Injectable Anesthetics

Question 1

induction of anesthesia is a

Answer 1

transition from a(semi-) conscious state to an unconscious one

Question 2

priorities during induction

Answer 2

rapidly sercure airways and give oxygen

maintain CV function

induce/maintain anesthesia

Question 3

why is induction with an inhalational agent via mask not recommended

Answer 3

takes longer to induce and intubate (hold breath) - increased chance for asipration

go through stages 1 and 2 slowly (excitement)

stressful, chance for injury

Question 4

if you have to do a mask induction which inhalant is better

Answer 4

sevoflurane

Question 5

which injectable anesthetics are GABA angonists

Answer 5

propofol

thiopental

etomidate

alphaxalone

Question 6

Ketamine and tiletamine are dissociative anesthetics that act on which receptor?

Answer 6

NMDA antagonists

Question 7

T/F ketamine may accumulate with repeated doses or CRI

Answer 7

True

Question 8

T/F Ketamine can cause an catatonic state if used alone

Answer 8

True

always use in combination

Question 9

does ketamine have an analgesic effect

Answer 9

yes but not as strong as opioids

prevent wind-up and central sensitization - may prevent developement of chronic pain

Question 10

T/F the anesthetic effect of ketamine is due to its actions on the GABA receptor

Answer 10

False

Question 11

CV effects of ketamine

Answer 11

direct: negative inotropy

indirect: catecholamine release→increased HR and contractility

Question 12

T/F the anesthetist can manipulate IC blood volume and therefore can influence ICP

Answer 12

True

Question 13

dissociative anesthetics increase/decrease ICP

Answer 13

increase

all the other injectables discussed will decrease

Question 14

factors increasing cerebral blood volume

Answer 14

hypercapnia, hypoxia

hypertension

C+/V+

head down position, jugular vein compression

drugs

Question 15

main indications for ketamine

Answer 15

hypovolemic shock

asthma

most risk patients tolerate in small doses

chemical immobilzation of aggressive animals

Question 16

contraindications of ketamine

Answer 16

brain trauma/tumor

perforating eye injury (increase intracorneal pressure)

HCM/ mpst heart diseases

seizures

hepatic/renal insufficiency

Question 17

what does telazol contain

Answer 17

tiletamine (similar to ketamine)

zelazepam (benzodiazepine)

Question 18

T/F telazols effect is similar to Ket/Val but is longer acting

Answer 18

True

useful for aggressive small/wild animals

Question 19

propofol

Answer 19

fast onset, short duration

smooth induction and recovery

no accumulation - ideal for TIVA

no analgesia

IV only

Question 20

CV effects of propofol

Answer 20

vasodilation - hypotension!

some neg inotropy

no reflex tachycardia

Question 21

T/F propofol can be used to terminate status epilepticus

Answer 21

True

has antiepileptic effects

Question 22

why should cats not have repeated administrations of propofol

Answer 22

can cause hemolysis and Heinz-body anemia

Question 23

propofol is the drug of choice

Answer 23

C-section

Question 24

when is propofol contraindicated

Answer 24

hemodynamically unstable patients

very sick patients in general

Question 25

thiopental

Answer 25

fast onset, short duration

withdrawn from USA

Question 26

thiopental should never be given

Answer 26

extravascularly

if happens - inject 2ml saline or 1% lidocane immediately to each side of the vein

Question 27

CV effects of thiopental

Answer 27

hypotension - neg inotropy, vasodilation

arrhythmogenic

Question 28

when is thiopental preferred

Answer 28

good choice for neurosurgery as an induction agent

Question 29

CV effects of etomidate

Answer 29

almost none!

Question 30

what is the #1 choice for induction of hemodynamically unstable patients

Answer 30

etomidate

Question 31

why is etomidate CRI contraindicated

Answer 31

adrenal suppression

propylene glycol accumulation

Question 32

T/F etomidate can cause V+ even while unconscious

Answer 32

True

combine with fentanyl to decrease etomidate dose and inhibit V+

Question 33

some cons of etomidate

Answer 33

excitement and twitching possible

pain during injection

hemolysis (propylene glycol)

not an easy to use drug- need experience!

Question 34

Alfaxalone

Answer 34

rapid onset, short duration

recovery can be rough

no analgesia

Question 35

CV effects of Alfaxalone

Answer 35

minimal

Question 36

what drug has the potential to replace etomidate as induction agent for high risk patients

Answer 36

Alfaxalone

Question 37

when giving Alfaxalone IM for sedation it should be in combination with

Answer 37

midazolam +/- opioids