Injectables Flashcards
Which injectable anesthetics may be given IM?
- Ketamine
- Telazol
- Alfaxalone
General qualities shared by injectable anesthetic drugs (6)
• Very liposoluble • Highly protein bound • Reach the Brain rapidly • Redistributed to other tissue • Accumulation in fat • Decrease in drug plasmatic concentration
Opiods review (6)
- Fentanyl or hydromorphone bolus
- ↓ HR and ventilation
- No myocardial depression
- Reversible
- Analgesic
- Short acting (fentanyl)
2 injectable opiods
- Fentanyl
- Hydromorphone
5 CV effects of Ketamine
• Sympathetic Stimulation • ↑ HR and BP • Careful in HCM • Direct myocardial depressant • May ↑ IOP
Injectable anesthetic drugs (6)
- Propofol
- Ketamine
- Telazol
- Etomidate
- Alfaxalone
- Opioids (Fentanyl and Hydromorphone)
Etomidate acts on _________ receptors and is _________ based. It is a ________ derivative and may cause _________.
- GABA A receptors
- propylene glycol
- Imidazole
- hemolysis
Ketamine undergoes Hepatic metabolism in ____ and _____ and is eliminated unchanged by ____
- dogs and horses
- cats
Propofol acts on the _________ to cause _________ resulting in _________
- GABA receptors
- ↑ influx of Cl
- hyperpolarization
2 shelf lives of Propofol formulations once opened
- 6 hours
- 28 days (2% Benzyl-alcohol)
Alfaxalone acts on _____
GABA
5 Neurologic effects of Propofol
- Decrease CMR02
- Decrease ICP
- Protective for brain ischemia
- Treatment for seizures
- Decrease EEG activity
Alfaxalone Review (6)
- Fast acting
- No problem if given perivascular
- Short cardiovascular depression
- Apnea, respiratory depression
- CNS friendly
- Can be given intramuscularly
What is the main drawback to Etomidate use?
adrenal suppression (Addisonian crisis)
Telazol Review (4)
- Similar effects of Ket/val
- Smaller volume
- Associated with rough recoveries w/o premeds
- Can be reconstituted with Ketamine and alpha2
3 Respiratory effects of Ketamine
• Apneustic breathing
• Apnea
• Maintained laryngeal
reflexes and PaO2
Neurologic effects of opiods
• Increase in intracranial pressure (if hypoventilation occurs) • May affect heart automaticity and conduction
The formulation of Propofol with the long opened shelf life is FDA approved only in _____
dogs
Characteristics of Propofol induction (6)
- Induction in 30 sec
- Excitation (bolus)
- Apnea
- Duration 10-15 min
- Cumulative
- Splenic engorgement
Neurologic effects of Etomidate
- CNS friendly
- Myoclonus
- Poor muscle relaxation
- Usually combined w/ benzo or opiods
Etomidate Review (6)
- Minimal cardiovascular changes
- Adrenal supression
- Poor muscle relaxant
- Combined with opioid or benzo for induction
- Expensive
- Good for cardiac patients
Neurologic effects of Alfaxalone
• CNS friendly
• Potential protective effect in premature fetus when labor is induced by glucocorticoids
(Betamethasone)
• Excitation in cats during recovery (IM route)
Propofol anesthesia lasts for ____-___ minutes after induction dose
10-15
Neurologic effects of Telazol
• Maintained reflexes
– Coughing
– Swallowing
– corneal reflexes
3 Neurologic effects of Ketamine
• ↑ ICP and CBF • Somatic analgesia • Excitement at emergence – Motor activity – Sensitivity to touch – Violent recovery
Ketamine is a _________ compound
cyclohexamine
Ketamine causes dissociation between the __________ and __________
- thalamus
- limbic system
What is the benefit of adding 2% Benzyl-alcohol to the Propofol formulation?
Extends opened shelf life from 6 hours to 28 days
CV effects of Etomidate
Cardiovascular and respiratory stability
CV and respiratory effects of Telazol
• Similar to ketamine
• ↑ HR, BP and SVR
due to sympathetic
stimulation
Telazol comes as a ____ which is reconstituted with ________
- lyophilized powder
- sterile water
Once saturation occurs, plasma concentration
only decreases with
_______
drug elimination
Propofol review (6)
• Fast acting • No problem if given perivascular • Short cardiovascular depression • Apnea, respiratory depression • CNS friendly • Contamination after 6 hours opened – Benzyl alcohol prolongs shelf-life and decrease contamination
4 Clinical effects of Ketamine
- ↑ Salivation and mucus
- Poor muscle relaxation
- Reflexes are maintained
- Rough recoveries
3 most important distribution tissues of the body
- Splanchnic viscera
- Muscles
- Fat
Cardiorespiratory effects of Alfaxalone
• Minimal cardiovascular effects – ↑HR and C.O. – ↓ BP (vasodilation) • Dose dependent respiratory depression – Apnea after bolus
Propofol is an __________ compound
alkylphenol
Ketamine Review (8)
- Increase sympathetic tone
- Poor muscle relaxant
- Combine with Benzodiazepines for induction
- Increase myocardium work load
- Increase ICP, CBF, IOP, â seizures threshold
- Rough recoveries
- Apneustic breathing, apnea
- Maintained reflexes
4 CV effects of Propofol
- Myocardial depression
- Decrease in CO
- Decrease in BP
- Increase HR
3 Respiratory effects of Propofol
- Decrease in Vt
- Hypoventilation
- Apnea
Cardiorespiratory effects of Opioids
• Cardiovascular friendly • ↓ HR • Dose dependent respiratory depression • Analgesia
