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Anesthesia > Exam 1 - premed & induction drugs > Flashcards

Exam 1 - premed & induction drugs Flashcards

1
Q

what are the three anticholinergics

A

atropine
glycopyrrolate
butylscopolamine

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2
Q

difference between atropine and glycopyrrolate

A

atropine - quick onset and short duration, cross BBB & placenta
glycopyrrolate - longer onset and longer duration, does NOT cross BBB or placenta

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3
Q

clinical side effect of anticholinergics in horses

A

ileus

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4
Q

anticholinergics in rabbits and ruminants

A

rabbits - atropinase
ruminants - rumen microflora renders atropine ineffective

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5
Q

when to use anticholinergics

A

opioid induced bradycardia
decrease secretions associated with dissociative drugs (ketamine)
bradycardic + hypotensive

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6
Q

what drug is a phenothiazine

A

acepromazine

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7
Q

acepromazine
cardiovascular effects:
resp effects:

A

hypotension
changes in heart rate variable
protects againist E induced dysrrhythmias

resp rate decreased when compounded with other drugs
tidal volume unchanges

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8
Q

contraindications of acepromazine

A

caution with seizure patients bc increase risk of seizures
caution with breeding stallions due to paraphimosis
avoid in shock patients due to hypotension
decreased PCV and TP
prolonged clotting time
weak antihistamine
may predispose regurgitation

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9
Q

5 types of alpha 2 agonist - list from least potent to most

A

xylazine
romifidine
detomidine
medetomidine
dexmedetomidine

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10
Q

how do you reverse alpha 2 agonists

A

atipamezole
yohimbine
idazoxan
tolazoline

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11
Q

alpha 2 agonist effects

A

transient hypertension followed by hypotension
bradycardia
2nd degree heart block
good analgesic
emesis in cats
hyperglycemia
diuresis

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12
Q

what is a peripheral antagonist and what does it do

A

Vatinoxan - partially reverses hypertension/bradycardia while maintaing sedation/analgesia

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13
Q

what is Zenalpha

A

vatinoxan + medetomidine
good for sedation only

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14
Q

what are the 3 types of benzodiazepines

A

diazepam
midazolam
zolazepam

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15
Q

what benzodiazepine is water soluble

A

midazolam
- can give IM

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16
Q

benzodiazepine effects

A

minimal effect on CV and resp
anti-seizure
cross placental barrier and cause neonatal depression
chronic oral use in cats = liver failure

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17
Q

indications for benzodiazepine use

A

Reduce dose requirement for injectable & inhaled drugs
Reduce muscle hypertonicity caused by dissociative drugs
Treat seizures
Appetite stimulant (cats)

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18
Q

benzodiazepine use can cause ____ in small animals and horses and _____ in ruminants, camelids, young animals

A

excitement

calming

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19
Q

benzodiazepine reversal agent

A

flumazenil

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20
Q

opioid antagonist

A

naloxone

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21
Q

morphine

A

mu agonist
least potent

22
Q

hydromorphone

A

mu agonist

23
Q

methadone

A

mu agonist
NMDA receptor antagonist

24
Q

fentanyl

A

mu agonist
most potent

25
Q

buprenorphine

A

partial mu agonist

26
Q

butorphanol

A

kappa agonist
mu antagonist

27
Q

main opioid effects

A

bradycardia (but can use anticholinergics concurrently)
vomiting (except fentanyl)
dysphoria/excitment
resp depression with IV or higher doses (less likely with SQ/IM)
histamine release w/ morphine
ileus in horses

28
Q

define neuroleptanalgesia

A

opioid + tranquilizer (acepromazine)

29
Q

rank the opioids in order of duration of action (short-long)

A

fentanyl
butorphanol
hydromorphone
methadone
morphine
buprenorphine

30
Q

what are 3 hypnotic-sedatives used for induction

A

propofol
etomidate
alfaxalone

31
Q

propofol pros

A

rapid onset 20-30 sec

32
Q

why limit propofol maintenance dose in cats to 30min

A

decreased glucoronidation metabolism

33
Q

effects of propofol

how can you minimize CV and resp effects

A

decreased ICP,CPP
variable effects on IOP
anticonvulsant
antiemetic
CV (vasodilation, decreased contractility)
resp (apnea)

give slowly

34
Q

indications for propofol use

A

dog, cat, small ruminants
short/minimally invasive procedures
liver patients if CV stable (due to extrahepatic metabolism)
neuro patients if CV stable
hyperthermic syndromes (pigs)
greyhounds
C-sections

35
Q

alfaxalone effects

how can you minimze these effects

A

less CV effects (no vasodilation) but not as well studied
resp depressant

give slowly

36
Q

alfaxalone indications

A

sighthounds
C-section
OK for patients with mild-moderate cardiac disease

37
Q

alfaxalone MOA

A

Neuro-active steroid with no glucocorticoid/mineralocorticoid actions

inhibits propagation of action potentials by altering Cl flux through GABA channel

38
Q

etomidate effects good and bad

A

minimal cardiopulmonary depression!

hemolysis, hematuria, pain on IV injection
adrenocorticol suppression
myoclonus, vomiting
opsithotonic/stargaze

39
Q

etomidate indications

A

safest for CV & resp!
compromised patients esp in CNS, CV or respiratory disease
cats with hypertrophic cardiomyopathy

40
Q

how can you minimize etomidates hemolysis, hematuria, pain on IV injection

A

dilute the drug or administer with IV fluids

caused by hyperosmolar propylene glycol

41
Q

why does ketamine have a longer duration of action in cats vs dogs

A

cats metabolize to norketamine
dogs metabolize to hydroxy-norketamine

42
Q

ketamine indications

A

healthy or mild-mod compromised patients
bronchoconstriction
bronchoscopy
aggressive animals

NOT patients with intracranial disease/seizures, pheochromocytoma, aneurysms, hyperthyroidism, hypertrophic cardiac disease or cats in renal failure

43
Q

Guaifenesin “GG”
what happens with >5%?
toxicity effects?
regular effects?

A

> 5% = hemolysis
toxicity = rigid, apnea
regular effects = sig ataxia and mental quietening

44
Q

tiletamine-zolazepam indications

A

safe handling not possible
rapid sedation is desired
(e.g wild wolves)

45
Q

tiletamine-zolazepam cautions

A

behavioral changes in tigers/lions
nephrotoxic in rabbits
similar to ketamine - don’t use in hypertrophic cardiac disease patients or renal failure cats

46
Q

tiletamine-zolazepam
____ of the each
____ in combination
recommended doses are based on ______

A

50mg each
100 mg of combination
combination

47
Q

for IV induction of opioids you want to select ones that do not cause histamine release, what would be these?

A

mu agonists:
fentanyl
hydromorphone
methadone

NOT morphine

48
Q

opioid as induction drugs indications

A

dogs with cardiovascular compromise/when CV safety needed
analgesia
when reversal of effects is important

49
Q

opioid as induction drug cautions

A

resp depression
bradycardia
excitation in horses/cats
slow induction
intubation conditions not ideal

50
Q

inhaled agent indications for induction

A

fractious patient
no catheter
small patient

51
Q

pros of using inhaled agents as induction agents

A

high FiO2
can control depth with vaporizer
facilitates ventilation

52
Q

cons of using inhaled agents as induction agents

A

no airway control
stressful
environmental contamination
high dose required for intubation comes with CV depression

Anesthesia (12 decks)

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