Exam 3 - Part 1 Flashcards
adverse effects of alpha2 agonists
vasoconstriction
bradycardia
decrease CO
occasional arousal by movement/noise
dogs - commonly used alpha2 agonist and what can you add for additional analgesia or sedation
dexmedetomidine
opioid - sedation/analgesia
acepromazine - sedation
horses - commonly used alpha2 agonist for standing procedures and what can you add for additional analgesia
detomidine - less ataxia
NSAIDs
opioids
local anesthetics
alpha2 agonists are used as emetics in what species
cats
disadvantages of acepromazine
not reversible
vasodilation = hypotension
tranquilizer - not good as sole agent
when is azaperone commonly used
pigs or wildlife
not horses due to large volume needed
choice of opioids in dogs, cats, horses and small ruminants/camelids
dogs - mu agonists
(increased dose, increased sedation)
cats - kappa agonist (butorphanol), lower doses of mu agonists due to excitation
(increased dose, increased excitation)
horses - lower dose mu agonist
(increased dose, increased excitation)
small ruminants/camelids - low dose mu agonists due to risk of GI stasis
what species are prone to excitatory effects of benzodiazepines
cats and horses
biggest disadvantage of opioids
dose-dependent resp depression
can also have nausea
benzodiazepines can be the primary sedative in which animals
young foals, camelids, goats and sheep
what drugs are good for total intramuscular protocols where GA is to be induced with a single injection (e.g. spay/neuter clinics or aggressive patients)
ketamine
telazol
common lung injuries in trauma patients
lung contusion
pneumothorax
myocardial contusion
diaphragmatic hernia
abnormalities due to lung contusions
atelectasis
hypoxemia/hypoventilation
if a patient has a lung contusion and may require IPPV however this may result in a risk of ______
barotrauma/pneumothorax
if a patient has a pneumothorax and IPPV is used, this will result in ______
tension pneumothorax
abnormalities associated with a tension pneumothorax
decreased lung compliance
decreased blood pressure
cardiovascular collapse
treatment for tension pneumothorax
emergency thoracocentesis
chest tube
abnormalities associated with diaphragmatic hernia
decreased FRC
atelectasis
hypoxemia
abnormalities with myocardial contusions? treatment?
arrhythmias - VPC
O2, fluids, analgesia, lidocaine
what drugs to avoid with myocardial contusions
alpha2 agonists
thiopental
halothane
what abnormalities are associated with ruptured bladder in trauma patient
azotemia
low NaCl
hyperkalemia = life threatening arrhythmias (bradycardia) - normalize before anesthesia
treatments for hyperkalemia
drain urine
calcium, bicarb, insulin, dextrose
what drug can you give during intubation to lessen the risk of intubation spiking an increase in ICP
lidocaine
anesthetic considerations to follow with trauma patient
CV and pulmonary sparing
reversible
titratable
Oxygen
secure airway
most common induction combination in a trauma patient
opioid + benzodiazepine
why do you want small amounts of inhalant anesthetics in trauma patients
IA cause loss of autoregulation in brain due to vasodilation
MAC REDUCTION < 1
Cardiovascular changes during pregnancy
↑ blood volume (plasma > RBC thus “anemia”)
↑ CO (40%)
compensatory reflex delayed
respiratory changes during pregnancy
how does progesterone affect respiration
↓ TLC & FRC
↑ risk of hypoxemia
progesterone ↑ sensitivity to PaCO2
CNS considerations during pregnancy
↑ sensitivity to anesthetics
↓ anesthetic requirement due to progesterone GABA modulatory effects & hormonal influence on pain
GI considerations during pregnancy
↑ risk of regurgitation and aspiration due to delayed gastric emptying and decreased esophageal sphincter tone
anesthetic management for C-section
correct any deficits
preoxygenate
rapid induction/secure airway
minimize dose and anesthetic time
resuscitate neonate
maintain normal BP
choice of pre-meds for pregnant
small animals -
large animals -
ruminants/camelids -
opiods
alpha2 agonists
benzos
choice of induction drugs for pregnant
small animal -
large animal -
IV only
propofol, alfaxalone
ketamine + propofol or benzo
care for neonate post C-section
remove placental membranes
clear oropharynx of secretions
antagonize drugs (sublingual or umbilical v)
physiologic considerations of the neonate
immature liver enzymes (increased duration of drugs due to decreased metabolism)
hypoglycemia
hypothermia
immature sympathetic NS (risk of hypotension and bradycardia)
atelectasis due to decrease FRC - hypoventilation/hypoxemia
anesthetic considerations for neonate
no fasting (hypoglycemic risk)
short, reversible drugs
warming techniques
maintain glucose > 70
avoid bradycardia (atropine if needed)
MAP > 55 (can give ephedrine)
