Pract 9, 10, 11

Question 1

examination of the effect of analgesics on mice

Answer 1

A: “tail flick test”

• focused infrared light
• measruing time until the tail is pulled away
• 3-5 sek is normal, and longer time with analgesia

B: “Hot plate” method

• observation of leg raises and sole licking
• observed for 15 min, calculate how many times it lifts its feets.

Question 2

Sigmund test “Wrtihing” test

Answer 2

• chemical nociceptive stimulus
• intraperitoneal administration of 1% Acetic acid –> will get convulsions, and number of conculsions is calculated
• prolonged pain stimulus –> widely prohibited!

Indreased dose = decreased convulsions in Detemodine and Xylazine

• alpha-2 agonists = dose dependent analgesic effect

Question 3

Definitions:

• Anaestheisa, Balanced anaesthesia, TIVA, neuroleptanalgesia, Ataranalgesia

Answer 3

Anaesthesia:

• Lack of sensations, total loss of motoric acitivity
• Sensory, voluntary and refexive motor activity and consciousness completely disengaged, while keeping the respiratory and vasomotor center functioning satisfactory
• Loal: without loss of consciousness
• genera: with total loss of consciousness

Balanced anaesthesia:

• combination of antimuscarinics, sedatives, opioids, anaesthetics and muscle relaxants
• Goal: good slepp, safe and deep anaesthesia, pain control, less side-effects, relaxed body, smooth recovery etc.

TIVA:

• Combination of agents given exclusively by the intravenous route without the usa of inhalationalagents
• eg: propofol + fentanyl, fentanyl + lidocaine + ketamine (“FLK”)

Neuroleptanalgesia:

• tranquillisers + opioids

Ataranalgesia:

• Benzodiazepine + ketamine = Zoletil
• Opioids + benzodiazepines

Question 4

Anaesthetic machine:

Answer 4

Gas source, rotameter, vaporizer, breathing circuit, soda lime, scavenging system

Question 5

Anticonvulsants - epilepsy

active agents for status epilepticus treatment

Answer 5

Question 6

Status epilepticus figure

Answer 6

Question 7

Anticonvulsants - epilepsy

active agents to prevent epilepsy, epilepsy control:

Answer 7

Question 8

Anticonvulsants - Phenobarbital:

Answer 8

• First line!
• Success: 82% (combination)
• Bioavailability:
• Dose:
• Monitoring:
• Adverse effects:

Question 9

Anticonvulsants - Potassium bromide:

Answer 9

• Success: 50-70% (in monoth.)
• Can be a first line drug!
• Failure –> combination
• With PB as a combination partner
• Dose:
• PK:
• Kidney failure!
• Monitoring:
• Adverse effects:

Question 10

Anticonvulsants - Imepitoin

Answer 10

• Mechanism of action:
• Dose:
• Adverse effects:
• First line!
• Failure –> combination

Question 11

Anticonvulsants - Levetiracetam

Answer 11

• Success: Monotherapy?

Second line! (in combinations)

• PK:
• Dose:
• Adverse effects:

Question 12

Anticonvulsants - Zonisamide:

Answer 12

• Success: limited data, ~60%
• Second line (in combinations)
• Dose:
• Monitoring:
• Adverse effects:

Question 13

anticonvulsants - other alternatives:

Answer 13

• N. vagus stimulation - implant
• CBD, Gabapentin - supportive
• Diet:
• ho: ketogenic diet (high fat, low protein, carbohydrates)
• ca: classic ketogenic NO!
  (pancreatitis) Ω3 fatty acids – no improvement

MCT (medium chain triglycerides)!

• Acupuncture, Homeopathy: NO!

Question 14

Anticonvulsants - not recommended agents:

Answer 14

• Primidone
• Carbamazepine (bad PK)
• Lamotrigine (myocardial damages)
• Vigabatrin
• Tiagabine
• Oxcarbazepine
• Phenytoin