Brainscape's Knowledge GenomeTM

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


See full index

anesthesia rotation notes > Article Notes 1 > Flashcards

Article Notes 1 Flashcards

1
Q

What are the NMDA antagonist induction agents?

A

ketamine and opioids

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

sevo is slightly less soluble in blood than iso, so what?

A

so onset of sevo and recovery times are faster than iso

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

First heart sound in each cycle is caused by closing of ____ and _____ valves

A

L and R AV valves

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

What is the second heart sound caused by?

A

second heart sound is caused by the closing of the aortic and pulmonary valves

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

systolic murmurs occur when?

A

between the first and second heart sounds

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

we want to avoid increases in myocardial contractility esp in what p?

A

P with HCM and/or ventricular outflow obstruction

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

what drug is medetomidine?

A

a synthetic alpha 2 receptor agonist and consistently induces sedation, analgesia, anxiolysis (anti-anxiety), and muscle relaxation

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

T/F IM administration of medetomidine may completely eliminate dynamic LVOT obstruction in cats with ventricular hypertrophy

A

Trueee

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

How can IM administration of medetomidine may completely eliminate dynamic LVOT obstruction in cats with ventricular hypertrophy??

A

Combo of lowered HR and increase SVR = minimized the effects of drag forces on the mitral valve

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

What artery do we not want to crush in cats while using mouth gag which is why mouth gags are a no-go?

A

the maxillary artery being the main bf to the brain
also compresses the pterygoid and temporalis muscles

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

MDR1 gene encodes for ____ which plays an impt role in drug deposition by transporting drugs in the blood brain barrier

A

P-glycoprotein

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

mutation of the genes (MDR1) leads to what involving meds?

A

Mutation of the gene leads to potentially toxic fatal adverse reactions and can be mainly documented in herding dogs

Most seen in collies, aussies, long hair whippet, border collie, GSD, English shep
“white feet don’t treat”

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

So what do we do w dogs with the MDR1 gene?

A

is 50% reduction of normal dose with the drugs involved, ESPECIALLY MORPHINE, BUTORPHANOL, BUPRENORPHINE, AND ACEPROMAZINE!!!! Another option is to chose drugs that are not substrates of p-Glycoprotein instead like NSAIDS and alpha-2 adrenergic agonists like dexmedetomidine

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

What does the release of histamine do in dogs (from the MCT tumor excision article)

A

histamine causes dilation of arteries and terminal arterioles and increases capillary permeability through actions of H1 and H2 receptors thus leading to decreased SVR and decreased BP

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

How does benadryl help decrease the systemic release of histamine?

A

Dihenhydramine (Benadryl) antagonizes H1 receptors that bind to and stabilize the inactive conformation of H1 receptors, preventing the effects of histamine

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

Summary from the MCT excision and Benadryl paper:

A

sooo basically systemic release of histamine from MCT causes dilation of arteries and decreases SVR and MAP and we give Benadryl to counteract this by blocking histamines

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

How do we position the p for CPR if they have barrel shaped chest like bullies?

A

sternal compressions (vs. lateral compressions on small dog or cat with normal keel shaped chest)

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

When is CPR C/I?

A

diaphragmatic hernia, hemoabdomen, recent hepatobiliary surgery or presence of gastric dilation volvulus

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

These drugs can be administered via ET tube if necessary in an ER situation though not recommended if not ER situation/last resort–>

A

naloxone, atropine, vasopressin, lidocaine, and epinephrine (NAVLE is the mnemonic) at least 2-3 times the IV dose

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

What is considered low bp in dogs for systolic and diastolic?

A

Systolic is < 80-90mmHg and diastolic is <60 mmHg

21
Q

How do isotonic crystalloid produce increases of BF and therefore CO?

A

Crystalloid solutions are isotonic plasma volume expanders that contain electrolytes. They can increase the circulatory volume without altering the chemical balance in the vascular spaces. This is due to their isotonic properties, meaning their components are close to those of blood circulating in the body.

22
Q

_____ saline is used in traumatic brain cases?

A

Hypertonic saline

23
Q

_____ are more effective than crystalloid for correcting intravascular volume deficits and for improving systemic and microcirculatory bf?

A

colloids

24
Q

____ contain molecules like albumin that produce colloid osmotic (oncotic) pressure (COP) and helps retain fluid within the blood vessels

A

Colloids

25
Q

Colloids can be which two types?

A

can be either natural (ex: albumin) or synthetic (Hetastarch) and are frequently categorized based on their molecular weight

26
Q

What is PVI?

A

plethysmography variability index (PVI) measures the dynamic changes in perfusion index (PI) over respiratory cycles

27
Q

What does PVI values tell you?

A

The greater the PVI, the more likely the patient will respond to fluid administration

28
Q

PVI is the responsiveness to fluid therapy, above ___ means what?

A

PVI valves above 20 indicates hypovolemia and a need for fluid replacement therapy
AND IT WILL RESPOND TO FLUIDS

29
Q

If hgb concentration is less than ___ g/dL do colloids or blood

A

5-7g/dL

30
Q

what are vasoconstrictors?

A

Catecholamines, dopamine, norepinephrine
maintains MAP (increases it)

31
Q

which are vasoconstrictors and which are positive inotropes?

A

Vasoconstrictors- Catecholamines, dopamine (does both), norepinephrine

Positive inotropes- dopamine and dobutamine

32
Q

What are the goals with using vasocontrictiors and positive inotropes?

A

restore MAP and maintain cardiac contractile function, bf in animals that are not responsive to fluid tx due to vasodilation or poor cardiac contraction

33
Q

What if there is relative hypovolemia due to peripheral vasodilation causing hypotension in the p???

A

Decrease the anesthetic depth and/or inhalant concentration
Provide an IV bolus of an isotonic crystalloid such as LRS
If response is inadequate, consider IV and administration of colloid (like hetastrach) slowly give 5-10mL/kg for dogs and 1-5mL/kg for cats, titrating to effect to minimize the risk of vascular overload

34
Q

What is more likely to increase BP, crystalloids or colloids?

A

Colloids for sureee

35
Q

What if response to crystalloid and/or colloid boluses is inadequate and patient is NOT hypovolemic?

A

do vasopressors (vasopressin, norepi, dopamine, phenylephrine, epinephrine)

36
Q

Do not use ______ solutions to correct hypovolemia or as a fluid bolus because this can lead to hyponatremia and water intoxication

A

hypotonic

37
Q

What does under administration of fluids look like?

A

increase in HR, poor pulse, hypotension, decrease urine output

38
Q

What does OVER administration of fluids look like?

A

increased respiratory effort/rate, peripheral and/or pulmonary edema, weight gain, pulmonary crackles
!!!CAREFUL in p with heart disease and renal disease

39
Q

In general, if 50% of the calculated shock volume is isotonic crystalloid has not caused much improvement, then you need to consider…..

A

either just doing a colloid or adding a colloid

40
Q

Use of _____ can prolong effects of ___ saline administration

A

colloids; hypertonic saline

41
Q

What should you do if you need to increase intravascular volume and replenish interstitial deficits?

A

do colloids AND crystalloids simultaneously

42
Q

Use of hypertonic saline:

NaCl
ringerssolution

A

To achieve translocation of fluids from the interstitial to the intravascular space (ex: initial management of hemorrhage)
In animals with hemorrhagic hypovolemic shock as a fast acting, low volume resuscitation

43
Q

When can you not use hypertonic saline?

A

in cases of severe dehydration or hypernatremic p

44
Q

Guidelines for fluid therapy when treating hypoalbuminemia include the following:

A

nutritional support is VITALLLL
synthetic colloids (like Hetastarch) Use up to 20mL/kg/day of Hetastrach for dogs and 10-20mL/kg/day for cats

45
Q

Will LRS cause worsening lactic acidosis???

A

nope.

46
Q

discontinue these meds before anesthesia:

A

ACE inhibitors, anticoagulants two weeks prior to anesthesia, and do insulin based on specific circumstances

47
Q

What if you have decreased cardiac contractility or excessive vasodilation are causing hypotension?

A

give positive inotrope or vasoconstrictor respectively

48
Q

Hypertension is MAP more than ____-___ in dogs or systolic arterial pressure more than ___-___

A

120-140mmHg; 160-180 mmHg

49
Q

High BP in p is rare under anesth, what would we do???

A

Give p opioids

anesthesia rotation notes (7 decks)

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