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Pharmacology II > Lecture 10: Injected Anesthetics > Flashcards

Lecture 10: Injected Anesthetics Flashcards

1
Q

General anesthesia should produce what 6 things

A
  1. Loss of consciousness
  2. Anxiolysis
  3. Analgesia
  4. Amnesia
  5. Inhibition of reflexes
  6. Skeletal muscle relaxation
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2
Q

What drugs produce the analgesic effect of GA

A

Opioids and ketamine

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3
Q

What drugs produce the loss of consciousness in GA

A

Iv anesthestics and alpha2 agonists

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4
Q

What drugs produce the amnesia affect of GA

A

Midazolam, ketamine

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5
Q

What drugs inhibit sensory/autonomic reflexes under GA

A

Opioids, anti-cholinergic

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6
Q

What drugs produce muscle relaxation under GA

A

Benodiazepines, guafenisen, NMJ blockers

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7
Q

What 5 things should be produced during dissociative anesthesia and what iv anesthetic typically produces this state

A
  1. Cataleptic state
  2. Analgesia
  3. Amnesia
  4. No responses
  5. Eyes open

Drug: ketamine

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8
Q

What is the purpose of preanesthetic medications

A

Improve rapidity and smoothness of induction, reducing anxiety, analgesia, amnesia, compensating for side effects of anesthesia

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9
Q

___are administered for analgesia

A

Opioids

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10
Q

___, ___, and ___ provide pre-op sedation and amnesia and help to counteract CNS stimulation

A

Alpha2 agonists, acepromazine, benzodiazepines

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11
Q

___prevent profuse salivation, bradycardia but thickening of saliva may cause endotracheal tube obstruction

A

Anticholinergic agents

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12
Q

What is the mechanism of action for propofol

A

Act on GABA a receptors to prolong effects of GABA and increase Cl- influx—> hyper polarizing neurons

Also some NMDA receptor blockade

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13
Q

Propofol can cause what adverse effect especially if used with opioids

A

Respiratory depression

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14
Q

How does propofol affect cerebral blood flow and ICP

A

Decreases both so good for head injuries

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15
Q

What is propofol used for

A

Induction and maintenance of anesthesia

Approved in dogs only

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16
Q

What are 3 potential drug interactions with propofol

A
  1. Hypoxemia with alpha2 agonists
  2. Hypothermia with benzodiazepines
  3. Cardiac collapse and delayed recovery with St. John worts
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17
Q

What are some adverse effects of propofol

A

Respiratory depression, hypotension, myocardial depression, myoclonic twitching and limb paddling, apnea, excitement in horses, increase IOP, Heinz body production in cats

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18
Q

If propofol causes myoclonic twitching and limb paddling what can you treat with

A

Benzodiazepine or subtherapeutic ketamine

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19
Q

What is the mechanism of action of etomidate

A

Facilitates GABA transmission, increase Cl- influx and causing hyperpolarization

20
Q

Compared to profool, etomidate has minimal depression on what 3 things

A
  1. Cardiovascular function
  2. Blood pressure
  3. Respiratory depression
21
Q

How does etomidate effect cerebral blood flood

A

Decreases

22
Q

What is etomidate used for

A

Alternative to propofol for anesthetic induction in small animals

23
Q

What are some adverse effects of etomidate

A

Pain and hemolysis upon IV injection, adrenocortical suppression

24
Q

What is the mechanism of action of alfaxalone

A

Synthetic neuroactive steroid that binds and modulates GABA A to facilitate GABA mediated Cl- influx

25
Q

In addition to anesthesia alfaxalone provides what other effect

A

Muscle relaxation

26
Q

Alfaxalone as a ___therapeutic index

A

High- safe

27
Q

What is alfaxalone used for

A

Induction and maintenance of GA in cats and dogs

28
Q

What are some adverse effects of alfaxalone

A

Post-induction apnea, psychomotor excitement, hypotension, hypothermia, increase IOP

29
Q

What is the mechanism of action of ketamine

A

Non-competitive antagonist of NMDA receptors, blocks glutamate (excitatory NT), depresses activity in thalamus, limbic system and reticular activating system

30
Q

Ketamine produces ___anesthesia

A

Dissociative

31
Q

Ketamine may have a weak analgesic effect through what mechanism

A

Weak mu opioid receptor stimulation but also NMDA block with glutamate

32
Q

How does ketamine affect cerebral blood flow and ICP

A

Increases, don’t use with head injuries

33
Q

How does ketamine affect SNS tone and what is result

A

Increases- increase HR and BP

34
Q

What are some uses of ketamine

A

Labeled for restraint/minor surgery in cats, induction in many species, maintenance of GA

35
Q

What are some adverse effects of ketamine

A

Muscle rigidity in horses and dogs, profuse salivation in cats, tachycardia, hypertension, difficulty assessing anesthetic depth due to eyes open, apneustic breathing

36
Q

Ketamine can be combined with __, ___ and ___ in horses

A

Alpha2 agonist for sedation, guafenisin for muscle relaxation and butorphanol for pain

37
Q

Ketamine can be combined with ___ or ___ to provide skeletal muscle relaxation, prevent seizures, and excitement or delirium in recovery

A

Benzodiazepines or alpha2 agonists

38
Q

What is the mechanism of action of midazolam

A

Potentiates GABA and increases the frequency of opening Cl- channels

39
Q

What is midazolam used for

A

Induction of anesthesia, tx neonatal seizures in foals, status epilepticus in dogs

40
Q

You can combine midazolam with ___ as a neuroleptanalgesic

A

Opioids (butorphanol or oxymorphone)

41
Q

Can combine midazolam with ___ to provide muscle relaxation

A

Ketamine

42
Q

What are some adverse effects of midazolam

A

Cardiorespiratory depression, paradoxical excitement/dysphoria

43
Q

What is used to reverse effects of midazolam

A

Flumazenil

44
Q

What is tiletamine/zolazepam used for

A

Labeled for short term anesthesia in dogs and cats and chemical restraint for fractious cats

45
Q

Hat are some adverse effects of tiletamine/ zolazepam

A

Excessive salivation, erratic recovery, muscle twitching

Pharmacology II (36 decks)

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