Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
271 Cards in this Set
- Front
- Back
What type of catergory are atropine and glycopyrolate?
|
anticholinergics
|
|
Name 2 anticholinergics.
|
atropine and glycopyrolate
|
|
What animal would you not use atropine or glycopyrolate in?
|
horses - they can colic
|
|
What is the mechanism of action of anticholinercis?
|
competitive antagonist of Ach at the muscarinic cholinergic receptor (PSN)
|
|
What are uses for anticholinergics?
|
-prevent and treat bradycardia
-decrease respiratory secretions -decrease salivation |
|
What is the respiratory effect of anticholinercis?
|
bronchodilation
|
|
Do anticholiercis increase or decrease GI movement?
|
decrease - stasis
|
|
What is the duration of action of atropine?
|
60-90 minutes
|
|
What is the main difference between atropine and glycopyrolate?
|
glycopyrolate lasts longer, takes longer to act and does NOT cross the BBB or placenta (atropine does)
|
|
What are contraindications to using anticholinergics?
|
-pre-exisitng tachycardia
-narrow angle glaucoma and synechia -horses |
|
What are the 4 main uses for acepromazine?
|
-sedative
antiemetic -antiarrhythmic -antihistamine |
|
What 2 NT does acepromazine block action of?
|
dopamine and serotonin
-also blocks alpha -1 receptors |
|
Does acepromazine have anaglesia effects?
|
no
|
|
Why might acepromazine cause hypotension?
|
it causes vasodilation
-may also dcrease PCV, TP and platelet function |
|
What is acepromazine a synergist with?
|
opioids
|
|
Does acepromazine have much of an effect on the respiratory system?
|
no
|
|
Is acepromazine reversible and if so, with what?
|
no
|
|
Why must you be careful when using acepromazine with male horses?
|
it causes relaxation of the retractor penis muscle
|
|
What is the effect of acepromazine on the CNS?
|
sedation and depression
|
|
What type of drug is acepromazine?
|
phenothiazine
|
|
How does acepromazine affect the bodys thermoregulation?
|
-causes hypothermia
|
|
When is acepromazine contraindicated?
|
-severe liver disease
-hypovolemia -anemia -shock |
|
Give three examples of benzodiazepines.
|
-diazepam
-midazolam -zolazepam |
|
What are the 4 uses of benzodiazepines?
|
-mild sedation
-anxiolysis -anticonvulsant -muscle relaxation |
|
How do benzodiazepines work?
|
increase affinity for GABA - inhibitory effects
|
|
What are the effects of benzodiazepines on CV and respiratory systems?
|
minimal
-CV - maybe thrombosis or pain due to 40% prpylene glycol -respiratory - may exaggerate depressant effects of opioid |
|
Which drug is better for sedation: acepromazine or a benzodiazepine?
|
acepromazine
-benzodiazepines cause minimal sedation and MAY cause paradoxical excitement |
|
Diazepam is erratically absorbed from what tissue and why?
|
SQ - b/c lipid soluble
|
|
When is zolazepam used (a benzodiazepine)?
|
only used in 1:1mixture with Tiletamine (Telazol)
|
|
What are main differences between diazepam and midazolam?
|
shorter duration and cost more
-water soluble at pH < 4 |
|
In what animal is zolazepam metabolized slower in?
|
cats
|
|
What is the reversal agent of benzodiazepine?
|
flumazen- works via competitive antagonism BUT expensive
|
|
Which drug (phenothiazines or benzodiazepines) would you use if.... you wanted an antiarrhythmic?
|
phenothiazine
|
|
Which drug (phenothiazines or benzodiazepines) would you use if.... wanted an anticonvulsant.
|
benzodiazepines
|
|
What would you use an alpha-2 agonist for?
|
-sedation
-analgesia -muscle relaxation -anxyolisis |
|
What are the CV effects of alpha-2 agonists?
|
bradycardia - AV blocks
|
|
What are the respiratory effects of alpha-2 agonists?
|
-decrease RR and tidal volume
|
|
In what animal do alpha-2s cause emesis?
|
cats
|
|
Do alpha-2s cause hypo or hyperglycemia?
|
hyperglycemia
|
|
What drug would you most use for analgesia: acepromazine, diazepam or an alpha-2 agonist?
|
alpha-2 --> it is the only one of the bunch with that quality --> but it also has profound CV and respiratory depression effects
|
|
Can alpha-2 agonists change your personality?
|
yes
|
|
How long does xylazine provide analgesia for and what is its duration of action?
|
duration - 1 hour
analgesia for 15-20 minutes |
|
What does xylazine have more affinity for: alpha 1 or 2?
|
alpha 1: alpha 2 = 1: 160
|
|
What is the species difference for sensitivity for xylazine?
|
most to least
cattle> horse-dog-cat> pig |
|
What can cause arousal when using xylazine?
|
auditory stimuli
|
|
Which has more predictable analgesisia/sedation: xylazine or medetomidine?
|
medetomidine
|
|
What is dexmedetomidine approved for?
|
FDA approved in dogs and cats for sedation and premedication
-active enantiomer of medetomidine -use 3/4 of the dose of medetomidine |
|
What is the duration of action of dexmedetomidine?
|
duration - 1.5 hours
analgesia - 45 minutes |
|
What animal is detomidine used in?
|
horse and cattle
|
|
What is unique about the administration of detomidine?
|
can administer oral transmucosal (OTM)
|
|
Of the alpha-2 agonists, which has the greatest affinity for alpha-2 receptors?
|
Dexmedetomidine/medetomidine
|
|
Is romifidine approved for small animals?
|
no
|
|
Would you use a alpha-2 agonist in a patient with preexisitng cardiac disease?
|
no - contraindicated in animals with arrythmias
|
|
Give 3 reversal agents for alpha-2s. Which is better and why?
|
atipemazole - better because a lot more selective for A2
yohimbine tolazoline |
|
Which agent would you use to revere medetomidine or dexmedetomidine?
Which route? |
atipemazole
IM only to avoid effects of sudden reversal |
|
Opiods cause presynaptic inhibition of what NTs?
|
Ach, dopamine, NE, substance P and therefore decrease NT
|
|
What are the type of receptors for opioids?
|
Mu, kappa, delta
|
|
What are the uses of opiods?
|
-analgesia
-+/- sedation -decrease anesthetic requirement |
|
Do opiods depress the CV system?
|
minimally
-maybe bradycardia |
|
Do opiods depress the respiratory system?
|
yes - decrease RR and tidal vollume
|
|
What are the specific CNS effects of opiods?
|
-nausea/vomiting
-reset thermoregulatory center -may increase ICP |
|
Why must you keep an animal well hydrated when using opiods (esp cats)?
|
decreased diuresis
-also constipation |
|
In what animals do opiods cause mydriasis?
|
dog, rat, rabbit
|
|
What type of release can morphine cause?
|
histamine release
|
|
What might morphine cause in cats with very high doses?
|
mania
|
|
The opioids morphine, hydromorphine, oxymorphone, and fentanyl are all examples of what?
Which of these are short acting - all others last 2-4 hours? |
full agonists
fentanyl is short acting |
|
Fentanyl is a full agonist opioid and does not cause vomiting or histamine release like morphine, but....
|
it is shorter acting (20-40 minutes) and it has more effects causing bradycardia
|
|
Hydromorphone and oxymorphone can cause what in cats?
|
hydromorphone --> hyperthermia
oxymorphone --> ataxia and hyperesthesia |
|
Why might you use hydromorphone instead of oxymorphone?
|
cost - oxymorphone is more expensive
|
|
Buprenophine is what type of drug?
How long does it last? |
partial agonist opioid
last longer than the others - 6-12 hours with a slow onset (45 minutes) |
|
What type of drug is butorphanol and what animal is it highly used in?
|
agonist (kappa) -antagoinist (Mu)
-horses - causes less respiratory depression and less GI effects |
|
What is the reversal agent for opiods?
|
naloxone --> binds to all receptors
|
|
How do you administer naloxone?
|
IV SLOWLY or IM -- avoid sudden reversal
-reverses everything |
|
What type of opioid would you use for severe pain and a duration of 3 hours?
|
morphine
|
|
Are iononized barbituates active or inactive?
-what about bound to albumin? |
inactive
inactive |
|
What happens with redistribution of barbirtuates?
|
gradually return to consciousness
|
|
What type of induction drug is thiopental?
|
US Acting barbituate - dose dependent
|
|
How does thiopental affect ICP?
|
decreases it
|
|
Does thiopental provide analgesia?
|
no
|
|
After administration of thiopental, HR _________ transiently and offsets the ________in BP.
|
increases
decrease |
|
What type of CV effect does thiopental have?
|
causes arrhythmias --> decreases CO, SV, contractility, BP and peripheral vascular resistance
|
|
What type of respiratory effect does thiopental have?
|
-decreases RR, tidal volume, threshold for CO2 and causes post-induction apnea
|
|
What organ does thiopental cause an increase in?
|
spleen
|
|
Does thiopental cross the placenta?
|
yes - causes neonatal depression
best to avoid for C-sections |
|
What happens when you give a perivascular injection with thiopental?
|
tissue sloughing
|
|
Does thiopental have a long or short shelf life?
|
long
|
|
What is the onset of induction with thiopental?
|
30 seconds
|
|
What is the main effect you are looking to get with thiopental?
|
CNS depression
|
|
Does thiopental have cumulative effects?
|
yes
|
|
What type of induction agent is propofol?
|
US acting non barbituate
|
|
What type of growth does propofol support?
|
bacteria
|
|
Which would you use for a C-section - thiopental or propofol?
|
propofol - does not cross placenta
|
|
Which drug is not cumulative - thiopental or propofol?
|
propofol
|
|
Which drug has a short shelf life - thio or propofol?
|
proppofol
|
|
Propofol decreases both what?
|
ICP and IOP
|
|
Which drug is an anticonvulsant - thio or propofol?
|
propofol
|
|
Thio and propofol both cause depression of what systems.
|
resp and CV
|
|
Which drug has a rough recovery if given alone? thio or propofol
|
thiopental
|
|
Why can't you use a constant rate infusion with thipental?
|
it has cumulative effects
|
|
What might you see with propofol that you may not with thiopental?
|
cyanosis
hypercapnea myoclonus |
|
What do multiple doses of propofol cause in the cat?
|
heinz body formations
|
|
Why would you use a propofol: thiopental 1:1 mixture?
|
to improve stability/shelf life
|
|
What might you use with propofol to decrease side effects?
|
ketamine - CV effects of each are opposite therefore balance each other out
-can mix in same syringe and titrate to effect -use less of each |
|
What type of drug is etomidate?
|
US acting non-barbituate
|
|
Is etomidate water soluble?
|
no
|
|
What is a major difference and benfit to etomidate over thiopental and propofol?
|
minimal cardio-pulmonary effects
|
|
What can happen with injection of etomidate?
|
pain on injection/hemolysis
|
|
Is etomidate a good choice for a C-section?
|
yes
|
|
What is the induction drug of choice for significant CV disease?
|
etomidate
|
|
Is etomidate an anti-convulsant?
|
yes
|
|
Which of the following are anaglesics: thiopental, propofol, etomidate?
|
none
|
|
What can etomidate suppress in dogs?
|
adrenal gland - therefore no constant rate infusion
|
|
What can happen at induction with etomidate?
|
nausea, vomiting
|
|
Etomidate decreases what?
|
ICP and IOP
|
|
What are 2 dissociative anesthetics?
|
ketamine and tiltamine
|
|
With ketamine, there is dissociation between what 2 systems?
|
thalamocortical and limbic systems
|
|
What is unique about ketamine?
|
induces a cataleptic state with amnesia - also analgelsia
|
|
What is the reversal agent for ketamine?
|
there is none
|
|
What type of pain is ketamine important in preventing?
|
chronic pain
|
|
Does etomidate cause vomiting?
Does propofol? Does thiopental? |
yes
no no |
|
What does ketamine do to ICP?
|
increases it
|
|
Why does ketamine have a fast onset of action?
|
it is lipid soluble
|
|
What type of behavior can be seen with ketamine use?
|
hallucinatory behavior --> hyperreflexia, sensitivity to touch ,ataxia
|
|
Does ketamine increase or decrease BP?
HR? |
increase
increase |
|
What type of respiratory side effect is seen with ketamine?
|
apnustic breathing --> holding breath
-increases salivation and secretions |
|
What type of reflex remains intact with ketamine?
|
pharyngal/laryngeal reflex remains intact
-palpebral and corneal reflex (eyes remain open) |
|
Are muscles rigid or flacid with ketamine?
|
rigid
|
|
What is the duration of action of ketamine?
|
IV - 3-10 minutes
IM - 10-30 minutes |
|
How is ketamine metabolized in cats?
|
eliminated via kidney
|
|
How is ketamine metabolized in dogs?
|
hepatic metabolism and excreted in urine
|
|
Tiletamine is only available with what other drug?
|
zolazepam
- called telazol in the US |
|
Is Telazol more or less potent than ketamine?
|
more
|
|
What is the difference between using tiletamine in the dog and the cat?
|
dog - emergence delrium
cat - less so |
|
True or False, ketamine is a negative inotrope?
|
true
|
|
What type of ulcers can you get with ketamine and why?
|
corneal - eyes stay open
|
|
Of the following drugs (thiopental, propofol, etomidate and ketamine), what are the best and worst for induction?
|
Best - thiopental and propofol
Worst - etomidate |
|
Of the following drugs (thiopental, propofol, etomidate and ketamine), what are the best and worst for recovery?
|
best - propofol
worst - ketamine |
|
Of the following drugs (thiopental, propofol, etomidate and ketamine), what are the best and worst for therapeutic margin?
|
best - etomidate
worst - propofol and thiopental |
|
Of the following drugs (thiopental, propofol, etomidate and ketamine), what are the best and worst for CNS effects?
|
best - thiopental
worst - ketamine |
|
Of the following drugs (thiopental, propofol, etomidate and ketamine), what are the best and worst for CV?
|
best - etomidate
worst - propofol |
|
Of the following drugs (thiopental, propofol, etomidate and ketamine), what are the best and worst for respiratory?
|
best - etomidate
worst - propofol |
|
What is the definition of neuroleptoanalgesia?
|
profound state of sedation and analgesia
tranquilizer (phenothiazine, A2 or benzodiazepine) + opioid |
|
What tranquilizer/opioid combo might you reserve for sick or old animals?
|
benzodiazepine with opioid
|
|
What do you want to give with a ketamine?
|
muscle relaxer
|
|
Can ketamine be given orally?
|
yes
|
|
What is the process of absorption for inhalent anesthesis?
|
breathed in ---> absorbed: alveoli into blood ---> absorbed: blood to brain then the whole process is reversible
|
|
Inspired concentration of inhalant anesthetic is directly proportional to what?
|
rise in alveolar partial pressure
|
|
What happens if an animal has rapid shallow breathing (poor ventilation) with inhalant anesthetic?
|
there is a slow rise of alveolar partial pressure
therefore, use mechanical ventilation - control the breathing to create a faster and more constant rise in PP |
|
What 2 added things help determine the rise in alveolar partial pressure of inhalant anesthetic?
|
inspired concentration
alveolar ventilation |
|
What is the time constant equal to?
|
V/flow
-it is the time required for flow thru a container to equal the capacity of the container |
|
What are the two factors that offset the rise of alveolar partial pressure?
|
anesthestic solubility
CO |
|
If inhalant anesthetic has a high solubility, is the speed of onset faster or slower?
|
slower - more drug moves into the blood from the alveoli and is not available as a diffusible gas
|
|
A low Blood: gas coefficient means....
A high B:G coefficient means... -here, partial pressures are equal, concentrations are NOT equal |
....low solubility (time of onset is faster)
....high solubility (time of onset is slower) |
|
List in order from most to least soluble...sevoflurane, halothane, isoflurane
|
halothane (most), isoflurane, sevolfurane (least and shortest onset time)
|
|
What is better to preserve the heart-lung perfusion - high or low CO?
|
low CO - large amount of anesthetic goes to the brain
|
|
With a high CO, what percentage of anesthetic gets to the brain?
|
8% - small amount
|
|
What type of animals will have a slow in clinical onset of anesthesia?
|
stressed or excited animals --> blood is going to muscle
|
|
What type of animals will have a rapid in clinical onset of anesthesia?
|
sick or debilitated animals or those with a CV compromise --> CO is low
|
|
Alveolar partial pressure increases fast when what 3 things occur?
|
-good alveolar ventilation
-low cardiac output -low anesthetic solubility |
|
What MAC is required for surgical anesthesia in most animals?
|
1.2-1.3 x MAC
-more than 1 MAC guarantees surgical anesthesia in 100% of patients |
|
What does MAC stand for?
|
minimum alveolar concentration --> % at which 50% of animals will not move in response to a surgical stimulus
|
|
In gas phase, what is partial pressure equal to?
|
% concentration x atmospheric pressure
-BUT dial on the machine is calibrated for barometric pressure |
|
When comparing MACs between agents, what are you also comparing?
Which is more potent - isoflurane or sevoflurane? |
potency
-iso bc there is a lower MAC |
|
What is the B:G coefficient of isoflurane and sevoflurane?
|
iso = 1.4
sevo = 0.6 |
|
What is the MAC of:
halothane isoflurane sevoflurane |
halothane -- 0.9 (1.1 in cats)
isoflurane -- 1.3 (1.6 in cats) sevoflurane -- 2.4 (2.6 in cats) |
|
If your patient is hypothermic, pregnant, old, or has hypothyroidism, is MAC increased or decreased?
|
decreased
|
|
Will hyperthermia, hyperthyroidism, hypernatremia or CNS stimulant drugs increase or decrease MAC?
|
increase
|
|
What might an overdose of inhalant anesthetic mean?
|
-severe ventilatory, CV, CNS depression
-death |
|
What does an EEG look like with inhalent anesthesia?
|
high amplitude, low frequency (opposite of awake)
|
|
Do inhalants provide analgesia?
|
no
|
|
Do inhalants vasodilate or vasoconstrict? What does this mean for the patient?
|
vasodilate - increase ICP
(hyperventilation will reduce this) |
|
At what MAC does contractility start to decrease?
|
> 1 x MAC
DOSE-DEPENDENT CHANGES |
|
With inhalant anesthesia, why does CO remain constant while SV is decreased?
|
because HR increases (remains constant)
-hypotension is a main complaint of these |
|
Inhalants can increase incidence of what due to the sensitization of the myocardium to catecholamine?
|
arrhythmias
-stress can induce endogenous catecholamine levels |
|
An increase in PCO2 causes what?
|
vasodilation
|
|
Do positive inotropes or vasopressors affect anesthetic requirements (inhalant)?
|
no -- but counteract unwanted CV depression
|
|
Do inhalants increase or decrease the body's sensitivity to CO2?
|
decrease
-decrease the body's hypoxic drive and pulmonary vasoconstriction |
|
Inhalants have an effect on the kidney - is it pre-renal, renal or post-renal?
|
pre-renal - correspond to decreased blood pressure --> decreased GFR and less urine output
|
|
What percent of iso and sevo are metabolized in the liver?
|
iso - .2%
sevo - 2-5% |
|
Recovery from inhalants in mainly due to what system?
|
respiratory - lungs
|
|
What is the treatment for malignant hyperthermia?
|
dantrolene IV - muslce relaxant and anit-pyretic
-stop anesthesia and leave on 100% O2 -body cooling |
|
Do low solubility drugs have more or less hangover?
|
less
|
|
Which inhalant is the most soluble?
Which is the most potent? |
desflurane
halothane |
|
What is the most reliable source of information for the cylinders?
|
the label
|
|
What is the size tank used in practice?
in the field? |
E and H
D |
|
When full, an oxygen cylinder has how much volume and pressure?
|
660 L
1900 psi |
|
When full, a NO cylinder has how much volume and pressure?
pressure drop will only be observed when the volume drops below what? |
1590L
745psi 250L |
|
What are the US color codes for:
oxygen - CO2 - NO - N - Air - |
oxygen - green (white internationally)
CO2 - gray NO - blue N - black Air - yellow (white and black internationally) |
|
Everything from the hanger yoke to the pressure regulator including cylinder pressure gauge are part of what system?
|
high pressure --> reflects the pressure in the gas cylinder
|
|
Everything downstream from the pressure regulator to the flowmeter flow control is part of what system?
|
intermediate --> constant pressure of 40-55psi
|
|
What is the oxygen flush valve part of?
|
intermediate system
|
|
What is the pressure in the intermediate system?
|
40-55 psi
|
|
Everything downstream from the flowmeter control to the common gas outlet is part of what system?
|
low pressure
|
|
Gauges are required to be calibrated in what?
|
kilopascals (kPa), but psi may also be used
|
|
What does the regulator due in the high pressure system?
|
reduces the pressure from the cylinder to a lower and more constant pressure 40-50 psig
|
|
Pipeline inlet connections that are part of the intermediate system have what type of safety system?
|
Diameter Index Safety System (DISS)
|
|
Flow indicator tubes are part of what system?
|
low pressure system
read in L/min |
|
What is the vapor pressure of iso and sevo at 20 degrees C?
|
iso - 238
sevo - 157 |
|
What does the vaporizor chamber contain?
Which area is FREE of anesthetic? |
anesthetic in its liquid and vapor state
the bypass chamber |
|
What happens if the vaporizor is set to 5%?
|
5% more gas goes thru the vaporization chamber
|
|
What is the safety system used for the vaporizor?
|
key and color system
|
|
What happens if the anesthetic machine is tilted more than 45 degrees?
What do you do if this happens? |
the bypass chamber can be contaminated with liquid anesthetic
-turn the flowmeter to 10L/min for at least 10 minutes |
|
T or F - You will use the oxygen flush valve to clean out the bypass chamber if anesthetic gets into it
|
F - the oxygen flush valve bypasses this
|
|
Technically, where does the anesthesia machine end and what exits here?
|
the common gas outlet -- all gases (all breathing systems are connected here)
|
|
What are the 4 main functions of breathing systems?
|
1 - deliver anesthetic gases and oxygen to the patient
2 - remove CO2 3 - facilitate assisted or controlled ventilation 4 - facilitate scavenging of waste gases |
|
What are the 2 main factors that influence breathing systems?
|
1 - resistance to breathing
2 - rebreathing of previously expired gas |
|
What size patient would you use a rebreating system on?
|
above 7kg because they can overcome the resistance of one way valves and CO2 absorber
|
|
Connectors in a machine increase what?
sharp angles? |
dead space
resistance to breathing |
|
How big should a reservoir bag be?
|
5 x tidal volume (15ml/kg)
or 75ml/kg -always select the bigger size |
|
What does APL stand for?
|
adjustable pressure limiting valve -- pop off valve
|
|
What is used to remove CO2 from the system with a non-rebreathing system?
|
fresh gas flow
|
|
As a general rule, what should be the fresh gas flow in a non-rebreathing system?
|
150ml/kg/min
|
|
Soda lime is used in a rebreathing system and it converts the CO2 to what?
|
salt and water --> a pH indictor changes from white to purple when the soda lime is exhausted (high pH)
|
|
What is the most reliable way to determine if the soda lime is fresh?
|
observe the capnograph of the patient
|
|
What is the absolute minimum flow rate for oxygen?
|
500ml/min
|
|
What is the recommended gas flow for a closed vs. semi-closed system?
|
closed - 3-10 ml/kg/min
semi - 10-40ml/kg/min |
|
What is the induction and maintenance oxygen for a rebreathing system?
|
induction--> 60 ml/kg/min
maintenance --> 30 ml/kg/min |
|
What is the point of highest resistance in the breathing system?
|
the ETT
|
|
What type of tube is less likely to kink?
Which one is disposible? |
PVC
PVC |
|
What are the 3 main types of ETT?
|
1 - murphey
2 - magil - no opening besides the bevel; cuff can be placed closer to bevel and reduce the change of endobronchial intubation 3 - cole - always uncuffed |
|
In what animals is direct visualization for intubation used?
|
dogs, cats, llamas, alpacas, lab animals, calves
|
|
In what animals is blind intubation used?
|
horses, rabbits
|
|
In what animals is digital palpation intubation used?
|
cows, camels
|
|
For ruminants why is it important to immediately seal the cuff and check the pressure later?
|
risk of regurgitation is greater
|
|
When do you deflate the cuff of the ETT?
-remove the tube? |
-until the patient is able to secure their airway
-wait until animal swallows |
|
What is hypoventilation?
|
PaCO2 is above normal (35-45)
-healthy animals are between 30 and 60 |
|
What are the disadvantages of high CO2 (4)?
|
1 - increase IOP
2 - increase ICP 3 - increase incidence of arrythmias 4 - decrease in pH |
|
What is a disadvantage of using mechanical ventilation?
|
decrease in CO, decreased GFR, decreased oxygen delivery
|
|
What is the I:E ratio?
|
1:2
|
|
What is a PEEP and what does it do?
|
positive end-expiratory pressure
-helps keep alveoli open and minimize atelectasis -not used all of the time because aggravates cardiac output depression |
|
What 4 things are part of general anesthesia?
|
1 - unconsciousness
2 - insensitivity to pain 3 - muscle relaxation 4 - absence of reflex responses (respiratory, NM, ocular) |
|
Stage I of anesthesia is characterized by what?
|
voluntary movement
-stress response, cough, laryngeal reflexes (time of administration of induction agent to loss of consciousness) |
|
Stage II of anesthesia is characterized by what?
|
delirium or involuntary movement
-still jaw tone, therefore can't intubate |
|
What stage is intubation performed in?
|
Stage III light plane
|
|
Stage III is characterized by what?
|
surgical anesthesia
|
|
What is still present in the light plane of stage III?
|
-eyeball movement
-palpebral reflexes and lacrimation -HR, BP and RR remain normal and regular (RR slows) |
|
If you open the eye during stage III, medium plane, what will you see?
|
see the sclera - eye is opeten obscured by the third eyelid
|
|
What plane of anesthesia is adequate for most procedures?
|
stage III, medium plane - here palpebral reflexes will be sluggish
|
|
Which palpebral reflex is lost first?
When are they beginning to be lost - sluggish? |
medial palpebral
stage III, medium plane |
|
What happens to the respiratory rate in stage III, deep plane?
|
increases with abdominal to diaphragmatic
|
|
Where is the eye at stage III, deep?
|
centered with dilated pupil - no lacrimation or palpebral reflexes
|
|
What happens in stage IV?
|
extreme CNS depression
-respiration ceases, BP barely palpable, SHOCK! -NOT responsive to light |
|
Which type of signs yield more information?
|
positive signs
|
|
What are the MOST reliable signs when monitoring a patient? there are 4
|
1 - gross purposeful reflex movement
2 - immediate hemodynamic or respiratory response to stimulation 3 - response to stimulation prior to incision 4 - stimulate patient before making a clinical judgment |
|
What nerves does the palpebral reflex test and what stage is the animal in if there is none?
|
CN 5 and 7
-stage III, medium or deep |
|
What nerves does the pupillary light response stimulate and what stages are they most sensitive?
|
CN 2 and 3
they will blink in stage III, light and medium |
|
Lacrimation idicates what stage?
|
stage III, light
|
|
What are LESS reliable signs in assessing anesthesia depth?
|
-HR, RR, BP, CRT/color
|
|
What are NOT reliable signs in assessing anesthesia depth?
|
-pupil size
-shivering -spasmodic muscular twitching -flick of ears with cats -nasal flaring |
|
What is the most important pieces of equipement that can tell you if your patient is alive or not?
|
esophageal stethescope - HR and rhythm
|
|
What are the 2 ways to assess arterial BP indirectly?
what is the direct method? |
indirect - doppler and oscillometer
direct - gold standard (in peripheral artery) |
|
What should systolic BP be kept at?
mean BP? |
systolic - over 90-100
mean - 70 - 90 |
|
What does Doppler flow measure?
|
only systolic BP
-hear an auditory heart rate, but tempermental -use on small patients when oscillometer won't work |
|
What does an oscillometer measure?
|
HR< systolic, diastolic, and MAP
-least accurate in cold animals because of vasoconstriction and small -involves the use of a cuff |
|
What does a pulse oximeter measure?
|
it is a non-invasive, continuous monitor of arterial oxygen saturation
-gets info from a light signal therefore works better on fair skin, no hair |
|
What values are good to see on a pulse oximeter?
|
above 90% (95%)
|
|
What do values obtained from a capnograph approximate?
|
alveolar ventilation
-it is a continuous, noninvasive method of monitoring CO2 |
|
What produces poor results with a pulse ox?
|
vasoconstriction, motion, methy, carboxy
|
|
How many phases are there to a capnogram and what are they?
|
4
I - inspiration - baselines should read 0 otherwise indicates rebreathing of CO2 II - expiratory upstroke III - expiratory plateau (highest point represents the best approximation of alveolar CO2 IV - start of inspiration |
|
What is the gold standard for measurement of CO2 and O2 tensions - measuring the patients ventilatory and metabolic status?
|
arterial blood gas
|
|
What should urine output be?
|
1-2 ml/kg/hr
-should be monitored using a closed system |
|
At what temperature is it considered life threatening and what temp needs agressive rewarming?
|
-life threatening - 86
90 - 92 needs aggressive rewarming |
|
What is the most common method for induction of wild animals?
|
IM
|
|
What is the only animal that allows to be nasotracheally intubated with sedation alone?
|
FOALS
|
|
When can intibation be done?
|
plane 2/3, stage III (medial plane)
|
|
What is the most important thing to do after induction of an animal?
|
palpate the pulse
|
|
What is the emergence period?
|
period between discontinuation of anesthesia and extubation
|
|
What must you always do before moving the patient?
|
disconnect to prevent tracheal tear
|
|
What is the minimum preop PCV?
|
27-30
|
|
How many ASA classifications are there?
|
5
I - normal, healthy patient II - neonatal or gereatric or patients with mild disease or moderate obesity III - moderate systemic disease IV - severe systemic disease that is a threat to their life V - not expected to survive for 24 hours |
|
What ASA class are neonates or geratrics?
|
II
|