Anesthetic Agents & Tech 2

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Anesthetic Agents & Tech 2
2012-02-16 19:19:39
Clinical Practice

Clinical Practice
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  1. What is propofol?
    an IV injectable anesthetic induction (and maintenance) drug
  2. How long has propofol been available in this country?
    since 1996
  3. When was propofol developed?
  4. When and where was propofol first used on animals?
    • 1986
    • UK
  5. Is propofol related to the other injectable anesthetic drugs, the barbiturates and the cyclohexamines?
  6. What color is propofol?
    milky white
  7. What should you do with propofol before using it?
    shake it well
  8. Is propofol a watery dry, an oily drug, or what?
    oil in water emulsion
  9. Can propofol be used alone for short procedures?
  10. Is propofol appropriate to use as an anesthetic induction agent?
  11. How is propofol administered?
    IV only
  12. How should propofol be maintained?
    on inhalation
  13. Does propofol need premedications such as atropine?
  14. Why would we use a preanesthetic tranquilizer when using propofol?
    reduces the dose of propofol needed
  15. How fast should propofol be administered IV?
    over 20 - 60 seconds
  16. What can happen if you give propofol too fast?
    under 5 seconds may cause apnea
  17. What can happen if you give propofol too slow?
    the patient may not get deep enough
  18. How long does it take for propofol to work?
    within 60 seconds
  19. How long is propofol effective?
    6 - 20 minutes
  20. What may we see in the patient while giving propofol?
    transient excitement and muscle tremors
  21. Is it a big deal if we get propofol outside of the vein?
    no - does not cause perivascular sloughing
  22. What kind of recovery does a patient with propofol have?
    fairly rapid recovery
  23. How long is the recovery with propofol?
    full standing recovery within 20 minutes
  24. Where is propofol redistributed and metabolized?
    in liver and lungs
  25. How are the metabolites of propofol excreted?
    in the urine
  26. What happens if you give ace as a premedication?
    it delays recovery
  27. Does propofol have an excitement stage?
  28. Can propofol be mixed directly with other drugs?
  29. If your patient has been induced with propofol alone, and he is waking up before the procedure is over, is it OK to give him some more propofol to keep him down a little longer?
    yes - does not prolong recovery
  30. Which is the safest IV induction agent - propofol, cyclohexamines, or the barbiturates?
  31. Is propofol considered to be safe in patients with renal or hepatic disease?
  32. What kind of "margin of safety" does propofol have for dogs and cats?
    wide margin of safety
  33. Is propofol a controlled drug?
  34. What kind of cardiovascular side effects does propofol have?
    • minimal
    • may cause tachycardia or bradycardia
  35. What kind of respiratory side effects does propofol have?
    • minimal
    • may cause transient apnea when give rapidly IV
  36. Does propofol provide good analgesia?
  37. What is septicemia?
    systemic disease caused by pathogenic organisms or their toxins in the bloodstream
  38. Why should we avoid propofol in septicemic patients?
    it may make infections worse. propofol is a nutrient broth - if it becomes contaminated, bacteria can grow well in it
  39. Is propofol expensive or inexpensive?
  40. What is the shelf life for unopened vials of propofol?
    about 3 years
  41. Once a vial of propofol is opened, does it have a long shelf life? Why not?
    no - no preservatives - bacteria can grow in it
  42. How long is an opened vial of propofol good for?
    use within 24 - 48 hours if refrigerated
  43. Should we use strict aspetic technique when handling a vial of propofol? What does this mean?
    yes. avoid contamination - wipe the top with a cotton ball dampened with alcohol. make sure your needle is not contaminated before insertion
  44. What can happen with too rapid administration or overdose of propofol?
    cardiopulmonary depression, apnea
  45. What do we need to do if our patient overdoses on propofol?
    • intubate and assist ventilation as needed using pure O2
    • supportive treatment
  46. What are the side effects of propofol (there are 15)?
    • apnea
    • tachypnea
    • dyspnea
    • hypotension
    • bradycardia
    • tachycardia
    • cyanosis
    • arrhythmias
    • muscle tremors
    • paddling
    • seizures
    • CNS excitation
    • CNS depression
    • vomiting
    • salivation
  47. Are side effects common with propofol?
  48. Are the side effects severe with propofol?
  49. Propofol has not been evaluated for use in...
    • pregnant or breeding dogs
    • pups under 10 weeks
    • dogs in renal or hepatic failure
  50. Propofol should be used with caution in...
    • sick or debilitated dogs
    • geriatric
    • hypovolemic
    • cardiac
    • respiratory
    • renal or hepatic disease
  51. What is neuroleptanagesia?
    state of profound sedation produced by the combination of an opioid and a tranquilizer
  52. List some opioids
    • morphine
    • butorphanol
    • oxymorphone
    • fentanyl
    • meperidine
  53. List some tranquilizers
    • acepromazine
    • diazepam
  54. What sort of patient is neuroleptanalgesia best for - young healthy patients, or sick debilitated patients?
    sick debilitated patients
  55. List 5 agents used in the post-anesthetic period
    • doxapram
    • yohimbine
    • atipamezole
    • flumazenil
    • narcotic antagonists
  56. What is an analeptic agent?
    a drug that causes general CNS stimulation
  57. How should doxapram - Dopram be administered?
  58. Does doxapram - Dopram have a wide margin of safety?
  59. What type of more specific stimulation is doxapram -Dopram known for?
    respiratory stimulation
  60. Is doxapram - Dopram a specific reverser for any drug?
  61. Why may doxapram be used in the post - anesthetic period?
    seems to speed up recovery from barbiturate and inhalation anesthetics
  62. Is doxapram used routinely after barbiturate or inhalation anesthesia?
    • no - only if needed.
    • pretty much an emergency drug
  63. If we wanted to use doxapram to stimulate respiration in newborn pup just delivered by Caesarian section, what would be a good way to administer it?
    place a drop under the tongue
  64. What type of patients should we use caution when administering doxapram - Dopram? Why?
    cardiac disease - may cause tachycardia, arrhythmias
  65. What drug is yohimbine - Yobine the reverser for?
    xylazine - Rompun
  66. What drug is atipamezole - Antisedan the reverser for?
    medetomidine - Domitor
  67. What drug is flumazenil - Anexate the reverser for?
    diazepam - Valium
  68. What drug is naloxone - Narcan the reverser for?
    • morphine
    • oxymorphone - opioids