anesthesia prep

• reduction and thickening of respiratory/salivary secretions

• can clog and produce thick mucous within airways predisposing patient to airway occlusion

• possible resp arrest in small animals

• reduction and thickening of respiratory/salivary secretions

• can clog and produce thick mucous within airways predisposing patient to airway occlusion

• possible resp arrest in small animals

what are anticholinergics effects on the respiratory system?

treatment of severe bradycardia, heart block, or excessive salivary secretions

what are anticholinergics used for?

Glycopyrrolate

Anticholingeric that is less likely to induce cardiac arrythmias

Atropine

anticholinergic that is usually a better choice for emergency treatment for bradycardia/cardiopulmonary arrest bc it has a faster onset of action

tranquilizer

reduces anxiety but does not decrease awareness and wakefulness

• Acepromazine is a major

Sedatives

reduces mental activity and produces sleepiness

Phenothiazines

Benzodiazepines

Alpha 2 adrenergic agonists

what are the 3 classes of sedatives/tranquilizers commonly used in VetMed?

tissues in the pharynx

sedatives relax what tissues ?

• resp distress

• upper airway occlusion

• be VERY careful in brachycephalic breeds (esp those w stridor before premedication)

sedatives may cause

Acepromazine

Phenothiazine:

“Major” Tranquilizer

non-controlled

water soluble

used in large and small med

can decrease the dose of gen anesthetic required

can ease induction and recovery

IM/IV route

no antagonist

• depression

• blocks alpha 2s, dopamine, and histamine receptors in brain

• metabolized by the liver

• crosses placental barrier slowly

• 15 min onset of action

• peaks at 30-60 min

• duration 4-8 hrs in small animal

• duration shorter than 1-3 hrs in equine

what are Phenothiazines mode of action?

No, because they cross the placental barrier and can spread meds to baby and baby cannot handle the hypotension it can cause.

are Phenothiazines good to give for c-sections?

calming, sedation, reluctance to move, and decreased interest in surroundings

-reduces seizure threshold (not good to give to epileptic or seizure patients)

-sedation is less pronounced in feline than in canine and equine

Phenothiazines effects on CNS

no; it is only a tranquilizer that reduces anxiety, calms, and causes sedation

do phenothiazines cause analgesia?

• dose dependent tachycardia in response to hypotension

• Antiarrhythmic effects protecting against ventricular arrhythmias

• peripheral vasodilation

• DECREASES cardiac output

• can lead to increased heat loss- hypothermia

• patients on isoflurane could experience significant hypotension

what are phenothiazine’s effects on the cardiovascular system?

Acepromazine does NOT cause significant respiratory depression

• drug of choice for patient in respiratory distress w/o other debilitating factors

Phenothiazines effect on respiratory system:

vomiting

Phenothiazines can help prevent

penile prolapse

phenothiazines can cause what in equine? (geldings, stallions to be exact)

PCV

Phenothiazines can decrease ______ in equine and canine due to increased uptake of red blood cells by the spleen.

histamines; do not use in patients undergoing allergy testing

Phenothiazines can prevent release of

Collies and Aussies

Doses of Acepromazine (phenothiazine) should be reduced by 25% in what breeds to minimize the effect of exaggerated/prolonged sedation?

Giant breed dogs - greyhounds and boxers

what breeds are extremely sensitive to Acepromazine (phenothiazine) and may experience severe bradycardia and hypotension?

• use w caution

Benzodiazepines

referred to as minor tranquilizers

Benzodiazepines

minor tranquilizer that is most often used in combinations with other agents for their muscle relaxant and anticonvulsant properties.

• may cause dysphoria

• unreliable sedative effects

Diazepam (IV; poorly absorbed and irritating)

Zolazepam (IM and IV)

Midazolam (IM and IV)

what are commonly used Benzodiazepine drugs?

where are they administered?

CNS

Benzodiazepines depress the

40% propylene glycol; water soluble

Injectable diazepam (benzodiazepine) is mixed with ___% propylene glycol and is not ______ ________.

Ketamine

Benzodiazepines should NOT be mixed with water soluble drugs except for

precipitate

Diazepam (Benzodiazepine) should not be mixed in a syringe with other drugs because a ____________ may form.

plastic

Diazepam (Benzodiazepine) can bind to ________; so should not sit in a syringe for long periods of time.

• should not be used as CRI as it will be absorbed by IV bags and IV tubing

water soluble

Midazolam and zolazepam (Benzodiazepines) are _______- _________ and can be used in combination with other water-soluble drugs.

15 min onset

1-4 hrs duration

Most Benzodiazepines have a rapid onset of action after IM injection with a ____ min onset and __-__ hours duration.

provides anti-anxiety and calming effects

• anticonvulsant activity (can be used with other agents that have the potential to cause seizures to outride them)

• reliable in geriatric patients

• does not cause significant sedation in young, healthy animals

• Diazepam enhances the sedation and analgesia of other agents

Benzodiazepines effects on the CNS:

few

at therapeutic doses, benzodiazepines have ____ effects on the cardiovascular and respiratory systems.

Benzodiazepines

__________________ have a high margin of safety even at an overdose, it typically wont affect anything.

• HR, BP, and cardiac output are minimally affected.

• good for anesthesia with high-risk and geriatric patients

skeletal

benzodiazepines provide ________ muscle relaxation.

200-400mL

tidal volume: 10-15ml/kg

what is the tidal volume range for a 20 kg beagle mix?

stage III, plane 2

what is the desired anesthetic plane for surgical procedures?

invasive blood pressure measurements

which of the following blood measure measuring techniques is considered “gold standard” in terms of accurate measurements?

they ensure that gases flow toward the patient in one breathing tube and away from the patient in the other breathing tube.

why are unidirectional valves an important part of an anesthesia machine?

direct

which of the following methods is the most accurate way to assess blood pressure in pediatric patients?

poor tissue perfusion

capillary refill time that is over 3 seconds is indicative of

an anesthetic waste gas scavenging system

all inhalant anesthetic machines should have

hypoglycemia

young puppies and kittens have limited glucose reserves and are at a greater risk of what condition because of fasting before anesthesia?

increase in airway resistance

placing an endotracheal tube that is too small compared with the diameter of the trachea can cause

alpha 2 agonists

which of the following drug classes is not commonly used in pediatric patients because of its side effect of bradycardia?

cattle

in the united states, xylazine is not approved for use in

atropine

which of the following preanesthetic drugs will cross the blood-brain barrier and placental barrier in pregnant patients?

direct

which of the following methods is the most accurate way to assess blood pressure in pediatric patients?

6 hours

a patient needs to receive 1.2 of lactated ringer’s solution at the drip rate of 50 drops/min using a 15 drops/mL administration set. How long will it take for the fluids to be administered?

headache

which of the following is experienced by veterinary personnel who are exposed to waste anesthetic agents on a short term basis?

morphine

which of the following preanesthetic drugs should be avoided in GDV patients?

lidocaine

which drug can prevent laryngospasm?

2 mg

0.1mg/kg x 60 kg = 6mg

6mg/4mg = 1.5 = 2

the dosage of acepromazine is 0.1 mg/kg and the maximum dose is 4 mg. how many milligrams would you administer to a 60 kg dog?

ventricular premature complexes

you are monitoring a 12 year old dog for a humeral fracture repair. you notice that the complexes on the ECG are intermittently wide and bizarre; otherwisem the rhythm is normal. which arrhythmia is most probably occurring?

spraying the endotracheal tube with lidocaine

all of the following techniques can be used to prevent laryngospasm in cats except:

retrobulbar block

what nerve block is commonly used to desensitize nerves and add additional analgesia to an ocular procedure?

pectoral muscles

intramuscular injections are most commonly administered into which of the following muscles in avian patients?

protein

which substance in blood can alter the rate and amount of absorption of barbiturates?

SC

which route of preanesthetic administration tends to produce longer lasting effects?

liver

which organ plays a crucial role in the metabolism and clearance of most anesthetic drugs?

capnometry

which of the following offers a continuous, noninvasive way to estimate the partial pressure of carbon dioxide in arterial blood?

swallowing reflex returns

in nonbrachycephalic breeds of dogs recovering from anesthesia, the endotracheal tube should be removed when

to deliver a burst of pure oxygen into the breathing system

what is the function of a flush valve within the anesthetic circuit?

to deliver safe and effective levels of anesthetic gas

what is the function of a vaporizer?

articular artery

all of the following sites are acceptable for palpating peripheral pulses in patients under anesthesia except

increasing ETCO2

all of the following are signs of hypotension except

reflexes

when monitoring vital signs of an anesthetized patient, you must observe and record all of the following except?

seizure

which of the following is a potential complication for a patient anesthetized for a myelogram?

atropine

which preanesthetic agent blocks acetylcholine at the muscarinic receptors?

surgery patients with blood loss may require colloids instead of crystalloids

all of the following statements regarding fluid infusion rates are false except

1100 psi

what will the tank pressure gauge read when the oxygen tank is half full?

0.26 to 0.52mg/0.52 to 1.04mL

13×0.02 = 0.26 mg

13×0.04 = 0.52 mg

13 kg x0.02/0.5=0.52mL

13kg x 0.04/0.5 = 1.04 mL

what is the dose range in mg and mL for a 13kg for atropine sulfate (0.5mg/mL) at dosage of 0.02 to 0.04 mg/kg?

two atria and one ventricle

reptiles have a 3 chambered heart consisting of the following:

increasing ETCO2

which of the following are signs of hypotension except:

surgical anesthesia

specific stage in general anesthesia where there is a sufficient degree of analgesia and muscle relaxation to allow surgery to be performed without patient pain or movement?

plasma-lyte 148

which of the following fluids is an example of a crystalloid?

26 ×15kg = 390 / 10 = 39kg

an animal is given 26 mg of a drug. the dosage is 1mL/15kg. the concentration of the drug is 10mg/mL. how much does this animal weigh?

ventricular premature complexes

you are monitoring a 12 year old dog for a humeral fracture repair. you notice that the complexes on the ECG are intermittently wide and bizarre; otherwise, the rhythm is normal. which arrhythmia is most probably occuring?

heart murmur and moderate dehydration

which patient situation is considered a category III risk for anesthesia complications, according to the ASA scale?

fasting is not recommended in young patients

you have been asked to induce and monitor anesthesia in an unwanted kitten presenting for wound care after being stepped on by a child. how long should you fast this patient before anesthetic induction?

atropine

which of the following drugs is not generally suggested for use in sheep?

the rostral maxilla

an infraorbital dental nerve block is used to block the sensation of pain to which of the following areas?

dexmedetomidine

which of the following drugs drastically reduces cardiac output?

prolong the recovery time

depressant preanesthetic medication may have what effect on the anesthesia procedure?

when the pressure manometer indicates 0-2 cm H20 while the patient is spontaneously breathing

how can you tell whether the endotracheal tube has been placed in the esophagus?

sex

which does NOT influence MAC?

• sex

• age

• temp

• stress

epiglotoscope

all of the following items make it easier to intubate swine except

yohimbine

flumazenil reverses benzos

what drug is used to reverse effects of xylazine

ketamine

which drug be avoided in patients requiring ocular surgery bc it causes an increase in intraocular pressure?

vapor pressure

which is a measure of the volatility of an anesthetic liquid?

alpha 2s= dexmedetomidine

which of the following drugs drastically reduces cardiac output?

17mL

how much sterile water is needed to make a 6% solution using 1 g of drug?

?

if a bucket holds 5 gallons, how much iodine must be added to make a concentration of 2ppm?

1 gallon = 3785 mL

atelectasis

diminished volume or a lack of air in part or all of a lung lobe

22.5g

how much NaCL should be measured out to produce 500 mL of a 4.5% w/v solution?

pressure measured when the left ventricle contracts

which of the following the best represents systolic blood pressure?

90mL

what volume of LRS fluids did a patient receive if the drip rate was approximately 30 drops/min using a 20 drop/mL administration set and the dr requested that the patient receive this volume of LRS over the next hour?

capnograph

when a capnometer is combined with a continuous graphical display, the monitoring device is referred to as a

swine and exotics

in which patient groups are butyrophenones most commonly used for preanesthesia?