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Pharmacology II > Lecture 12: Induction Agents > Flashcards

Lecture 12: Induction Agents Flashcards

1
Q

What monitoring should you have on patient before inducing

A

ECG, pulse ox, BP

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2
Q

Why pre-oxygenate

A

Saturate blood with O2 so when you induce you have time to intubate because they come apneic fast

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3
Q

Why do we intubate

A
  1. Airway protection
  2. Ventilation
  3. Maintenance under GA
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4
Q

How do we assess anesthesia depth

A
  1. Jaw tone
  2. Palpebral reflex
  3. Eye position
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5
Q

At what depths do we prefer our sx anesthesia patients

A

1-light or 2-medium
Don’t want too deep

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6
Q

After induction what do you do

A
  1. Hook up to anesthesia machine
  2. Turn on O2
  3. Leak check
  4. Turn on inhalant
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7
Q

What is the mechanism of action of propofol

A

GABA agonist

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8
Q

What are the affects of propofol on CNS

A

Depression, decrease ICP, anticonvulsant

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9
Q

What are the cardiovascular effects of propofol

A

Decrease BP d/t vasodilation

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10
Q

What are the respiratory effects of propofol

A

Depression, apnea

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11
Q

T or F: propofol relaxes muscle

A

True but can see myoclonic movements

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12
Q

T or F: propofol provides analgesia

A

False

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13
Q

What is the route of administration for propofol

A

IV or else ouchie

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14
Q

What is the onset of effect and duration of action for propofol

A

Onset: 20-30 seconds
Duration: 5-10 minutes

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15
Q

What is mg/kg for propofol alone and then with other induction agents

A

1-6mg/kg alone
1-4mg/kg with co-inductions

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16
Q

What is the mechanism of action of alfaxalone

A

GABA agonist

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17
Q

What are the CNS effects of alfaxalone

A

Depression, decrease ICP

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18
Q

What are the cardiovascular effects of alfaxalone

A

HR maintained or increased
Hypotension d/t vasodilation

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19
Q

What are the respiratory effects of alfaxalone

A

Depression, apnea

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20
Q

T or F: alfaxalone relaxes muscles

A

True, myoclonic activity c an be seen though

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21
Q

T or F: alfaxalone provides analgesia

A

False

22
Q

What are the routes of administration for alfaxalone

A

IV, IM

23
Q

What is the onset of effect and duration of effect for alfaxalone

A

Onset: 30-45 seconds
Duration: 5-10 mins

24
Q

What is the mg/kg dose for alfaxalone alone and then with other co-inductions

A

Alone: 0.5-4mg/kg
Combined: 0.5-2mg/kg

25
Q

What is the mechanism of action for ketamine

A

NMDA receptor antagonist in limbic system and thalamus

26
Q

What are the effects of ketamine on CNS

A

Depression, increase ICP, increase reactiveness (don’t use ketamine alone)

27
Q

What are the effects of ketamine of cardiovascular system

A

Increase SNS- increase resistance, increase HR, increase CO, increase myocardial O2 consumption, arrhythmias

28
Q

What are the respiratory effects of ketamine

A

Apneustic breathing, bronchodilation

29
Q

How are reflexes affected by ketamine

A

Intact or slightly decreased

30
Q

T or F: ketamine provides analgesia

A

True- NMDA receptor antagonist- glutamate blocked

31
Q

T or F: ketamine provides muscle relaxation

A

False- causes muscle rigidity- give with muscle relaxant

32
Q

What is a negative effect ketamine can have in cats with renal disease

A

Prolonged effect because active metabolite norketamine

33
Q

What are the routes of administration for ketamine

A

IM, IV, OTM (cats)

34
Q

What is the onset of effect and duration of action for ketamine

A

Onset: 1-20 minutes
Effect; 30-45 minutes

35
Q

Ketamine should always be administered with ___

A

Muscle relaxant (midaz)

36
Q

What drugs make up telazol

A

Tiletamine and zolazepam

37
Q

What species does telazol have increased risk of seizures and death

A

Tigers

38
Q

What is the mechanism of action for etomidate

A

GABA agonist

39
Q

What are the effects of etomidate on CNS

A

Depression, decrease ICP

40
Q

What are the cardiovascular and respiratory effects of etomidate

A

Minimal- cardiovascular stability, respiratory depression can be seen

41
Q

T or F: etomidate provides analgesia

A

False

42
Q

T or F: etomidate causes myoclonus and tremors

A

True

43
Q

T or F: etomidate causes intravascular hemolysis

A

True

44
Q

When should you avoid using etomidate

A

Addisons disease, CRI, critically ill patients

45
Q

What is the route of administration for etomidate

A

IV

46
Q

What is the onset of action and duration of action for etomidate

A

Onset: 20-30 seconds
Duration; 10-15 minutes

47
Q

Always administer etomidate with a ___

A

Muscle relaxant

48
Q

Administer etomidate IV very __

A

Slowly to minimize rough induction

49
Q

Which induction agent would be Contraindicated or bad for patients with heart disease

A

Ketamine- increase SNS, HR, resistance, O2 consumption, arrhythmias

50
Q

What induction agent would be bad for patients with increase ICP

A

Ketamine

51
Q

Which induction agent is contraindicated for addisons patients and for use as CRI

A

Etomidate- causes adrenocortical suppression

Pharmacology II (36 decks)

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