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RUSVM Anesthesiology > Premedication > Flashcards

Premedication Flashcards

1
Q

Sedation

A

indiction of CNS deression and drowsiness by use of drugs

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2
Q

tranquilization

A

used somewhat synonymously to sedation

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3
Q

analgesia

A

aka antinociception

loss or reduction or pain sensation

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4
Q

general anesthesia

A

controlled and reversible loss of consciousness, nociception and mobility

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5
Q

balanced anesthesia

A

using multiple drugs to achieve the goals of general anesthesia with less side effects than using a single agent

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6
Q

dissociative anesthesia

A

a form of general anestheisa characterized by a catatonic state; dissociate the different parts of the brain - neural informaton is processed without proper coordination in space and time

e.g Katamine

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7
Q

neuroleptanalgesia

A

state similar to general anesthesia produced by a sedative and an analgesic agent

e.g. phenothiazine + opioid

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8
Q

inhalation anesthesia

A

general anesthesia using inhalational drugs

e.g Isoflurane, Sevoflurane

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9
Q

Total Intravenous Anesthesia (TIVA)

A

achieved soley by injectable drugs

e.g. propfol, opioids

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10
Q

Partial Intravenous Anesthesia

A

combination of injectable drugs and lower concentration of inhaled anesthetic agent

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11
Q

local anesthesia

A

loss of sensation in a smaller, circumscribed body area

e.g infiltration, small nerve blocks

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12
Q

regional anesthesia

A

loss of sensation in a larger but limited body area

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13
Q

parts of the anesthetic procedure

A

premedication

induction

maintenance

recovery

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14
Q

list 2 anticholinergics that can be used as a premed

A

atropine

glycopyrrolate

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15
Q

Main indications for anticholinergics

A

Bradycardia

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16
Q

when are anticholinergics contraindicated

A

tachycardia

hyperthyroidism (almost the same as tachycardia)

most heart diseases

narrow angle glaucoma

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17
Q

CV side effect of anticholinergics

A

2º AV block, bradycardia, cardiac arrest

tachycardia, hypertension

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18
Q

what should atropine (anticholinergics) not be given with

A

alpha 2 agonist (metetomidine)

can result in vasocontriction, tachycardia, hypertension

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19
Q

how should bradycardia be treated

A

is there even a problem - consider species, age and Dz of patient

drugs: atropine, atipamezole (alpha 2 antagonist)

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20
Q

T/F anticholinergics may cause intestinal paralysis leading to colic in horses

A

True

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21
Q

should you give atropine to rabbits

A

No

have high levels ofatropinase enzyme - broken down quickly and not effective

glycopyrrolate is the preferred anticholinergic

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22
Q

what are the strongest available sedatives

A

alpha 2 agonists

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23
Q

location of alpha 2 adrenergic receptors

A

presynaptic memebrane (CNS)

post-synaptic membrane (vascular smooth muscle)

extra-synaptic sites (pancreas, adipocytes)

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24
Q

how do alpha 2 agonist work

A

supression of NE release by negative feedback

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25
Q

T/F both alpha 1 and 2 mediate vasoconstriction

A

True

receptors located in the walls of arteries and veins

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26
Q

T/F one side effect of alpha 2 agonists is hyperglycemia

A

True

inhibit insulin release from beta cells in the pancreas

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27
Q

CNS effects of alpha 2

A

strong sedation (except pigs)

some analgesic effect

muscle relaxation

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28
Q

alpha 2 agonist CV effects

A

strong vasocontriction

reflex bradycardia

results in: low CO and tissue perfusion

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29
Q

T/F you can use atropine to reverse some of the effects of alpha 2 agonists

A

FALSE!!!

Don’t do this! use atipamezole instead

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30
Q

respiratory effects of alpha 2 agonists

A

mild respiratory depression

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31
Q

T/F alpha 2 agonists can cause lung edema and hypoexemia in ruminants

A

True

32
Q

Xylazine is contraindicated in which species

A

sheep

33
Q

when is vomitting most likely to occur with alpha 2 agonists?

A

cats on xylazine

34
Q

indications for alpha 2 agonists

A

sedation of aggressive animals

sedation in the ICU

sedation to manage post opertative airway obstruction

prevention/ treatment of seizures

35
Q

alpha 2 agonist contraindications

A

too young/old

hemodynamic instability

severely debilitated patient

not suitable for risk patients

36
Q

what should always be used to antagonize and alpha 2 agonist

A

atipamezole

37
Q

what receptor(s) do phenothiazine antagonize

A

dopamine

serotonin

histamine

alpha 1

38
Q

which phenothiazone is typically used as a premed

A

acepromazine

39
Q

main indications of phenothiazines

A

sedative - weaker than alpha 2

antiemetic

antiarrhythmic

40
Q

CV effects of phenothiazines

A

vasodilation and hypotension

41
Q

when are phenothiazines contraindicated

A

hypovolemia, hemodynamic instability

boxers may be sensitive

42
Q

Butyrophenones are more likely to cause:

A

behavioral side effects

43
Q

Main indications for benzodiazepines

A

sedative

anticonvulsant

muscle relaxant

44
Q

what receptor do benzodiazepines work on

A

GABA agonist

45
Q

CV effects of benzodiazepines

A

minimal

46
Q

what can be given as a reversal to benzodiazepines

A

flumazenil

47
Q

T/F benzodiapepines are rarely used alone

A

True

disorientation and excitation may occur when used alone

48
Q

benzodiazepines can be combined with _____ as a premed

A

opioids

alpha 2 agonists

both

49
Q

what can benzodiazepines be combined with for induction

A

dissociative anesthetics (ketamine)

barbiturates or propofol

50
Q

T/F diazepam can be givem IM

A

False

poor absorption and painful

51
Q

what are the strongest available systemic analgesics

A

opioids

52
Q

T/F opioids are suitable for most risk patients

A

True

53
Q

What receptors do opioids work on

A

mu - strong analgesia

kappa - weaker analgesia

54
Q

full agonist

A

activate receptors and trigger full tissue response

55
Q

partial agonists

A

activate receptors but do not trigger full tissue response even at high doses

56
Q

antagonists

A

bind to receptors but do not activate them

57
Q

mix agonist antagonist

A

activate one receptor type and inhibit another

58
Q

what is an example of mixed agonist antagonist

A

butorphanol

anatgonist on mu and agonist on kappa

59
Q

potency tells you

A

the dose

60
Q

efficacy tells you

A

the strength of the effect

61
Q

main indications for opioids

A

analgesia

62
Q

T/F opioids decrease the MAC of inhalants

A

True

63
Q

T/F opioids may trigger or inhibit vomitting

A

True

64
Q

which opioids cause more vomitting

A

water soluable (morphine)

enter the brain slowly

65
Q

CV effects of opioids

A

minimal

no direct inotropy or vasodilation

suitable for most risk patients

66
Q

opioids as a premed and be used alone or in combination with:

A

benzodiazepines +/- ketamine

acepromazine

alpha 2 agonists

67
Q

T/F morphine may cause histmine release, especially after high IV dose

A

True

68
Q

Tramadol inhibits

A

NE and serotonin reuptake (analgesia)

its metabolite is a mu opioid agonist

69
Q

opioid antagonists

A

naloxone

naltrexone

70
Q

2 types of muscle relaxants

A

centrally acting

peripherally acting

71
Q

Guaifenesin

A

skeletal muscle relaxant

use in large animal anesthesia

no analgesia or unconsciousness-don’t use as sole agent

72
Q

what is included in a “triple” drip

A

GG + alpha 2 agonist + ketamine

73
Q

dantrolene is used for the Tx of

A

malignant hyperthermia

74
Q

what can happen if antibiotics are given IV too quickly

A

may cause hypotension

75
Q

when are antihistamines typically given as a premed

A

before mast cell removal Sx

RUSVM Anesthesiology (39 decks)

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