Induction Injectable Anesthetics Part I

Question 1

what are the main sedative/hypnotics?

Answer 1

propofol
alfaxalone

Question 2

what do propofol and alfaxalone cause in the CNS?

Answer 2

decreased cerebral blood flow, intracranial pressure, and VO2
dose-dependent depression of CNS
modulates GABAa receptor

Question 3

what is the lipid emulsion of propofol?

Answer 3

soybean oil
egg lecithin

Question 4

does recovery from propofol depend on liver function?

Answer 4

no

Question 5

where does propofol cause depression?

Answer 5

respiratory
cardiovascular

Question 6

does propofol provide analgesia?

Answer 6

no

Question 7

how does propofol cause respiratory depression?

Answer 7

decreased responsiveness to elevations in CO2 and hypoxemia

Question 8

how does propofol cause cardiovascular depression?

Answer 8

decreased MAP due to decrease in cardiac output and peripheral vascular resistance

Question 9

who should you avoid using propofol in due to its cardiovascular effects?

Answer 9

hypovolemic, hypotensive patients

Question 10

is there reflex tachycardia with propofol?

Answer 10

no

Question 11

propofol undergoes rapid oxidative metabolism by _____________________________

Answer 11

cytochrome P450 enzymes
hepatic and extra-hepatic

Question 12

do disease and obesity significantly affect recovery from propofol?

Answer 12

no

Question 13

why does propofol cause methemoglobinemia in cats?

Answer 13

phenolic ring

Question 14

what can cause myoclonus and seizure-like activity?

Answer 14

propofol

Question 15

what are the doses of propofol for dogs?

Answer 15

with premed: 2-4 mg/kg
without: 4-6 mg/kg

Question 16

what is alfaxalone registered for?

Answer 16

induction and maintenance of anesthesia in dogs and cats

Question 17

does alfaxalone cause analgesia?

Answer 17

no

Question 18

how can alfaxalone be administered?

Answer 18

IM
IV

Question 19

what systems does alfaxalone cause depression in?

Answer 19

cardiovascular
respiratory

Question 20

is the therapeutic index of propofol or alfaxalone higher?

Answer 20

alfaxalone: harder to ovedose

Question 21

what are the metabolic pathways for alfaxalone?

Answer 21

similar to endogenous steroids
rapidly redistributed and metabolized

Question 22

when can alfaxalone result in very rapid and uncontrolled recoveries?

Answer 22

if not well premedicated

Question 23

what is the duration of action of alfaxalone after full induction dose?

Answer 23

dogs: 10 minutes
cats: 25 minutes
both not premedicated

Question 24

what are the induction dose rates of alfaxalone for cats?

Answer 24

without premedication: 4 mg/kg
with: 2-3 mg/kg

Question 25

what are the dissociatives?

Answer 25

ketamine and benzodiazepine tiletamine and zolazepam

Question 26

what are dissociatives useful for?

Answer 26

IV induction of anesthesia in all mammalian species IM chemical restraint difficult animals

Question 27

what do dissociatives require to act?

Answer 27

functional cortex

Question 28

how do dissociatives work?

Answer 28

NMDA receptor antagonist depression of thalamocortical system but spares RAS and limbic system

Question 29

does ketamine provide analgesia?

Answer 29

yes

Question 30

what are the cardiovascular impacts of ketamine?

Answer 30

indirect: increases HR, SV, CO, MAP, PAP direct: decreases SV and CO overall: increases HR, BP, CO

Question 31

what does ketamine cause in the respiratory system?

Answer 31

bronchodilation apneustic breathing

Question 32

what does ketamine cause in the CNS?

Answer 32

stimulation: avoid if history of seizures increases CSF and intraocular pressures if used alone

Question 33

what are the metabolites of ketamine like in cats?

Answer 33

active

Question 34

how is ketamine metabolized?

Answer 34

rapidly distributed and redistributed liver metabolism and renal excretion

Question 35

is there a reversal agent for ketamine?

Answer 35

no

Question 36

does ketamine cause good muscle relaxation?

Answer 36

no

Question 37

what analgesia does ketamine provide?

Answer 37

some visceral excellent somatic

Question 38

can you use tiletamine and zolazepam in rabbits?

Answer 38

no

Question 39

is ketamine or tiletamine and zolazepam more potent?

Answer 39

tiletamine and zolazepam

Question 40

who should you avoid using tiletamine and zolazepam in?

Answer 40

cats with renal disease or hypertrophic cardiomyopathy animals getting a C-section animals with liver disease animals with seizure history rabbits

Question 41

what do tiletamine and zolazepam cause in rabbits?

Answer 41

nephrotoxicity