Injectable Anesthetics Flashcards

1
Q

induction of anesthesia is a

A

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

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2
Q

priorities during induction

A

rapidly sercure airways and give oxygen

maintain CV function

induce/maintain anesthesia

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3
Q

why is induction with an inhalational agent via mask not recommended

A

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

go through stages 1 and 2 slowly (excitement)

stressful, chance for injury

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4
Q

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

A

sevoflurane

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5
Q

which injectable anesthetics are GABA angonists

A

propofol

thiopental

etomidate

alphaxalone

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6
Q

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

A

NMDA antagonists

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7
Q

T/F ketamine may accumulate with repeated doses or CRI

A

True

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8
Q

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

A

True

always use in combination

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9
Q

does ketamine have an analgesic effect

A

yes but not as strong as opioids

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

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10
Q

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

A

False

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11
Q

CV effects of ketamine

A

direct: negative inotropy

indirect: catecholamine release→increased HR and contractility

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12
Q

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

A

True

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13
Q

dissociative anesthetics increase/decrease ICP

A

increase

all the other injectables discussed will decrease

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14
Q

factors increasing cerebral blood volume

A

hypercapnia, hypoxia

hypertension

C+/V+

head down position, jugular vein compression

drugs

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15
Q

main indications for ketamine

A

hypovolemic shock

asthma

most risk patients tolerate in small doses

chemical immobilzation of aggressive animals

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16
Q

contraindications of ketamine

A

brain trauma/tumor

perforating eye injury (increase intracorneal pressure)

HCM/ mpst heart diseases

seizures

hepatic/renal insufficiency

17
Q

what does telazol contain

A

tiletamine (similar to ketamine)

zelazepam (benzodiazepine)

18
Q

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

A

True

useful for aggressive small/wild animals

19
Q

propofol

A

fast onset, short duration

smooth induction and recovery

no accumulation - ideal for TIVA

no analgesia

IV only

20
Q

CV effects of propofol

A

vasodilation - hypotension!

some neg inotropy

no reflex tachycardia

21
Q

T/F propofol can be used to terminate status epilepticus

A

True

has antiepileptic effects

22
Q

why should cats not have repeated administrations of propofol

A

can cause hemolysis and Heinz-body anemia

23
Q

propofol is the drug of choice

24
Q

when is propofol contraindicated

A

hemodynamically unstable patients

very sick patients in general

25
thiopental
fast onset, short duration ## Footnote **withdrawn from USA**
26
thiopental should never be given
extravascularly if happens - inject 2ml saline or 1% lidocane immediately to each side of the vein
27
CV effects of thiopental
hypotension - neg inotropy, vasodilation arrhythmogenic
28
when is thiopental preferred
good choice for neurosurgery as an induction agent
29
CV effects of etomidate
almost none!
30
what is the #1 choice for induction of hemodynamically unstable patients
etomidate
31
why is etomidate CRI contraindicated
adrenal suppression propylene glycol accumulation
32
T/F etomidate can cause V+ even while unconscious
**True** combine with fentanyl to decrease etomidate dose and inhibit V+
33
some cons of etomidate
excitement and twitching possible pain during injection hemolysis (propylene glycol) not an easy to use drug- need experience!
34
Alfaxalone
rapid onset, short duration recovery can be rough no analgesia
35
CV effects of Alfaxalone
minimal
36
what drug has the potential to replace etomidate as induction agent for high risk patients
Alfaxalone
37
when giving Alfaxalone IM for sedation it should be in combination with
midazolam +/- opioids