Injectable anesthetics

Question 1

Definition of injectable anesthetic

Answer 1

a compound that by itself produces a state of general

anesthesia–> amnesia-unconsciousness-immobility ± analgesia

Question 2

What is the MOA for all anesthetics except Ketamine?

Answer 2

GABA A receptor

Question 3

Major implications for Barbiturates having a pH 10

Answer 3

Caustic (irritant) & long shelf life

Question 4

T/F

Barbiturates are safe to use in C-section?

Answer 4

False, they are liposoluble so pass barrier causing fetal death

Question 5

What injectable anesthetic is termed dissociative?

Answer 5

Cyclohexamine Derivative

CS- open eyes + light nystagmus

Question 6

What is the only category of injectable anesthetics that provide anesthesia and analgesia

Answer 6

Cyclohexamine Derivative

Question 7

Cyclohexamine Derivative moa

Answer 7

NMDA antagonist

Question 8

What is a good sedative, hypnotic but does not provide analgesia

Answer 8

Propofol

Question 9

Why should propofol be used with liver dysfunction?

Answer 9

Both hepatic & extra-hepatic metabolism

Question 10

Alfaxalone is characterized as

Answer 10

neuroactive steroid providing hypnosis, myorelaxation but NO analgesia

Question 11

Imidazole derivatives are characterized as

Answer 11

providing hypnosis, myorelaxation but NO analgesia

Question 12

CV effect:

• Barbiturates
• Cyclohexamine derivatives
• Propofol
• Neuroactive steroids
• Imidazole

Answer 12

• Barbiturates: hypotension & reflex tachycardia (depressed contractility & vasodilation)
• Cyclohexamine derivatives: increased CO, O2 consumption, HR & MAP
• Propofol: mild CV depression, tachycardia (transient), arrhythmogenic, vasodilation & bradycardia
• Neuroactive steroids: BP maintained, temporary tachycardia and no arrhythmogenicity
• Imidazole: Cardio safe

Question 13

What are respiratory effects of gaba receptor agonist?

Answer 13

dose- dependent ventilation depression & transient apnea

- NMDA antagonist do not have these effects!

Question 14

Which injectable anesthetics maintain laryngeal function?

Answer 14

Barbiturates and cyclohexamine derivatives

Question 15

Does Ketamine cause seizures?

Answer 15

No, but may lower seizure threshold

Question 16

CNS effect:

• Barbiturates
• Cyclohexamine derivatives
• Propofol
• Neuroactive steroids
• Imidazole

Answer 16

• Barbiturates: decrease ICP & paradox excitement

- Cyclohexamine derivatives: increased cerebral blood flow & ICP

Question 17

Which barbiturate predisposes patient to arrhythmias?

Answer 17

Thiobarbiturates

Question 18

What active metabolite is responsible for excitement seen in prolonged ketamine CRI?

Answer 18

Norketamine

Question 19

Which drug is choice for induction of C-section?

Answer 19

Propofol; it crosses barrier but is short lasting

Question 20

Should propofol be used as the sole induction agent in adult horses?

Answer 20

NO

Question 21

What is propofol infusion syndrome

Answer 21

can occur with prolonged infusion- observe metabolic acidosis, myopathy (rhabdomyopathy) & cardiomyopathy (arrhythmias)

Question 22

Is propofol toxicity in cats:

Answer 22

No, but cats do have decreased glucoronidation, which is needed for metabolism of propofol and benzyl alcohol

• Phenol compound accumulate causing methemoglobinemia & Heinz bodies
• Benzyl alcohol accumulations and can cause acidosis & neurological signs

Question 23

What are 3 things you should know about etomidate before use?

Answer 23

adrenal gland suppression, acute hemolysis & risk of thrombophlebitis