Anaesthetic agents

Name 7 advantages of premedication

Reduces excitation
Reduces stress
Improves patient experience
Makes patient handling easier
Begins analgesia
Giving small doses of different medications is better than a large dose of one medication
Reduces volume of inhalant and induction agents needed

Name 8 traits of an ideal premedication

Fast acting
Small dose volume
Analgesic properties
Muscle relaxant
Reversible
Affordable
No cardio/respiratory depression
No regurg/vomiting

Name 5 common side effects of premedications

Relaxation of oropharynx that can cause suffocation
Vomiting
Thermoregulatory effect
Excitatory effects
Stinging

Define anaesthetic induction

The administration of drugs, either injectable or inhaled, that bring about a state of unconsciousness

Why are most inductions done by IV injection?

It has the fastest onset

Name 8 things that make an ideal induction agent

Lipid soluble
Fast acting
Can be given IV
Can be given to effect
Minimal side effects
Short lasting
Small volume
Cheap

Name 5 things that make a good induction period

Rapid
Stress free
Minimal physiological changes
Rapid intubation
Closely monitored

Name 5 properties of an ideal inhalant agent

Minimal side effects
Not irritating to mucous membranes
Cheap
Slight smell so you can detect a leak
Quick acting

Which inhalation agent has the most environmental impact

Nitrous oxide

Which inhalation agent has the least environmental impact

Sevoflurane

Name 5 disadvantages of isoflurane

Hypoventilation
Hypocapnia
Reduced cardiac output
Vasodilation
Irritating to respiratory tract

Name 5 advantages of isoflurane

Quick induction and recovery
No effect on kidneys
Minimal effect on liver
Cheaper than sevoflurane
Licensed in all species

What is the MAC of isoflurane in dogs

1.28%

What is the MAC of isoflurane in cats

1.63%

What is the maintenance range of isoflurane

1.5-2.5%

Name 4 advantages of sevoflurane

Very rapid induction and recovery
Non-irritant
Minimal effect on the liver and kidneys
Licensed in dogs and cats

Name 6 disadvantages of sevoflurane

Hypoventilation but less than isoflurane
Hypocapnia but less than isoflurane
Reduced cardiac output
Vasodilation
More expensive than isoflurane
May react with dessicated sodalime

What is the MAC of sevoflurane in dogs?

2.4%

What is the MAC of sevoflurane in cats?

2.6%

What is the maintenance range of sevoflurane?

3.3-3.8%

Define TIVA

Total Intravenous Anaesthesia, when anaesthesia is given through injection with no inhalant agent

Name 4 advantages of TIVA

Minimal equipement required
Does not require oxygen
Lower anaesthetic stress response
Can add inhalant if needed

Name 2 disadvantages of TIVA

Not easy to alter the level
Can be expensive

What must be considered when using propofol in cats?

Only suitable for up to 30 minutes as it can cause accumulation and toxicity

Name 3 uses of ketamine

Analgesia
Can “dart” wild animals
Can be used in TIVA

Name 2 uses of alfaxolone

Topping up anaesthesia
CRI

Define PIVA

partial intravenous anaesthesia

Name 3 advantages of PIVA

Better maintained blood pressure
Less cardiovascular depression
Reduced environemtnal impact

Name 3 disadvantages of PIVA

Strain on hepatic and renal systems
Patients appear lighter
Slower recovery

What class is butorphanol in?

mixed opioid

What species can butorphanol be used in?

Dog
Cat
Horse

What routes can butorphanol be administered?

IM
IV
SC

What is the duration of butorphanol?

1-4 hours

Can butorphanol be reversed?

Partially, with naloxone

Name 3 advantages of butorphanol

Mild analgesia
Sedative
Minimal respiratory depression

What class is methadone in?

Full mu agonist

What species can methadone be used in?

Dog
Cat

What routes can methadone be administered?

IM
IV
SC

What is the duration of methadone?

4-6 hours

Can methadone be reversed?

Yes, with methadone

Name 2 advantages and 3 disadvantages of methadone

Strong analgesic
Minimal emesis
Mild bradycardia
Mild respiratory depression
Reduced GI motility

What class is fentanyl in?

Full mu agonist

What species can fentanyl be used in?

Dog
Cat

What routes can fentanyl be administered?

IV bolus
CRI
Transdermal patch

What is the duration of fentanyl?

Minutes when IV
48-72 hours when patch

Is fentanyl reversible?

Yes, with naloxone

Name 3 disadvantages of fentanyl

Respiratory depression
Hypothermia
Noise sensitivity

What class is buprenorphine in?

Partial mu agonist

What species can buprenorphine be used in?

Dog
Cat
Horse

What routes can buprenorphine be given?

IM
IV
Transmucosal

What is the duration of buprenorphine

6-8 hours

Is buprenorphine reversible?

Partially but difficult, with naloxone

Name 4 advantages of buprenorphine

Long acting
Mild sedation
Good post-op analgesia
Minimal adverse effects

what class is ACP in?

Phenothiazine tranquilliser

What species is ACP used in?

Dog
Cat
Horse

What routes can ACP be administered?

IM
Slow IV
SC

What is the duration of ACP

4-8 hoursI

Is ACP reversible?

No

Name 3 disadvantages of ACP

Hypotension
Hypothermia
No analgesia

What class is medetomidine in?

adrenergic agonist

What species can medetomidine be used in?

Dog
Cat

What routes can medetomidine be administered

IM
IV

What is the duration of medetomidine?

30-90 minutes

Can medetomidine be reversed?

Yes, with atipamezole

Name 2 advantages and 2 disadvantages of medetomidine

Sedation
Analgesia
Bradycardia
Reduced cardiac output

What class is xylazine in?

alpha 2 - adrenergic agonist

What species is xylazine used in?

Horse

What routes can Xylazine be administered?

IV
IM

What is the duration of xylazine?

20-30 minutes

Is xylazine reversible?

Yes, with atipamezole

name 2 advantages and 1 disadvantage of xylazine

Sedation
Analgesia
Ataxia

What class is ketamine in?

NMDA antagonist and dissociative anaesthetic

What species can ketamine be used in?

Dog
Cat
Horse

What routes can ketamine be administered?

IV
IM

What is the duration of ketamine?

10-20 minutes when IV
20-40 minutes when IM

Is ketamine reversible?

No

Name 1 advantage and 3 disadvantages of ketamine

Analgesic
Hypertension
Increased intracranial pressure
Increased Intraocular pressure

What class is propofol in?

GABA agonist

What species is propofol used in?

Dog
Cat

What routes can propfol be administered?

IV only

What is the duration of Propofol?

5-15 minutes

Can propofol be reversed?

No

Name 1 advantage and 2 disadvantages of propofol

Rapid onset
Hypotension
Apnoea

What class is alfaxalone in?

Neuroactive steroid

What species can alfaxalone be used in?

Dog
Cat
Rabbit
horse

What routes can alfaxalone be administered?

IV
IM

What is the duration of alfaxalone?

10-25 minutes

Is alfaxalone reversible?

No

Name 2 advantages and 2 disadvantages of alfaxalone

Smooth recovery
Minimal CV depression
Can cause muscle contraction
Can cause seizures

What class is diazepam in?

Benzodiazepines

What species can diazepam be used in?

Dog
Cat
Horse

What routes can diazepam be administered?

IV
IM

What is the duration of diazepam?

30-60 minutes

Is diazepam reversible?

Yes, with flumezenil but expensive

Name 2 advantages and 1 disadvantage of diazepam

Muscle relaxant
Minimal cardiovascular effects
May cause excitation

What class in atropine in?

Anticholinergics

What species is atropine used in?

Dog
Cat
Horse

What routes can atropine be administered?

IM
IV
SC

What is the duration of atropine?

30 minutes

Is atropine reversible?

No