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Anesthesiology > Preanesthetic medications and induction agents > Flashcards

Preanesthetic medications and induction agents Flashcards

1
Q

What classes of drugs would you use to achieve analgesia?
Anticholinergic?
Neuroleptics?

A

Analgesia: Opioids, dissociatives, NSAIDs

Anticholinergic: atropine and glycopyrrolate

Neuroleptics: phenothiazines, alpha-2 agonists, benzodiazepines

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2
Q

Opioids are good for what?

A

Analgesia
mild sedation when used alone
mild CV effects
Decrease the MAC of inhalant

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3
Q

What are the opioid drugs we discussed?

A 
Butorphanol 
Buprenorphine 
Hydromorphone
Oxymorphone
Morphine
Methadone
Fentanyl
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4
Q

What is the mechanism of action for Butorphanol?

A

kappa agonist, mu antagonist

Ceiling effect, mild sedation and analgesia

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5
Q

How is butorphanol used in dogs/cats/horses/ruminants

A

Dogs: alone or with a sedative for non or mildly painful procedures

Horse: with alpha-2 agonist for pre-med

ruminants: During or after induction for large;

Small: with benzo as pre-med

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6
Q

What is the mechanism of action for buprenorphine and what does it do?

A

Partial mu agonist; little sedation and mild-moderate analgesia

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7
Q

When would you NOT use buprenorphine?

A

As pre-med for a painful procedure; very sticky for mu receptor and is difficult to reverse

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8
Q

T/F The animal dose for Buprenorphine is very small

A

TRUE; .01 - .04 mg/kg

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9
Q

What are the full mu agonists?

A

hydromorphone, morphine, oxymorphone, methadone, and fentanyl

Used for moderate to severe pain

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10
Q

What full mu agonist is also a NMDA antagonist?

A

Methadone

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11
Q

T/F All of the opioids have a ceiling effect

A

FALSE; The full mu agonists do not have a ceiling effect

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12
Q

What is unique about the administration of Fentanyl?

A

It requires an IV catheter and constant rate infusion

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13
Q

When would you use Fentanyl?

A

As an induction agent in critically ill Small animal patients

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14
Q

What are some sedatives/tranquilizers?

A

Acepromazine, benzodiazepines, alpha-2 agonists, and dissociatives

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15
Q

What is the reversal agent for Acepromazine?

A

There is no reversal agent

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16
Q

What effects does Acepromazine have? Any analgesic effects?

A

More profound/reliable sedation than benzodiazepine; Also significant MAC sparing drug

NO analgesic effects

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17
Q

T/F Acepromazine can cause seizures

A

FALSE

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18
Q

Dexmedetomidine is classified as a:

A

alpha-2 agonist

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19
Q

Dexmedetomidine works as a:

A

Potent sedative and analgesia

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20
Q

Dexmedetomidine should be reserved for use in what kind of patients?

A

healthy or very painful, fearful, or aggressive patients

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21
Q

What are the reversal agents for Xylazine, Detomidine, and Romifidine/

A

yohimbine and tolazoline

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22
Q

Diazepam and midazolam are classified as what?

A

Benzodiazepines

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23
Q

T/F Diazepam and Midazolam are the sedatives of choice for young, healthy dogs and cats

A

FALSE

24
Q

What kinds of patients see more profound sedation with Diazepam and Midazolam?

A

pediatric, geriatric, or critical patients

25
Q

What effects do Diazepam/Midazolam have?

A

Muscle relaxants and anticonvulsants; no analgesia

26
Q

Diazepam contains _____ which makes it painful on injection and toxic at high doses

A

Propylene glycol

27
Q

Anti-cholinergic drugs work to do what?

A

Decrease vagal effects and decrease salivary secretions; Also used to counter vagal effects of anesthetic drugs

28
Q

Atropine is classified as what?

A

Anti-cholinergic

29
Q

T/F Atropine crosses the BBB

A

TRUE

30
Q

Glycopyrrolate is classified as what?

A

Anti-cholinergic

31
Q

T/F Glycopyrrolate crosses the BBB

A

FALSE

32
Q

Glycopyrrolate should be avoided in what animal?

A

Large animals: cause GI stasis

33
Q

Guaifenesin is used as what?

A

Central muscle relaxant

Also in the “triple drip” with ketamine and xylazine

34
Q

When using Guaifenesin, concentrations should not be above:

A

5%

35
Q

Anesthetic induction of dogs and cats:

A

There’s like 100, look at the powerpoint

36
Q

Anesthetic induction of horses

A

ketamine + midazolam +/- GG

37
Q

Anesthetic induction of ruminants

A

Triple Drip: GG + xylazine + ketamine

38
Q

Anesthetic induction of sm. ruminants

A

ketamine + midazolam OR

ketamine + propofol

39
Q

Anesthetic induction of camelids

A

Triple drip OR

ketamine + midazolam

40
Q

T/F Propofol must be discarded 6 hours after opening

A

TRUE

41
Q

What is the mechanism of action for Propofol?

A

GABA-A receptors

42
Q

Propofol is used for what?

A

Sedation, induction, or CRI for maintenance of anesthesia

NO analgesia

43
Q

What are some precautions for using Propofol?

A

can cause hypoventilation, potentiates bradycardia, and is cumulative in cats

44
Q

What is the shelf life of Propofol 28?

A

28 days dum dum

45
Q

What is the mechanism of action for ketamine?

A

NMDA receptor agonist

46
Q

What is the classification of Ketamine? What is it used for?

A

Dissociative anesthetic

used to catelepsy, amnesia, and a good analgesia

47
Q

What are some precautions with Ketamine?

A

May cause muscle rigidity, may cause seizures, and it is a very rough recovery

48
Q

What will be different about a patient given Ketamine?

A

Eyelids will remain open with the pupil centered in the globe

49
Q

What are some characterists of animals given Telazol

A

Eyes remain open with globes centered

Maintain palpebral and laryngeal reflexes

50
Q

Does Telazol provide analgesia?

A

YES

51
Q

T/F Cats recover much smoother from Telazol than dogs do

A

TRUE; Zolazepam lasts longer in the cats

52
Q

Alfaxalone interacts with what?

A

GABA A receptors

53
Q

What is the major advantage and use of Etomidate?

A

Minimal myocardial depression/hypotension

Anticonvulsant

54
Q

A dog is presenting with a GDV. What would you use to induce it?

A

Opioid + Benzodiazepine

55
Q

Rank the three classes of opioids on their MAC sparing effects

A

Mu agonists&raquo_space; Buprenorphine&raquo_space; Butorphenol

56
Q

Opioid analgesics are considered the….

A

Backbone of analgesic protocals

Anesthesiology (13 decks)

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