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VN06 > Premedication, analgesia, and anaesthetic > Flashcards

Premedication, analgesia, and anaesthetic Flashcards

1
Q

what is the purpose of pre-medication?

A
  • restraint
  • reduce anxiety or stress
  • achieve balanced anaesthesia
  • reduction in dose of induction
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2
Q

what is balanced anaesthesia?

A

the use of multiple anaesthetic drugs in combination to provide general anaesthesia

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3
Q

what are some premedicants?

A
  • phenothiazine
  • alpha 2 adrenergic agonist
  • alpha 2 adrenergic antagonist
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4
Q

what is a phenotiazines?

A
  • acepromazine
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5
Q

what are some alpha 2 adrenergic agonist?

A
  • medetomidine
  • dexmedetomidine
  • xylazine
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6
Q

what is a alpha. 2 adrenergic antagonist?

A

atipamazole

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7
Q

what are some advantages of acepromazine?

A
  • works well with opioids to product neuroleptanalgesia
  • long lasting - 6 hours
  • anti-arrhythmic action
  • IM, SC or slow IV
  • anti-emetic
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8
Q

what are some disadvantages of acepromazine?

A
  • slow onset
  • no analgesic effect
  • poor muscle relaxation
  • ceiling effect in large breeds
  • hypotension
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9
Q

what are some advantages of alpha 2 adrenergic agonist?

A
  • profound sedation
  • good muscle relaxation
  • profound drug sparing effect
  • peripheral vasoconstriction reduces heat loss
  • rapid recoveries
  • given IM, IV, or SC
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10
Q

what are some disadvantages of alpha 2 adrenergic agonist?

A
  • significant cardiovascular depression
  • not suitable for severe liver disease
  • can cause vomiting
  • analgesic effect is reversed by atipamazole
  • hypertension
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11
Q

what are some advantages of benzodiazepines?

A
  • good sedation in sick/young animals
  • minimal cardiovascular effects
  • good sedation if used in an opioid
  • anti-epileptic
  • given IM, slow IV or SC
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12
Q

what are some disadvantages of benzodiazepines?

A
  • minimal sedation in healthy animals
  • can cause excitement
  • muscle relaxation may impair breathing effort
  • cannot be given in an infusion as they are absorbed in plastic
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13
Q

what are some classes of analgesics?

A
  • opiates
  • NSAIDS
  • alpha 2
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14
Q

what are three types of pain?

A
  • physiological (localised and appropriate)
  • inflammatory (tissue damage associated with trauma or surgery)
  • neuropathic (damage to the nervous system)
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15
Q

what is a noxious stimulus?

A

something that causes tissue damage

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16
Q

what is nociception?

A

the processing of noxious stimuli which activates nociceptors and their pathways

17
Q

what is a pain pathway?

A

after repeated noxious stimulus has triggered the nociceptive pathway, the site of injury and surrounding tissues become highly sensitive to pain (wind up)

18
Q

what is pre-emptive analgesia?

A

administering analgesics before the onset of noxious stimuli such as surgery

19
Q

what are pure agonists?

A

occupy and strongly stimulate the sites and thus have a stronger effect

20
Q

what are partial agonists?

A

occupy but don’t fully stimulate the sites

21
Q

what enzymes do NSAIDS interfere with?

A

the cyclo-oxygenases (COX-1 + COX-2)

22
Q

what are some side effects of NSAIDS?

A
  • gastric ulceration
  • renal damage
23
Q

what are some ways induction of anaesthesia?

A
  • intravenously
  • intramuscularly
  • via mask or induction chamber
24
Q

what is propofol?

A
  • induction agent
  • quickly distributed - lasts 10-15 mins
  • doesn’t cause arrhythmias
  • can be given incrementally
  • suitable for TIVA or PIVA
25
Q

what are some disadvantages of propofol?

A
  • causes excitement
  • extensor rigidity
  • causes brief apnoea when injection
  • causes resp and cardiovascular depression
26
Q

what is alfaxalone?

A
  • steroid inducing agent
  • most predictable when given IV (10 mins surgical anaesthesia)
  • high/wide therapeutic index
  • can be given incrementally
  • causes minimal respiratory and cardiovascular depression
  • TIVA and PIVA
27
Q

what is ketamine?

A
  • dissociative anaesthetic
  • induces a feeling of separation
  • good analgesic
  • causes muscle hypertonicity
  • causes a rise in HR and BP
28
Q

how can anaesthesia be maintained?

A
  • inhalant agents alone
  • TIVA
  • PIVA
  • Injectable agents given IM
29
Q

what does PIVA stand for?

A

partial intravenous anaesthesia

30
Q

what does MAC stand for?

A

minimum alveolar concentration

31
Q

what are some factors for isoflurane?

A
  • non-flammable
  • good muscle relaxation
  • non-explosive
  • smell is poorly tolerated
32
Q

what are some factors for sevoflurane?

A
  • less soluble than iso (quicker induction and recovery)
  • better tolerated by patients
  • less potent than iso
33
Q

what is allodynia?

A

pain from a stimulus that does not normally provoke pain

34
Q

what is hyperalgesia?

A

increased sensitivity to pain

35
Q

what is multimodal analgesia?

A

more than one class of analgesic that target different receptors along the pain pathway

36
Q

what is central sensitisation?

A

a state in which the central nervous system. amplifies sensory input

37
Q

what is local anaesthetic?

A

a temporary interruption in nerve conduction in sensory and motor nerves without loss of consciousness

38
Q

what is neuroleptanalgesia?

A

provides a combination of deep sedation and analgesia by a synergistic combination of a neurolept and a narcotic analgesic

VN06 (12 decks)

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