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Anesthesia Test 1
| Question | Answer |
|---|---|
| What is the sequence of events that occur under anesthesia | amnesia, loss of coordination, loss of consciousness, reduction in reflexes, relaxation of skeletal muscles, analgesia, mild cardio and resp depression, severe cardio and resp depression, resp arrest, cardiac arrest, death |
| What history do we need from the patient before any meds or procedures | concurrent illness, previous history of anesthesia, concurrent medication, when the animal ate last |
| how long should an animal be fasted before surgery? | 6-8 before surgery, up to12 hours |
| what could happen if the patient vomits under general anesthesia and it is inhaled? | aspiration pneumonia |
| What to look for on the Pre OP PE | TPR, Auscultation, MM, CRT, oral cavity, breed, temperament, BCS, gender, hydration status |
| what should the ideal MM look like | pink and moist |
| what is the ideal CRT | <2 seconds |
| __________ frequently have respiratory complications under anesthesia | brachiocephalic |
| Which breeds exhibit prolonged effects from barbiturates | sight hounds |
| Why should Obese animals be dosed on their lean weight? | because fat exhibits very little metabolism |
| common tests ordered prior to anesthesia | PCV/TP CBC Blood Chemistries Urinalysis Radiographs ECG |
| Release forms is important for the animals admission when going under anesthesia, this form should include.... | informed consent, emergency contact, written estimate, resuscitation status |
| what animals can fall under the healthy but high risk category | brachiocephalic sighthounds/thin animals obese animals neonates geriatrics animals in advanced pregnancy |
| what animals fall under the sick and at risk category | cardiac disease resp disease live disease renal disease shock anemia dehydration |
| What does ASA stand for | American Society of Anesthesiology |
| Class 1 Minimum risk | normal healthy animal, no underlying diseases |
| Class 2 slight risk | animals with slight to mild systemic disturbances, animal able to compensate |
| Class 3 moderate risk | mild clinical signs, animals with moderate systemic disease |
| Class 4 high risk | animals with pre-existing systemic diseases |
| Class 5 Grave risk | surgery performed in desperation on animals with threatening systemic disease |
| When is water taken away from the animal before surgery | morning of anesthesia |
| these 3 types of animals are not normally fasted because of their rapid metabolism and likely hood of developing hypoglycemia | neonates, birds, lab animals |
| when are preanesthetic meds given? | within 1 hour of anesthesia |
| 3 classes of anesthetic agents | anticholinergics, sedatives, opioids |
| What do Anticholinergics do? | block activity of parasympathetic system which is responsible for relaxation and digestion. also block excess salivation and bradycardia |
| Name 2 anticholinergics | atropine, glycopyrrolate |
| name two contradictions for anticholinergics | cause tachycardia and constipation |
| When are anticholinergics used other than pre medications | -ophthalmic ointment -antispasmodic -poison antidote |
| Atropine causes ______ ______ to help reduce ________ spasm. | pupil dilation, ciliary |
| what are some commonly given drugs with atropine | xylazine, opiods, ketamine |
| true or false: ketamine given without atropine can cause excessive salivation | true |
| What drugs are in the sedatives group | acepromazine, dexmedetomidine, diazepam, xylazine |
| sedatives ________ the amount of _________ required | reduce, anesthetic |
| what does Acepromazine prevent that is common in anesthesia | vomiting and arrhythmias |
| why is acepromazine commonly used in young animals? | causes vasodilation leading to decreased BP or hypothermia |
| Negative side effects of acepromazine | may cause increased aggression low seizure threshold prolapse of 3rd eyelid provides no analgesia |
| what is diazepam also known as? | valium |
| diazepam is more commonly used to _______ _______ than as a _________. | reduce anxiety, sedative |
| true or false: diazepam both treats and prevents seizures | TRUE |
| Why is diazepam and ketamine a good mix | diazepam helps counteract the rigidity of skeletal muscles produced by ketamine |
| Diazepam should be avoided in patients with hepatic disease because it is _________ by the __________ | metabolized, liver |
| diazepam is most effective when administered in which route? | IV |
| Diazepam is a __________ drug in Canada and requires the same record keeping as barbiturates or opioids. | controlled |
| Diazepam can only be mixed with what drug and how long can it be stored? | ketamine, 1 week |
| Why can Diazepam not be mixed with any other drug except for ketamine | other drug mixes will create precipitate |
| which drug is similar to diazepam but can be given IM and causes excitement in cats | Midazolam |
| What are two other common names of xylazine | Rompun, Anased |
| Not commonly used in Canada in ________ animals but commonly in _________ or _________. | domestic, wildlife, exotics |
| what does xylazine provide | potent sedation, muscle relaxation, some analgesia |
| what drug can reverse xylazine | yohimbine |
| when using xylazine as a pre-anesthetic reduce dosage of induction agent by _________. | 50-80% |
| xylazine causes emesis in _______ of dogs and ________ of cats. | 50%, 90% |
| Why should xylazine be avoided in deep chested dogs | causes bloat |
| xylazine may cause __________ in animals and humans | abortion |
| what 2 diseases must the patient be free of if they are to be given xylazine | hepatic, renal diseases |
| what is demedetomidine also known as | dexdomitor |
| dexdomitor can be used alone or more commonly with ________ and _____________ | opioids and tranquilizers |
| 2 benefits of dexdomitor | very good sedation and analgesia |
| negative side effects of dexdomitor | excessive sedation, bradycardia, pal gums and peripheral vasoconstriction |
| what drug can reverse dexdomitor | atipamazole (Antisedan) |
| dexdomitor used with butorphanol can be useful for.... (6 things) | -radiography, joint palpation, minor laceration repairs, skin/oral biopses, aggressive patient exam, sedation for euth |
| What is DKT | "Kitty magic" butorphanol, ketamine, and dexdomitor |
| what is kitty magic great for | catheter placement, elective surgeries, and intubation |
| what are the 5 most commonly used opioids in order from weakest to strongest analgesia | butorphanol morphine hydromorphone fentanyl bupenorphine |
| What drug can reverse opioids | Naloxone |
| controlled drug, potential for _________ abuse. | human |
| which opioid should you avoid in cats and why? | morphine, causes excitement |
| Butorphanol causes less ___________ and _________ depression. | cardiac and respiratory |
| which species can butorphanol be used on? | cats and dogs |
| True or False: Atropine is not necessary to use with butorphanol? | true |
| what can butorphanol partially reverse? | mu opioids |
| oxymorphone provides excellent ____________. | analgesia |
| what happens is oxymorphone is not used with atropine | more respiratory depression and bradycardia |
| True or false: Oxymorphone is inexpensive? | False |
| Meperidine has decreased in use but what preanesthetic "cocktail" was it in? | OVC Premix |
| What was included in the OVC premix? | atropine, meperidine, acepromazine |
| what are the downsides to meperedine | analgesia is short and a weak potency |
| what combination did fentanyl used to be in? | innovar vet |
| What is one benefit of fentanyl | very effective analgesia. |
| Fentanyl has a very ________ __________ of safety | narrow margin |
| Fentanyl was associated with _________ changes in some dogs and often became _________ and sometimes panted _____________. | behavioural, hypotensive, excessively |
| The injectable agent of fentanyl has a rapid onset of _____ minutes. but only lasts about _______. | 2, 1/2 hour |
| What method is most common for fentanyl to be administered | transdermal patch |
| When fentanyl is given in a transdermal patch it provides analgesia for a long period of time but has no _________ effect | sedation |
| how early does the transdermal patch need to be placed before surgery in order to have sufficient blood levels | 12 hours |
| how long does the transdermal patch take to kick in for horses, cats and dogs | dogs: 12-24 hours cats: 6-24 hours horses: 6+ hours |
| morphine is the _________ opioid | oldest |
| if you give a feline a canine dosage of morphine you can cause __________ in the cat | mania |
| which route should morphine not be given | IV |
| negative side effects or morphine (3 things) | -severe resp depression -vomiting (GI stimulation) -hypotension |
| Morphine is also associated with physical dependency in _________. | humans |
| hydromorphone is similar to what opioid when it comes to its analgesic effect | oxymorphone |
| hydromorphone is less likely to cause _________ in cats than morphine. | excitement |
| what is a potential side effect of hydromorphone in cats | transient hyperthermia |
| what does neuroleptanalgestia mean? | "almost anesthesia" -good degree of sedation -used for short procedures such as quill removals |
| what two categories of drugs can give you neuroleptanalgesia? | opioids and tranquilizers |
| which type of dogs can be contradicted when given acetylpromazine? | British Lineage gene of boxer breeds |
| trade name of meperidine | demerol, pethidine |
| what is the trade name of dexmedetomidine | dexdomitor |
| what is the trade name of atipamazole | antisedan |
| trade name of xylazine | rompun, anased |
| trade name of glycopyrrolate | robinul |
| trade name of butorphanol | torbugesic |
| trade name of yohimbine | yobine |
| trade name of acetylpromazine | atravet |
| trade name of diazepam | valium |
| trade name of naloxone | narcan |
| trade name of oxymorphone | numorphan |
| what are inducing agents used for? | given to an animal to anesthetize them sufficiently to allow for intubation |
| induction agents via ____________ and more dangerous than ____________. | injectables, inhalation |
| what are the 6 basic classes of commonly used inducing agents | -barbiturates -opioids -dissociative agents -phenol group -neurosteroids -inhalation agents |
| we administer to __________ until we reach the _________ of our goal | effect, point |
| barbiturates are ___________ drugs | controlled |
| 3 categories of barbiturates | 1. ultrashort (thiobarbiturates) 2. short acting 3. long acting |
| which is the only barbiturate category do we use? | ultrashort (thiobarbiturates) |
| what is the ultrashort used for, how long does it act for, and how is it given? | induction, 5-15 mins, IV |
| what is transient apnea? | expected respiratory depression from a drug |
| what is the short acting used for, how long does it act for, and how is it given? | general anesthesia/euth, 45mins-1.5 hours, IV/IM/IP |
| what is the long acting used for, how long does it act for, and how is it given? | anticonvulsant (stops seizures), lasts 8-12 hours, Orally |
| what is 3 drugs of ultra short barbiturates | thiopental, thiamylal, methohexital |
| what an example of a short acting and long acting barbiturates | pentobarbital sodium |
| thiobarbiturates very rapidly enter the _______ and exert their effects within _____ minute of administration | brain, 1 |
| in which breed should you avoid thiopental and why? | sighthounds, lack of body fat and may have impaired hepatic function as well |
| what 2 procedures are to be avoided when using thiopental | c-sections because there is 100% mortality of fetuses splenectomies because it may cause splenic engorgement |
| what do barbiturates suppress? | the central nervous system specifically the reticular activating system |
| barbiturates effect the ___________ cells | myocardial |
| barbiturates can cause, hypercarbia and respiratory acidosis. explain them. | hypercarbia is increased carbon dioxide in the blood resp acidosis is when carbon dioxide is not blown off |
| barbiturates should be used with caution in _________ and _________ animals | thin, obese |
| what is the preferred barbiturate drug for sight hounds if you need to use one | Methohexital |
| a normal dose of barbiturates might be toxic to an _________ animal | acidotic |
| barbiturates have a direct ____________ effect on the resp system | depressive |
| normaly ___________% of an injected dose of barbiturate becomes bound by _____________ | 65%, protein |
| what is Euthanyl | a concentrated form of pentobarbital |
| barbiturate injections have a pH of ________ to ________ and if accidentally goes ____________ it can cause sloughing | 9.5-10.5, perivascularly |
| what do you do if a barbiturate injection has gone perivascularly | inject a mixture of 3-5 ml saline and 1-2 mls of 2% lidocaine under the affected skin |
| what is the hangover effect? | the blood and brain level of barbiturate remain high and the animal remains asleep for longer than expected after repeated injections |
| opioids and tranquilizers are combined to give a __________________ effect | neuroleptanalgesia |
| opioids are often used in _______ and _______ patients but are often too weak for _______ _________ animals | sick, geriatric, young, healthy |
| opioids are reversible with.... | naloxone |
| BONUS= what is MDMA | Molly the drug |
| what do dissociative agents produce | central nervous systen stimulation |
| what is catalepsy | animal appears awake, but is unaware of its surroundings (eyes remain open and pupils remain centered) |
| what reflex often persists even at a surgical anesthetic level especially when using what drug | palpebral, ketamine |
| muscle tone can make positioning of an animal difficult that is why we use a _______ to alleviate it | tranquilizer (diazepam. ace, xylazine) |
| which actor died from euphoria and because of what drug | angus cloud, MDMA or Molly |
| what is PCP | angel dust |
| dissociative agents can be given in what routes | IM, IV |
| when giving a dissociative agent by the IM route the dosage must be _________. | doubled |
| in dogs how is ketamine metabolized | by the liver and excreted by the kidneys |
| in cats how is ketamine metabolized | by the kidney directly |
| ketamine should be used with caution in patients with _________ disease | cardiac |
| ketamine causes _______ respirations. and what does this term mean | "aspneustic" long/slow inhalation, pause, short abrupt expiration but patient remains well oxygenated |
| ketamine causes the pupils to remain central so therefore we cannot use ________ __________ to tell us the depth of anesthetic. | eye position |
| ketamine can cause profuse ______ so it is sometimes used with an anticholinergic | salivation |
| why should ketamine and atropine not be given to an animal that has a relatively fast heart rate | because they both increase heart rate which could cause pathological tachycardia |
| ketamine is ________ when given _____ | painful, IV |
| to help reduce the chance of a rough recovery after given ketamine the animal should be given a ___________ preoperatively and provided a ______ and _______ kennel postoperatively | tranquilizer, quiet, padded |
| ketamine induced seizures usually respond well to _____ ________ | IV diazepam |
| ketamine and ______ are a very common ________ agent | diazepam, induction |
| ketamine given IV has an onset reaction of.... | 30-90 seconds |
| ketamine has a short duration of effect which is.... | 3-10 minutes |
| SUMMARY: when using ketamine be cautious when giving it to patients with... | seizure history eye injury cat renal disease dog liver disease cardiac disease |
| in horses ________ is given first and then _______ is given after sedation is seen | xylazine, ketamine |
| Atropine is not used in horses because it can result in _______. | colic |
| what is the only member in the phenol group as of right now | propofol |
| what is the human name for propofol | diprivan |
| Propofol is unusual because it is one of the few drugs given ____ that appears ______ _________. | IV, milky white |
| propofol is safe in ________ | sight hounds |
| can give multiple injections of propofol without a __________ effect | hangover |
| _________ is usually given to reduce the dosage rate of propofol | premedication |
| giving propofol to effect seems to minimize effects of ______ or _______. | apnea or cyanosis |
| it is important not to _____ long before giving additional _______ of propofol | wait, aliqouts |
| propofol is great for what procedure | c-section |
| what can you develop after repeated use of propofol | heinz bodies |
| the ____ ________ propofol can act as a substrate for bacteria | oil suspension |
| careful attention to _____ when drawing up propofol | asepsis |
| what is bacteremia | bacteria in the blood |
| propofol should not be given to patients who are suspected to have __________ | bacteremia |
| you can use a neurosteroid without _________ | pre medication |
| __________ or _________is neurosteroid that just became available in canada | alfaxalone or alfaxon |
| alfaxalone can be used for both __________ and _______________ of ______________. | induction, maintenance of anesthesia |
| Alfaxalome does not cause tissue irritation when injected ____________ | perivascularlay |
| what are the most commonly used inhalant anesthetics | isofluorane and sevofluorane |
| inhalant anesthetics are less toxic to _______, __________, _________, and __________ systems | cardiac, resp, renal, hepatic |
| why is inhalant anesthetics less dangerous than injectables | anesthetist can quickly change the concentration if animal is experiencing difficulties |
| an anesthetic mask should fit _______ to minimize _______ of _________ vapour | tightly, leakage, anesthetic |
| what is the first thing given to the animal when doing inhalant anesthetics | 100% oxygen |
| what is the flow rate for oxygen for the inhalant method of induction | 2-4 L/min for 2-3 mins |
| what is the ISO and HALO % set at on the anesthetic vapourizer | 0.5% |
| Normally the concentration of the inhalant anesthetic is ________ by 1% every _____ __________. | increased, 15 seconds |
| what is the main disadvantage to both methods | risk of human exposure to waste anesthetic gas |
| what are the 3 pros of inhalation anesthetics | -alter depth quickly -less metabolism required -controlled oxygen via patent airway |
| what are 2 cons of inhalation anesthetics | -increased equipment and costs -waste gas environment pollution |
| what are inhalant agents | vapours or gases administered directly to the respiratory system |
| what 10 things would make an ideal gas anesthetic | -depth easy to control -minimal effects of body systems -minimal retention by body fat -minimal effects for techs and personnel -rapid induction and recovery -good muscle relaxation -good post op analgesia -nonflammable - minimal equip -inexpensive |
| anesthetic is usually supplied in a _______ form | liquid |
| the oxygen and anesthetic _____ cross the ______ and are dissolved in the ______ _______. | molecules, alveoli, blood stream |
| molecules on the side with the _______ concentration will diffuse to a _______ concentration | high, low |
| removal of the majority of the anesthetic is by _________. | expiration |
| some of the anesthetic remains in the ______ and other _____ waiting to be ___________ and _________. | fat, tissues, metabolized, excreted |
| anesthetics differ in both their __________ and _________ properties | physical and chemicals |
| what are the 3 most important characteristics used to compare the inhalation anesthetics | 1. vapour pressure 2. solubility coefficient 3. minimum alveolar concentration |
| what is the OG anesthetic | diethyl ether |
| what is the vapour pressure | the tendency of a liquid to evaporate at room temperature |
| an anesthetic that is quite stable at room temperature is described as ________ | less volatile |
| the vapour pressure is significant because it determines the type of ____________ that is required | vapourizer |
| what is the vapour pressure of iso | 32% |
| what is the vapour pressure of sevo | 22% |
| what is vapour pressure of halothane | 32% |
| iso needs a ___________ vapourizer | precision |
| normally an animal can be maintained at an anesthetic concentration of less than _________ | 5% |
| volatile anesthetics require __________vaporizers to ensure a very ________ concentration of _________ does not reach the animal | precision, high, anesthetic |
| a non precision vaporizer is essentially a...... | glass jar with a wick in it |
| anaesthetics should never be _______ in the vaporizers | mixed |
| what is the solubility coefficient | a measure of whether the anesthetic prefers to be in tissue or in a gas state |
| the solubility coefficient dictates the ________ in which it will be ___________. | speed, absorbed |
| solubility of sevo | 0.63 |
| solubility of iso | 1.4 |
| solubility of halo | 2.3 |
| what is the sponge effect | when the lung tissue acts as a sponge to soak up the anesthetic |
| when the anesthetic agent crosses the _______________ it will exert its effects on the _________ | alveoli/blood barrier, brain |
| what does MAC stand for | minimum alveolar concentration |
| what does the MAC do | another method of comparing inhalation anesthetic agents |
| what is the definition of MAC | the lowest concentration of anesthetic that produced no response in 50% of patients exposed to a painful stimulus |
| The _____ the MAC the more ________ the anesthetic is | lower, potent |
| surgical anesthetic usually occurs at ________ to _______ times the MAC | 1.5-2.0 |
| factors that affect the MAC | obesity, disease, pregnancy, temperature, species, age and other drugs |
| the potency of a drug could be increased or decreased depending on its __________ state. | metabolic |
| Nitrous Oxide has the highest MAC at.... | 188% |
| Iso is ______ to _______ times less expensive than sevo | 7-8 |
| when was diethyl ether first introduced | 1840 |
| before anesthetic agents surgery was performed under manual __________ and the best skill of the surgeon was _________. | restraint, speed |
| 4 disadvantages of diethyl ether | post op nausea, excessive salivation, long term liver disease, cancer |
| Methoxyfluorane is now being studied as a alternative to _______ and _________ analgesia | opioids, NSAID |
| Methoxy is the only inhalation anesthetic to provide _________ __________. | post op analgesia |
| Methoxy is the most _______ depressive of the inhalant anesthetics and you always had to ______ for them. | respiratory, breath |
| ______________ is the most expensive of the inhalant anesthetics | methoxy |
| 4 disadvantages of Halothane | -precision vaporizer is necessary -contains a preservative "Thymol" that impairs its performance -associated with effects on the heart -does not provide post op analgesia |
| how much of Halothane is removed by expiration | 80% |
| almost all of isoflurane is removed by __________ and ____% is removed with the bodies metabolism | expiration, 0.2% |
| which inhalant anesthetic is the safest for operating personnel? | ISO |
| 2 disadvantages to ISO | - no post op analgesia -excitement in recovery period |
| For Sevo patients must be kept at a higher concentrations to induce and maintain due to the __________ being _________ | MAC, higher |
| sevofluorane is primarily being used in _________ _________ and _____________ vet practices | research facilities, specialized |
| what is nitrous oxide also known as | laughing gas |
| why has nitrous oxide not been used very much in the vet field | lack of potency in domestic animals |
| nitrous oxide must be used in combination with another inhalant anesthetic to produce a _________ _________ of anesthesia | surgical plane |
| what is diffusion hypoxia? | prefers to stay as a gas rather than in the tissue, insufficient oxygen is provided and the animal will suffocate. |
| nitrous oxide will defuse into the __________ very quickly resulting in the ___________ of _____________. | alveoli, displacement of oxygen |
| how can diffusion hypoxia be avoided? | providing high flows of oxygen for 5-10 minutes after the nitrous oxide is shut off |
| nitrous oxide should be avoided in which 3 conditions? | -pneumothorax, diaphragmatic hernias and gastric dilations |
| recommended ratio of nitrous oxide and oxygen | 1:1 or 2:1 |
Created by:
jscott41
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