Peri-Anesthetic Agents

Question 1

what is general anesthesia characterized by?

Answer 1

muscle relaxation
unconsciousness
amnesia
analgesia

Question 2

what is responsiveness like with deep sedation/analgesia?

Answer 2

purposeful response following repeated or painful stimulation

Question 3

why should you perform pre-oxygenation before induction?

Answer 3

delays time to deoxygenation/desaturation: gives time to figure it out

Question 4

how is acepromazine excreted?

Answer 4

in urine, both conjugated and unconjugated

Question 5

how is acepromazine metabolized?

Answer 5

hepatic

Question 6

what are the general effects of acepromazine?

Answer 6

muscle relaxation
sedative (anxiolysis)

Question 7

when can you use acepromazine?

Answer 7

premedication: young, healthy dogs, horses
postoperative sedation: cardiovascular stable dogs, cats, horses

Question 8

what are the general effects of alpha2 adrenergic agonists?

Answer 8

analgesia
muscle relaxation
sedation

Question 9

what is the cardiovascular response to alpha2 adrenergic agonists like?

Answer 9

biphasic: peripheral and then central
decrease cardiac output

Question 10

do alpha2 adrenergic agonists cause a decrease in coronary artery perfusion or myocardial oxygenation?

Answer 10

no

Question 11

what are the gastrointestinal effects of alpha2 adrenergic agonists?

Answer 11

decrease motility, ruminal contractions, gastric emptying
salivation, emesis, reflux

Question 12

what is sedation like with alpha2 adrenergic agonists as the sole agent?

Answer 12

very rousable sedation

Question 13

what is the mechanism of action of benzodiazepines?

Answer 13

enhance GABAa receptor affinity for GABA
increased chloride conduction and hyperpolarization of postsynaptic cell

Question 14

when can you use benzodiazepines for premedication?

Answer 14

neonatal or geriatric
unstable, critical
combined with 2+ other sedatives

Question 15

what is buprenorphine useful for?

Answer 15

mild to moderate pain, long-acting
post-op analgesia in stable patients
good post-op choice for cats

Question 16

can airway intervention be required for deep sedation?

Answer 16

may be required

Question 17

is cardiovascular function usually maintained under deep sedation?

Answer 17

yes

Question 18

what are the sedatives/tranquilizers/analgesics?

Answer 18

phenothiazines
alpha2-agonists
benzodiazepines
opioids

Question 19

what is a phenothiazine?

Answer 19

acepromazine

Question 20

which drug should you not use the labeled dose on the bottle of?

Answer 20

acepromazine

Question 21

what is the duration of acepromazine?

Answer 21

4-6 hours dogs/cats
2-4 hours horses

Question 22

does acepromazine provide analgesia?

Answer 22

no

Question 23

can you reverse acepromazine?

Answer 23

no

Question 24

what are the cardiovascular effects of acepromazine?

Answer 24

vasodilation
decreases stroke volume and cardiac output and high doses, may increase heart rate
antiarrhythmic

Question 25

how does acepromazine affect the CNS?

Answer 25

does not affect electrical activity thermoregulation impacted

Question 26

is acepromazine MAC sparing?

Answer 26

yes

Question 27

when should you avoid acepromazine?

Answer 27

hepatic disease or shunt unstable animals prior to laparoscopic procedure stallions low doses on large floppy dog breeds euro boxers

Question 28

what is phase 1 of alpha2 agonist cardiac effects like?

Answer 28

peripheral vasoconstriction lead to baroreceptor-mediated reflex bradycardia

Question 29

what is phase 2 of alpha2 agonist cardiac effects like?

Answer 29

central alpha 2a receptor acitvation decreases sympathetic outflow and increases parasympathetic tone

Question 30

what are the respiratory effects of alpha2 agonists?

Answer 30

decreases respiratory rate but increases tidal volume: maintains minute ventilation

Question 31

what are the gastrointestinal effects of alpha2 agonists?

Answer 31

decreased motility, ruminal contractions, gastric emptying salivation, emesis, reflux

Question 32

what are the genitourinary effects of alpha2 agonists?

Answer 32

inhibition of antidiuretic hormone release increased myometrial tone and intrauterine pressure decreased oxygen delivery

Question 33

what are the alpha2 adrenergic agonists?

Answer 33

xylazine detomidine romifidine medetomidine/dexmedetomidine

Question 34

what is the duration of dexmedetomidine?

Answer 34

60-90 minutes dose dependent

Question 35

when should you avoid alpa2 agonists?

Answer 35

neonates hemodynamically unstable patients diabetic animals? urinary obstruction cardiovascular disease species sensitivity

Question 36

what are the general effects of benzodiazepines?

Answer 36

anticonvulsant muscle relaxation amnesia sedation/anxiolysis

Question 37

which animals sedate well on benzodiazepines alone?

Answer 37

ferrets rabbits birds pigs

Question 38

are benzodiazepines MAC sparing?

Answer 38

minimal

Question 39

which benzodiazepine has pain on injection and poor bioavailability when given IM or SQ?

Answer 39

diazepam

Question 40

when should you avoid benzodiazepines?

Answer 40

young, excited dogs/cats hepatic disease, hypoproteinemia

Question 41

what are the cardiovascular effects of opioids?

Answer 41

bradycardia

Question 42

what are the genitourinary effects of opioids?

Answer 42

increased urethral sphincter tone

Question 43

what is buprenorphine not useful for?

Answer 43

sedation severe pain unstable patients- poorly reversible