Anesthesia Intro Flashcards

1
Q

what is the ASA physical status scale used for?

A

determining the risk of putting a specific patient under anesthesia

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2
Q

ASA I

A

minimal risk
normal, healthy animal with no underlying disease

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3
Q

ASA II

A

slight risk, minor disease present
slight-mild systemic disturbance, animal able to compensate, neonate, geriatrics, obese animals

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4
Q

ASA III

A

moderate risk, obvious disease present
moderate systemic disease/disturbances, mild CS, anemia, moderate dehydration, fever, low-grade heart murmur/cardiac disease

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5
Q

ASA IV

A

high risk, significantly compromised by disease
animals with preexisting systemic disease/disturbances of severe nature
severe dehydration, shock, uremia, toxemia, high fever, uncompensated heart disease, uncompensated diabetes, pulmonary disease, emaciation

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6
Q

ASA V

A

extreme risk, moribund
surgery performed in desperation on animal with life threatening systemic disease
advanced cases of heart, kidney, liver, or endocrine disease, profound shock, severe trauma, pulmonary embolus, terminal malignancy

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7
Q

anesthesia

A

loss of sensation
common halogenated anesthetics: Isoflurane, Sevoflurane, Desflurane
older anesthetics: Methoxyflurane, Halothane, Enflurane

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8
Q

analgesia

A

absence of pain
opioid type: agonists, partial agonist, agonist antagonist, antagonist
preemptive analgesia is essential

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9
Q

sedation

A

CNS depression and unawareness of surroundings caused by administration of a drug
good for simple procedures

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10
Q

tranquilizer

A

CNS depression and awareness of surroundings caused by drug administration
good for anxious patients

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11
Q

neuroleptanalgesia

A

state of profound sedation and analgesia produced by the administration of an opioid and a tranquilizer
ex: Hydromorphone and acepromazine, Fentanyl and midazolam

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12
Q

opioids

A

derived from opium
synthetic or natural forms
used for analgesia or as an adjunct for induction
may be used as CRI +/- with other drugs
great MAC reducer

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13
Q

versatile opioid classes

A

agonists, partial agonists, agonist-antagonists, antagonists

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14
Q

opioid mode of action

A

opioid receptors found on neurons throughout the body, brain, spine
produce effects of sedation and analgesia

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15
Q

what are the 3 major opioid receptors?

A

mu, kappa, delta
each receptor produces a different effect

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16
Q

which classes of opioids bind to which receptors?

A

full agonists bind to mu and kappa receptors, best analgesics
partial agonists bind partially stimulate mu receptors
mixed agents only bind to kappa receptors
antagonists bind to but don’t stimulate mu and kappa receptors

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17
Q

which class of opioids is best for dogs?

A

agonists produce maximal effects on dogs

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18
Q

which class of opioids is best for cats, horses, and ruminants?

A

partial agonists work best in cats, horses, and ruminants

19
Q

full agonist opioids

A

morphine, hydromorphine, oxymorphone, fentanyl, meperidine, and methadone
cause histamine release
C-II controlled
IV, IM, SQ, ID, epidural

20
Q

partial mu agonist opioids

A

they have a ceiling effect = at some point increasing dosages won’t increase analgesia
ex: Buprenorphine (Buprenex)

21
Q

Buprenorphine (Buprenex)

A

C-III controlled
delayed onset action: 45-60 minutes
duration: 4-6 hours
IV, IM, epidural, TM (cats)
kappa-receptor antagonist and partial mu agonist
AE: respiratory depression, pain on injection site

22
Q

Simadol

A

long acting Buprenorphine injectable for cats

23
Q

Butorphanol

A

mixed agonist-antagonist opioid
C-IV controlled
antitussive effects too
partially reverses opioid agonists
less respiratory depression and potential for abuse
has ceiling effect
half life: 20-50 minutes
duration: 2-6 hours

24
Q

opioid antagonists

A

have a higher affinity for opioid receptor sites than narcotics do so they displace bound molecules and prevent binding of new opioid molecules to their receptors
used to treat the respiratory and CNS depression caused by opioids

25
Naloxone
full mu opioid antagonist IV, IM, SQ administration for neonates after C-section: sublingual or injected into umbilical vein ER drug, reverses opioids IV and sublingual onset: 1-2 minutes IM onset: 10-20 minutes doesn't revere Buprenorphine
26
Tramadol
atypical opioid centrally acting mostly mu receptor activity SNRI (serotonin and norepinephrine reuptake inhibitors) C-IV controlled oral, IV
27
Gabapentin
atypical opioid oral add-on anticonvulsant inhibits calcium channels resulting in decreased excitatory neurotransmission excreted by kidneys capsules and oral solution
28
NSAIDs
nonsteroidal anti-inflammatory drugs: decrease inflammation by blocking action of the enzyme cyclooxygenase (COX) steroidal anti-inflammatory drugs: contraindicated for surgery, delays healing not immunosuppressive have antipyretic effects (fever reducing)
29
types of cyclooxygenase enzyme (COX)
COX-1 and COX-2 COX-1 performs activities that maintain health COX-2 is involved in production of prostaglandins that promote inflammation
30
what two drugs shouldn't be administered concurrently?
NSAIDs and glucocorticoids
31
salicylates
oldest anti-inflammatory agents aspirin: analgesic, antipyretic, anti-inflammatory, decreases platelet aggregation non-selective inhibitor so blocks COX-1 and COX-2, not FDA approved
32
propionic acid deriatives
ibufropen (humans), ketoprofen (horses), carprofen (dogs), naproxen (horses) -fen drugs ibuprofen not animal approved analgesic, antipyretic, anti-inflammatory
33
selective COX-2 inhibitors (drug names)
Deracoxib, Firocoxib, Robencoxib
34
Deracoxib
selective COX-2 inhibitor dogs > 4lbs, pain and inflammation, give after meal, blood chem before use
35
Firocoxib
dogs and horses treats fever pain and inflammation, chewable tablet for dogs, oral paste for horses *caution with renal, hepatic, or cardiao dysfunction patients*
36
Robenacoxib
dogs and cats, > 5.5 lbs and > 4 months old injectable and tablets give without food
37
Oxicam
Meloxicam: preferentially inhibits COX-2 approved for: dog (injectable, oral, or transmucosal), cat (injectable, oral, extra-label), large animal (extra-label) *don't use with liver, cardiac, kidney, or GI patients*
38
local anesthetics
lidocaine, bupivicane, mepivacaine, procaine ophthalmic anesthetics: tetracaine and proparacaine blockade of sodium channels if deposited in proximity to the neuron infiltration, topical, intraarticular, nerve plexus, vein, or epidural
39
Lidocaine
injectable, topical, patch rapid onset short duration mix with epinephrine for longer duration
40
Bupivacaine
narrow therapeutic index never give IV!! longer onset and duration
41
Nocita
bupivacaine liposome injectable suspension 5.3 mg/kg half life: 72 hours used for infiltrative surgical incision anesthetic
42
isotonic crystalloids
used to maintain hydration and to compensate for vasodilation, decrease in CO, or fluid loss surgical rate: 1st hour 10 mL/kg, then 5 mL/kg shock rate: dog 90 mL/kg, cat 60 mL/kg bolus: 1/4 shock rate over 15-20 minutes
43
colloids
aka plasma expanders support expansion of blood volume or BP synthetic rates: bolus 5 mL/kg over 20-30 minutes, CRI dog 10-20 mL/kg/day, cat 5-10 mL/kg/day natural: used for anemia, hypoproteinemia, coagulation disorders, thrombocytopenia
44
hypertonic saline
3%, 5%, 7%, 23.5% used to treat hypovolemic, traumatic, or endotoxic shock and increase ICP rapidly but temporarily draws water into the IVF space and increases BP rapidly diffuses to the ISF space usually given with colloid or crystalloids 3-4 mL/kg slow over 5-10 minutes if given too fast can cause decreased BP, bradycardia, shallow tachypnea, bronchoconstriction