Preanesthetic 3.txt

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Preanesthetic 3.txt
2012-01-19 19:30:08
Clinical Practice

Clinical Practice
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  1. What are preanesthetic agents?
    Drugs given before the general anesthetic drugs are given.9
  2. List 4 reasons to use preanesthetic drugs
    • Tranquilize
    • Reduce side effects
    • Balanced anesthesia
    • Analgesia
  3. Do all patients need to be tranquilized before they are anestheized?
  4. What are the 2 main advantages to tranquilizing a veterinary patient before anesthesia?
    Reduces the amount of drug needed for general anesthesia & makes the patient easier to work with
  5. List 4 side effects of general anesthetic drugs that may be reduced by administration of preanesthetic drugs
    • Salvation
    • Bradycardia
    • Arrhythmia
    • Vomiting
  6. What is "balanced anesthesia"?
    Using a combination of preanesthetic & anesthetic drugs in order to decrease the doses of each, decrease side effects, & increase patient safety
  7. Are all preanesthetic drugs analgesic?
  8. List 2 advantages of using an analgesic drug as a preanesthetic drug.
    Pain relief can help with procedures such as a catheterization. Also the pain control may last long enough to provide post op relief for short procedures
  9. Name the 2 main classes of preanesthetic drugs
    • Anticholinergics
    • Tranquilizers and sedatives
  10. Name another class of drug that can be used as a preanesthetic
  11. Do all tranquilizers and sedatives have analgesic effects
    No (example - acepromazine is a tranquilizer but not analgesic)
  12. Do some tranquilizers and sedatives have analgesic effects?
    Yes (example - xylazine)
  13. Do all analgesic drugs also act as tranquilizers or sedatives l?
    No (examples - aspirin is analgesic but not a tranquilizer)
  14. Do some analgesic drugs also act as tranquilizers or sedatives?
    Yes (example - butorphanol)
  15. What does "anticholinergic" mean?
    "anti" - against, "choline" - acetylcholine. Against acetylcholine - a drug that blocks some of the effects of acetylcholine
  16. What does parasympathetic mean?
    "parasympatho" - parasympathetic. "lytic" - lyse, burst, destroy. A drug that blocks parasympathetic effects. Since acetylcholine is the main parasympathetic neurotransmitter, this means the same thing as "anticholinergic"
  17. If a drug blocks parasympathetic effects in the patient, what kind of effects is that patient going to show?
    Sympathetic effects
  18. Name the 2 main examples of anticholinergic drugs.
    • Atropine
    • Glycopyrrolate
  19. The nervous system has both "incoming" and "outgoing" impulses. What type of impulse is Afferent?
    Sensory - touch, sight, hearing, taste, smell
  20. What type of pulse is efferent?
    Motor - causes contraction of muscles, secretion of glands
  21. What are 2 types of motor impulses?
    • Voluntary - skeletal muscle
    • Autonomic - smooth muscle, cardiac muscle, and glands
  22. What general type of body functions is the autonomic nervous system concerned with? Give examples
    Involuntary control. Functions that the individual cannot consciously control. Examples - blood pressure & heart rate
  23. What are 2 parts of the autonomic nervous system?
    Sympathetic nervous system and parasympathetic nervous system
  24. The sympathetic nervous system operates under what general condition?
    Fight or flight
  25. What body functions does sympathetic stimulation tend to increase?
    • Heart rate
    • Respiratory rate
    • Blood pressure
  26. What body function does sympathetic stimulation tend to decrease?
    Gastrointestinal function
  27. Name the 2 main neurotransmitters of the sympathetic nervous system
    • Epinephrine
    • Norepinephrine
  28. The parasympathetic nervous system operates under what general conditions?
    Rest and restore
  29. What body functions does parasympathetic stimulation tend to decrease?
    • Heart rate
    • Respiratory rate
    • Blood pressure
  30. What body function does parasympathetic stimulation tend to increase?
    Gastrointestinal function
  31. Name the main neurotransmitters of the parasymapthetix nervous system
  32. Name the 2 main types of parasympathetic receptors.
    • Muscarinic
    • Nicotinic
  33. Are nicotinic receptors located close to the CNS or on organs?
    Close to the CNS
  34. Are muscarinic receptors located close to the CNS or on organs?
    On organs
  35. Which type of receptor is found at the neuromuscular junction of skeletal muscle cells - nicotinic or muscarinic?
  36. Do anticholinergic drugs block nicotinic or muscarinic receptors?
  37. Name the 2 main examples of anticholinergic drugs
    • Atropine
    • Glycopyrrolate
  38. Are anticholinergic drugs commonly given SQ or IM?
  39. Are anticholinergic drugs commonly given IV?
    No - is possible, just not common
  40. Can anticholinergics be mixed in the same syringe with ace, ketamine, and butorphanol?
  41. Can anticholinergics be mixed with diazepam?
  42. What is the advantage of mixing drugs into one syringe?
    Less pain and stress for the patient
  43. What plant is atropine originally derived from?
    European deadly nightshade - belladonna atropa
  44. Is atropine analgesic?
  45. Is atropine a tranquilizer?
  46. Name the main nerve supplying parasympathetic stimulation to the organs of the thorax and most of the abdomen l?
    Vagus nerve
  47. What nerve carries sensory information from the thorax and most of the abdomen to the brain?
  48. What nerve (left and right branches) lies on each side of the trachea?
    Vagus nerve
  49. What happens to the patients heart rate when the trachea or abdominal viscera are handled?
    Heart rate slows down
  50. Do atropine and glycopyrrolate stimulate or block stimulation of the vagus nerve?
    Block stimulation
  51. Does administration of atropine and glycopyrrolate cause or block bradycardia?
    Blocks bradycardia
  52. Is salvation considered to be a gastrointestinal function?
  53. Does administration of atropine and glycopyrrolate cause or block salvation?
    Blocks salvation
  54. What problems can excess salvation cause during anesthesia?
    • Aspiration
    • Asphyxiation
  55. Does administration of atropine and glycopyrrolate cause or block GI activity?
    Blocks GI activity
  56. Does atropine tend to cause or prevent vomiting?
    Prevent vomiting
  57. What is miosis? What is mydriasis?
    • Miosis - constriction of pupil
    • Mydriasis - dilation of pupil
  58. Does atropine cause miosis or mydriasis?
  59. Does atropine increase or decrease tear secretions?
  60. What should you do about decreased tear secretions in your anesthetic patient?
    Place artificial tears or ophthalmic ointment in his eyes
  61. Is it possible for atropine administration to cause problems in a patient with dyspnea? How?
    Yes - can dry up respiratory secretions causing blockage of airways, & can cause bronchodilation, which means that the patient has to pull in more air ( or more anesthetic gases) in order to get air to his alveoli
  62. What is a contradiction?
    A reason not to use a drug
  63. List 4 contraindications to use of atropine
    • Tachycardia
    • Congestive heart failure
    • Constipation
    • Respiratory distress
  64. What is an indication?
    A reason to use a drug
  65. List 4 indications for use of atropine
    • Preanesthetic
    • Antidotal for organophosphate toxicity
    • Antispasmodic for vomiting and diarrhea
    • Topical mydriatic
  66. The effects of which drug last longer - atropine or glycopyrrolate?
  67. Which drug has les tendency to cause tachycardia and cardiac arrhythmia - atropine or glycopyrrolate?
  68. Which drug suppresses salivation better - atropine or glycopyrrolate?
  69. Which drug cost more - atropine or glycopyrrolate?
  70. Is glycopyrrolate analgesic?
  71. Is glycopyrrolate a tranquilizer?
  72. List the 3 main classes of tranquilizers and sedatives
    Phenothiazines, benzodiazepine, Thorazine derivatives
  73. List 3 specific phenothiazine drugs. Which one is most commonly used in small animal medicine?
    • Acepromazine, chlorpromazine, triflupromazine
    • Acepromazine is most commonly used in small animal medi ine
  74. What is the long form of the word acepromazine? What is the short form?
    • Acetylpromazine maleate
    • Ace
  75. What color is an acepromazine solution?
  76. Is acepromazine an emetic or an antiemetic?
    Antiemetic - prevents vomiting
  77. What effect does act administration have on the third eyelids?
    Causes them to prolapse
  78. Does ace cause or prevent cardiac arrhythmias?
    Prevent - antiarrhythmic
  79. Should we use ace as a preanesthetic on an animal about to undergo allergic skin testing? Why or why not?
    No - is antihistaminic, prevents skin reaction to allergens
  80. Is ace more likely to cause hypotension or hypertension? Why?
    Hypotension - low blood pressure, because it causes peripheral vasodilation
  81. Should ace be given to an animal who dehydrated or in shock?
  82. Should ace be given to a patient who is prone to seizures?
    No - lowers the seizure threshold
  83. Which drug would be the most appropriate tranquilizer to use in an apileptoc animal - acepromazine or diazepam?
  84. Is ace analgesic?
  85. Is ace addictive?
  86. What is photosensitivity? Can ace cause photosensitivity?
    more likely to sunburn. Yes
  87. Is ace a relatively safe drug?
  88. List 3 other drugs that ace can be mixed with
    • Atropine
    • Ketamine
    • Butorphanol
  89. List 1 non-anesthetic, non-tranquilizer use for acepromazine
    Antiemetic, prevent motion sickness
  90. List the 3 most commonly used benzodiazepine tranquilizers/sedatives in veterinary medicine
    Diazepam - Valium, zolazepam - telazol, midazolam
  91. Are the benzodiazepines controlled drugs?
  92. What is the common trade name of diazepam?
  93. The commercial combination Telazol is composed of what 2 drugs?
    Zolazepam and tiletamine
  94. What are the main advantages of midazolam over diazepam?
    More water soluble, can mix with more drugs, more effective IM administration
  95. What effect do the benzodiazepine have on the patients frame of mind?
    Anti-anxiety, calming
  96. Which is a more effective tranquilizer for a healthy patient - diazepam or acepromazine?
  97. For our purpose in this class, is diazepam an analgesic?
  98. What effect do the benzodiazepine have on skeletal muscle?
    Relaxation - skeletal muscle relaxation
  99. Which drug is the most appropriate pre-anesthetic for an epileptic patient - acepromazine or diazepam? Why?
    diazepam - it is used to treat seizures in progress. Ace can cause seizure - lowers the seizure threshold
  100. What does anticonvulsant mean?
    Drug that treats or prevents seizures
  101. Which drug is more appropriate for risky patients - ace or diazepam?
  102. How is diazepam most commonly administered, for either preanesthetic or anticonvulsant purposes - IM, IV, or SQ?
  103. Should diazepam be injected IV fast or slow? Why?
    Slowly - bc it's carrier - the liquid it is dissolved in - is propylene glycol, which is a cardiovascular depressant
  104. Is diazepam an oil or water based compound?
    Oil based
  105. Can diazepam be mixed with water - soluble drugs?
  106. What drug can diazepam be mixed with?
  107. What drug can be used as a reverser for diazepam?
    Flumazenil - anexate
  108. List the 4 main uses for diazepam
    Preanesthetic, treat seizure in progress, appetite stimulant in cats, behavior modification in dogs, cats and people
  109. What kind of drug is zolazepam?
    Benzodiazepine tranquilizer
  110. What kind of drug is glycopyrrolate?
  111. What kind of drug is diazepam
    Benzodiazepine tranquilizer
  112. What kind of drug is atropine
  113. What kind of drug is acepromazine
    Phenothiazine tranquilizer
  114. What kind of drug is midazolam
    Benzodiazepine tranquilizer