Pharm II, Inj. Anesthetics

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HLW
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74647
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Pharm II, Inj. Anesthetics
Updated:
2011-03-22 23:09:21
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Pharm
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Pharm II, Inj Anesthetics
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  1. The effect site for injectable anesthesia?
    Brain
  2. Rout of admin for wildlife/zoo animals, usually suboptimal?
    IM
  3. Route of admin for very small animals?
    IP
  4. Relative to IV, drawbacks of using IM for anasthetics (6):
    • Slow Onset
    • Higher dose required
    • Less Predictable
    • No secure Venous Access
    • Must use small volume
    • Must be non-irritant
  5. What factors affect the seed of onset (5)?
    • Drug
    • Dose
    • Rate of admin
    • Route
    • P factors
  6. What drug properties affect the speed of onset (4)?
    • Lipid Solubility
    • Molecular Weight
    • Protein Binding
    • Ionisation
  7. What P factors affect the speed of onset?
    • Acid-Base balance
    • Electrolyte Balance
    • Plasma Protein Concentration
    • CO
  8. What influence does lipid solubility have on drug?*
    +lipid solubility-> crosses membranes faster
  9. What influence does molecular weight have on drug?
    Smaller MW -> Cross BB faster
  10. What influence does Protein binding have on drug?*
    Determines how much drug can leave vascular space and exert effects (hypoalbuminaemia= greater Fx)
  11. What influence does Ionization have on drug?*
    • Ionized drugs cannot cross membrane
    • (pH changes can cause ionization of drug)
  12. What factors influence Distribution?
    • Organ Perfusion
    • Protein Binding
    • Lipid Solubility
  13. After Admin, plasma concentrations fall b/c of... (3)
    • Redistribution (to vessel rich tissues, muscle, fats)
    • Elimination (through metab and excretion)
  14. What factors affect recovery?
    • Duration of admin
    • Distribution to other tissues
    • Elimination 1/2 Life
  15. How are barbiturates categorized?
    Duration
  16. What is Thiopental classified as?
    Ultra-Short
  17. Thiopental, not in solution, is classified as..... (pH)
    Weak Organic Acid
  18. Thiopental, IN solution, is classified as ... (pH)
    10.5, HIGHLY ALKALI
  19. Once injected, what happens to Thiopental?
    The pH falls (blood is 7.4) and becomes UN-IONIZED
  20. One reconstituted, what is the shelf life of Thiopental?
    7 Days (High pH = bactericidal)
  21. Thiopental concentrations greater than ____%, can cause sloughing, pain and self trauma
    • >2.5%
    • (Dilute w/ SQ ++NaCl if accidental peri-vascular injection)
  22. Thiopental Mechanisms of Action (3):
    • Interacts with GABA to increase the duration of GABAa dependent Cl channel in the CNS= Hyperpolarzation and Neurolnal Inhibition
    • Depresses the reticular activating system in the brainstem => sleepy
    • Depresses transmission in sympathetic ganglia
  23. Thiopental...
    Speed of onset:
    Speed of Redistribution:
    Recovery:
    • Onset: VERY rapid (<30 sec)
    • Redistribution: Rapid
    • recovery: Slow
  24. What increases the effects of barbiturates?
    • Acidosis
    • Hypoproteinaemia (active form unbound)
  25. Ionized VS Unionize
    Which is in plasma?
    Which is Active?
    • Both are in plasma
    • Un-ionized is active (highly lipid soluble, crosses BB)
  26. What technique can increase the rate of induction and recovery?
    Rapid Inj using Minimal Effective Dose
  27. Why isnt thiopental used for maintenance?
    It is cumulative
  28. Two determinants of thiopental induction dose requirements:
    • Lean Body Mass
    • CO
  29. Avoid Thiopental in...
    • Sight Hounds
    • Thin Animals (little depot)
    • Use caution in hypovolemia/shock/cardio Dz
  30. Thiopental CNS Fx (3):
    • Rapidly Crosses BBB
    • Splenomegaly
    • No alangesia
  31. Thiopental Cardio Fx (4):
    • Vasodilation
    • Hypotension
    • Drop CO
    • Arrythmogenic
  32. Thiopental Respiratory Fx:
    • Depression
    • Post-induction Apnea
    • Laryngospasm
  33. Advantages of Thiopental (2):
    • Potent & Short Acting
    • Long history of use in many species
  34. Disadvantages of Thiopental (7):
    • CVS and Resp Depression
    • Fx depend of admin technique
    • Cumulative
    • Hyperalgesic
    • Tissue Irritation
    • Splenomegaly
    • Solutions dont mix with other drugs
  35. Barbiturate used for ET:
    Pentobarbital +/- Phenytoin
  36. Propofol is classified as a...
    Steroid Anasthetic
  37. Lipid Solubility of Propofol:
    HIGHLY lipid Soluble
  38. Protein Binding of Propofol
    High Protein Binding
  39. Shelf life of Propofol:
    • 12-24 hrs, in fridge
    • (NO PRESERVATIVES)
  40. Propofol is available as...
    • 1% or 2% emulsion in
    • 10% soybean oil
    • 2.2% glycerol
    • 1.25 purified egg phosphatide
  41. pH of Propofol
    7
  42. Propoclear is a _____ formulation of propofol
    Microemulsion
  43. Propoclear...
    Redistribution:
    Metabolism:
    Clearance:
    Recovery:
    • Redistribution: Rapid
    • Metabolised: Rapid
    • Clearance: Exceeds Hepatic Flow
    • Recovery: Rapid (except in cats) & No hangover
  44. Propoclear should be administered____
    Slowly
  45. Proprclear CNS Fx (4):
    • GABA-ergic
    • Inhibits NMDA
    • Anti-convulsant (give w/ Propofol)
    • Central Anti-Emetic
  46. Propoclear Cardiovascular Fx(4):
    • Depress CO
    • Vasodilation= hypotension
    • Inhibit/Reset Baroreceptor Reflex
    • Splenic Engorgement
  47. Propoclear Respiratory Fx(2):
    • Depressant
    • Post-Induction Apnea
  48. Important Propoclear Side Fx(4):
    • CVS Depression
    • Respiratory Depreassion
    • Pain on Injection
    • Shakes
  49. Administration of Propofol slowly => (2)
    • Min hypotension
    • Min Respiratory Depression
  50. Tx for persistant Propofol Shakes
    Ketamine
  51. Which is used for epileptic dogs that don't respond to Valium?
    Propofol
  52. Cats should not anesthetized on consecutive days with...
    Propofol

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