Exam 3 Anesthesia

anesthetic agent

any drug used to induce a loss of sensation with/without unconciousness

adjunct

drugs that are not true anesthetics (used during anesthesia to produced other desired effects), used as part of BALANCED anesthesia

sedation, muscle relaxation, analgesia, reversal, neuromuscular blockade, parasympathetic blockade

list 7 effects that adjuncts can provide

route of administration, time of administration, principle effect, chemistry

list four classifications of anesthetic agents and adjuncts

not true analgesics

most commonly used general anesthesia have little to no pain control:

halogenated inhalent agents (iso, sevo), propofol

list two examples of general anesthesia we may use

true analgesics

general anesthesia must be accompanied by administration of ___ ___ if pain control is necessary

opioids, alpha-2 agonists, dissociatives

list 3 examples of true anesthetics we can use if pain control is necessary

calm/sedate fractious animal, minimize adverse effects, reduce required dose of concurrent drugs, smoother induction, decrease pain, muscle relaxation

list 6 reasons we would use preanesthetic medications

SQ

slow onset, long duration

IM

faster onset, shorter duration

IV

fastest onset, shortest duration, dose usually ½ the dose of SQ/IM

PO/OTM

slowest onset, longest duration, rarely used, given to patients too aggressive to be handled

intramuscular

which route of administration is most common to balance onset of time/duration

water -soluble

most anesthetic agents and adjuncts are ___-___

diazepam, propofol

what two drugs are NOT water-soluble?

diazepam with ketamine

what two drugs can be mixed even though only one of them is water-soluble?

agonist

drug that binds to and stimulates tissue receptors (what most anesthetic agents and adjuncts are!)

antagonist

drug that competitively binds to target receptors and displace corresponding agonist, blocking further action (Reversal agents!)

partial agonist (opioid)

drug that binds to and partially stimulates tissue receptors

agonist-antagonist (opiods)

drug that binds to more than one receptor type and simultaneously stimulate at least one and block at least one

parasympatholytic drug

drugs that prevent and treat bradycardia (decreases salivary secretions

atropine, glycopyrrolate

list two examples of anticholinergics

atropine

faster onset, shorter peak, shorter duration anticholinergic

glycopyrrolate

slower onset, longer peak, longer duration anticholinergic

atropine, glycopyrrolate

these two drugs will NOT work well in hypothermic patients

5 minutes

onset of action of atropine via IM

1 minute

onset of action of atropine via IV

30-45 minutes

onset of action of glycopyrrolate via IM

up to 5 minutes

onset of action of glycopyrrolate via IV

60-90 minutes

duration of action of atropine via IM

30 minutes

duration of action of atropine via IV

60-90 minutes

duration of action of glycopyrrolate via IM

up to 1 hour

duration of action of glycopyrrolate via IV

central nervouse system

anticholinergics have little impact and is NOT a sedative on this region of body

cardiovascular system

anticholinergics help prevent and treat bradycardia in this region of body, may treat hypotension, and may induce temporary cardiac arrhythmias

respiratory system

anticholinergics help reduction and thickening of respiratory secretions in this region of body

GI motility, secretions

anticholinergics help reduce ___ ___ and salivary/lacrimal ___ (this is why we keep eyes lubricated!)

intestinal peristalsis inhibition

anticholinergics may lead to colic in horses of bloat in ruminants (___ ___ ___)

tranquilizer

drug group that reduces anxiety, does not decrease awareness or wakefulness

sedative

drug group that reduces mental awareness, causes sleepiness

pre-anesthetic period

tranquilizers and sedatives are terms often used interchangeably and are commonly used in ___-anesthetic period

phenothiazines, benzos, alpha 2-agonist

list 3 drug classes that are commonly used for sedation/tranquility

acepromazine

drug example of phenothiazines

no

is acepromazine controlled?

pre-anesthetic/tranquilizer

acepromazine is a ___-anesthetic and a ____

decrease

acepromazine helps ___ dose of general anesthesia needed

opiods

acepromazine may be used with ___ for minor procedures

IV, IM, PO

acepromazine can be administered via these 3 routes:

no antagonist agent

acepromazine has no ___ agent

liver

acepromazine is metabolized by the ___

placenta

acepromazine can slowly cross the ___

yellow

acepromazine is commonly this distinct color:

calming, sedation, reluctant movement, decreased interest

list 4 effects that acepromazine can have on the central nervous system

no

is acepromazine an analgesic?

peripheral vasodilation

to cause hypotension and hypothermia

peripheral vasodilation, antiarrhythmic efffect

list two effects that acepromazine has on cardiovascular system

up to 30 minutes

onset of action of acepromazine via IM

5-15 minutes

onset of action of acepromazine via IV

45-60 minutes

peak effect of acepromazine via IM

30-45 minutes

peak effect of acepromazine via IV

4-8 hours

duration of action of acepromazine via IM or IV for dogs

1-3 hours

duration of action of acepromazine via IV or IM for horses

respiratory system

acepromazine has no significant affect to this body system

antiemetic

acepromazine causes this effect to the GI system

antihistamine effect

acepromazine has a ___ effect; prevents histamine release (decreases allergic response)

allergey-testing patients

acepromazine should be avoided in these types of patients

penile prolapse

acepromazine can cause ___ ___ in horses and other large animals, and is best to avoid using this in breeding stallions

decreased PCV

acepromazine causes decreased ___ in horses and dogs. it drops within 30 minutes

bradycardia and hypotension

acepromazine can cause these two effects in giant breeds

increased excitement

acepromazine causes this main effect in boxers

terriers

this breed of dog is commonly resistant to acepromazine

neonates, geriatrics, liver/cardiac dysfunction, debilitated patient

acepromazine can have increased potency/duration in these 4 types of special patients:

vein

ensure IV injections of acepromazine in horses enter the ___

severe CNS excitement/depression, seizure, death

what are 3 things that can happen if we give acepromazine in the artery of a horse?

midazolam, diazepam, zolazepam

list 3 examples of benzodiazepines

benzodiazepines

drug class that is controlled, reversible, and often used with other agents for their muscle relaxant and anticonvulsant properties

young, healthy patients

benzos can have unpredictable sedation for ___,___ patients causing dysphoria, excitement, or ataxia

15 minutes or less

onset of action of benzos via IM

1-3 minutes

onset of action of benzos via IV

15-30 minutes

peak effect of benzos via IM

5-20 minutes

peak effect of benzos via IV

1-2 hours

duration of action of benzos via IM

1-4 hours

duration of action of benzos via IV

midazolam, diazepam

two most commonly used benzos in vet anesthesia

anticonvulsent

midazolam or diazepam commonly used for its ___ effects

light sensitive

midazolam and diazepam are ___ sensitive

flumazenil

the antagonist for midazolam and diazepam

midazolam

this benzo is water-soluble, can be given IV or IM, faster onset of action, and shorter duration of action

diazepam

this benzo is NOT water-soluble, hurts via IM, slower onset of action, longer duration of action

viscid

painful with IM injection

antianxiety and calming

benzos cause ___ and ___ effecrts only in old or ill animals

disorientation and excitment

benzos cause ___ and ___ in young, healthy animals

dysphoria and aggression

benzos cause ___ and ___ in cats

involuntary muscle twitching

benzos cause ___ ___ ___ in horses

ataxia or recumbent

benzos cause ___ or ___ in large animals

minimal, high

benzos have ___ effect and ___ margin of safety on the cardiovascular and respiratory systems

slowly IV

diazepam must be given ___ IV

dexmedetomidine, xylazine

list two examples of alpha 2-agonists

alpha 2-agonist

this drug class is uncontrolled, reversible, and decreases sympathetic nervous system causing sedation, analgesia, and muscle relaxation