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86 Cards in this Set

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Anesthesia - injectables & inhalants
Anesthesia - injectables & inhalants
Name two Cyclohexamines and one combo of
Ketamine, Tiletamine, TKX (Telazol, Ketamine, Xylazine)
Cyclohexamines can induce ___ in dogs and horses so it is used w/ a tranquilizer
seizures
Ketamine, Tiletamine, and TKX are examples of what kind of injectable induction agent?
Cyclohexamines
How do Cyclohexamines affect reflexes? muscles?
reflexes are exaggerated, persistent laryngeal reflexes (cats), sensitive to light, touch, sound, increased muscle tone and rigidity
Define apneustic respiration - what drugs can cause?
breath holding after inspiration, quick expiratory stage
cyclohexamines can cause this
How do cyclohexamines affect the heart? blood pressure? salivation?
tachycardia, inc blood pressure and salivation
Will cyclohexamines cause skin necrosis if given IM?
No, it stings but will not cause necrosis
Define dissociative analgesia/catalepsy. What drugs cause this?
A distinctive type of trancelike anesthesia where the animal appears awake but immoble and unaware of its surroundings. Caused by cyclohexamines - Ketamine, Tiletamine
What are 5 contraindications for cyclohexamines?
dog/horses w/o tranq, seizure disorder or hx of, renal dz/blockage, hepatic dz in dogs, procedures involving CNS
What are some unique things about the recovery period when cyclohexamines are used (3)?
Avoid stimulation (dec light & sound, avoid touching), hallucinatory behavior possible (pawing face), monitor closely to prevent self-injury
Are cyclohexamines controlled?
Yes
Is Ketamine controlled?
Yes
Is tiletamine/Telazol controlled?
Yes
What is the most commonly used induction agent?
Ketamine
How is Ketamine administered to dogs? cats?
IV only in dogs, in cats IV or IM/orally in fractious animals
What could happen if a IM does if Ketamine was given IV?
serious overdose or death
What is the onset IV, IM, and orally for Ketamine?
90 sec IV, 2-4 min IM, 5-10 mins orally
How long is the recovery period w/ Ketamine?
2-6 hours depending on route and patient
What are three tranquilizers commonly used w/ ketamine?
Acepromazine, diazapam, xylazine
An overdose of a cyclohexamine will cause what?
seizures
Tiletamine is only sold w/ ___ as ___. What form does it come in?
w/ zolazepam as Telazol - comes in a powder and must be reconstituted
Telazol has a long or short shelf life? How long?
Short - 4 days at room temp, 14 days refrigerated
Telazol has onset and duration similar to ___
ketamine
How are cyclohexamines eliminated?
Ketamine - mostly renal in cats/hepatic in dogs
Telazol - hepatic metabolism and renal excretion
What is TKX?
Telazol/ketamine/xylazine
In what form is TKX purchased?
Ea drug separately - the "cocktail" is mixed in-house
What is the dose and route for TKX?
0.015ml/lb IM
What injectable induction drug is a substituted phenol?
Propofol
Propofol is what kind of drug?
substituted phenol - injectable induction agent
What route(s) can propofol go?
IV only
What form does propofol come in?
milky oil-in-water emulsion
Propofol has a very short shelf life once opened - how short and why?
6 hour shelf life once opened - product contains soybean oil, egg lecithin, and glycerol which support bacterial growth
How is the IV of propofol given?
SLOWLY to prevent apnea - give 1/3 to 1/2 initially and then smaller injections after that until desired plane of anesthesia is reached
What is the duration of propofol?
Short - 5-10 mins only
How is propofol maintained?
IV drip or injections every 3-5 minutes
What are 4 uses of barbiturates?
Induction, maintenance, anticonvulsant, euthanasia
Barbiturate solutions are sold as a ____ w/ ___ & ___
Kit with powdered drug and sterile water
Barbiturates need to be __ after reconstitution and should be discarded if ___ &/or occurs
need to be refirgerated after reconstition and should be discarded if cloudiness &/or crystallization occurs
Barbiturates produce dose dependent ___. In what stages does this progress?
CNS depression - sedation, anesthesia, depression, death
Do barbiturates provide good analgesia?
No
By what route are barbiturates given? How dosed?
IV only - titrate to effect - 1/2 dose, then 1/2 of remainder and so on
What meds cause tissue sloughing and necrosis when administered perivascularly?
Barbiturates - Thiopental and Pentobarbital
Name two barbiturates
Thiopental, Pentobarbital
Thiopental and Pentobarbital are what kind of drugs?
Barbiturates
What kind of meds commonly cause post-induction apnea and/or transient arrhythmias?
Barbiturates - Thiopental and Pentobarbital
Barbiturates may profoundly ___ respiration
depress
What cardio vascular effects do barbiturates have(2)?
dose dependent decrease in cardiac output and blood pressure, increases sensitivity to epinephrine, thus could cause arrhythmias
What are some contraindications for barbiturates?
cardiovasc or resp dz, acidosis, CNS depression, thin/poor nutrition, sighthounds, fearful/agitates animals, geriatrics, neonates, C-sections
Are barbiturates (Thiopental & Pentobarbital) controlled?
Yes
Thiopental has an onset of ___ thus is it considered ___-acting
30-60 seconds, ultrashort-acting
___ may be used as the sole anesthetic for very brief procedures. What is the duration of this drug?
Thiopental, 10-20 minutes
What drug is intermediate acting, has a narrow margin of safety, and is administered via continuous titration ofer 5-10 minutes?
Pentobarbital
What drug is an anticonvulsant that may be used if Diazepam is ineffective?
Pentobarbital
What drug in a concentrated form is used in some euthanasia solutions?
Pentobarbital
Ihalation anesthetics are mixed with ___ for administration
oxygen
Inhalation anesthestics are eliminated primarily via the respiratory system - explain the path
airway to lungs(alveoli) to blood to brain
The rapid uptake & elimination of inhalation drugs provides ___ depth control and ___ recovery
excellent depth control and rapid recovery
Inhalation drugs provide deeper anesthesia and better muscle relaxation w/ less ___ than injectables
less resp depression
Define vapor pressure
the tendency of a molecule to ecape the liquid state and become a vapor or gas
Agents w/ a high/low vapor pressure require a precision vaporizer
high
Define tidal volume
The amount of gas which moves into and out of the lungs w/ each breath
___ x ___ determines the amount of anesthetic agent delivered per minute
tidal vol x resp rate
The ___ soluble the gas in blood, the faster the agent leaves the blood to enter the brain or alveoli
less
What is second gas effect?
Adding a second gas takes up space in the alveoli, concentrating the primary agent and speeding up it's entry into the blood.
What are the two primary factors that affect an inhalation agent's elimination from the body?
tidal volume and resp rate
What is MAC?
Minimum alveolar concentration - the concentration of drug needed to anesthetize 50% of patients to a particular painful stimulus
___ x ___ determine maintenance levels of inhalation agents
1.5 to 2.0 x MAC
Name three inahalation agents
Halothane, Isoflurane, and Sevoflurane
What inhalation agent provides poor analgesia and sensitizes the heart to arrhythmic effects of epinephrine?
Halothane
Halothane produces more/less resp depression than Isoflurane
less
At what % Halothane maintained at?
1.5%
At what % is Isoflurane maintained at?
1.5-2.0%
At what % is Sevoflurane maintained at?
3.5%
What inhalation agent provides excellent maintenance of cardiac output but respiratory depression?
Isoflurane
What inhalation agent is excellent for birds, geriatrics, and critical care?
Isoflurane
What inhalation agent provides fast induction and recovery? What agent is faster and smoother?
Isoflurane, Sevoflurane
Nitrous Oxide is not an anesthetic: it is used for ___ and ___
analgesia and 2nd gas effect
Nitrous can reduce the vaporizer setting of other agents by __-__%
10-20%
Nitrous is combined w/ O2 at a ratio of _:_
2:1
What color is a Nitrous tank?
Blue
What type of inhalation system has no rebreathing, no circuit, no reservoir bag (can't ventilate patient), and no CO2 absorber?
Open system
What inhalation system has no rebreathing, no circuit, no CO2 absorber, has a reservoir bag and valve (can vent pt) and is used for pts 15# or smaller?
Semi-open system - Arye's T-piece, Bain apparatus
What inhalation system is rebreathing, has a reservoir bag and CO2 absorber, and has a pop-off valve that is adjusted throughout procedure?
Semi-closed system
What inhalation system is rebreathing, has a reservoir bag and CO2 absorber, and has a pop-off but it is closed?
Closed system
With what kind of inhalation system can the pt not breathe out - pressure builds up in the circuit?
Closed system