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FA2 Anesthesiology > Lecture 2 8/22/24 > Flashcards

Lecture 2 8/22/24 Flashcards

1
Q

What are the reasons for providing pre-medication prior to induction?

A

-facilitate handling
-have a smooth induction
-decrease dose of induction and maintenance drugs
-reduce adverse effects of induction and maintenance drugs
-improve/provide preemptive analgesia
-decrease airway secretions
-improve quality of recovery

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2
Q

What is a tranquilizer?

A

drug that relieves anxiety without causing major sedation

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3
Q

What is a sedative?

A

drug that relieves tension and anxiety, allowing sleep

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4
Q

What is neurolept analgesia?

A

combination of neurolept and analgesic

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5
Q

What are the properties of neurolepts?

A

-inhibition of emesis
-inhibition of motor activity and arousal

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6
Q

What are the components of dissociative anesthesia?

A

-analgesia
-amnesia
-catalepsy (paralysis with motor and sensory failure)

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7
Q

What is balanced/multimodal anesthesia?

A

using drugs/methods that act through different mechanisms/receptors

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8
Q

What are the components of balanced anesthesia?

A

-sedation or unconsciousness
-muscle relaxation
-analgesia
-amnesia

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9
Q

Which drug classes are considered sedatives/tranquilizers?

A

-phenothiazines
-butyrophenones
-benzodiazepines

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10
Q

Which drug classes are considered analgesics?

A

-alpha-2 adrenoceptor agonists
-opioids

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11
Q

What are the characteristics of acepromazine?

A

-commonly used in healthy animals
-not a potent sedative
-decreases minimum alveolar concentration of volatile drugs

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12
Q

What is the receptor activity of acepromazine?

A

blocks dopamine receptors; dopamine has important role in motor activity

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13
Q

What are the physiological effects of acepromazine?

A

-mild tranquilizing effect
-decreases involuntary movements/reflexes
-anti-histaminic
-anti-emetic
-reduces risk of arrhythmias
-vasodilation
-hypothermia
-penile paralysis
-antipyretic

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14
Q

What are the clinical uses of acepromazine?

A

-tranquilization
-premedication prior to GA
-recovery from GA/smooth process

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15
Q

What are the characteristics of acepromazine for clinical use?

A

-mild muscle relaxation
-no analgesia
-slow onset
-sedation persists for several hours
-metabolized by liver

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16
Q

What are the considerations when dosing acepromazine?

A

-clinical doses are much lower than label doses
-higher doses do not increase depth of sedation
-higher doses DO prolong sedation and increase adverse effects
-no reversal agent

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17
Q

What is the most commonly used drug class in vet med?

A

alpha-2 adrenergic drugs

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18
Q

What are the characteristics of alpha-2 adrenergic drugs?

A

-dose dependent effects
-reliable sedation
-effective analgesia
-reversible
-effective in most species
-administered IM, IV, epidural, or transmucosal

19
Q

What are the clinical uses of alpha-2 adrenergics?

A

-sedation
-analgesia
-premedication prior to GA
-recovery from GA

20
Q

What are the physiological effects of alpha-2 agonists?

A

-decreased MAC of volatile anesthetics
-visceral and somatic analgesia
-initial hypertension combined with bradycardia
-later vasodilation and decreased contractility and cardiac output
-increased urine output
-decreased GI motility
-hyperglycemia
-uterine contraction in late pregnancy
-resp. depression
-decrease in surgical stress (good)

21
Q

What are the advantages of alpha-2 agonists?

A

-small volume
-reversible
-compatible with most drugs
-analgesia
-dose-dependent sedation
-decreased MAC
-block stress response
-can induce emesis

22
Q

What are the disadvantages of alpha-2 agonists?

A

-cardiovascular effects
-decreased GI motility
-emesis
-diuresis
-hyperglycemia
-respiratory adverse effects

23
Q

What are the characteristics of alpha-2 adrenoceptor antagonists?

A

-reverse over-sedation or cardiovascular adverse effects
-less selective antagonists
-can lead to hypotension and tachycardia

24
Q

What are the characteristics of atipamezole/antisedan?

A

-most selective antagonist
-primarily for dexmedetomidine
-can be used to reverse other alpha-2s

25
Q

What are the adverse effects of alpha-2 antagonist overdose?

A

-neurological; excitement and tremors
-cardiovascular; hypotension and tachycardia
-GI; salivation and diarrhea

26
Q

What is the preferred administration route for alpha-2 adrenoceptor antagonists?

A

IM

27
Q

What are the characteristics of benzodiazepine function?

A

-GABA receptor agonists
-enhance binding between GABA and receptor to open chloride channels
-hyperpolarization inhibits cell function

28
Q

What are the clinical effects of benzodiazepines?

A

-sedation/anxiolysis
-muscle relaxation
-anticonvulsant
-retrograde amnesia
-minimal CV and resp. side effects

29
Q

In which animals do benzos have better effects?

A

debilitated or old dogs and cats

30
Q

What are the characteristics of diazepam?

A

-water insoluble
-IM administration is irritating and has unpredictable absorption
-IV administration must be done slowly to avoid adverse effects
-sensitive to light
-adheres to plastic
-highly protein bound
-highly lipid soluble

31
Q

What is diazepam used for?

A

-co-induction muscle relaxant
-neuroleptic anesthesia induction
-sedation/induction in debilitated and/or high risk animals

32
Q

What is midazolam used for?

A

-sedative and muscle relaxant effects
-sedation in ruminants/pigs

33
Q

What are the characteristics of midazolam?

A

-water soluble
-can be administered IM with no pain
-can be mixed with other drugs
-lipid soluble after injection
-light sensitive
-shorter duration of action compared to diazepam

34
Q

What are the characteristics of zolazepam?

A

-only found in telazol
-mixed with tiletamine
-combination is used for premedication and as anesthetic
-longer duration of action
-longer recovery time

35
Q

What is flumazenil?

A

benzodiazepine antagonist

36
Q

What are the characteristics of flumazenil?

A

-binds to GABA receptor
-rarely needed clinically
-reverses benzo overdose

37
Q

What is the role of anticholinergics?

A

block the action of Ach at muscarinic receptors

38
Q

What are the clinical effects of anticholinergics?

A

-increase heart rate and enhance AV conduction
-bronchodilation
-decrease salivary and GI secretions
-decrease peristalsis

39
Q

What are the characteristics of atropine sulfate?

A

-intense effect on heart rate
-first line of treatment for severe bradycardia
-shorter duration of action than glyco
-rabbits are resistant and need higher doses
-can be given IM, IV, SQ, IT

40
Q

What are the possible adverse effects associated with atropine crossing the BBB?

A

-excitement/delirium
-blindness
-hyperthermia
-redness
-bladder distension and/or no urge to urinate

41
Q

What are the characteristics of glycopyrrolate?

A

-no BBB crossing and therefore no CNS signs
-less intense cardiovascular effects
-less likelihood of arrhythmias compared to atropine
-longer acting than atropine
-longer onset of action compared to atropine
-given IM, IV, SQ

42
Q

When is atropine used vs glyco?

A

Atropine: increasing heart rate quickly/in emergency situation
Glyco: increasing heart rate when bradycardia is not severe; premed. to decrease secretions

43
Q

What are the contraindications for anticholinergic use?

A

-hypertension
-tachyarrhythmias
-congestive heart failure
-cardiovascular diseases that do not tolerate tachycardia
-glaucoma
-increased intraocular pressure

FA2 Anesthesiology (23 decks)

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