but before surgery

92
Q

Why is preservative free morphine preferred for epidurals?

A

Because morphine with preservatives has formaldehyde and phenol which are potentially neurotoxic

93
Q

What should morphine be diluted with?

A

Saline at 0.3ml/kg

94
Q

What is the maximum volume that should be injected during an epidural

A

0.45ml/kg

95
Q

How long does it take for the onset of an epidural

A

20-60min

96
Q

How long does an epidural last

A

6-24hrs.

97
Q

If prolonged analgesia is needed via epidural what can be used.

A

A epidural catheter can be placed and used for hours or days.

98
Q

When should an epidural not be given

A

when there is septicemia local infections in the LS space, bleeding disorders, spinal trauma, or neurologic disease of the spine.

99
Q

What are some complications that can arise from administering the epidural

A

hematomas or accesses

100
Q

In some patients how long does it take them to urinate after an epidural

A

24hrs

101
Q

Why should recumbent patients be rotated

A

to prevent pulmonary atelectasis or prolonged pressure on superficial nerves leading to temporary or permanent loss of function.

102
Q

What other opioid has the same analgesic effect as a fentanyl patch?

A

oxymorphone but the fentanyl patch lasts longer than oxymorphone.

103
Q

What does fentanyl patch should be used?

A

less than 4kg 12.5mcg/hr
4-6kg 25mcg/hr
7-20kg 50mcg/hr
21-30kg 75mcg/hr
more than 30kg 100mcg/hr
Large animals require several patches

104
Q

In patients not showing improvement within 24 hours of wearing a fentanyl patch what can you do?

A

you can add another patch

105
Q

How long does it take for the fentanyl patch to work

A

it takes 4-12 in cats hrs and 12-24hrs in dogs due to absorbing slowly through skin

106
Q

If using the patch for analgesia during surgery when should be patch be placed on the patient?

A

6 hours prior to anesthesia

107
Q

What opioids should not be used with a fentanyl patch and why?

A

Butorphanol and buprenorphine because the partially block the opioid receptors reducing analgesic effect.

108
Q

Why do you have to watch patients for signs of break through pain or overdose when using fentanyl patches?

A

because each patient absorbs the medication at different rates

109
Q

What are the signs of overdose when using fentanyl patches

A

ataxia and sedation in dogs
dysphoria and disorientation in cats
fearful or excited, hypersensitive to sound, and widely dilated pupils.

110
Q

How do you treat an overdose when using a fentanyl patch

A

take the patch off or give a narcotic antagonist like naloxone or butorphanol

111
Q

What can be seen in trauma patients especially those with CNS signs when using the fentanyl patch

A

respiratory depression

112
Q

After removal of the patch what skin condition can some patients get?

A

mild transient dermatitis and delayed hair regrowth

113
Q

What can cause an excessive release in patches?

A

heat

114
Q

What is the high concentration of fentanyl

A

Recuvyra 50mg/ml 1000x more than the injectable version of fentanyl.3

115
Q

NSAID

A

nonsteroidal anti-inflammatory analgesic (NSAAs)

116
Q

What are some common NSAIDs

A

acetylsalicylic acid aspirin, acetaminophen, robenacoxib, carprofen, meloxicam, etodolac, ketoprofen, tolfenamic acid, fircoxib, deracoxib

117
Q

What do NSAIDs help treat

A

dental pain, panosteitis, osteoarthritis, meningitis, mastitis, and other painful condition.

118
Q

What’s the NSAID mechanism of action

A

All appear effective for somatic (musculoskeletal pain). Some have little effect on visceral pain but others like ketoprofen and carprofen are potent and help both visceral and somatic activity.

119
Q

How long does it take for NSAIDs to work

A

30min to 60min no matter the route

120
Q

What does the anti inflammatory properties help treat

A

osteoarthritis, panostetitis, hypertrophic osteodystrophy, and muscle pain

121
Q

What does NSAIDs inhibit

A

prostaglandin (PG) synthesis

122
Q

What do prostaglandins do

A

They are in all body tissues and mediate pain and inflammation after tissue injury and they keep homeostasis by maintaining normal GI, reproductive, renal, and ophthalmologic functions.

123
Q

What does NSAIDs inactivate and why is it important

A

they inactivate cyclooxygenase (COX) which catalyzes one of the steps in the production of prostaglandins.

124
Q

How many COX enzymes are there and what are their names

A

2
Cox 1
Cox 2

125
Q

What do cox 1 and Cox 2 do

A

Cox 1 is in most tissues
Cox 2 is in some tissues, like the CNS, kidney, reproductive organs, eyes. inducible (not normally present) but is produced under certain circumstances like during tissue damage and inflammation

126
Q

What are some Cox 2 selective NSAIDs

A

carprofen, meloxicam, deracoxib, rebenacoxib) or specific (firocoxib) They are less likely to interfere with intestinal barrier function and produce GI ulcers.

127
Q

What do all NSAIDS have the potential to be

A

nephrotoxic

128
Q

What are some NSAIDs that exert their effects mainly on prostaglandin synthesis in the brain tissue so they are centrally active?

A

acetaminophen and ketorolac

129
Q

What are some NSAIDs that exert effects on both centrally and peripheral tissues?

A

ketoprofen and meloxicam

130
Q

Where are NSAIDs metabolized and conjugated?2

A

The liver, followed by renal or biliary elimination

131
Q

What do NSAIDs have very little effect on

A

cardiac and respiratory function

132
Q

Do NSAIDs depress the CNS?

A

No

133
Q

What are some adverse effects of NSAIDs

A

can have serious toxic effects in animals that are dehydrated or hypotensive

134
Q

Do NSAIDs also inhibit the beneficial prostaglandins as well as the ones that mediate pain and inflammation?/

A

yes

135
Q

What do cox 2 inhibitors focus on

A

the prostaglandins that are active in damaged or inflamed tissues and those that cause pain but not the Cox 1 prostaglandins that maintain normal physiologic functions like protecting the GI mucosa and modulation of blood flow to the kidney.

136
Q

What does prostacyclin do

A

helps reduce gastric aid ion ad promotes86 mucous productions. NSAIDs affect this prostaglandin0 so acid increase and mucous production decreases which causes ulcers.

137
Q

Which NSAIDs can cause adverse effects in dogs if used for more than 5 days?

A

ketprofen, naproxen, ibuprofen, flunixin, piroxicam, meclofenamic acid

138
Q

Which NSAIDs can be used long term in dogs

A

Carprofen, meloxicam, and etodolac

139
Q

What does sucralfate do

A

it forms proteinaceous complex that adheres to dmaged gastric mucosa preventing further injury. Give on empty stomach with NSAID

140
Q

What is misoprostol

A

A GI protectant 2-4mg/kg PO q 8hrs

141
Q

What do famotidine and rantidine do

A

They are histamine 2 receptor antagonists and help with GI ulcers but should not be given with sucralfate because sucralfate needs an acidic environment to work

142
Q

Why should NSAIDs be given after surgery

A

because prostaglandin PGE2 maintains adequate blood flow within the kidney. in anesthetized patients and those prone to hypotension (trauma patients) PGE2 plays a vital role in renal blood flow. NSAIDs block PGE2 and blood flow leading to renal hypoxia.

143
Q

What are dogs susceptible to when BP decreases

A

renal failure

144
Q

When is it ok to give NSAIDs in surgery

A

if the patient is on fluids and their BP is being watched closely.

145
Q

What can reverse NSAID renal insufficiency in young. healthy patients

A

Fluids

146
Q

What should be checked to ensure renal function is good

A

blood urea nitrogen, creatinine and or urine specific gravity

147
Q

Can NSAIDs cause impaired platelet aggregation leading to prolonged bleeding times0

A

yesf

148
Q

Why can carprofen be used before surgery if needed

A

because it is known to have less renal toxicity and platelet inhibiting effects.

149
Q

Hepatocellular toxicosis

A

can appear most commonly in labs and is evident within 2 weeks after starting NSAIDS monitor bile levels to detect early signs of toxicity.

150
Q

When should NSAIDs be avoided

A

in patients that are dehydrated, have coagulopathies of liver of kidney dysfunction, those with GI issues, those getting corticosteroids, those with low BP, congestive heart failure, or hemostatic disorders like thrombocytopenia. Those with trauma that are not stable and could hemorrhage, and those going under general anesthesia within 48hrs.

151
Q

What do local anesthetics do

A

they block sodium channels which prevents transduction and transmission of noxious stimuli into nerve impulses peripherally (local blocks) and centrally (epidural)

152
Q

What is the method of administration with local anesthetics

A

sprayed or injected into injury or surgical site or infiltrated around the nerve supply areas

153
Q

Do local anesthetics give complete anesthesia to the area

A

yes

154
Q

When do local anesthetics become a danger

A

When they are repeatedly used they can cause CNS or cardiac toxicity

155
Q

What are some alpha 2 adrenoceptor agonists and what do they act on

A

Xylazine, dexmedetomidine
They act on alpha 2 adrenergic receptors both centrally and peripherally

156
Q

What are the pain control limitation to using alpha 2 adrenoceptor agonists on small animals

A
  1. short duration of analgesic effect (xylazine 30-60min/dexmed 30-90 min)
  2. Strong sedative effects
  3. potential for serious adverse effects (resp. depression, vomiting, bradycardia, heart block, and hypotension) which can be exacerbated by opioids
157
Q

What patients should alpha 2 adrenoceptor agonsists be used on

A

young to mid aged healthy patients

158
Q

What doses of xylazine and dexmed. appear to potentiate the effects of opioids.

A

xylazine 0.01mg/kg
Dexmed. 0.001-0.005mg/kg

159
Q

What are butorphanol and dexmed together good for

A

analgesia and sedation in minor procedures

160
Q

When do alpha 2 adrenoceptor agonists provide significant analgesia?

A

when used as an epidural
dexmed 0.005mg/kg can be mixed with morphine to prolong the duration of epidural analgesia.

161
Q

What can reverse dexmed and xylazine

A

dexmed can be antagonized by atipamezole
Xylazine can be antagonized by yohimbine

162
Q

What Alpha 2 adrenoreceptors are used in horses for sedation, muscle relaxation, and analgesia

A

xylazine, detomidine, romifidine

163
Q

What are the adverse effects of alpha 2 adrnoreceptors

A

cardiovascular like bradyarrhythmia (second degree atrioventricular block), initial hypertension then hypotension

164
Q

What should be avoided with sedating a horse with stridor to prevent a respiratory obstruction

A

heavy sedation due to the relaxation potentially causing the obstruction

165
Q

What can alpha 2 adrenoreceptor agonists due to horses guts?

A

cause distention and colic due to a decrease in gut motility post operatively

166
Q
A
167
Q
A
168
Q

What drugs can be used in pain management for neurogenic or cancer pain that is hard to control?

A

antidepressants, antianxiety, and bisphosphonates

169
Q

What is multimodal therapy

A

using more than 1 type of analgesia combination or balanced analgesia combining opioids and NSAIDs can cause a 20-50% reduction in opioid doses.

170
Q

Acetaminophen/codeine combo

A

can be used in dogs for f5 days (never cats). Can cause constipation and sedation. Supplement diet with fiber.

171
Q

Can opioids be given at the same time as NSAIDs

A

yes or they can be spaced out and given at different times

172
Q

What’s an example of a co-infusion that can be given during surgery and has 3 different mechanisms of action?

A

MLK
Morphine
Lidocaine
ketamine

173
Q
A

Anesthesia (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions