Anesthesia Module Flashcards
Following ETCO2- what wrong
esophageal intubation
what are signs of light anesthetic plane
- Eye position central
- Palpebral reflex present
- Increased jaw tone
- Increase HR, BP, RR
how do you manage light plane of anesthesia
- Increase inhalant dose
- Give IV drug
what are some signs of too deep in anesthetic plane
- Eye position central
- No palpebral reflex
- No jaw tone
- Bradycardia, hypotension, hypoventilation, hypothermia
how do you solve being too deep in anesthetic plane
decrease inhalant
what is the formulae for minute ventilation
Minute ventilation= RR X TV
what is normal ETCO2
35-45mmHg
what is ETCO for hypocapnia and what is ventilation status
<35mmHg, hyperventilation
what is consequence of hypocapnia
vasoconstriction of cerebral vessels= ischemia, respiratory alkalosis
what is ETCO2 for hypercapnia and what is ventilation status
> 45mmHg, severe >65mmHg
Hypoventilation
what is consequence of hypercapnia
vasodilation of cerebral vessels= increase ICP
Worsening of hyperkalemia
Respiratory acidosis
Coma
what are some causes of hypocapnia
- Reps: increase ventilation
- Hypothermia
- Leaking cuff, high oxygen flow
what are some causes and tx for hyperventilation
- Inadequate depth: tx: increase inhalant +/- IPPV
- Inadequate analgesia: provide analgesia
- Hyperthermia: stop heating, or cool down
t or f: rapid RR is same as hyperventilation
False
if you notice rapid RR and give a breath and CO2 increases then likely there is __ventilation and animal is __
dead space ventilation, hypoventilating
what are some causes of hypercapnia
- Resp- decreased ventilation
- Inadequate O2 flow, equipment dead space
what are some causes and tx for hypoventilation
- Excessive depth- decrease inhalant
- Obstruction- remove
- Obesity- provide IPPV
- Dorsal recumbency: provide IPPV
what are some indications for IPPV
- Improve tidal volume therefore remove CO2
- ETCO2 >60mmHg
- Light plane
- Panting
what wrong, possible causes, what do
wrong: increased based during inspiration, hypercapnia >45
Cause: rebreathing, excessive depth- decrease inhalant, check equipment, provide IPPV
what wrong, causes, what do
rapid RR
Causes: hyperventilating, hypothermia, leaking cuff, high O2 flow
Do: increase inhalant, check for leaks, provide analgesia
what wrong and cause
loss of alveolar plateau
Cause: leaking
what is equation for BP
cardiac output X systemic vascular resistance
what is cardiac output equation
stroke volume X HR
what does stroke volume depend on
preload, contractility, afterload
blood pressure is an indirect measurement of __
cardiac output
what are some causes of hypotension
- Hypovolemia
- Drugs
- decreased contractility- inhalant
- decrease SVR/vasodilation- acepromazine, proprofol, alfaxalone
- increased afterload/ vasoconstriction and bradycardia- dexmed - IPPV
what do you do to tx hypotension with bradycardia
- Decrease inhalant if possible
- Anticholingeric-atropine or glycopyrolate
how do you tx hypotension with tachycardia or normocardia
- Decrease inhalant
- Give fluid bolus
- Dobutamine or dopamine CRI if unresponsive to fluids
how does PPV effect BP
positive pressure= pressure on vena cava—> decreased venous return—> decrease CO—> decreased BP
hypothermia is <__F
97
what are some side effects of hypothermia
- Increased risk of anesthetic overdose- decrease MAC
2, bradycardia- unresponsive to anticholinergics - Prolonged recovery
hyperthermia is most patients under anesthesia >__F
101
whaat are some causes of hyperthermia
- Heating pad too high
- Response to drugs (opioids)
- Heavily muscled/furry
- Malignant hyperthermia
if SPO2 below 95%, try giving __ to see if it improves
manual breath
What is standard protocol for pediatric dogs <16 weeks
IM pre-med
1. Ace
2. Hydromorphone
3. Atropine
Induction:
1. Propofol
Local:
1. Lidocaine
what is standard protocol for adult dogs
IM pre-med
1. Ace
2. Hydromorphone
3. Dexmed
SC NSAID:
1. Meloxicam
Induction:
1. Propfooll
Local:
1. Lidocaine
what is standard protocol for cats
IM pre-med
1. Buprenorphine
2. Ketamine
3. Dexmed
Induction
1. Propfool
Local:
1. Lidocaine
what is MOA of Hydromorphone
full-mu receptor agonist
how long does analgesia last for Hydromorphone IV and IM
IV: 2hr
IM: 4hr
what are the sedative and analgesia properties of Hydromorphone
good sedation, excellent analgesia
what is reversal for Hydromorphone
Napa one
what is Hydromorphone used for
- Moderate to severe pain
- MAC sparing
- Pre-op sedation
what are side effects of Hydromorphone
- Vomiting (non-painful animals)
- Regurgitation
- Ileus, constipation
- Hyperthermia
- Excitement/dysphoria
what is MOA of buprenorphine
partial Mu receptor agonist opioid
what is analgesic and sedation properties of buprenorphine
moderate analgesia, minimal sedation
what is effect of buprenorphine on resp and cardio systems
minimal resp and cardio depression
t or f: buprenorphine has ceiling effect- increasing dose leads to smaller and smaller gains in analgesia but increase in side effects
true
What is onset of action time for buprenorphine
30 mins
what is duration of action for buprenorphine
6-8hrs
what is buprenorphine used for
- Mild to moderately painful procedures
- Post-op analgesic
- Good post op choice for cats
what is buprenorphine not useful for
- Sedation when given alone
- Intra-op- slow onset, not titratable
- Severe pain
what drugs are in “kitty magic” pre-med
dexmed, ketamine, buprenorphine
what are the routes of administration for dexmedetomidine
IM and IV
what is MOA for dexmedetomidine
alpha 2 agonist
what are the sedative, analgesic, and muscle relaxation properties for dexmedetomidine
- Dose dependent sedation
- Analgesic properties
- Excellent muscle relaxation
what is reversal for dexmedetomidine
atipamezole/ antisedan
what are the side effects of dexmedetomidine
- Biphasic BP effect
- phase 1: vasoconstriction/ hypertension and reflex bradycardia
- phase 2: vasodilation/ hypotension and bradycardia or normal HR - Decrease cardiac output
- Cardiac arrhythmias- AV block
what is dexmedetomidine used for
- Chemical restraint
- Sedation
- Pre-med of healthy patients
- Post-op sedation
what are some contraindications and what patients should you be careful with when using dexmedetomidine
CI: sick animals, cardiac disease
Careful: geriatric, renal dz
what is acepromazine good at
anxiolytic, sedative
What is onset of action for IM ace
30-45 minutes
what is duration of action for ace
up to 6hrs
why is ace good for recovery
post-op anxiety, smooth recovery
Acepromazine has no __ properties
analgesic
what are some side effects of acepromazine
- Vasodilation- alpha 1 receptor antagonist- hypotension
- Respiratory depression
- Depression of myocardium and vascular smooth muscle
ketamine IM added to pre-med protocol helps increase __
chemical restraint
t or f: ketamine provides some analgesia
true
what are the effects of ketamine on cardio and resp systems
- Cardio: increase HR, BP, increase risk tachyarrhythmias
- Resp: minimal, retain pharyngeal and laryngeal reflexes
when should you not use ketamine
- When increase HR is harmful- cats with HCM
- Severe heart dz, cardiac arrhythmias
- Severe renal injury
- Liver dysfunction
propofol may decrease __activity
seizure
t or f: propofol has analgesic effects
false
what are some side effects of propofol
- Hypotension due to vasodilation
- Post-induction apnea
how do you avoid post-induction apnea with propofol
slow IV injection over 60 seconds
what IV antibiotic is used in sx lab
cefazolin
what is MOA of NSAIDS
COX inhibitor- inhibits prostaglandins
what agents are useful if patient is bradycardia and hypotensive
atropine and glycopyrolate
which crosses BBB and placenta: atropine or glyco
atropine
what is the drug of choice for CPR: atropine or glyco
atropine
which has a slower onset but less profound tachycardia: glyco or atropine
glyco
what is toxic dose for lidocaine
10mg/kg
what is recommended dose for dogs and cats for lidocaine, what dose will we use in lab
dog: 6mg/kg
Cat: 4mg/kg
Lab: 2mg/kg
what species should you not give lidocaine IV
cats
what is MOA of cerenia
neurokinin 1 receptor antagonist
what are the properties of cerenia
anti-emetic, anti-nausea
how do you convert mcg to mg
mcg/1000=mg
how do you convert % to mg/ml
% x10
dexmed dose example:
Weight: 8kg
Dose: 5mcg/kg
Concentration: 0.5mg/ml
(5mcg/kg)/1000= 0.005mg/kg
0.005mg/kg (8kg)=0.04 mg
(0.04mg)/ (0.5mg/mL)=0.08 mL
lidocaine dose example
Weight: 15kg
Dose: 2mg/kg
Concentration: 2%
2% X 10= 20mg/ml
15kg (2mg/kg) =30mg
30mg/ (20mg/kg) - 1.5mL
what is fluid rate for dogs and cats
cats: 3ml/kg/hr
Dogs: 5ml/kg/hr
fluid rate ex:
Dog Weight: 15kg
15kg (5ml/kg/hr)- 75ml/hr
what is fluid bolus size
5ml/kg
fluid bolus ex:
Dog weight: 15kg
fluid bolus size: 5ml/kg
15kg(5ml/kg)=75 mL
Calculate rate to deliver fluid bolus over 10 minutes
75mL (6)=450 mL/hr
