Premedication Flashcards by Kate Guiremand

Sedation

indiction of CNS deression and drowsiness by use of drugs

How well did you know this?

Not at all

Perfectly

tranquilization

used somewhat synonymously to sedation

How well did you know this?

Not at all

Perfectly

analgesia

aka antinociception

loss or reduction or pain sensation

How well did you know this?

Not at all

Perfectly

general anesthesia

controlled and reversible loss of consciousness, nociception and mobility

How well did you know this?

Not at all

Perfectly

balanced anesthesia

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

How well did you know this?

Not at all

Perfectly

dissociative anesthesia

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

How well did you know this?

Not at all

Perfectly

neuroleptanalgesia

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

e.g. phenothiazine + opioid

How well did you know this?

Not at all

Perfectly

inhalation anesthesia

general anesthesia using inhalational drugs

e.g Isoflurane, Sevoflurane

How well did you know this?

Not at all

Perfectly

Total Intravenous Anesthesia (TIVA)

achieved soley by injectable drugs

e.g. propfol, opioids

How well did you know this?

Not at all

Perfectly

Partial Intravenous Anesthesia

combination of injectable drugs and lower concentration of inhaled anesthetic agent

How well did you know this?

Not at all

Perfectly

local anesthesia

loss of sensation in a smaller, circumscribed body area

e.g infiltration, small nerve blocks

How well did you know this?

Not at all

Perfectly

regional anesthesia

loss of sensation in a larger but limited body area

How well did you know this?

Not at all

Perfectly

parts of the anesthetic procedure

premedication

induction

maintenance

recovery

How well did you know this?

Not at all

Perfectly

list 2 anticholinergics that can be used as a premed

atropine

glycopyrrolate

How well did you know this?

Not at all

Perfectly

Main indications for anticholinergics

Bradycardia

How well did you know this?

Not at all

Perfectly

when are anticholinergics contraindicated

tachycardia

hyperthyroidism (almost the same as tachycardia)

most heart diseases

narrow angle glaucoma

How well did you know this?

Not at all

Perfectly

CV side effect of anticholinergics

2º AV block, bradycardia, cardiac arrest

tachycardia, hypertension

How well did you know this?

Not at all

Perfectly

what should atropine (anticholinergics) not be given with

alpha 2 agonist (metetomidine)

can result in vasocontriction, tachycardia, hypertension

How well did you know this?

Not at all

Perfectly

how should bradycardia be treated

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

drugs: atropine, atipamezole (alpha 2 antagonist)

How well did you know this?

Not at all

Perfectly

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

True

How well did you know this?

Not at all

Perfectly

should you give atropine to rabbits

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

glycopyrrolate is the preferred anticholinergic

How well did you know this?

Not at all

Perfectly

what are the strongest available sedatives

alpha 2 agonists

How well did you know this?

Not at all

Perfectly

location of alpha 2 adrenergic receptors

presynaptic memebrane (CNS)

post-synaptic membrane (vascular smooth muscle)

extra-synaptic sites (pancreas, adipocytes)

How well did you know this?

Not at all

Perfectly

how do alpha 2 agonist work

supression of NE release by negative feedback

How well did you know this?

Not at all

Perfectly

T/F both alpha 1 and 2 mediate vasoconstriction

**True** receptors located in the walls of arteries and veins

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

**True** inhibit insulin release from beta cells in the pancreas

CNS effects of alpha 2

strong sedation (except pigs) some analgesic effect muscle relaxation

alpha 2 agonist CV effects

strong vasocontriction reflex bradycardia results in: low CO and tissue perfusion

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

**FALSE!!!** Don't do this! use atipamezole instead

respiratory effects of alpha 2 agonists

mild respiratory depression

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

**True**

Xylazine is contraindicated in which species

sheep

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

cats on xylazine

indications for alpha 2 agonists

sedation of aggressive animals sedation in the ICU sedation to manage post opertative airway obstruction prevention/ treatment of seizures

alpha 2 agonist contraindications

too young/old hemodynamic instability severely debilitated patient **not suitable for risk patients**

what should always be used to antagonize and alpha 2 agonist

atipamezole

what receptor(s) do phenothiazine antagonize

dopamine serotonin histamine alpha 1

which phenothiazone is typically used as a premed

acepromazine

main indications of phenothiazines

sedative - weaker than alpha 2 antiemetic antiarrhythmic

CV effects of phenothiazines

vasodilation and hypotension

when are phenothiazines contraindicated

hypovolemia, hemodynamic instability boxers may be sensitive

Butyrophenones are more likely to cause:

behavioral side effects

Main indications for benzodiazepines

sedative anticonvulsant muscle relaxant

what receptor do benzodiazepines work on

GABA agonist

CV effects of benzodiazepines

minimal

what can be given as a reversal to benzodiazepines

flumazenil

T/F benzodiapepines are rarely used alone

**True** disorientation and excitation may occur when used alone

benzodiazepines can be combined with _____ as a premed

opioids alpha 2 agonists both

what can benzodiazepines be combined with for induction

dissociative anesthetics (ketamine) barbiturates or propofol

T/F diazepam can be givem IM

**False** poor absorption and painful

what are the strongest available systemic analgesics

opioids

T/F opioids are suitable for most risk patients

**True**

What receptors do opioids work on

mu - strong analgesia kappa - weaker analgesia

full agonist

activate receptors and trigger full tissue response

partial agonists

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

antagonists

bind to receptors but do not activate them

mix agonist antagonist

activate one receptor type and inhibit another

what is an example of mixed agonist antagonist

**butorphanol** anatgonist on mu and agonist on kappa

potency tells you

the dose

efficacy tells you

the strength of the effect

main indications for opioids

analgesia

T/F opioids decrease the MAC of inhalants

**True**

T/F opioids may trigger or inhibit vomitting

**True**

which opioids cause more vomitting

water soluable (morphine) enter the brain slowly

CV effects of opioids

minimal no direct inotropy or vasodilation suitable for most risk patients

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

benzodiazepines +/- ketamine acepromazine alpha 2 agonists

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

**True**

Tramadol inhibits

NE and serotonin reuptake (analgesia) its metabolite is a mu opioid agonist

opioid antagonists

naloxone naltrexone

2 types of muscle relaxants

centrally acting peripherally acting

Guaifenesin

skeletal muscle relaxant use in large animal anesthesia no analgesia or unconsciousness-don't use as sole agent

what is included in a "triple" drip

GG + alpha 2 agonist + ketamine

dantrolene is used for the Tx of

malignant hyperthermia

what can happen if antibiotics are given IV too quickly

may cause hypotension

when are antihistamines typically given as a premed

before mast cell removal Sx