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Vet. Anesthesiology & Sx proc. > Ch.3 Anesthetic Agents and Adjuncts > Flashcards

Ch.3 Anesthetic Agents and Adjuncts Flashcards

1
Q

What is an anesthetic agent

A

any drug used to induce a loss of sensation with or without unconsciousness

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2
Q

What is an adjunct

A

a drug that is not true anesthetic, but that is used during anesthesia to produce other desired effects such as sedation, muscle relaxation, analgesia, reversal, neuromuscular blockage, or parasympathetic blockade

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3
Q

What is pharmacokinetics

A

the effect the body has on the drug

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4
Q

What is pharmacodynamics

A

the effect the drug has on the body

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5
Q

Reversal agents are _

A

antagonists

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6
Q

what type of opioid binds to more than one receptor, simultaneously stumbling at least one and blocking at least one

A

agonist-antagonist

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7
Q

What type of opioid binds to and partially stimulates receptors

A

Partial agonists

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8
Q

What can be used to block pure agonists

A

partial agonists and agonist-antagonists

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9
Q

Most general anesthetics are not _

A

analgesics

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10
Q

Analgesia must be provided when regarding sx

A

pre and post-op

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11
Q

True analgesics don’t provide _ _

A

general anesthesia

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12
Q

Don’t administer a drug combination if a _ develops when the drugs are mixed

A

precipitate

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13
Q

Most anesthetic agents and adjuncts are _ soluble

A

water

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14
Q

Diazepam is not water soluble and can only safely be mixed in the same syringe with _

A

ketamine

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15
Q

Unexpected, significant loss must be reported to the DEA and local police within how long?

A

1 business day

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16
Q

Precautions to take when prescribing controlled substances

A

keep rx pads in secure location and prevent illegal alteration of the prescription

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17
Q

What type of drugs do the following:
-Block acetylcholine
-Prevent and tx bradycardia
-Decrease salivary secretions

A

Parasympathetic drugs

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18
Q

Differences in atropine and glycopyrrolate (dogs and cats)

A

Atropine- faster onset, shorter duration
Glycopyrrolate- slow onset, longer duration

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19
Q

_ and _ should not be given if HR >140bpm dog, >180bpm cat

A

Atropine and glycopyrrolate

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20
Q

The following are effects of _ drugs:
CNS-limited effect
Cardiovascular- prevent bradycardia
Secretions-decrease
Eye-mydriasis and corneal drying
Bronchodilation

A

Anticholingerics

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21
Q

Adverse effects of anticholingerics

A

-Cardiac arrhythmia
-Temp, bradycardia
-Thickened resp. and salivary secretions
-Intestinal peristalsis inhibition

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22
Q

The following are _ and _
Phenothiazines
Benzodiazepines
Alpha2-adrenoceptor agonists
-Alpha2-antagonists

A

Tranquilizers and sedatives

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23
Q

Example of a phenothiazine

A

acepromazine

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24
Q

Effects of acepromazine on cardiovascular system

A

-peripheral vasodilation that leads to hypotension, increased HR, and hypothermia
-protects against arrhythmias and decreases cardiac output

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25
Q

Effects of acepromazine on CNS:

A

-calming, reluctance to move, decrease interest in surroundings
-sedation less pronounced in cats
-not an analgesic

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26
Q

Affect of acepromazine on GI system

A

antiemetic

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27
Q

Averse effects of acepromazine

A

-CNS (reduce seizure threshold, poss. aggression or excitement
-Cardiovascular system (hypotension)
-Penile prolapse (horses and other LA)
-Decreased PCV (poss. due to splenic engorgement)

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28
Q

Acepromazine caused increased potency and duration ,,_ _

A

geriatrics, neonates, debilitated animals

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29
Q

Overdose tx of acepromazine

A

IVF, Norepi

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30
Q

Breed considerations for acepromazine

A

Australian shepherd (reduce by 25%)
Giant breeds, boxers, greyhounds
Terriers and cats

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31
Q

Examples of benzodiazepines

A

-Diazepam (valium)
-Zolazepam (telazol)
-Midazolam

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32
Q

Onset of action and duration of action for benzodiazepines

A

15min; 1-4hrs

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33
Q

The following are adverse effects of _:
-Disorientation and excitement-young, healthy dogs
-Dysphoria and aggression- cats
-Muscle fasciculations- horses
-Ataxia and recumbency- any LA

A

Benzodiazepines

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34
Q

Oral diazepam in cats can cause _ _

A

liver failure

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35
Q

The following are effects of _
-Calming in only old or ill patients
-Not an effective sedative or analgesic
-Anticonvulsants
-Appetite stimulation in cats and ruminants

A

benzodiazepines

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36
Q

Reversal for benzodiazepines

A

flumazenil

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37
Q

Diazepam can only be given _

A

IV slowly

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38
Q

Alpha2-Adrenoceptor Agonists can be readily reverse with

A

alpha 2-antagonist

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39
Q

What following are examples of -
Xylazine (Rompun, Anased)
Detomidine (Dormosedan)
Romifidine (Sedivet)
Dexmedotmidine (Dexdomitor)

A

Alpha2-Agonists

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40
Q

Effects of alpha2 agonists

A

sedation, analgesia, bradycardia, hypotension, and hypothermia

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41
Q

Adverse effects of alpha2 agonists

A

vomiting (immediate in dogs and cats)
hyperglycemia
hypothermia
bloat
salivation and regurgitation
sweating-horses
premature parturition-cattle

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42
Q

Alpha2 agonists can be absorbed through

A

skin abrasions and MM (wash off immediately)

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43
Q

Avoid use in alpha2 agonists in ,,,,_ patients

A

geriatric, diabetic, pregnant, pediatric, ill

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44
Q

How should dosing of alpha 2 agonists be adjusted for cattle

A

use 1/10 horse dose

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45
Q

Antagonist for dexmedetomidine

A

atipamazole (antisedan)

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46
Q

Dose for agonist to antagonist

A

10:1

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47
Q

Yohimbine reverse CVS and sedative effects of _

A

xylazine

48
Q

When administering atipamezole used _ the dose in cats compared to dogs

A

1/2

49
Q

If dexdomitor (0.1mg/ml) is used, the reversal agent is given at _ dose

A

1/5

50
Q

Opioids are classified as

A

agonists, partial agonists, agonist-antagonist, antagonists

51
Q

Agonist opioids

A

morphine, hydromorphone, oxymorphone, fentanyl, meperidine

52
Q

Partial agonist opioids

A

buprenorphine

53
Q

Agonist-antagonist opioids

A

butorphanol and nalbuphine

54
Q

Antagonist opioids

A

naloxone, etorphine, and carfentenil

55
Q

Effects of opioids in dogs

A

causes sedation , narcosis

56
Q

Effects of opioids on cars, horses, and ruminants

A

CNS stimulation, bizarre behavior patterns or dysphoria (pure agonists), use lower dose

57
Q

Effects of opioids on CVS and respiratory system

A

bradycardia, decrease RR and tidal volume, panting in dogs

58
Q

What effect do opioids have on the temperature of dogs, cats , and horses

A

Dogs-hypothermia
cats- hyperthermia
horses-sweating

59
Q

What is neuroleptanalgesia

A

a profound state of sedation and analgesia induced by simultaneous admin. of an opioid and a tranquilizer

60
Q

The following are used in combo to cause_:
-Opioids: morphine, buprenorphine, butorphanol, hydromorphone
-Tranquilizers: acepromazine, diazepam, midazolam, xylazine, dexmedetomidine

A

Neuroleptanalgesia

61
Q

Neuroleptanalgesics should not be used for induction in

A

young, healthy dogs,(sedation not enough to intubate) not in cats (mania/excitement)

62
Q

Opioid antagonists

A

naloxone hydrochloride (dogs, horses, cats, exotic mammals) Naltrexone (in wild animals)

63
Q

Use opioid antagonists

A

-emergencies
-overdose
-reverse neuroleptanalgesia
-reviving neonates delivered by C-section (if dam received opioids)

64
Q

Injectable anesthetics that are admin. to effect IV

A

barbiturates, propofol, alfaxalone, dissociative and etomidate

65
Q

The following describes _ acting barbiturates:
-Thiopental sodium, methohexital, and thiamylal
-Dogs, cats, and horses
-Induce general anesthesia

A

Ultrashort

66
Q

The following describes _ acting barbiturates:
-Pentobarbital
-Laboratory animals
-Induce general anesthesia
-Tx epilepsy in small animals

A

Short

67
Q

Barbiturates can be _, _, , acting

A

ultrashort, short, intermediate, long-acting

68
Q

Ultrashort barbiturates are _lipid soluble -tissue redistribution

A

highly

69
Q

Short acting barbiturates is _ lipid soluble - metabolized

A

moderately

70
Q

Intermediate and long acting barbiturates are _ lipid soluble -excreted

A

low

71
Q

What does acidoses cause when using barbiturates

A

-increased nonpolarization
-increased drug amounts to brain
-exaggerated P response
-lower dose to anesthetize

72
Q

Barbiturates travel in the blood bound to _ _and freely circulating

A

plasma proteins

73
Q

Hypopreteinemia (<3g/dl) results in more _ _

A

free drug

74
Q

Barbiturates are distributed fastest to _-rich tissues (brain, heart, liver, kidneys, and endocrine gland)

A

vessel

75
Q

Effects of Thiopental (barbiturate) on the CVS

A

-autonomic nervous system imbalances
-increased cardiac sensitivity to epi
-cardiac arrhythmias

(give lidocaine IV before giving to reduce likelihood of arrhythmias)

76
Q

Effects of barbiturates on respiratory system

A

-Decreased respiratory rate and tidal volume
-Brief apnea (thiopental)
-Shallow breaths (pentobarbital)

77
Q

Barbiturates have exaggerated potency in what patients?

A

sighthounds, criticality ill, hypoproteinemic, or acidotic

78
Q

How to tx tissue irritation and sloughs from barbiturates

A

Tx with saline (=to barbiturate amount) + lidocaine

79
Q

What drug is described
-ultra short acting, non barbiturate anesthetic
-IV for anesthetic induction and short term maintenance
-SA, small ruminants, exotic animals, neonates of all species
-Other use: IV bolus and CRI to tx status epilepticus in dogs and cats
-Wide margin of safety

A

propofol

80
Q

Onset of action and duration of action for propofol

A

30-60 seconds; 5-10 minutes

81
Q

Use of propofol is safe for use in animals with _ or _ disease

A

liver or kidney

82
Q

Other effects of propofol

A

-muscle relaxation
-twitching during induction (dogs)
-appetite stimulant (low dose)
-antiemetic
-decrease IOP and ICP

83
Q

The following are adverse effects of _
-Seizure like signs (induction)
-Pain with IV injection
-Cats with repeat dose (Heinz body on RBCs, diarrhea and anorexia, prolonged recoveries)
-Sighthounds (prolonged recovery if maintained on drug for >30minutes)

A

propofol

84
Q

Giving propofol IM only produces _ _ and _

A

mild sedation and ataxia

85
Q

Propofol is highly _ bound

A

protein

86
Q

Admin. of propofol

A

-initially give 1/4-1/3 dose slow IV, then 10% increments to effect
-boluses repeated every 3-5 min for 20 min
-CRI w/ syringe pump or through IV line

87
Q

Propflo-28 has a 28 day shelf life once opened but cannot be used in cats due to preservative

A

benzyl alcohol

88
Q

Alfaxalone is given IV for anesthetic induction; IM in cats for _ _

A

deep sedation

89
Q

Alfaxalone is similar to

A

propofol

90
Q

Dissociatives decreased _ pain through NMDA inhibition

A

windup

91
Q

Dissociatives cause _ state where the animal appears awake but is immobile and unaware of surroundings

A

trancelike

92
Q

All dissociative are either metabolized in the liver or excreted unchanged in the urine so avoid use in animals with

A

liver or kidney disease

93
Q

The following are effects of _ on the CNS
-Cataleptoid state
-Intact reflexes
-Ocular effects (eyes remain open, central dilated pupil, use ophthalmic ointment)

A

Dissociatives

94
Q

Dissociatives provide _ and _ analgesia

A

somatic and visceral

95
Q

Dissociative effects on the CVS

A

-Increased HR
-Increase cardiac output
-Increased mean BP
-Effects due to stimulation of the SNS

96
Q

Dissociatives should be avoided in what patients

A

-seizure disorders
-animals that have ingested CNS stimulants
-avoid in animals undergoing neurological system procedures

97
Q

Overdosage of dissociative can cause what effects on the respiratory system

A

depression and arrest

98
Q

Tiletamine is only sold in combination with zolazepam (__)

A

Telazol

99
Q

The following are effects of _ on the CNS
-Hypnosis
-Very little analgesia
-Decreased brain oxygen consumption
-Brain perfusion maintained
-Anticonvulsant

A

Etomidate

100
Q

Adverse effects of Etomidate

A

-painful IV injection
-Perivascular sterile abscesses
-Hemolysis w/ rapid admin in cats
-Decreased adrenal cortex function
-Nausea, V+, involuntary excitement during induction and recovery

101
Q

When using etomidate, you should premedicate with

A

opioid or diazepam or dexamethasone

102
Q

Guaifinesin is common in LA for

A

muscle relaxation, facilitate intubation, ease induction and recovery

NOT AN ANESTHETIC OR AN ANALGESIC

103
Q

How is guaifenesin administered

A

IV rapidly until animal is ataxic

104
Q

Isoflurane and sevoflurane are _ compounds

A

halogenated

105
Q

Halogenated organic compounds (Iso and Sevo) will rapidly diffuse to _, then to vessel-rich, lipid-rich tissue

A

blood

106
Q

Effects of Halogenated organic compounds on CNS

A

-Increase ICP in patients with head trauma or brain tumors
-Considered safe for epileptic animals
-Hypothermia

107
Q

Effects of Halogenated organic compounds on CVS

A

-decrease blood pressure and may decrease renal blood flow
-depresses function

108
Q

Effects of Halogenated organic compounds on respiratory system

A

-Hypoventilation
-Carbon dioxide retention and respiratory acidosis

109
Q

Important physical and chemical properties of inhalant anesthetics

A

-Vapor pressure
-Partition coefficient
-MAC
-Rubber solubility

110
Q

Vapor pressure determines how readily an inhalation anesthetic will _ in the anesthetic machine vaporizer

A

evaporate

111
Q

Isoflurane is almost completely eliminated through the _

A

lungs

112
Q

Doxapram is an _ agent

A

analeptic

113
Q

What does doxapram do

A

stimulates respiration and speeds recovery

114
Q

Which inhalant anesthetic is better for mask induction

A

Sevo

115
Q

Iso MAC

A

1.5

116
Q

Sevo MAC

A

2.5

117
Q

Adverse effects of Doxapram

A

-wide margin of safety
-lowers seizure threshold
-CNS damage

Vet. Anesthesiology & Sx proc. (8 decks)

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