Pharmacology I: Goals & Pre-Anesthetics Flashcards
Sedation definition
Relaxed state, but with full pain sensation
- Drowsy or “hypnotic” patients
- Sedated Pt can respond quickly to pain or noxious stimuli
Tranquilization definition
Relaxed state without altered mentation
- Full pain sensation
- Also called anxiolytic
Anesthesia (as a sedative) definition
Without sensation
- Can be general or local
Local anesthesia definition
Reversible loss of pain & sensory sensation without loss of consciousness
General anesthesia definition
Reversible loss of pain sensation with loss of consciousness
Analgesia definition
Decreased perception of pain without loss of other sensations
- Touch, motor, temperature
What are three goals of balanced anesthesia?
What are examples of each?
- Achieve desired effects
- Analgesia
- Unconsciousness
- Muscle relaxation - Minimize negative effects
- Resp depression
- Cardiovascular depression
- Decreased homeostasis (temp, renal function, airway protection) - Neuroleptanalgesia
- Part of a balanced anes.
- Combo of sedative & analgesia meds
- Synergistic effects
Perfusion definition
The process of delivering blood to tissue
Importance of perfusion
The longer & more severely we impair perfusion…
The worse the damage
How do we monitor perfusion? (4)
- Pulse quality
- CRT
- Blood pressure
- MAP is most useful indicator (>60mmHg) - Central Venous Pressure (CVP)
T/F: In anesthesia, we want to maintain the patient as close as possible to physiologic normal!
True!
Define Anesthetic stages
Stage 1: (3)
Stage 2: (4)
Stage 1:
- Inducement, excitement
- Pupils constricted
- Voluntary struggling
Stage 2:
- Obtunded reflexes
- Pupil diameters start to dilate
- Still excited
- Involuntary struggling
Define Anesthetic stage 3
Plane I (6)
Plane II (4)
Planes III & IV (5)
- Plane I: Light
- More decreased reflexes:
- Pupils constricted
- Brisk palpebral reflex, Corneal reflex
- Absence of swallow reflex
- Lacrimation still present
- No involuntary muscle movement - Plane II: Medium
- Ideal for most invasive procedures
- Pupils dilated
- Loss of pain, palpebral reflex
- Corneal reflexes present - Plane III & IV: Deep
- Respiratory depression
- Severe muscle relaxation
- Bradycardia
- No reflexes
- Pupils dilated
Define Anesthetic stage 4: (2)
- Respiration ceases
- Cardiovascular function depressed & death IMMEDIATLEY ensues
What are reflexes to monitor for? (5)
Why?
- Palpebral reflex
- Dogs may have no reflex at adequate Sx depth
- Lateral palpebral reflexes are lost before the medial - Corneal reflex
- Should ALWAYS be present!
- Doesn’t disappear until deep, deep anesthesia - Nystagmus
- Indication of excitement & light anesthesia - Ventromedial eyeball position
- This is the most desirable position in most species (except horses; central position) - Jaw tone
- Moderate to lose is most desirable
Dissociative anesthetics (ex ketamine) can cause ___ at moderate anesthetic depths.
Nystagmus
If a patients HR &/or RR suddenly jumps up during surgery, the patient is likely ___ ___ even though they didn’t respond to the stimulation of Sx prep.
Too light (anesthesia)
Why do we “dose to effect?”
Every patient is unique in its response to anesthetic agents, so we want to use as little as possible without under dosing
Three goals of the anesthetic technician is to give…
- Enough anesthetic to perform procedure
- As little agent as possible to minimize complication & normalize physiology
- Constant monitoring & drug adjustment is ideal!!
What are reasons to use pre-anesthetic drugs? (4)
- Support patient homeostasis
- Decrease patient anxiety
- Decrease amount of anesthetic needed
- Analgesic effects
Anticholinergic drugs are: Atropine or Glycopyrrolate
Action: (2)
Potential side-effects: (3)
- Action:
- Prevents bradycardia –> Increases HR
- Prevents excessive salivation & excessive airway secretions –> prevents mucous plugs in ET tube/better visualization - Side effects:
- Increased O2 consumption by heart
- Thick airway secretions
- GI ileus
Ileus is the…
Absence of normal intestinal peristalsis
