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74 Cards in this Set

  • Front
  • Back
Systems affected by Anaesthesia
Cardiovascular
Respiratory
Hepatic
Renal
Definition of Hypoxia
SpO2 <60mmHg
Stages of Anaesthesia
1. Voluntary Excitement
2. Involuntary Excitement
3. Surgical Anaesthesia
4. Bulbar Paralysis
Planes of Stage 3 Anaesthesia AND which one do we use for most surgical procedures?
1. Light
2. Medium (most sx procedures)
3. Deep
4. Very deep
Eye positions during 4 planes of Sx anaesthesia
Light - central constricted
Medium - ventromedial
Deep - central constricted or dilated
Very deep - central dilated
Why do we fast patients before anaesthesia?
Decreased lower oesophageal sphincter tone and positioning of patient for sx may predisp to regurg. Oesophagitis, oesophageal stricture. Regurg may lead to aspiration due to impaired laryngeal function.
How long prior to anaesthesia for dogs and cats do we remove food and water?
Food 12 hours
Water - up until premed
Reasons for premedication
Calms patient, easier handling
Decrease stress, smoother induction
Better recovery
Some: decrease resp secretions, prevent bradycardia, relax muscles
Can decrease dose of more depressant agents
Pre-emptive analgesia
"Families" of Premed agents
Sedatives
Analgesics
Dissociatives
Anticholinergics
Antihistamines
3 types of sedatives for Premed
Phenothiazines
Benzodiazepines
Alpha-2 agonists
Two types of analgesics for premed
Opioids
NSAIDS
Drug name of phenothiazine for premed + 4 advantages of it
Acepromazine
Sedative (dose dependent)
Anti-emetic
Antihistamine
Anti-arrhythmic
Onset and duration of action of ACE
Both long (5min onset w IV tho)
CV effects of ACE
Depresses CV system - alpha-1 antagonist BUT good anti-arrhythmic.
Peripheral vasodilation - decreased TPR - causes reflex tachycardia to maintain MAP
Resp effects of ACE
Minor depression but also lower metabolic requirement
5 Disadv of ACE
Lowers seizure threshold
Slow metabolism
No reversal
No analgesia
Vasodilation - hypothermia
7 Contraindications for ACE
Young, Old, Sick (YOS)
Severe heart dz
Liver dz
Epilepsy
Myelography
3 types of Benzodiazepines
Diazepam
Midazolam
Zolazepam
Difference btn Diazepam and (Midazolam & Zolazepam) and implication of this
M and Z are both water soluble, so better absorption after IM or SQ administration
Sedative effects of BZs
Unpredictable in most spp.
What type of receptors do BZs act on?
GABA potentiators - anxiolytics
Why do we use BZs?
Anticonvulsants
Muscle relaxants
CV effects of BZs
Minimal
Resp effects of BZs
Minimal
BZ metabolism?
By liver! Avoid in liver dz, prolonged action.
Speed of IV administration of Diazepam?
SLOW
Is Diazepam reversible?
Yes - flumazenil
What do we use instead of ACE for young, old, CV disease, epilepsy or myelography?
Diazepam
Alpha-2 agonist most commonly used in smallies incl. trade name
Medetomidine - Domitor
Two main uses of Medetomidine
Sedation for minor procedures
Restraint of Aggressive animals
Is Medetomidin reversible?
Yes - Atimpamezole (Antisedan)
How does Medetomidine work i.e. what is its mechanism of action?
Stimulates presynapse so inhibits release of noradrenaline centrally
-sedation
-analgesia
-cardiopulmonary depression

Stimulates postsynapse peripherally
-peripheral vasoconstriction
Side effects of Domitor
Emesis (cats)
Marked CV depression
Arrhythmogenic
Biphasic BP change
Decreased resp rate and tidal volume
CV effects of Domitor
Profound depression.
Biphasic BP change.
Arrhythmogenic.
Decreased HR
Resp effects of Domitor
Decreased RR and TV
4 Advantages of Medetomidine
Profound sedation (dose dependent)
Excellent anticonvulsant
Good muscle relaxation
Good analgesia
Metabolism of Medetomidine
Liver. Or reverse w antisedan (atipamezole)
5 types of Opioids used for premeds
Morphine
Methadone
Meperidine
Buprenorphine
Butorphanol
3 classes of opioids (receptor-wise)
Pure opioid agonists
Partial opioid agonists
Opioid agonist-antagonists
Morphine contraindications
If vomiting is contraindicated
Morphine receptor function
Pure opioid agonist at mu and kappa
Onset and duration of morphine
Onset 10-30 min
Duration 4-6 hours
CV effects of morphine
Mild.
Vagal stimulation leads to bradycardia.
Resp effects of morphine
Depressive
What speed do we give morphine IV and why?
Slowly because otherwise it can cause histamine release
Is morphine reversible?
Yes
How does morphine wear off?
Glucuronidation - mostly liver metabolism
Side effects of morphine
Vomiting
CRTZ
Constipation
Bradycardia
Resp depression
Advantages of morphine
Dose-dependent analgesia
Dose-dependent sedation in dogs
Cheap!
Moderate duration of action
Methadone side effects
CRTZ
Constipation
Bradycardia
Resp depression
i.e. same as morphine but no vomiting
Compare Meperidine to Morphine
10% the potency of Morphine
No vomiting
Faster onset, shorter duration
No bradycardia
Don't give IV in dogs
Drug name of Temgesic
Buprenorphine
Trade name of Buprenorphine
Temgesic
Buprenorphine receptor activity
Partial Opioid Agonist
Compare buprenorphine to morphine
More potent than morphine
No vomiting
Slower onset
Shorter duration
Trade name of Butorphanol
Butorphic
Torbugesic
Drug name in Butorphic
Butorphanol
Drug name in Torbugesic
Butorphanol
Compare Butorphanol to morphine
-potency
-onset
-duration
More potent than morphine
Slower onset
Shorter duration
What do we always use Ketamine with?
A muscle relaxant (benzodiazepine or alpha-2 agonist
Ketamine CV effects
Stimulatory
Take care with pre-exisitn tachycardia or e.g. hyperthyroid cats
Ketamine resp effects
Minimal
How does Ketamine wear off?
Liver metabolism
There is no reversal
What does Ketamine premed do to dogs?
Causes excitement
What does Ketamine premed do to cats?
Dose-dependent sedation
Great for aggressive cats
What stage of anaesthesia is Ketamine most commonly used for?
Induction (with Diazepam)
Name two anticholinergics used in premeds?
Atropine, Glycopyrrolate
What class of drug is Atropine?
Anticholinergic
What class of drug is Glycopyrrolate?
Anticholinergic
What do we use Atropine for in premeds?
Offset potential bradycardia caused by other agents or procedures
Decrease salivary and bronchial secretions in cats
Decrease laryngospasm in cats
What are the actions of Atropine (and glycopyrrolate) on the nervous system?
Sympathomimetic, Parasympatholytic
Give 4 disadvantages of Atropine
No sedation
No analgesia
Arrhythmogenic
Decrease GIT motility
Effects of Atropine on CV system
Increases HR
Arrhythmogenic
Resp effects of Atropine
Bronchodilation