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Pharmacology > general anaesthetics > Flashcards

general anaesthetics Flashcards

1
Q

whats analgesia

A

a lack of pain sensation

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2
Q

whats anaesthesia

A

lack of sensation, total loss of motoric activity

  • local
  • general
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3
Q

whats local anaesthesia

A

without loss of conscious

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4
Q

whats general anaesthesia

A

total loss of consciousness

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5
Q

how many stages are there to general anaesthesia

A
  • stage 1
  • stage2
  • stage 3
  • stage 4
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6
Q

describe stage 1 of general anaesthesia

A

disordered consciousness - induction

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7
Q

describe stage 2 of general anaesthesia

A

excitment

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8
Q

what happens in stage 3 of general anaesthesia

A

surgical anaesthesia - unconsciousness, amnesia, immobility, unresponsive to surgical stimulation

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9
Q

what happens in stage 4 of general anaesthesia

A

overdose

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10
Q

what types of anaesthetics do we use for induction

A

injectable anaesthetics

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11
Q

what types of anaesthetics do we use for maintenance

A

inhalational anaesthetics

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12
Q

injectable anaesthetics

A
  • barbiturates
  • propofol
  • imidazole anaesthetics
  • steroid anaesthetics
  • NMDAr antagonists
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13
Q

inhalational anaesthetics

A
  • halothane
  • isoflurane
  • sevoflurane
  • dinitrogen monoxide
  • desflurane
  • methoxyflurane
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14
Q

barbiturates for use as injectable anaesthetics

A
  • pentobarbital
  • methohexital
  • hexobarbital
  • thiopental
  • thiamylal
  • venobarbital
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15
Q

steroid anaesthetics for use as injectable anaesthetics

A

-alfadolone and alfaxolone in combo

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16
Q

imidazoles for use as injectable anaesthetics

A
  • etomidate

- medomidate

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17
Q

dissociative injectable anaesthetics

A
  • ketamine

- tiletamine

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18
Q

properties of an ideal injectable anaesthetic

A
  • water and lipid soluble
  • sufficiently potent
  • good analgesic activity
  • muscle relaxation
  • non irritant to tissue
  • rapid and safe induction and recovery
  • limited effect on vital fnctions
  • high TI
  • not have direct reno and hepatotoxicity
  • rapid metabolism
  • no chemical or pharmacological incompatability
  • pharmacological antagonist
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19
Q

barbiturates mechanism of action

A
  • GABA bariturate receptor complex allosteric activator

- decr in Ca accumulation -> inhibit release of NTs, stabilisation of membranes

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20
Q

barbiturates pharmacological effects

A

CNS, circulation, resp - slight overdosing can lead to resp and cardio inhibition

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21
Q

barbiturates duration of action for anaesthesia

A

short or ultra short acting

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22
Q

barbiturates application

A

only IV, effective and harmless

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23
Q

short acting barbiturates duration

A

15-60 mins

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24
Q

ultra short acting barbiturates duration

A

5-8mins

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25
Q

short and ultra short acting barbiturates distribution

A
  • fast - complete, blood brain barrier
  • placenta -> fetus -> pronounced side effect
  • redistribution
  • accumulation -> no readministration
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26
Q

ultra short acting barbiturates indication

A
  • induction, general anaesthesia, no analgesia
  • convulsive state, epilepsy
  • euthanasia
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27
Q

ultra short acting barbiturates contra indications

A
  • younger age, under 2 months

- diminished cardiac output

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28
Q

ultra short acting barbiturates therapeutic index

A

small

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29
Q

ultra short acting barbiturates side effects

A
  • resp depression - neonates
  • cardio depression
  • tissue irritation
  • pre/postnarcotic excitations
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30
Q

which breed of dog are oversensitive to barbiturates

A

greyhounds - no fatty tissue, 2nd distribution not possible, try to completely avoid use in greyhounds

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31
Q

ultra short acting barbiturates

A
  • thiopental
  • metohexital
  • hexobarbital
  • pentobarbital
  • thiamylal
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32
Q

propofol pharmacological effects

A
  • unconscioussness
  • muscle relaxation good
  • analgesia not pronounced - combo with opioids
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33
Q

propofol duration

A

IV 30-45mins

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34
Q

propofol distribution

A

fast - complete, blood brain barrier, placenta

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35
Q

propofol metabolism

A

quick hepatic and extrahepatic metabolism - in liver failure administration is safe

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36
Q

propofol elimination

A

in urine in the form of metabolites, mainly as gluronide conjugate or other inactive forms

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37
Q

propofol indications

A
  • induction and maintainance general anaesthesia
  • TIVA with opioids
  • convulsions, epileptic seizure
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38
Q

propofol contraindications

A

cardiac, respiratory, renal, hepatic impairment

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39
Q

propofol side effects

A
  • transcient apnoea during induction
  • cardiovascular depression
  • vomiting, excitation during recovery
  • allergy septicaemias
  • increased ICP and ocular pressure
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40
Q

propofol proprietary products

A
  • narcofol inj
  • vetofol inj
  • frescofol inj
  • diprivan inj
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41
Q

etomidate anaesthetics receptor

A

GABAa

42
Q

etomidate pharmacological effect

A
  • unconsciousness
  • muscle relaxation good
  • analgesia not pronounced - combo
43
Q

etomidate duration

A

up to 10-20mins

44
Q

etomidate distribution

A

fast - complete, blood brain barrier, placenta

45
Q

whats wake up like under etomidate

A

quick wake up and excitation

46
Q

etomidate indication

A
  • induction before inhalational anaesthesia

- combo - opioids, short procedure

47
Q

etomidate side effects

A
  • severe tissue irritation - only IV
  • resp depression
  • cardiovascular depression none
  • adrenocortical suppression - 2-3hr - no cont inf
  • pre/post narcotic excitation - frequent and violent
48
Q

etomidate therapeutic index

A

broad

49
Q

metomidate most commonly used species

A

pigs

50
Q

metomidate is an anaglogue of what

A

etomidate

51
Q

metomidate analgesic effect

A

moderate, better in combo with azaperone

52
Q

is metomidate acidic or basic

A

highly acidic, can only be injected into large veins

53
Q

are excitations common with metomidate

A

frequent, pre and post anaesthetic

54
Q

whats cardio depression like with metomidate

A

moderate

55
Q

possible side effects metomidate in horses

A

tremors, convulsions

56
Q

steroid anaesthetics fixed combo

A

alphaxalone+alfadolone = althesin, when used in fixed combo they have a common name

57
Q

althesin pharmacological effect

A
  • unconscioussness
  • muscle relaxation good
  • analgesia not pronounced - combo with opioid
58
Q

althesin onset

A

IV 30mins, IM 5-10mins

59
Q

althesin duration

A

up to 10-30mins

60
Q

althesin metabolism

A

quick metabolism, no accumulation -> readministration

61
Q

althesin recovery

A

quick

62
Q

althesin therapeutic index

A

broad

63
Q

althesin side effects

A
  • cardio depression - hypotension, neg ionotropic
  • histamine release - allergy
  • postnarcotic excitation - stimulation during recovery
64
Q

althesin licensed products

A
  • cremofor - cat, shock in dogs bc of intensive histamine release
  • cyclodextrine - dog and cat
65
Q

ketamine proprietary products

A
  • bioketan inj
  • CP-ketamin inj
  • narketan inj
  • calypsol inj
66
Q

tiletamine proprietary products

A

zoletil inj

67
Q

ketamine indications

A

-anaesthesia in combo, inductions and maintainance

68
Q

ketamine contraindications

A

sole use in horses and dogs, hepatic and or liver impairment, late pregnancy

69
Q

ketamine side effects

A
  • catalepsy like condition
  • increased sympathetic nervous system tone
  • increased cardiac output, heart rate, blood pressure, arrythmias
  • mild resp depression, tidal volume slightly incr
  • salivation
  • pre/postanaesthetic excitations, convulsions
  • incr ICP/eye pressure
  • hallucinations -> missuse, dependancy
70
Q

in which species can ketamine only be used in combo

A

horses and dogs

eg opioids, alpha2-agonists, benzodiazepines etc

71
Q

zoletil how does it come prepared

A

freshly dissolved in water, saline or 5% dextrose - 14 days if stored in a refrigerator

72
Q

zoletil onset

A

very fast onset of unconsciousness, 2-5min

73
Q

zoletil side effects

A
  • incr sympathetic tone -> tachycardia, arrythmias, hyperthermia, incr ICP
  • dose dependant resp depression
  • pain response when drug given by IM or SC
74
Q

types of combined anaesthesia

A
  • balanced anaesthesia
  • total intravenous anaesthesia
  • neuroleptanalgesia
  • ataranalgesia
75
Q

whats balanced anaesthesia

A

combo of antimuscarinics, sedatives, opioids, anaesthetics and muscle relaxants

76
Q

balanced anaesthesia effects

A
  • safe and deep anaesthesia
  • pain control
  • less side effects
  • relaxed body
  • smooth recovery
77
Q

whats TIVA, total intravenous anaesthesia

A

combo of agents given exclusively by the intravenous route without the use of inhalation agents

78
Q

whats neuroleptanalgesia

A

tranquiliser and opioids, a state of sedation combined with analgesia

79
Q

whats ataranalgesia

A

benzodiazepine or opioid and ketamine -> zoletile A.U.V

80
Q

advantages of neuroleptanagesia

A
  • less amount of sedative, safer

- prior anaesthesia - induction safer, analgesia more pronounced

81
Q

examples of combos used for neuroleptanalgesia

A
  • etorphine, acepromazine
  • butorphanol, acepromazine
  • fentanyl, fluanisone
  • fentanyl, droperidol
82
Q

physiological signs of neuroleptanalgesia in dogs

A
  • pupil myosis
  • circulation - mild bradycardia and hypotension
  • musculature - usuay relaxation
  • respiration - depression
83
Q

physiological signs of neuroleptanalgesia in horses

A
  • pupil - mydriasis
  • circulation - prolonged tachycardia, hypotension, transcient hypertension + incr hematocrit
  • muscles - incr muscle tone, forelimbs ext, hindlimbs flex
  • resp - depression
84
Q

groups of inhalational anaesthetics

A

organic and inorganic

85
Q

organic types of inhalational anaesthetics

A

non halogenated and halogenated

86
Q

halogenated inhalational anaesthetics

A
  • chloroform
  • halothane
  • isoflurane
  • desflurane
  • sevoflurane
  • methyoxyflurane
87
Q

non halogenated inhalational anaesthetics

A

diethyl ether

88
Q

criteria for efficacy of inhalational anaesthetics

A
  • good vaporisation
  • good blood gas distribution
  • lipid solubility, good oil; gas distribution
89
Q

whats the MAC

A

minimum alveolar conc

90
Q

halothane side effects

A
  • teratogenic, carcinogenic, hepatotxic, arrhythmogenic,
  • sensitivity to catecholamines incr
  • ADH level incr
  • EU bans therapeutic use
91
Q

isoflurane, svoflurane indications

A

induction and maintainance of general anaesthesia

92
Q

isoflurane, sevoflurane contra-indications

A

younger age, pregnant, lactating animals, susceptibility to malignant hyperthermia

93
Q

isoflurane, sevoflurane side effects

A
  • cardio and resp depression
  • cardiac arrhytmias
  • malignant hyperthermia
  • nephrotoxicity
94
Q

isoflurane dose induction

A

3-5%

95
Q

isoflurane maintainance dose

A

1.5-3%

96
Q

sevoflurane induction dose

A

5-7%

97
Q

sevoflurane maintainance dose

A

3.3-3.8%

98
Q

desflurane side effects

A

more common than others

  • resp tract irritation
  • tachyacardia
99
Q

which group of animals should methoxyflurane not be used in

A

reptiles, risk of nephrotoxicity

100
Q

methoxyflurane is preferred to be used when

A

maintainence

Pharmacology (23 decks)

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