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Surgery Theo > Lec.3 Preanesthetic > Flashcards

Lec.3 Preanesthetic Flashcards

1
Q

How do premedication drugs affect the amount of anesthetics required?

A

They decrease the amount of injectable and inhalant anesthetics required.

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2
Q

What is the primary purpose of administering premedication drugs in anesthesia?

A

To minimize patient stress and anxiety, facilitate restraint, and enhance the safety of the patient and staff.

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3
Q

What benefit do premedication drugs provide during the transition between anesthetic phases?

A

They facilitate a smooth transition between anesthetic phases and improve cardiopulmonary stability.

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4
Q

What are phenothiazine derivatives classified as in the context of preanesthetic drugs?

A

Phenothiazine derivatives are classified as major tranquilizers and antipsychotic drugs (or neuroleptics).

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5
Q

What effects do phenothiazine derivatives have due to their action as dopamine antagonists?

A
  • Calming effects
  • Mood-altering (antipsychotic) effects
  • Powerful antiemetic action, particularly against opioid-induced vomiting.
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6
Q

How does the degree of sedation produced by phenothiazine derivatives vary?

A

The degree of sedation produced varies between different phenothiazine drugs.

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7
Q

What is the primary mechanism of action of phenothiazine derivatives?

A

Phenothiazine derivatives act as dopamine antagonists and also block α1-adrenoceptors.

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8
Q

What is a potential risk associated with long-term dosage of phenothiazine derivatives?

A

Long-term dosage can lead to liver damage.

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9
Q

What are the major cardiovascular side effects of phenothiazines?

A
  • Fall in arterial blood pressure due to peripheral vasodilatation
  • Decrease in packed cell volume caused by splenic dilation.
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10
Q

What antiarrhythmic effect do phenothiazines exert on the heart?

A

Phenothiazines exert an antiarrhythmic effect on the heart that may be caused by a blocking action on the cardiac α - arrhythmic receptors.

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11
Q

What is the current understanding of the antiarrhythmic effect of phenothiazines?

A

Phenothiazines exert an antiarrhythmic effect on the heart, which may be due to a blocking action on cardiac α-arrhythmic receptors rather than a quinidine-like action.

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12
Q

What are the CNS effects of certain preanesthetic drugs?

A
  • Induce CNS depression by affecting various brain structures
  • Lack generalized hypnotic effect
  • Do not produce analgesia
  • Act as anti-emetic
  • Can lower seizure threshold.
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13
Q

What is the effect of combining phenothiazines with opioids and hypnotics?

A

When combined with opioids and hypnotics, phenothiazines have an additive effect, which may lead to respiratory depression.

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14
Q

What happens to ventilation when large doses of phenothiazines are administered?

A

Large doses of phenothiazines can depress ventilation.

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15
Q

What are the respiratory effects of phenothiazines at therapeutic doses?

A

At therapeutic doses, phenothiazines have negligible respiratory effects.

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16
Q

What are some physiological effects of certain preanesthetic medications?

A
  • Skeletal muscle relaxation
  • Delayed gastric emptying with spasmolytic action on the gut
  • Decreased body temperature
  • Some anticholinergic activity.
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17
Q

Which preanesthetic medications exhibit anticholinergic activity?

A
  • Acepromazine
  • Promazine
  • Chlorpromazine
  • Propiopromazine
  • Triflupromazine.
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18
Q

What is Acepromazine and how is it prepared?

A

Acepromazine is prepared as the maleate, a yellow crystalline solid.

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19
Q

For how long has Acepromazine been available and what are its uses in veterinary medicine?

A

Acepromazine has been available for over 50 years and is widely used in veterinary medicine for sedation, premedication, and non-anesthetic related indications.

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20
Q

How is Acepromazine metabolized and excreted?

A

Acepromazine is metabolized in the liver, and both conjugated and non-conjugated metabolites are excreted in the urine, with some detectable for a considerable period.

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21
Q

What protective effect does preanesthetic medication have against epinephrine?

A

It has antiarrhythmic effects and protects against epinephrine-induced fibrillation.

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22
Q

How does premedication affect the incidence of death associated with anesthesia and surgery in horses?

A

It significantly reduces the incidence of death associated with anesthesia and surgery.

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23
Q

What is the impact of premedication on anesthetic-related deaths in dogs?

A

Its use significantly reduces anesthetic-related deaths when compared with no premedication.

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24
Q

What potential risk does Acepromazine pose to horses during sedation?

A

Acepromazine poses a risk of physical damage to the dangling penis in horses.

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25
Q

How does Acepromazine affect the retractor penis muscle in bulls and stallions?

A

Acepromazine causes paralysis of the retractor penis muscle and protrusion of the flaccid penis from the prepuce.

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26
Q

What cardiovascular effect does Acepromazine cause in horses?

A

Acepromazine causes tachycardia in horses.

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27
Q

What is the effect of Acepromazine on ventilation in horses?

A

Acepromazine has little effects on ventilation in horses.

28
Q

Why is Acepromazine often administered to bulls and stallions?

A

Acepromazine is often given to facilitate examination of the penis.

29
Q

Can Acepromazine be used in conjunction with local anesthesia in ruminants?

A

Yes, Acepromazine can be used with local anesthesia in ruminants.

30
Q

Why should Acepromazine not be given to ruminants if general anesthesia is to be administered?

A

Acepromazine relaxes the gastroesophageal junction, increasing the risk of regurgitation of ruminal content during induction and causing delayed recovery.

31
Q

Why should acepromazine not be used in dogs with epilepsy?

A

Acepromazine might reduce the threshold at which epileptiform seizures occur.

32
Q

What is a potential use of very small doses of acepromazine in dogs and cats?

A

Very small doses of acepromazine have been used to treat behavioral problems, such as anxiety and noise phobias.

33
Q

What is a notable effect of Chlorpromazine hydrochloride?

A

Chlorpromazine hydrochloride has a potent antihistaminic effect and its effects may last for 24 to 47 hours.

34
Q

What is Propionyl promazine used for in veterinary medicine?

A

Propionyl promazine is used in combination with methadone for general sedation of all species of animals.

35
Q

How do benzodiazepines achieve muscle relaxation?

A

Benzodiazepines achieve muscle relaxation through inhibition of the internuncial neurons at spinal levels.

36
Q

What is the primary mechanism through which benzodiazepine compounds exert their sedative effects?

A

Benzodiazepine compounds exert their main sedative effects through depression of the limbic system.

37
Q

At which receptors do benzodiazepines act selectively within the central nervous system?

A

Benzodiazepines act selectively at GABAA receptors within the central nervous system.

38
Q

What is a notable characteristic of benzodiazepines regarding their effects on the cardiovascular and respiratory systems?

A

Benzodiazepines have minimum adverse effects on the cardiovascular and respiratory systems at therapeutic doses.

39
Q

What are the primary actions provided by benzodiazepines?

A
  • Antianxiety action
  • Sedation and hypnosis
  • Anticonvulsant effects
  • Muscle relaxation
  • Anterograde amnesia.
40
Q

Can you name two examples of benzodiazepines?

A
  • Diazepam
  • Midazolam.
41
Q

Which benzodiazepines are most commonly used as agonists in veterinary practice?

A
  • Diazepam
  • Midazolam
  • Zolazepam.
42
Q

What is the function of Flumazenil (Romazicon) in veterinary practice?

A

Flumazenil (Romazicon) is a benzodiazepine antagonist that works by competing for benzodiazepine inhibitory receptor sites.

43
Q

What are the potential cardiovascular effects of rapid infusion of Diazepam due to propylene glycol?

A
  • Hypotension
  • Bradycardia
  • Apnea.
44
Q

What is a unique absorption characteristic of Diazepam?

A

Diazepam is absorbed by the plastic of the container it is stored in, which can lead to reduced efficacy if stored improperly.

45
Q

Which drugs should not be mixed in a single syringe with Diazepam due to the risk of precipitation?

A
  • Atropine
  • Acepromazine
  • Barbiturates
  • Opioids.
46
Q

What is the solubility characteristic of Diazepam and what is used to increase its solubility?

A

Diazepam is insoluble in water and requires propylene glycol to increase its solubility.

47
Q

Can Ketamine be mixed with Diazepam in a single syringe?

A

Yes, Ketamine can be mixed with Diazepam in a single syringe.

48
Q

What is the recommended dosage of Diazepam for dogs and cats?

A

0.2 - 1 mg/kg IV or SQ in dogs and cats.

49
Q

How does the sedative effect of phenothiazines vary among individuals?

A

The sedative effect of phenothiazines varies considerably among individuals; it may produce calming effects in animals, but paradoxical excitement is also a possibility.

50
Q

What is the effect of phenothiazines on anxiety?

A

Phenothiazines reduce anxiety without marked sedation.

51
Q

What effect do phenothiazines have on memory in humans?

A

Phenothiazines produce amnesia in humans.

52
Q

What parts of the brain do phenothiazines primarily work on?

A
  • Limbic system
  • Thalamus
  • Hypothalamus.
53
Q

What are the cardiopulmonary effects of diazepam at clinical doses?

A

At clinical doses, minimal cardiopulmonary effects prevail.

54
Q

What can high IV doses of diazepam produce?

A

High IV doses may produce respiratory depression and decrease blood pressure.

55
Q

What percentage of diazepam is protein bound?

A

Up to 96% of diazepam is protein bound.

56
Q

What is the typical dosage range of Midazolam for dogs and cats?

A

0.1 – 0.5 mg/kg in dogs and cats.

57
Q

How does the potency of Midazolam compare to Diazepam?

A

Midazolam is 2 - 5 times more potent than diazepam.

58
Q

Why is Midazolam well absorbed from IM or SC injections?

A

Due to its good water solubility.

59
Q

Is Midazolam physically compatible with many other solutions?

A

Yes, it is physically compatible with many other solutions.

60
Q

What is a key physiochemical characteristic of Midazolam?

A

Midazolam is water soluble.

61
Q

What is the clinical duration of midazolam compared to diazepam?

A

The clinical duration of midazolam is shorter than that of diazepam.

62
Q

What are the cardiopulmonary effects of midazolam compared to diazepam?

A

Midazolam has similar cardiopulmonary effects to diazepam with minimum alteration, but it may be more respiratory depressant than diazepam.

63
Q

How predictable is the onset of clinical effects for midazolam?

A

The onset of clinical effects for midazolam is more predictable than that of diazepam.

64
Q

How does the metabolism and excretion of midazolam compare to diazepam?

A

The metabolism and excretion of midazolam is similar to that of diazepam.

65
Q

What is Zolazepam used in combination with for its administration?

A

Zolazepam is used in combination with tiletamine in Telazol.

66
Q

For what type of patients is the use of zolazepam and tiletamine popular?

A

Their use is popular for exotic patients.

67
Q

What is the composition of each vial of Telazol?

A

Each vial contains 250 mg of zolazepam and 250 mg of tiletamine.

Surgery Theo (6 decks)

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