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Anesthesiology > Pre-anesthetic Medication and Induction Agents > Flashcards

Pre-anesthetic Medication and Induction Agents Flashcards

1
Q

There are advantages and disadvantages to preanesthetic analgesia and sedation. What are 3 advantages?

A
  1. Chemical restraint
  2. Decreased stress + decreased catecholamines = Decreased risk of arrhythmia
  3. Decreased induction and inhalant doses = Decreased dependent CV/respiratory depression
  4. Pre-emptive analgesia
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2
Q

There are advantages and disadvantages to preanesthetic analgesia and sedation. What are 3 disadvantages?

A
  1. Bradycardia (opioids & alpha 2 agonists)
  2. Hypotension (acepromazine)
  3. Excitation (opioids & benxodiazepines)
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3
Q

There are 5 Mu-opioid and kappa agonists. Name 3 of them.

A
  1. Hydromorphone
  2. Fentanyl
  3. Morphine
  4. Methadone
  5. Oxymorphone
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4
Q

What type of agonist is Buprenorphine?

A

Partial Mu agonist

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5
Q

What type of agonist/antagonist is Butorphanol?

A

Mixed kappa agonist & mu antagonist

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6
Q

What are the 2 reversal agents for opioid analgesics (hydromorphone, fentanyl, morphine, methadone, oxymorphone, butorphanol, buprenorphine)?

A

Naloxone & naltrexone

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7
Q

Opioids can have mild cardiovascular effects. Which factor within the cardiovascular system is decreased by these drugs? What is increased to cause these effects?

A

Decreased heart rate due to increased vagal tone

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8
Q

True or False: Opioids increase the MAC of an inhalant.

A

FALSE: Opioids decrease the MAC of an inhalant

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9
Q

True or False: Opioids can cause respiratory depression.

A

TRUE

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10
Q

Which opioid analgesic is a partial agonist?

A

Buprenorphine

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11
Q

Which opioid analgesic is a mixed agonist/antagonist?

A

Butorphanol

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12
Q

Which opioid analgesics are FULL mu-opioid agonists?

A

Hydromorphone, Fentanyl, Morphine, Oxymorphone, & Methadone

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13
Q

True or False: Butorphanol has a “ceiling effect”.

A

TRUE

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14
Q

Compared to mu-opioid agonists, Butorphanol elicits less what?

A
  1. Panting
  2. Bradycardia
  3. Respiratory depression
  4. Analgesia
  5. Nausea (no vomiting)
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15
Q

True or False: Buprenorphine has a “ceiling effect”.

A

TRUE

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16
Q

In dogs and cats, what is the dose in mg/kg for Butorphanol?

A

0.2 - 0.4 mg/kg

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17
Q

How long does sedation last under Butorphanol?

A

1 - 2 hours

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18
Q

How long does sedation last under Buprenorphine?

A

Dogs: 4 - 10 hours

Cats: 6 - 12 hours

19
Q

Which of the following has a slow onset, Butorphanol or Buprenorphine? How long is that onset?

A

Buprenorphine: 30 - 45 minutes

20
Q

In small animals, what is the Buprenorphine dose in mg/kg?

A

0.1 - 0.4 mg/kg

21
Q

Compared to FULL mu-opioid agonists, Buprenorphine elicits less what?

A
  1. Respiratory depression
  2. Panting
  3. Bradycardia
  4. Analgesia
  5. Nausea
22
Q

What is the duration of action of hydromorphone and oxymorphone?

A

2 - 4 hours

23
Q

What is the duration of action of morphine and methadone?

A

4 - 6 hours

24
Q

How long is Fentanyl’s duration of action?

A

Short: 15 to 30 minutes

25
Q

True or False: ALL full mu-opioid agonists cause nausea and vomting.

A

FALSE: Fentanyl does NOT cause vomiting

26
Q

Which of the mu agonists causes the greatest respiratory depression?

A

Fentanyl

27
Q

What type of agonist or antagonist is Acepromazine?

A

Alpha 1 antagonist

28
Q

What is the onset of action of Acepromazine? What is the duration?

A

Onset: 20 - 30 minutes

Duration: 4 - 6 hours

29
Q

What are the cardiovascular side effects of Acepromazine?

A

Vasodilation

Hypotension

Bradycardia

30
Q

Which of the sedative/tranquilizer drugs is NON-REVERSIBLE?

A

Acepromazine

31
Q

True or False: Acepromazine causes seizures.

A

FALSE: Acepromazine may actually decrease the risk of seizure activity by decreasing excitation out of surgery

32
Q

What type of agonist or antagonist is Dexmedetomidine?

A

Alpha 2 agonist

33
Q

What is the time till onset of action for Dexmedetomidine? What is the duration?

A

Onset: 5 minutes

Duration: 30 - 60 minutes

34
Q

What is the reversal agent for Dexmedetomidine?

A

Atipamazole

35
Q

For what type of patients would you reserve Dexmedetomidine?

A

Very painful, fearful, aggressive patients

36
Q

These alpha-2 agonists are used in horses: xylazine, detomidine, ad romifidine. What are their reversal agents?

A

Yohimbine & tolazoline

37
Q

For which patients should Benzodiazepines like Diazepam and Midazolam be reserved?

A

Pediatric and geriatric patients and the critically ill

38
Q

What is the reversal agent for Diazepam or Midazolam?

A

Flumazenil

39
Q

Diazepam contains propylene glycol, causing which 3 unwanted effects?

A
  1. Pain on injection
  2. Poor absorption
  3. Toxicity at high doses
40
Q

What is the dosage for Midazolam to be given IM or IV?

A

0.1 - 0.2 mg/kg

41
Q

Atropine can be used for emergencies because of its quick onset of action. What is its time of onset IM and IV?

A

IM = 5 minutes

IV = 1 minute

42
Q

How long is Atropine’s duration of action?

A

60 - 90 minutes

43
Q

What is the onset of action for Glycopyrrolate? What is its duration?

A

Onset: 3 - 5 minutes

Duration: 2 - 4 hours

Anesthesiology (6 decks)

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