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23 spring anesthesia > Test 1: 4 benzo > Flashcards

Test 1: 4 benzo Flashcards

1
Q

what are some benzodiazepine meds

A

diazepam
lorazepam
midazolam

benzo: increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

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2
Q

what are some effects of benzos

A

reduce anxiety
sedation
anticonvulsive
spinal cord mediated muscle relaxants- Diazepam causes horse to fall over/ataxia
anterograde amnesia in humans

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3
Q

3 reasons to use benzos in vet med

A
  • Prevent muscle rigidity associated with ketamine
  • First line drug for treating acute onset of seizures
  • Synergistic effect with other drugs
     Induction of anesthesia (propofol or etomidate)
     With opioids (neuro-leptic induction)
     Inhalant sparing properties

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

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4
Q

what receptors do benzo work on and how do they work

A

GABA A

will increase affinity of receptor for GABA (turn on easier)

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

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5
Q

what can happen in cats if given benzo?

A

will become excited/aggressive - may cause inhibition of learned behaviors in some species

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

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6
Q

what benzo in fast onset with short duration

A

midazolam

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

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7
Q

what benzo is a fast onset and long lasting

A

diazepam

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

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8
Q

what benzo is long lasting and used in combo with Telazol

A

zelazepam

benzo: increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

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9
Q

what % of receptors filled for gaba A will cause anxiolysis, unconsciousness and sedation

A

20% Anxiolysis
30-50% Sedation
>60% Unconsciousness

benzo- GABA A receptor agonist that allow it to bind to GABA easier

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10
Q

how do benzos effect CNS

A

will decrease amount of O2 needed by brain= protect against hypoxia

increases seizure theshold of local anesthetics

midazolam DOES NOT produce isoelectric EEG but is still used to treat seizures because can be given nasally

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

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11
Q

benzo effect on respiratory

A

no effect if given alone

can cause ↓breathing when given with other drugs

benzo: diazepam

⍺2 agonist: xylazine- causes muscle relaxation- increased work and resistance in horses

Opioids: respiratory depressent

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12
Q

benzo effect on heart

A

does not effect heart

will increase GABA A receptability to GABA, does not directly effect GABA

diazepam, midazolam

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

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13
Q

why do we not use diazepam as often

A

diazepam is insoluble in water

needs to be mixed with propylene gylcol

propylene gylcol is toxic to the heart if given quickly (need to push slowly)

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

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14
Q

what happens during break down of diazepam

A

broken down in the liver into other active metabolities

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

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15
Q

if midazolam is water soluable, how does it get into the brain?

A

water soluble in the bottle

but when in the blood stream, change in pH will make it very lipid soluble (even more then diazepam)

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

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16
Q

break down of midazolam

A

short duration, fast redistribution

metabolized in the liver into metabolites that are not as toxic as diazepam and rapidly peed out

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

17
Q

reversal of benzo

A

flumazenil

Competitive antagonist at GABA A receptor

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

18
Q

why might you have to give flumazenil twice?

A

reversal for benzo that only last 1 hr

may need to redose if benzo still in the system

benzo: diazepam, midazolam
increase GABA binding to GABA A receptor
for anxiety, sedation, anti-seizure, muscle relaxant, amnesia

23 spring anesthesia (40 decks)

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