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Anaesthetic drugs
Anaesthesia and Surgery
| Question | Answer |
|---|---|
| What makes up the triad of anaesthesia? | 1) Hypnosis 2) Analgesia 3) Muscle relaxation |
| What are the aims of pre-medication? | 1) Calms patient 2) Reduce total dose of anaesthetic drugs needed 3) Relieve pain- provide analgesia 4) Allow smooth recovery 5) Reduce autonomic side effects |
| What is the necessary information needed when inducing anaesthesia? | 1) What effects/side effects you should expect from the agents used for induction + maintenance 2) How to use agents safely 3) The difference between routes used to induce and maintain anaesthesia |
| What are the properties of an ideal induction agent? | 1) Get to stage 3 plane of anaesthetic 2) Short-acting but allows enough time for inhalation agent to build up 3) Minimal effects on cardiovascular + respiratory systems |
| What are the stages of anaesthesia used to describe? | 1) Anaesthetic depth |
| Explain what occurs in the animal during Stage 1 | 1) Voluntary excitement, lasts until unconsciousness is present 2) Patient may show fear the disorientation |
| Explain what occurs in the animal during Stage 2 | 1) Involuntary excitement 2) Unconsciousness until rhythmic breathing present 3) Cranial nerve reflexes present 4) Struggling movements |
| Explain what occurs in the animal during Stage 3, Plane 1 | 1) Reflexes less prominent 2) Regular deep respiratory movements 3) Eye central but beginning to rotate ventrally, muscle tone still present |
| Explain what occurs in the animal during Stage 3, Plane 2 | 1) Palpebral reflexes absent 2) Slight reduced respiratory movements 3) Heart rate slightly reduced 4) Muscles relaxed |
| Explain what occurs in the animal during Stage 3, Plane 3 | 1) All reflexes absent but corneal 2) Shallow respiration and rate decreased, reduced HR and Bp 3) No muscle tone |
| Explain what occurs in the animal during Stage 4 | 1) Reduced resp rate 2) Irregular/jerky progressing to agonal 3) Heart rate low, pulses weak and slow 4) Reflexes absent 5) Eye central, fixed dilated 6) Muscle tone flaccid 7) Cardiac arrest imminent |
| What is the fucntion of Phenothiazines? | Tranquilliser at low doses/sedative at higher doses |
| What are the effects of Phenothiazines? | 1) Anti-emetic 2) Decreases seizure threshold 3) Peripheral vasodilation 4) Prevents sympathetic induced arrhythmias |
| What are Phenothiazines used in combination with? How does that benefit the patient? | 1) Opioids 2) Reduces total anaesthetic dose by 1/3rd |
| What is an example of a Phenothiazine? | 1) Acepromazine – ACP, Calmivet (brands) |
| What are the reported problems of Phenothiazines? | 1) Can promote aggression in nervous aggressive patients 2) Some lines of boxers and brachy dogs affected |
| What are the function of Opioids? | 1) Analgesic 2) Sedation if used in combination w/ tranquiliser (e.g Phenothiazine) |
| How do Opioids work? | 1) Bind to specific receptors in CNS, block pain signals |
| What is a pure agonist and how do they work? | 1) Positive effect on receptor, full response as fully bind to receptor. |
| What is a partial agonist and how do they work? | 1) Partial response, partial bind with receptor so don’t get the full response |
| What is an example of an Opioid? | 1) Buprenorphine- Buprenodale, vetergesic (brands) |
| What are the effects of Opioids? | 1) Possible respiratory depression 2) Morphine may cause vomiting 3) Anti-tussive 4) Many are controlled drugs, less accessible |
| What are the functions of Alpha-2 Agnostics? | 1) Effective sedative and hypnosis 2) Analgesia |
| What are the effects of Alpha-2 Agnostics? | 1) Sedation unreliable if given on own 2) Reduces total anaesthetic dose 3) Muscle relaxation 4) Marked peripheral vasoconstriction 5) Bradycardia 6) Depressed resp rate 7) Can cause abortion 8) Diuretic effect 9) Emetic 10) Visceral analgesia |
| What is an example of an Alpha-2 Agnostic? | 1) Medetomidine 2) Dexmedetomidine 3) Xylazine |
| What are some seen problems with Alpha-2 Agnostics? | 1) Hyperglycaemia 2) Abortion 3) Vomiting 4) Binds w/ blood vessels, causes vasoconstriction- raises blood pressure, heart rate slows to compensate 5) Significant impact on the cardiovascular system |
| What is the action of Antimuscarinics? | 1) Blocks the parasympathetic system reducing secretions and preventing bradycardia |
| What are the effects of an Antimuscarinic? | 1) Reduces salivation 2) Reduce respiratory secretions 3) Blocks parasympathetic system; prevents bradycardia |
| What are the problems associated with an Antimuscarinic? | 1) May cause tachycardia 2) Pupil dilation 3) Dry mouth |
| When is are Antimuscarinic mainly used? | 1) Brachycephalic breeds prone to bradycardia 2) Enucleation (surgical removal of the eyeball) where vagus nerve is stimulated |
| What are some examples of an Antimuscarinic? | 1) Atropine 2) Glycopyrollate |
| What is the function of NSAIDS? | 1) Analgesia 2) Anti-inflammatory action |
| What are the effects of NSAIDS? | 1) Analgesic 2) Reduces renal blood flow- risks of seeing problems with kidneys if patient is hypotensive |
| What are some examples of NSAIDS? | 1) Carprofen 2) Ketoprofen 3) Meloxicam |
| What are the functions of Dissociative Anaesthetics? | 1) Analgesia |
| What is an example of a Dissociative Anaesthetic? | 1) Ketamine |
| What are the effects of Dissociative Anaesthetics? | 1) Very superficial on own, eyes remain open and rotated centrally so ocular lubricants must be used 2) Apneustic breathing- slow inspiration, pause, then rapid expiration |
| Why must Ketamine be administered in combination with other drugs? | 1) No muscular relaxation |
| What are the advantages of Ketamine? | 1) Good analgesia 2) Given IM or IV 3) Combination w/ benzodiazepine very safe in sick animals, dogs can be sensitive to effects 3) Cardiovascular system stimulated 4) Respiratory function not compromised 5) Rapid onset 6) Absorbed over MM |
| What are the disadvantages of Ketamine? | 1) Pain on IM 2) Reclassified as Schedule 2 3) No muscle relaxation 4) Eyes remain open: must eye lube 5) Cannot be used on own, risk of extreme excitement or seizures |
| What is the function of Steroids? | 1) Maintenance of general anaesthesia |
| What are the effects of Steroids? | 1) Considered very safe 2) Previously associated with oedema of paws and face when used as “saffan” |
| What is an example of a Steroid? | 1) Aflaxalone |
| What are the advantages of Alfaxalone? | 1)Less cardiopulmonary suppression than propofol 2) Very rapidly metabolised in liver 3) High safety margin 4) No pain on injection 5) Can be used for caesarean |
| What are the disadvantages of Alfaxalone? | 1) Non-preservative 2) Limited analgesia 3) Can get twitchy on recovery when moved 4) Top up= prolonged recovery |
Created by:
robynfutter69
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