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Anesthesia -Scott Newman & Janet King > Test 2 Notes: Janet > Flashcards

Test 2 Notes: Janet Flashcards

1
Q

Why is species important when administering different medications & dosages?

A

Cats can be sensitive to medicines that are normally fine for dogs
Smaller animals need different dosages than larger animals

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2
Q

2 Breed complications during anesthesia

A

Brachycepahlics tend to get airway obstructions during recovery due to:
Small tracheas
Narrow nares
Parasympathetic tone

Sight hounds are sensitive to barbituates during recovery due to their lack of fat
(barbituates need fat to metabolize)

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3
Q

How should obese patients be dosed?

A

by their ideal weight -most drugs are dosed according to brain size, not weight

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4
Q

How should emaciated patients be dosed?

A

by their true weight -these patients are prone to hypothermia and hypoglycemia so a quick recovery is ideal, may need to add dextrose to fluids to prevent hypoglycemia

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5
Q

Geriatric patients are prone to ____

A

Early, sub-clinical renal failure & hypothermia

always use IV fluids!

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6
Q

Why is it important to have IV fluids running on a patient?

A

Functional nephrons need good renal perfusion (Blood pressure and volume)
IV fluids keep the nephrons functional and prevent renal failure in the long run

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7
Q

Both geriatric and young animals ideally need what kind of drugs during anesthesia?

A

Short acting

Reversible

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8
Q

If a female is in heat during a spay what could happen?

A

Hemorrhage risk is increased due to increased blood flow and bigger arteries around uterus

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9
Q

Why would pregnant spays be an increased risk?

A

The patient will be dehydrated due to the removal of the fetuses and all of the enzymes and fluids she was providing for them. Give bolus of fluids

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10
Q

Aggressive patients are at a higher risk due to ____

A

Lack of ability to get PA information

Increased stress

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11
Q

Why is knowing how long the surgery will be important?

A

So you know when to turn down the anesthetic %

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12
Q

Liver and Kidney problems could be and issue with anesthesia due to ____

A

Decreased metabolism- would have trouble excreting the drug

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13
Q

Vomiting/Diarrhea

A

loss of electrolytes
Dehydration
Acid/base imbalance

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14
Q

What type of drug do you avoid if you have a patient with a history of seizures? and why?

A

Epileptogenic Drugs

They have a lower seizure threshold

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15
Q

What two specific drugs should be avoided for epileptic dogs?

A

Ketamine & Acepromazine (Use Valium instead)

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16
Q

Hyperthyroidism in cats causes ____ during anesthesia

A

Increased heart rate

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17
Q

Why is it important to know if the patient is currently on any other drugs?

A

Not all drugs work well together and may produce adverse side effects

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18
Q

Anesthesia history would be beneficial to have because ____

A

You can see if the patient had any previous complications or allergies

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19
Q

How long should you withhold food & water before PA drugs are given?

A

8-12 hours for food, water is okay up until PA drugs are given

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20
Q

Why is food withheld before a anesthesia procedure?

A

Most anesthetic drugs will cause vomiting which could lead to aspiration

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21
Q

Normal patient temp.

A

101.5 +/- 1degreeF

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22
Q

Respiratory rate

A

15-30rpm in dogs

20-30rpm in cats

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23
Q

Fever may indicate ___ which may worsen following anesthesia due to ____

A

an infection

stress and immunosuppression

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24
Q

Hypothermia ____ the effects of anesthesia, so ___

A

Potentiates

Less drugs are needed

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25
Q

Hypothermia complications

A

Longer recovery
Delay in wound healing
Longer clotting times

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26
Q

Normal heart rate in dogs and cats and what spot is used to get this?

A

60-160 (up to 180 in toy breeds and 220 in puppies)

110-220 in cats

Femoral ARTERY

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27
Q

Cachexia means ____

A

emaciated

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28
Q

S&S or S&R stand for

A

Strong and Synchronous

Strong and Regular

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29
Q

What is evaluated when palpating a pulse?

A

rate and character

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30
Q

A weak or absent pulse may indicate ____

A

hypotension

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31
Q

A bounding pulse may indicate ____

A

Hypertension

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32
Q

What could auscultating the heart help you find?

A 
The rate and rhythm
Could hear respiratory sinus arrhythmia (normal in dogs) 
Cardiac murmurs (fast-slow-fast-slow: matches respirations)
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33
Q

2 Main reasons for increased CRT and pale MM color

A

Peripheral Vasoconstriction

Decreased Tissue Perfusion

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34
Q

Examples of Peripheral Vasoconstriction causes

A

Hypothermia
Pain
Alpha-2 agonists (sedatives)

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35
Q

Causes of Cyanosis and why this is a result

A

Hypoxia

Because there is an increase in the amount of unsaturated hemoglobin

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36
Q

Things to look at when evaluating the pulmonary system

A

Respiratory rate, depth and effort
MM color
Auscultation of breath sounds

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37
Q

What is important to know when evaluating neuro system?

A

History of seizures–avoid epileptogenic agents–use Valium= tranquilizer + anticonvulsant
Pupillary light reflex–both eyes should constrict

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38
Q

Hepatic function is important during anesthesia for ____

A

LIVER:
Metabolism and elimination of drugs
May effect other body systems

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39
Q

Renal function is important during anesthesia for ____

A 
KIDNEYS:
Elimination
Water distribution 
Electrolytes 
Blood pressure
RBC production
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40
Q

Sign of abnormal renal function

A

PU/PD

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41
Q

Things to evaluate when checking GI system

A

Do they have any:
V/D– dehydration & electrolyte imbalances
Parasites– anemia, diarrhea
GDV– impairs ventilation, decreased cardiac output, hypovolemic shock, ^^^RISK!
Ascites– fluid in abdomen, could indicate liver dz. or heart failure

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42
Q

What are the bare minimum lab tests that should be run? What tube should be used?

A

PCV & TP

RTT

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43
Q

What does the PCV evaluate for?

A

Anemia
Oxygen carrying capacity
Hydration status

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44
Q

If your patient is dehydrated the PCV will have a ____ & if they are over-hydrated the PCV will have a

A

Relative increase

Relative decrease

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45
Q

TP evaluates for ____

A

Hydration status
Blood loss
Liver function

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46
Q

Increased TP would indicate

A

dehydration

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47
Q

Decreased TP could indicate ____

A

Over-hydration
Liver disease
Malnutrition

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48
Q

When there is blood loss and acute hemorrhage what will drop first?

A

TP, PCV will be normal ~12 hours post blood loss

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49
Q

CBC consists of what tests, and what will they evaluate?

A 
RBC/Hct/Hgb= oxygen carrying capacity
WBC= leukocytosis (infection/stress) leukopenia (immunosuppression/viral infection)
Eos= parasites/allergies
Plt= coagulation
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50
Q

The PA panel usually includes what 4 things?

A
  1. Glucose
  2. BUN/Creat
  3. ALT/alk phos
  4. TP
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51
Q

Glucose

A

pancreatic function test (DM)

could be stress induced

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52
Q

How to differ between DM and stress induced glucose in urine

A

Urine test to check for ^ GLU

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53
Q

BUN/creatinine

A

Kidney function (glomerular filtration of kidney)

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54
Q

When will glomerular filtration of the kidney be increased?

A 
(Azotemia) 
When the animal is:
Dehydrated
In shock
Hypotension 
or Impaired renal function
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55
Q

ALT/alk phos

A

Liver Function
ALT= hepatocyte damage or destruction
Alk phos= hepatobiliary obstruction or bone growth/injury

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56
Q

What is the liver specific enzyme in dogs and cats?

A

ALT

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57
Q

Normal electrolyte balance is important for _____

A

Normal physiologic function

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58
Q

Blood gas tests are more important in what species?

A

Equine anesthesia

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59
Q

Urinalysis consists of ____

A

USG– renal tubular function
Dipsticks– pH, blood, bilirubin, GLU
Sediment– crystals (ethylene glycol/ammonium biurate)

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60
Q

What are 2 additional tests that may be run

A

ECG – known heart dz.

Rads – fractures, thorax, abdomen

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61
Q

4 reasons why placing a patient on a IVC is beneficial

A
  1. easier to admin. IV induction agents (titrate)
  2. can use CRI of anesthetics/analgesics
  3. important if emergency drugs are needed
  4. IV fluids
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62
Q

2 Reasons IV fluids are highly recommended

A

To maintain blood volume and support blood pressure

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63
Q

When would you DEFINITELY want IV fluids hooked up?

A

If the sx will result in significant blood loss
Patient is dehydrated
Long anesthesia
Animal is at risk for hypotension or shock

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64
Q

Class I anesthetic risk

A

Excellent anesthetic risk

Normal healthy patient getting a elective procedure only (OHE, Declaw, Neuter)

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65
Q

Class II anesthetic risk

A 
Good anesthetic risk 
Patient with slight to mild systemic disease 
Well controlled disease of ONE body system
Neonatal or Geriatric 
Mild to Mod obese 
ACL repair 
Brachycephalic 
Sighthound 
Well-regulated diabetic
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66
Q

Class III anesthetic risk

A 
Fair anesthetic risk 
Moderate systemic disease 
Mild clinical signs
Controlled dz of 1 or more body systems 
Low to moderate fever 
Moderately dehydrated 
Anorexia/Cachexia 
Heart or renal disease 
Complicated fracture
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67
Q

Class IV anesthetic risk

A 
Poor anesthetic risk 
Severe systemic disease that is a threat to life
At least 1 poorly controlled severe disease
High fever
Azotemia
Severe dehydration
Morbidly obese
Severe anemia
Emaciated 
DKA, GDV 
*Sx must be preformed to save life*
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68
Q

Class V anesthetic risk

A 
Guarded anesthetic risk 
Moribund (close to death)
Patient not expected to survive 24 hours with or without surgery 
Sx preformed in desperation 
Not expected to survive
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69
Q

What are some myths of pain in animals?

A

Animals don’t perceive pain like people- they tolerate it better than humans
Owners won’t pay for analgesics
Better to keep animals in pain so they won’t ruin the sx. site

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70
Q

Biology/physiology of pain

A

Increased anxiety and stress
Alters metabolism
Affects endocrine system
Decreased immune function

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71
Q

Signs that animal is in pain

A 
Vocalization
Facial expressions 
Body posture- hunched over/abnormal 
Activity- restless/not moving 
Attitude- aggression/depressed 
Guarding/Licking/Chewing 
Decreased appetite 
Not sleeping 
Panting/Salivation
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72
Q

What are the first 4 vital signs?

A
  1. Temp
  2. Pulse
  3. Resp.
  4. Pain assessment
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73
Q

What is the wind-up effect?

A

Hyper-excitability of central neurons due to constant bombardment of pain signals – will wake up with overwhelming pain sensation, harder to control.

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74
Q

Why should pre-emptive analgesics be used?

A

Decreases the wind-up effect

Decreases the amount of GA needed

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75
Q

What 2 things does the wind-up effect lead to?

A

Allodynia

Hyperalgesia

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76
Q

Allodynia

A

Pain caused by a stimulus that normally does not result in pain
ex: petting

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77
Q

Hyperalgesia

A

increased response to a painful stimulus

Over-exaggerated

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78
Q

Opioids

A

Agonists

Best choice

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79
Q

What do opioids act on?

A

receptors in the brain and spinal cord

may also provide some sedation

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80
Q

OTM

A

Oral trans-mucosal

Butorphanol- cheek pouch in cats

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81
Q

Routes of administration for Opioids

A 
PO 
IM & SQ
Transdermal (patch)
Intraarticular
Epidural
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82
Q

Epidural duration of action

A

Most commonly morphine

Provides 6-24 hours of analgesia to caudal thorax, abdomen, hind limbs, pelvis, and tail

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83
Q

3 Properties of NSAIDs

A
  1. Analgesia
  2. Anti-Inflammatory
  3. Anti-Pyretic (decreases fever)
84
Q

2 Types of NSAID analgesia

A

Somatic (bones/joints)

Visceral (soft tissues/organs)

85
Q

NSAIDs cause inhibition of ____

A

Prostaglandins (inflammation)

86
Q

What 2 enzymes are inhibited by NSAIDs?

A

COX1 & COX2 (important in production of prostaglandins)

87
Q

COX1 produces ____ prostaglandins & maintain what 3 things?

A

GOOD
Renal blood flow
Production of gastric mucus
Platelet function

88
Q

What can inhibition of the COX1 enzyme lead to?

A

Gastric ulcers

Kidney failure

89
Q

COX2 enzymes produce prostaglandins that cause what 2 things?

A

Pain

Inflammation

90
Q

What are some examples of NSAIDs?

A 
Aspirin
Acetaminophen
Carprofen
Meloxicam
Deracoxib
Etodolac
91
Q

What are some examples of Opioids?

A

Morphine
Hydromorphone
Fentanyl
Butorphanol

92
Q

What is the shortest acting Opioid?

A

Remifentanil

8-10min.

93
Q

What are 3 NSAIDs not typically used in animals due to toxicity?

A

Aspirin
Acetominophen
Ibuprofen

94
Q

How long does injectable carprofen usually last?

A

24 hours of analgesia

95
Q

What are 4 side effects of NSAIDs

A

Gastric ulcers
Renal toxicity
Impaired platelet function
Hepatic damage (from long term use)

96
Q

If you are worried about an animal’s liver before giving NSAIDs what test should you do?

A

Bile acids test to assess hepatic function

fast animal, test, feed animal, and test again

97
Q

What do local anesthetics do?

A

Block sensory nerve impulses and transmission of pain impulses
Temporary loss of sensation

98
Q

What are 4 benefits of local anesthetics?

A

Few cardiovascular side effects
Low cost
Good pain control
Minimal patient recovery

99
Q

Why would local anesthetics be used with GA?

A

Not as much GA gasses are needed

Pain control during and after surgery

100
Q

Topical local anesthetics normally come in an ____ and can be used to ____

A

Ointment
Decrease laryngospasms when intubating a cat
“Splash block” by applying directly on nerves during sx.

101
Q

How are infiltration local anesthetics used?

A

By blocking the nerves on the incision site

Ring block for a Onychectomy

102
Q

What does a direct nerve block do?

A

Targets specific nerves

Can be used for dental blocks,onychectomies, brachial plexus blocks, enucleation sx

103
Q

MLK & benefit of this drug combo

A

Morphine Lidocaine Ketamine
IV Local anesthetic
Reduces inhalant anesth. requirements by 25-30%

104
Q

FLK

A

Fentanyl Lidocaine Ketamine

105
Q

Lidocaine patch

A

Produces analgesia, but no anesthetic effect

Apply at surgery site

106
Q

Example of IV local anesthetics and benefits

A

CRI of Lidocaine
Analgesia
Decreased vaporizer settings
Increases GI motility (horses)

107
Q

Where do you inject an epidural?

A

Into lumbosacral region

108
Q

What does local epidural do?

A

Loss of sensation and motor function

109
Q

What does a opioid epidural do?

A

Use for pain control post-op

110
Q

4 examples of local anesthetics

A

Lidocaine
Bupivacaine
Mepivacaine
Tetracaine

111
Q

What does adding epinephrine to local anesthetics do?

A

Causes vasoconstriction so local is not absorbed into the blood stream, and can increase the duration by 50%

112
Q

What are some negative aspects of local anesthetics

A

Lidocaine toxicity- neurotoxicity
Lidocaine CRI in cats- can cause seizures and bradycardia
Bupivicaine- Never IV

113
Q

Alpha 2 agonists are ____ & are _____ than analgesia

A

Sedatives

Longer lasting

114
Q

What do Alpha-2 agonists act on?

A

Pain receptors in brain & spinal cord to diminish pain perception

115
Q

Examples of Alpha-2 agonists

A

Xylazine
Medetomidine
Dexmedeomidine

116
Q

How are Alpha-2 agonists reversed?

A

With Alpha-2 antagonists

117
Q

Ketamine is a ____/____

A

Cyclohexamine/Dissociative

118
Q

When is Ketamine commonly used?

A

For induction of anesthesia or as GA for short procedures (Does NOT create unconsciousness)

119
Q

What are NMDA receptors?

A

Pain receptors in the spinal cord

120
Q

Why would a NMDA antagonist be used?

A

To prevent a wind up effect

121
Q

What are some non-pharmacologic methods of pain control?

A 
Acupuncture
Massage
Chiropractic
Cold/Heat
Herbal
Nursing care
122
Q

What 2 things can amplify pain and how is this prevented?

A

Anxiety & Fear

Sedatives and Tranquilizers can help calm the patient

123
Q

What are 5 reasons why we use PA drugs?

A
  1. Sedate/Tranquilize- calms, decreases stress, and muscle relaxation
  2. Pre-emtive analgesia to prevent wind up
  3. Prevent bradycardia, dry secretions
  4. Decrease amount of GA needed
  5. Safer and smoother induction & recovery
124
Q

How are PA drugs given?

A

IM or SQ

IV for Diazepam or emergency drugs

125
Q

What are 5 classifications of routine Pas?

A 
Anticholinergics
Tranquilizers
Alpha-2 agonists (sedatives) 
Opioids (narcotics)
Neuroleptanalgesia (Combo)
126
Q

What are the 2 Anticholinergics?

A 
Atropine sulfate (Atropine) 
Glycopyrrolate (Robinul-V)
127
Q

How do Anticholinergics work?

A

Against the cholinergic (parasympathetic) nervous system

Block function of acetylcholine and vagal nerve

128
Q

What are the main effects of anticholinergics?

A

slured<3= Heart- prevents bradycardia or may increase rate

129
Q

What is the MAIN reason for using an anticholinergic?

A

to prevent bradycardia

130
Q

What is the duration of Atropine sulfate?

A

60-90 minutes

131
Q

Which anticholinergic has a faster onset and increases the HR more?

132
Q

Which anticholinergic prevents bradycardia, without the risk of causing tachycardia?

A

Glycopyrrolate- milder on the heart than atropine

133
Q

Which anticholinergic has a longer duration of action?

A

Glycopyrrolate

134
Q

When would you NOT use an anticholinergic?

A

Tachycardic patient
Constipated
CHF or Hyperthyroidism

135
Q

What are the 2 groups of Tranquilizers?

A

Benzodiazapines “P’s”

Phenothiazines “Z’s”

136
Q

What is the 1 Phenothiazine Tranquilizer?

A

Acepromazine (Promace)

137
Q

What are the 3 Benzodiazapine Tranquilizers?

A

Diazepam (Valium)
Midazolam (Versed)
Zolezapam (in Telazol)

138
Q

What are some physical properties of Acepromazine?

A

Water soluble
Yellow
10mg/ml concentration (usually diluted to 1mg/ml)

139
Q

How long do Phenothiazines last?

A

(Acepromazine)
4-8 hours, sedation can last 24 hours
24-48 hours in geriatric or neonates

140
Q

What are 10 effects of Phenothiazines?

A 
(Acepromazine) 
Calming 
Decreased anxiety 
**Antiemetic (decreased V/D) 
Antiarrhythmic 
Antihistamine (dont use in animals getting allergy test) 
**Vasodilation**- can cause profound hypotension and hypothermia 
Prolapse of 3rd eyelid (Ace face) 
Penile prolapse in horses 
May lower seizure threshold 
NO analgesia but can improve analgesic effects 
Dysphoria in some cases
141
Q

What is the maximum dose of Acepromazine?

A

3mg (IM,SQ)

NOT reversible!

142
Q

What is the reversal agent for Benzodiazepines?

A

Flumazenil

143
Q

What are some physical properties of Benzodiazepines?

A

Diazepam is NOT water soluble
(can only be mixed with Ketamine)
NO analgesic properties
Controlled -human abuse potential

144
Q

What are some main effects of Benzodiazepines?

A

Anti-anxiety and calming
not as much CNS as Ace- appear calm, but still alert
NO Analgesia
Excitement instead of calming in some cases (works best when combined with other drugs)

145
Q

What combination works best together to prevent excitement instead of calming?

A

Opioid & Benzodiazepines (tranquilizer)

146
Q

Other effects of Benzodiazepines

A

Good skeletal muscle relaxation (counteracts muscle rigidity caused by Ketamine)
Anticonvulsant - good for PA patients with seizure disorders
Appetite stimulant
Behavior modification: (oral diazepam)- aggression, anxiety, marking, licking

147
Q

Which group of tranquilizers has minimal adverse side effects?

A

Benzodiazepines

148
Q

Diazepam

A 
(Valium)
Benzodiazepine 
Calming
Muscle relaxant 
Anticonvulsant
149
Q

How should Diazepam be given?

A

IV slowly
In combination with other drugs as PA
May cause excitement if given alone

150
Q

Midazolam

A

(Versed)
Water soluble- can mix with other PA drugs
Given IM or SQ
Minimal sedation and possible excitement if used alone (use in combo)

151
Q

Zolazepam

A 
found in (Telazol) 
Can be used as induction agent or sole anesthetic agent for short, minimally painful procedures
152
Q

What 2 drugs are in Telazol?

A

Zolazepam & Tiletimine

153
Q

What are the 3 Alpha-2 agonists?

A

(Sedatives)
Xylazine (Rumpun)
Medetomidine (Domitor)
Dexmedetomidine (Dexdomitor)

154
Q

What is Xylazine reversed with?

A

Yohimbine alpha-2 antagonist (Yobine)

155
Q

What are Dexmedetomidine and Medetomidine reversed with?

A

Atipamezole alpha-2 antagonist (Antisedan)

156
Q

Properties of Alpha-2 agonists (sedatives)

A

NOT controlled
Reversible
Can be absorbed through skin & mm
Produce analgesia, sedation, muscle relaxation
Emetic- vomiting in 50% of dogs and 90% cats

157
Q

How do Alpha-2 agonists (sedatives) work?

A

By binding to alpha-2 adrenoreceptors on sympathetic nerves within brain and spinal cord

158
Q

Which group of drugs produces a potent, sleep-like state?

A

Alpha-2 agonists

159
Q

Does sedation or analgesia last longer in alpha-2 agonists?

160
Q

How can alpha-2 agonists be given?

A

IV, IM, SQ, Epidural

161
Q

Side effects of alpha-2 agonists

A 
**Bradycardia and arrhythmias 
Hypotension
Resp. depression
Hypothermia 
Peripheral vasoconscriction
162
Q

Xylazine

A

(Rompun)
Only used in young, healthy animals
Emetic

163
Q

Medetomidine

A

(Domitor)
Only used in young, healthy, calm animals
Bradycardia is common

164
Q

How is Medetomidine and Dexmedetomidine dosed?

A

By mcg per square meter of body surface (use chart for volume using body weight)

165
Q

Dexmedetomidine

A

(Dexdomitor)
Newer version of Medetomidine (Domitor)
Adverse reaction in excited animals
Use only in young, healthy and calm patients

166
Q

What should be given before administration of alpha-2 sedatives?

A

Anticholinergics to decrease adverse cardio effects

167
Q

What group of drugs are the most effective for treatment of pain?

168
Q

How are Opioids used?

A

For PA- decrease GA and windup
Induction
Intra-articular

169
Q

What are the 3 classifications of Opioids and which is the best?

A

Pure agonists
Partial agonists
Mixed agonist/antagonist

170
Q

What are the 2 Opioid receptors in the brain?

A

Mu
Kappa
Sigma

171
Q

What are the 5 Pure agonist Opioids?

A 
Morphine
Hydromorphone
Oxymorphone
Methadone
Fentanyl
172
Q

What is the 1 mixed agonist/antagonist opioid?

A

Butorphanl

173
Q

What is the 1 partial agonist opioid?

A

Buprenorphine

174
Q

What is the reversal of Pure Agonist Opioids?

175
Q

What are some CNS effects of Opioids?

A

CNS depression or excitement (dysphoria)

Euphoria in some patients (Cats love buprenorphine)

176
Q

What are some signs of dysphoria?

A

Whining, barking, anxiety, restlessness

177
Q

Analgesic effects of Opioids?

A

Most effective as pure agonists

Excellent PA for animals having painful surgery

178
Q

What is the most common side effect of Opioids?

A

Respiratory depression
can be serious
dose related- smaller doses are much safer

179
Q

What are a few GI side effects of Opioids and what drug can be used to decrease these?

A

Emetic (Vomiting/Diarrhea)
Flatulence

Atropine or Acepromazine decreases these effects

180
Q

Dogs get ___ and ___thermia with Opioids

Cats get ___ and ___thermia with Opioids

A

Miosis & Hypothermia

Mydriasis & Hyperthermia

181
Q

Morphine

A

(Duramorph)
Pure agonist
Can cause dysphoria
Best when used with tranquilizer

182
Q

What 2 things does Morphine produce?

A

(Duramorph)

Analgesia & Sedation

183
Q

What are some benefits of Morphine?

A

(Duramorph)
Inexpensive and effective for severe pain
Can be added to fluids and given IV

184
Q

Routes and duration of Morphine?

A

IM, SQ, IV (dogs only) Epidural
Epidural- 12-24 hours
IM or SQ- 4+ hours in cats (less chance of bad reaction SQ)

185
Q

Hydromorphone

A

(Dilaudid)
Pure agonist
5X more potent than morphine
IV, SQ, or IM in both cats and dogs

186
Q

Duration of Hydromorphone

A

Lasts 4 hours (IM,SQ)

187
Q

Effects of Hydromorphone

A 
Less likely to cause vomiting 
Less potential to cause excitement in cats
-Resp. depression
-Dysphoria
-Bradycardia
-Panting
188
Q

Oxymorphone

A

(Numorphan)
Pure agonist
10X more potent than morphine and more sedation

189
Q

Duration and effects of Oxymorphone

A 
(Numorphan)
3-4hours 
Less likely to cause vomiting 
More expensive than morphine and hydro 
Increased sensitivity to sound
190
Q

Fentanyl

A

(Sublimaze)
Pure agonist
100-150X more potent than morphine

191
Q

Who is fentanyl not recommended in?

192
Q

Duration of fentanyl

A

(Sublimaze)

Only 30min. so commonly used as CRI or Transdermal patch

193
Q

Fentanyl patch brand name & facts

A

(Duragesic)

Transdermal delivery that provides continuous, steady-state analgesia for 3-5 days (Post op)

194
Q

How long does it take the Fentanyl patch to reach therapeutic blood levels?

A

4-12 hours in cats
12-24 hours in dogs
Apply patch 12-24 hours prior to anesthesia

195
Q

Butorphanol

A

(Torbugesic or Torbutrol)
Mixed agonist/antagonist
Not as effective as pure is at treatment of severe pain
Some sedation

196
Q

What can Butorphanol reverse?

A

(Torbugesic or Torbutrol)
Partially reverses pure agonists- can use to somewhat reverse resp. depression, sedation, or dysphoria but also reverses some analgesic effects.

197
Q

Duration of Butorphanol

A

(Torbugesic or Torbutrol)
1-4hours
1 hour in dogs
Up to 4 hours in Cats

198
Q

Buprenorphine

A 
(Buprenex)
Partial agonist 
Expensive 
Analgesia for mild to moderate pain 
Some sedation 
Has the longest duration
199
Q

Duration of Buprenorphine

A

(Buprenex)

Lasts 6-8 hours and up to 12 in some patients

200
Q

Which opioid has a better analgesia for cats that is administered OTM?

A

Buprenorphine (Buprenex)

201
Q

What does OTM mean?

A

Oral Transmucosal
Cheek pouch administration in cats
(Buprenorphine/Buprenex)

202
Q

What do Opioid antagonists do?

A

Displace opioids from receptors, causing a reversal of the agonist effect
Can reverse sedation, dysphoria, panting, resp. depression, hypotension, bradycardia…etc.

203
Q

Naloxone blocks all ____ receptors

A

(Narcan)
Mu receptors
Can be titrated to minimize the reversal of analgesia

204
Q

What is the elephant opioid?

A

Etorphine (M99)
3,000-8,000X more potent than morphine
Can immobilize elephants and other large mammals
Reversed with M5050

205
Q

What are some common Neuroleptoanalgesics?

A

Acepromazine & Butorphanol
Diazepam & Hydromorphone
Versed & Fentanyl

Anesthesia -Scott Newman & Janet King (13 decks)

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