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31 Cards in this Set
- Front
- Back
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What are the Slow Acting Injectable Anesthetics?
(CN-PoUCh) |
Chloralose
Neuroleptanalgesics Potent Opiods Urethan Chloral Hydrate |
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What is the oldest injectable hypnotic in veterinary medicine?
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Chloral Hydrate
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What is Chloral Hydrate generally used for?
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IV anesthesia for Horses
(perivenous causes sloughing) -though it is not very common anymore as there are more rapid/short acting drugs |
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What is the molecular mechanism of Chloral Hydrate?
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Unknown.
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What are the effects of Chloral Hydrate?
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Sedative-Hypnotic
POOR Analgesic Slow onset - Long recovery Does NOT produce Recumbency Minimal Resp/Cardio interxn *High Doses - Resp/Cardio Depression |
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ADVERSE EFFECTS:
Chloral Hydrate |
Relatively Safe at sedative/hypnotic doses
At anesthetic doses - depresses respiratory and cardiovascular systems - also arrhythmogenic |
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Can you give Chloral Hydrate during a C-section?
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NO - rapidly crosses placenta and depresses fetus.
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Chloral Hydrate is metabolized to _______ and _______
Which one carries hypnotic activity? |
Trichlorethanol and Trichloracetic Acid
Trichlorethanol is hypnotic |
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How long does Chloral Hydrate take to knock you out?
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5-10 mins (slow passage across BBB)
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What's up with Chloralose?
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Trichloracetaldehyde + Glucose
Alpha and Beta forms (Alpha is Active) Stable, long-lasting (8-12hrs) LIGHT anesthesia. Minimal resp/cv depression. MAINTAINS CV REFLEXES making it great for studies *really only used in Lab Animal Medicine. |
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What's up with Urethan?
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Urea (nitrate) + -OH + NaNitrite
JUST LIKE CHLORALOSE - EXCEPT: has ANALGESIC fx (chloralose does NOT) is Mutagenic/Carcinogenic -- **do NOT allow lab animals to recover from Urethan anesthesia** |
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Are opioids anesthetics?
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Not pharmacologically...
they are Analgesics, but high dose IV has anesthetic fx |
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What are the effects of anesthetic doses of opioids?
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severe respiratory depression
(must mechanically ventilate) CV is spared, but possible vagal reflex bradycardia (prevented by anticholinergic - atropine/glycopyrrolate) |
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Numerous reports in human anesthesia of _________ during high-dose fentanyl anesthesia soon highlighted the fact that ___________
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patient awareness
opioids are NOT anesthetics |
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What are potent injectable opioids commonly used for today?
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Used with a Benzodiazepine or inhalant - giving great anaglesic (opioid) and anesthetic (benzo-d or inhalant)
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How do PD of potent opioids differ bw:
Older Small Animals Younger Small Animals Large Animals |
Old - induction w/o complications, though it is relatively slow
Young - unpredictable - may have CNS excitement Large Animals- Excitatory Fx |
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Fentanyl --- Go!
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'Sublimaze' - potent opioid
Great analgesia (75-125x morphine) Good for cont. infusion (discontinue ~30mins before end of surgery) with Diazepam or Midazolam = HEMODYNAMICALLY STABLE - so great for patients where that is of concern |
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Sufentanil --- Go!
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'Sufenta' - analog of fentanyl
5-10x potency of Fentanyl Unpredictable when used alone Combine with Midazolam |
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Alfentanil --- Go!
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'Alfenta' 1/5 to 1/10 the analgesia of fentanil
Onset is more rapid Duration about 1/3 -not widely used- |
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Remifentanil --- Go!
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'Ultiva'
metabolized by Plasma Esterases thus really short t-1/2 (6 mins in Dog; 15 mins in Cat) Little resp effect - Very Safe -Commonly Used- |
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What are the Neuroleptic compounds?
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Phenothiazine and Butyrophenone
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What is Neurolept Analgesia?
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Neurolept + Opioid =
Neuroleptic - sedation with decreased motor activity, low anxiety, and indifference to environment Opioid - intense analgesia **allows for performance of painful diagnostics or minor surgical procedures without causing unconsciousness |
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What is Neurolept Anesthesia?
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Neurolept + Opioid + Anesthetic (benzo-d, or injectable/inhalant)
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What are some Opioid Antagonists?
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Naloxone and Nabuphine
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What are the fx of Neurolept Analgesia?
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CV okay, maybe opioid induced bradycardia
Respiration moderate-severe depression Muscle relaxation Inadequate for Major Sx |
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What are some other Neuroleptic derivative compounds?
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Acepromazine, Chlorpromazine, Azaperone, Fluanisone, Droperidol
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B_L_N_E_ A_E_T_E_I_
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BALANCED ANESTHESIA
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What is Balanced Anesthesia?
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Mixing stuff up to try to take advantage of agonist/antagonist/synergistic effects to have the lowest adverse effects and lowest doses plausible.
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What is the worry with inhalants?
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Low Doses are Great for Maintenance
higher doses really depress CV and Resp |
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What are the components of general anesthesia you are accounting for in your balanced regimen?
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Hypnosis/Amnesia
Muscle Relaxation Absence of Somatic/ANS responses Regional Anesthesia |
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What is awesome and not awesome with the potent opioids?
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Awesome - minimal CV fx and good PK
Not Awesome - Severe Resp Depression |
