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45 Cards in this Set
- Front
- Back
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What should you do to treat hypertension?
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Treat the cause
-**Pain: opioids CRI or bolus -Pheochromocytoma: use esmolol a short acting beta-blocker |
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Why don't we use propanolol to treat hypertension as often as we use esmolol?
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Esmolol is short acting and propanolol isn't so its easier to adjust esmolol up and down
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What should you do for tachycardia?
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Treat the cause- fentanyl (most profound bradycardic effects), esmolol is an option
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What are 5 causes of tachycardia?
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1) Pain
2) Hypoxia 3) Hypercarbia 4) Hypotension (reflex response) 5) Pheochromocytoma |
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Premature ventricular contractions need to be differentiated from ________.
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Ventricular escape beats
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When is it necessary to treat ventricular arrhythmias?
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-> 15-20 PVCs/ min or runs of 5 or more
-Multifocal PVCs (means more than one area of ventricle not functioning properly) -identify by seeing different configurations |
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What is a premature ventricular contraction? Escape beats?
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PVCs: ventricle is firing early and contracting early
Escape beats: when atria fires off but nothing happens so ventricle fires on its own |
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What is the drug of choice to treat ventricular arrhythmia under anesthesia?
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Lidocaine
-bolus -CRI - caution in cats!!! |
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What are 2 uses for lidocaine other than treating cardiac arrhythmia?
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Pain management
Improve GI motility -use in colic cases alot |
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What is albuterol?
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Beta2 agonist==> bronchodilator
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What are the uses of albuterol during anesthesia?
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Asthmatic events
-cats Unexplained hypoxia |
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What type of a drug is doxapram?
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Neuroleptic drug
-a respiratory stimulant -originally marketed to suport ventilation following barbiturate administration |
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What are the 2 current uses of Doxapram?
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1) Stimulate ventilation in neonates
2) Stimulate ventilation as part of laryngeal function evaluation |
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What are the 4 components to a patient's signalment?
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Species, breed, age, gender
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What breed of horses is prone to hyperkalemic periodic paralysis?
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Quarter horses
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What is the only true genetic anesthetic problem documented to date in dogs?
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Sighthounds- have difficulty with barbiturate metabolism, wake up a little slower when use propofol
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What are 2 anesthetic considerations specific to dobermans?
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1) Von Willibrands
2) Cardiomyopathy |
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What are 2 anesthetic considerations specific to boxers?
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1) sensitive to ace??
2) Cardiomyopathy** |
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How does gender affect preanesthesic considerations?
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-Largely unknown effect
-need to recognize effect on temperament, behavior |
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What are 2 things to consider regarding anesthesia in obese patients?
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commonly overdosed because don't base dosage off lean body mass
Dont breathe as well because of the mass occupying effect of fat- often put on ventilator |
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What are some special considerations for anesthesia in cachexic patients?
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RED FLAG= HIGH risk
Limited reserve capacity, highly stressed, need lots of support |
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Do you tend to use the high end of drug dosages in large or small animals?
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Small, the big guys need less on a per kilo basis
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Are acute or chronic complaints more of a concern for anesthesiologists?
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Acute, bc with chronic patient has had time to adapt
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What should you make sure to pay attention to when performing a physical exam on an animal prior to anesthesia?
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-General demeanor, attitude, mentation
-Hydration status -thoracic auscultation: cardiopulmonary*****, pulse deficits? |
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Why is it so important to evaluate an animals temperament prior to anesthesia?
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Gauge response to restrain, handling
Important for preanesthetic drug protocol |
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What are the 4 components of the minimal data base that needs to be collected for preanesthic evaluation?
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1) PCV
2) Total plasma protein 3) Glucose 4) BUN -perform CBC, chemistry profile if indicated |
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When should you perform an ECG prior to anesthetizing a patient?
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Preexisting arrhythmia present
Significant cardiac disease apparent |
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What are 2 situations where we like to take thoracic radiographs prior to anesthesia?
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1) Trauma
2) Significant pulmonary disease |
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What does a I mean according to the ASA physical status?
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I: normal, healthy patient
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What does a II mean according to the ASA physical status?
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Patient w/ mild systemic disease
-compensated, no functional limitations |
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What does a III mean according to the ASA physical status?
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Patient with severe systemic disease
-decompensated, functional limitations |
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What does a IV mean according to the ASA physical status?
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Patient w/ severe systemic disease that is a constant threat to lfie
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What does a V mean according to the ASA physical status?
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Patient unlikely to survive 24 hours w/ or w/o intervention
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What does a VI mean according to the ASA physical status?
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Brain- dead patient
-harvest organs for transplantation |
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What does a E mean according to the ASA physical status?
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Added to above categories indicating procedure is performed on emergent basis (increases risk)
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What is the ASA physical status of a dog that was previously diagnosed w/ pulmonic stenosis and was having significant problems?
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At least ASA III
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Compare the anesthetic risk of humans, horses, dogs and cats.
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Humans- 1: 10,000
Dogs, cats- 1:1,000 Equine- 1:100 |
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What are 5 factors that affect anesthetic risk?
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1) Specie
2) Patient factors -ASA classification 3) Type/ duration of diagnostic/ surgical procedure 4) Expertise of surgeon 5) Expertise of anesthesia personnel |
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How long do we withhold food & water from monogastrics?
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Food: 8-12 hours
Water: 2 hours |
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Why is regurgitation a greater concern in monogastrics?
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Regurgitate is acidic so aspiration is much more serious
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How long do we withhold food and water from ruminants?
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Food: 24-48 hours
Water: 12-24 hours |
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What are 5 abnormalities that should always be corrected before anesthesia?
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1) Fluid balance
2) Electrolyte abnormalities 3) Acid- base disturbances 4) Anemia 5) Cardiac rate/ rhythm |
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What are 5 complications that should be anticipated before performing anesthesia?
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1) Pain & discomfort
2) Blood & fluid losses 3) Patient positioning 4) Complications associated w/ specific diseases e.g. GDV, hepatic disease 5) Complications associated w/ specific procedures -e.g. laproscopy, airway surgery, bronchoscopy, myelograms |
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What are 3 considerations of delaying anesthesia in a patient?
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1) Is the procedure necessary
2) Will a delay improve or impede outcome? 3) Can existing abnormalities be managed during anesthesia? |
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You have a dog with a fractured pelvis with traumatic myocardial contusions. What should be your first step?
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Stabilize the heart problem before anesthetizing to fix bones
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