Anesthetic Agents and Adjuncts

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Anesthetic Agents and Adjuncts
2014-02-20 20:13:13
Anesthesia Surgery

Ch. 3
Show Answers:

  1. anticholinergics
    • atropine
    • glycopyrrolate
  2. proprietary name for glycopyrrolate
  3. what is atropine derived from?
    atropa belladonna
  4. a phenothiazine tranquilizer
    acepromazine maleate
  5. benzodiazepines
    • diazepam (valium)
    • zolazepam + tiletamine (telazol)
    • midazolam (versed)
    • lorazepam (ativan)
  6. do tranquilizers produce analgesia?
  7. do benzodiazepines produce analgesia?
  8. this is the mechanism by which benzodiazepines work
    increase activity of GABA
  9. benzodiazepine that is not water soluble and therefore, cannot be mixed with other drugs (except ketamine)
  10. this drug is absorbed through plastic
  11. benzodiazepine antagonists
  12. alpha-2 agonists
    • xylazine
    • dexmedetomidine
    • detomidine
    • romifidine
  13. proprietary name for xylazine
    • rompun
    • anased
  14. proprietary name for dexmedetomidine
  15. proprietary name for detomidine
  16. proprietary name for romifidine
  17. what type of derivative are alpha-2 agonists?
  18. do alpha-2 agonists produce analgesia?
  19. this alpha-2 agonist will cause vomiting in cats and dogs
  20. what type of patient should alpha-2 agonists not be administered to?
    patients showing signs of respiratory disease
  21. this species has a much lower tolerance for xylazine
  22. this alpha-2 agonists has greater potency and fewer adverse effects than xylazine
  23. dexmedetomidine antagonist
    atipamezole (antisedan)
  24. xylazine antagonist
    yohimbine (yobine)
  25. do opioids produce analgesia?
    yes- most effective agents for Tx of pain
  26. naturally derived opioids
  27. pure opioid agonists
    • morphine
    • hydromorphone
    • oxymorphone
    • fentanyl
    • meperidine
  28. proprietary name for hydromorphone
  29. proprietary name for oxymorphone
  30. proprietary name for meperidine
  31. partial opioid agonist
  32. opioid agonist-antagonist
  33. proprietary name for butorphanol
  34. pure opioid antagonist
  35. proprietary name for naloxene
  36. total reversal of analgesia associated with opioids can be avoided by using
    agonist-antagonist such as butorphanol
  37. renarcotization
    • duration of action of the drug being reversed is longer than the duration of naloxene
    • signs of CNS/respiratory depression recur
  38. do not cross the placenta
  39. the least likely of anticholinergics to cause CNS effects because it does not cross the blood-brain barrier
  40. causes penile prolapse in stallions
  41. do tranquilizers cause a reduction in the seizure threshold?
  42. appetite stimulant in cats and ruminants
  43. proprietary name for diazepam
  44. proprietary name for zolazepam
  45. proprietary name for midazolam
  46. proprietary name for lorazepam
  47. this drug reduced secretion of insulin causing transient hyperglycemia
  48. what is the dosage we use for xylazine?
    0.25 mL/20 #
  49. second degree AV block is commonly seen with this sedative
  50. proprietary name for acepromazine
  51. duration for acepromazine
    4-8 hrs
  52. what is the dosage strength for ace?
    10 mg/mL
  53. does acepromazine provide antiemetic effects?
  54. does acepromazine provide antihistamine effects?
  55. does acepromazine provide antidysrhythmic effects?
  56. is there a reversal agent for ace?
  57. what are 3 proprietary names for ketmaine?
    • ketaset
    • vetalar
    • vetamine
  58. does ketamine provide analgesia?
  59. catalepsy is associated with what drug?
  60. does ketamine lower the seizure threshold?
  61. what is the dosage we use for ketamine?
    0.1 mL/#
  62. this drug is given to reduce salivation and prevent bradycardia
  63. this drug provides longer vagal blocking
  64. this drug is safer to use in animals with pre-existing heart problems because it has causes less tachycardia and cardiac arrhythmias 
  65. what is the dosage strength for atropine?
    • 0.01-0.02 mg/kg
    • IV
  66. what is the dosage strength for xylazine?
    20 mg/mL
  67. stages of general anesthesia
    • stage 1- prenarcosis
    • stage 2- narcosis
    • stage 3- general anesthesia
    •      plane 1
    •      plane 2- surgical anesthesia
    •      plane 3
    •      plane 4- respiratory depression
    • stage 4- respiratory cessation, general hypoxia >shock<
  68. what is our cocktail for the dog?
    0.1 mL/# ketamine, 0.25 mL/20# xylazine, 0.005 mg/# glycopyrrolate
  69. what is our cocktail for the cat?
    10 mL vial of ketamine, 1 mL ace, 1 mL glycopyrrolate
  70. why do we never use a phenothiazine derivative tranquilizer on a heart failure patient?
    will cause hypotension
  71. a dog that was given xylazine is experiencing respiratory depression, what would you administer now?
  72. this will extend recovery
  73. certain breeds have adverse reactions to iso/sevo, resulting in:
    malignant hyperthermia
  74. fluid flow and diuresis must be monitored constantly in pediatric/geriatric patients. why?
    • young- kidneys not fully developed yet to diuresis
    • old- wear and tear on kidney, not working as good anymore
  75. neonatal
    less than 2 wks
  76. pediatric
    2-8 wks
  77. preoperative fasting of neonate may be inadvisable because of
    hypoglycemia and dehydration
  78. these drugs should be avoided in neonates since the liver is inefficient in the metabolism of them
    • acepromazine
    • xylazine
    • barbiturates
  79. reasons to use a catheter
    • emergency drugs
    • fluids
    • highly alkaline anesthetics causing perivascular irritation
    • inject more than 1 item with different syringes
    • drugs for systemic problems (organ function)
    • drugs that need prolonged administration
  80. crystalloids
    • LRS
    • saline solutions
    • D5W
  81. colloids
    • blood
    • plasma
    • synthetic colloids (dextran, hetastarch)
  82. plasma expander, increases total blood volume
    synthetic colloids
  83. main reasons to use glycopyrrolate over atropine
    • longer vagal blocker
    • safer to use with preexisiting heart problems (less tachycardia/dysrhythmias)
  84. what is the primary reason we use pre-anesthetics?
    to reduce the amount of general anesthetic needed
  85. reduced mental activity with some reduction in pain
  86. thiazine derivatives are also known as
    alpha-2 agonists
  87. what is the main side effect associated with sedatives?
    respiratory depression
  88. explain MAC
    • amount of gas actually needed to maintain stage 3, plane 2
    • lower the #, the better
  89. natural stimulants of opioid receptors
    • endorphines
    • enkephalins
  90. to check oxygenation, you look where?
    under the tongue
  91. ultra short acting barbiturates
    • thiamylal sodium (biothal)
    • thiopental sodim (pentothal)
    • methohexital (brevane)
  92. what is the length of duration for ultra-short acting?
    10 mins
  93. what is the length of duration for short acting?
    45 min-1 hr
  94. what is the length of duration for long acting?
    6-7 hrs
  95. short acting bariturate
  96. long acting barbiturate
  97. thiobarbiturates
    • thiamylal sodium
    • thiopental sodim
    • methohexital
  98. oxybarbiturates
    • pentobarbital
    • phenobarbital
  99. one injection of propfol provides what duration of anesthesia?
    5-7 mins
  100. what is the dosage for propofol?
  101. things to do for shock
    • 1:10,000 epi
    • mannitol
    • solu-delta-cortef
    • fluids (crystalloid-LRS)
    • warmth
  102. 3 types of animals prone to hypoxemia and hypercarbia caused by increased mechanical dead space
    • cats
    • small dogs
    • pediatrics
  103. breed of dog sensitive to ace
  104. breed of dogs resistant to ace
  105. young patients are prone to 2 symptoms with surgery
    • hypothermia
    • hypoxia
  106. pediatric/geriatric patients are a concern for what when given IV fluids?
    hydremia (over-hydration) due to kidney function
  107. 5 classes of anesthetic risk patients
    • class 1- minimal risk (healthy, elective Sx)
    • class 2- slight risk (can compensate)
    • class 3- moderate risk (mild systemic disturbance)
    • class 4- high risk (shocky, high fever 104+)
    • class 5- grave risk (Sx necessary for survival)
  108. why should anticholinergics be avoided in ruminants and horses?
    paralytic ileus
  109. sedatives stimulate alpha-2 receptors causing a decrease in this neurotransmitter
  110. 4 phases of general anesthesia
    • preanesthetic phase
    • induction phase
    • maintenance phase
    • recovery phase
  111. type of anesthetic decomposed by liver and excreted through kidneys
  112. pre-narcosis, patient is awake but act unpredictably
    stage 1
  113. narcosis, all reflexes present but will loose consciousness, still able to swallow/bite
    stage 2
  114. swallowing reflex is lost, can now intubate patient (give stage, plane)
    stage 3, plane 1
  115. muscles are relaxed, respiration regular, HR&BP mildly depressed (give stage, plane)
    stage 3, plane 2
  116. respiration falls below 12 rpm, BP falls below 79, CRT >2sec (give stage, plane)
    stage 3, plane 3
  117. respiration cardiac arrest starts, eyes dilate, pupillary light reflex absent (give stage, plane)
    stage 3, plane 4
  118. stage where pupils are dilated and fixed, total circulatory collapse and death
    stage 4
  119. a dog that was given a barbiturate is experiencing respiratory depression, what would you administer now?
    • doxapram
    • to make aoritc arch and carotid sinus more sensitive to CO2 concentrations therefore increasing respirations (barbiturates decrease response of CO2 receptors)
  120. not used due to irritation of mm and explosive nature
    diethyl ether
  121. halothan, sevo, iso, mathoxyflurane, enflurane, desflurane are classified as what type of compound?
    halogenated compounds
  122. the more soluble the agent, the ______(more or less) uptake in blood and tissues which causes what?
    • more
    • a delay in alveolar concentration
  123. low soluble gas (low partition coefficient) means what for the patient?
    able to bypass tissues and go straight to CNS= fast induction, fast recovery
  124. name the gases in order of lowest partition coefficient to highest
    • nitrous oxide
    • sevo
    • iso
    • halothane
    • diethyl ether
    • methoxyflurane
  125. the lower the numerical measure of the blood:gas coefficient, the _________ (faster or slower) the gas reaches the nerves
  126. exact definition of MAC
    the anesthetic concentration required to prevent gross muscular movement in response to painful stimulus in 50% of a tested population
  127. MAC concentration needed for surgical anesthesia

    (exception: sevo)
  128. a good anesthetic gas needed for surgical anesthesia should have what 2 properties
    • low MAC
    • low partition coefficient
  129. in order of highest to lowest, MAC of gases for the dog:
    • methoxyflurane
    • halothane
    • isoflurane
    • enflurane
    • sevoflurane
    • diethyl ether
    • desflurane
    • nitrous oxide
  130. how much iso/sevo is metabolized by the liver?
  131. 5 factors that affect MAC
    • age
    • temp
    • CNS drugs
    • concurrent illness
    • pregnancy
  132. high partition coefficient =?
    slow induction, slow recovery
  133. drugs contraindicated with epinephrine
    • halothane
    • barbiturates
    • cyclohexamines
    • xylazine
  134. all anesthetic gases increase what in the body
    • cerebral blood flow
    • intracranial pressure
  135. gas that produced the most rapid induction and recovery
  136. #1 reason we do not use nitrous oxide for patients
    high MAC--hard to maintain anesthesia
  137. what is to be expected when administering propofol?