Anesthetic agents

Methods to administer anesthetics: ___ or ___

inhalation, injectable

Inhalable agents function through the ___, ___, and ___

respiratory, vascular, CNS

Injectable anesthetic agents function through the ___, and ___

vascular, CNS

Between inhalation and injectable agents , ___ has a higher margin of safety

inhalation

Inhalable agents allow for ___ control of depth, as the ___ can be altered

rapid, concentration

Inhalable agents can be eliminated via the ___ system, but other do get metabolized by the ___

respiratory, liver

using inhalable agents also means you have control of the ___

airway

With injectable agents to alter the depth it requires more ___aka more ___, but there is ___ available

injection, agent, reversal

Elimination of injectable agents can be ___ with like in ultrashorts, ___ ___ as long as it functions properly, or ___ ___ again as long as it functions properly

redistribution, hepatic metabolism, renal excretion

the delivery of injectable anesthetic has ___ and ___, but it is convinient that is requires ___ ___

peaks, valleys, minimal equipment

Considerations of anesthetic agents include: ___, ___, ___, ___, ___, ___, and ___ ___

depth, elimination, delivery, convinience, expense, inductions, physiologic effects

Initially inhalation agents are ___ expensive due to requiring a ___ and ___

more, machine, equipment

Inhalation tends to have ___ induction, having a ___ phase and could emit ___ gases

slower, excitement, waste

Physiologic effects of inhalants includes being an overall ___, on the ___, ___ and ___

depressant, cardiovascular, respiratory, thermoregulation

injectable agents have a initial ___ expense as it doesn’t require specific ___

less, equipment

for injectable inductions overall it is ___ than inhalation but ___ is even faster than ___

faster, IV, IM

injectable induction has ___ durations

variable

Injectable agents have a ___ ___ on ___, ___, and ___

overall depressant, cardiovascular, respiratory, thermoregulation

The ideal injectable agent is ___ acting in both ___ and ___, ___-___, having minimal ___ effects, has ___, and ___ ___

fast, onset, recovery, non-toxic, adverse, analgesia, muscle relaxation

Ideally an injectable agent will be non-toxic and have minimal adverse effects on the ___, ___ and ___

cardiovascular, respiratory, tissues

barbiurates are ___, ___, ___ and relatively ___ in healthy patients

common, inexpensive, familiar, safe

barbiturates have four classes: ___, ___, ___, _-__

long, intermediate, short, ultra-short

Long acting barbiturates includes ___. These do not act as a ___, but it is a ___ and ___

phenobarb, anesthetic, anticonvulsant, sedative

Intermediate barbiturates include ___. Due to having a low fat solubility it has a ___ effect, it must be eliminated from ___, and metabolized in the liver

pentobarbital, slow, brain

pentobarbital has a ___ ___ solubility leading to a slow effect, it must be eliminated from the brain; metabolized in the ___, so it has a ___ recovery

low fat, liver, slow

Short acting barbiturates include ___, which is highly fat soluble leading to a ___ effect, and can be ___ eliminating it from the brain, and recovery ___

thiopental, rapid, redistributed, quickly

Thiopental is ___ ___ soluble so it has a rapid effect, can be eliminated from the ___ via redistribution

highly fat, brain

Ultrashort barbiturates includes ___, which is highly fat soluble leading to a ___ effect, and get eliminated from the brain via ___, and recovers ___

methohexital, rapid, redistribution, quickly

methohexital is ___ ___ soluble resulting in a rapid effect, and redistributes from the ___

highly fat, brain

methohexital is a ___ ___

ultrashort barbiturate

thiopental is a ___ ___ ___

short acting barbiturate

pentobarbital is a ___ ___ ___

intermediate acting barbiturate

Phenobarbital is a ___ ___ ___

long lasting barbiturates

barbiturates’ CNS effect is that it ___ ___

depresses RAC

Barbiturate effects are terminated when it exits the ___

brain

Barbituates exit the brain via the ___ ___

concentration gradient

Barbituates are stored in the body unless ___ ___ or ___ ___ occurs, and repeated doses can cause a ___, or prolong ___

Hepaic metabolism, renal excretion, overdose, revcovery

barbiturate on respiratory system: ___ and increase ___ ___, and it has the possibility to cross the ___ affecting the ___

depression, CO2 sensitivity, placenta, fetus

Cardiac barbiturate effects are less ___. It can ___ the heart cells, ___ the heart to ___,

common, depress, sensitize, catecholamines

barbituates are given at very ___ concentrations about ___-___, and the patients are often ___ before administration

dilute concetration, 2-2.5%, preoxygenate

Caution with using barbiturates in ___ due to minimal fats and it may slow ___ ___

sighthounds, hepatic metabolism

Sight hounds tend to have trouble with barbiturates due to minimal ___, and ___ ___ metabolism

fat, slow hepatic

Caution with barbiturates with patients with ___/ ___ disease, ___/___ which increases flow to the brain, ___, ___, ___ ___, ___ __, and it being a ___ drug

renal/hepatic, hypotension/shock, hypoprotenemia, acidosis, tissue irritation, stage II, controlled

___ ___ drugs have no effect, and ___ drugs have a effect

protein bound, unbound

With hypoproteinemia there is less protein to bind ___ so it has a stronger ___

drug, effect

increased acid levels increase the effect of ___ like phenobarbital, and methohexital

barbiturates

Barbiturates cause tissue irritation as it is ___, and can cause ___ ___. This is why the solution can be ___, with things like ___

alkalotic, tissue necrosis, diluted, saline

barbituates have a ___ stage II, which can be seen in ___ and ___

excitement, induction, recovery

barbiturates are controlled drugs ranging from Class __-__

II-III

Thiopental has a ___ onset of _-_ _

rapid, 30-60s

The duration of thiopental is ___ being from __-__ __

short, 10-20 min

Concentration of thiopental is __-__ in SA and __ in LA, and since it is variable read the __

2-2.5%, 5%, label

thiopental dosage ranges from __-__ _/_ and depends on the __, and if there is a __

6-20 mg/kg, premeds, condition

Methohexital is __-__ duration, works better in __, and has a __ __ __

ultra-short, sighthounds, narrow safety margin

at __-__x the anesthetic dose methohexital becomes __

2-3, lethal

pentobarbital is a __ barbiturate, and has a __ __ __ and is often used as a __ agent about __ the anesthesia dose

intermediate, narrow safety margin, euthanasia, double

Cyclehexamines have effects on the CNS like __ pathways, stimulating the __, and is a __ __

disrupts, RAC, dissociative anesthetic

cyclohexamines are a dissociative anesthetic which __ __, __ __, increases __ __, increases __ __, and functions as a __ __

exaggerates reflexes, weakens laryngeal, stimuli sensitiviy, muscle tone, cutaneous analgesic

Cyclohexamines are eliminated in canines via __ __, and in felines via __ __

hepatic metabolism, renal excretion

respiratory effects of cyclohexamines include a __ breathing pattern, decreased __ __

apneustic, tidal volume

a apneustic pattern is when a __ is taken between inhalation and exhalation

pause

cardiac effects from cyclohexamines: it isn’t __, releases __ causing __ and incresed __

depressive, epinephrine, tachycardia, BP

Caution with cyclohexamines with patients with __ diseases, and instead of atropine preferably __ is used when neccessary

heart, glycopyrrolate

Cautions with cyclohexamines is that it is __ IM/perivascular, increases __ which is why anticholinergics may be used, increased __ activity, increases __ and __ pressure, with the __, may cause a __ __, it is __, and it should be avoided if there is a __ potential

painful, salivation, CNS, CSF, intraocular, eyes, personality change, controlled, seizure

Cyclohexamines are irritating and painful if given: __ or __

IM, perivascular

Cyclohexamines increases salivations which is why __ are used to counteract it

anticholinergics

CNS activity increases with cyclohexamines, resulting in __ behaviors, and sometimes a __ __ change

bizarre, transient personality

Cyclohexamines should be avoided if the patient has __ __ or __

head trauma, glaucoma

with cyclhexamines the eyes may not __ which is why __ is needed, the eyes do not __, they __, and have __

close, lube, rotate, dilate, nystagmus

things that could increase seizure potential: __, or __ from strychnine, street drugs, or organophosphates

epilepsy, toxicosis

cyclohexamines are a class __ drug

III

ketamine has a __ onset; IV is __-__ _, IM __-__ _, oral __-__ _

rapid, 30-90s, 2-4 min, 3-5 min

the duration of ketamine varies from __-__ _ due to dose, route, or patient

2-6 hrs

accumulation of ketamine increases the risk of __, and prolongs __

seizures, recovery

In cat ketamine can be given __, __, or __

IM, IV, oral

In dogs ketamine is given __

IV

The concentration of ketamine is __ _/_

100 mg/ml

ketamine dosage varies from _-_ _/_. It can be lower with a __ of drugs, or if __

2-20 mg/kg, combination, IV

Combinations of ketamine: __/__ given IV, __/__ given IV or IM, __/__ which is risky, __/__ where IM works better than IV, and __/__

ketamine/diazepam, ketamine/midazolam, ketamine/xylazine, ketamine/medetomidine, ketamine/acepromazine

ketamine/diazepam combilation is given __

IV

ketamine/midazolam combination is given __ or __

IV, IM

Ketamine/xylazine is risky becaus in canines it may cause __ __ __, and in cats it causes __ which can lead to __

late cardiovascular collapse, emesis, aspiration

ketamine/medetomidine combination is better given __ rather than __, be cautious with the __

IM, IV, reversal

ketamine/acepromazine is __ than the combination with zylazine

safer

both ketamine and tiletamine are __

cyclohexamines

tiletamine is combined with __ to create __

zolazepam, telazol

tiletamine is good for aggressive dogs as there are many ways to administer it including __, __, __, __(in dogs)

IM, IV, SubQ, oral

tiletamine works well with __

exotics

Tiletamine is a __ drug of class __

controlled, III

Recovery after using tiletamine is __, and __ may due to __ and __

prolonged, difficult, tremors, hyperthermia

Tiletamine shouldn’t be used in __ __ patients above ASA __. Especially with issues of __, __, __ and __

high risk, III, CNS, hyperthermia, heart, ocular

propofol is a __ __

substituted phenol

propofol is an emulsion of __ and __, so it can support __, which is why it has a __ shelf life

water, oil, bacteria, short

propofol should only be given __ as a __ agent or combined with __

IV, single, thiopental

propofol has the CNS effect of __ __ of __

rapid loss of consciousness

propofol is eliminated via rapid __, and __, and isn’t __

redistribution, metabolism, cumulative

Due to propofol not being cumulative it can be __ __, and used for prolonged __

constant infusions, procedures

Propofol effects on respiratory includes __ administration leads to __, and __ which is why it needs to be __

rapid, depression, apnea, titrated

Cardiac effects of propofol is similar to __, work fine for __ patients, and causes __ __

barbiturates, cardiac, transient hypotension

propofol decreases __ and __ pressure

intracranial, intraocular