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45 Cards in this Set

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