NERVOUS SYSTEM GENERAL ANESTHESIA – Flashcards
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_______ are a CNS depressor and all are controlled substances. Cannot use this group of drugs for patients with *liver dz*. *Apnea* and tissue *necrosis* occurs with this. Is rare in the US now days.
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Barbiturates
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Barbiturates are classified by what?
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duration
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_____acting barbiturates acts as an *anticonvulsant* agent administered *IV* or oral. After administering this drug, blood must be measured. How long does this drug act?
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long 8-12hours
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Name a *long-acting barbiturate*:
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Phenobarbital CIV
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______acting barbiturates acts as anesthesia induction *only* and is administered *IV* only or causes tissue necrosis due to its high pH. This drug can cause *apnea* How long does this drug act?
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ultrashort 5-15 minutes
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Name a *ultrashort acting barbiturate*:
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Thiobarbiturates
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Name a *thiobarbiturate* that is now off the market due to easily overdosing sighthounds and other very thin patients:
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Thio*pent*al (*Pent*othal®) 5% solution? anyone have this in their notes?
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*Pentothal®* is no longer on the market as an ultrashort barbiturate, but what drug is out there that is safer for thin patients and sighthounds?
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Methohexital (Brevane® )
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_____acting barbiturates act as a general anesthetic administered IV and is also a *euthanasia* solution. How long does this drug last?
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short 45 minutes to 11/2 hours
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Name a *short-acting barbiturate*:
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phenobarbital CII
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Phenobarbital euthanasia solution *alone* is a class____controlled substance. When it is *mixed*, it becomes a class______controlled substance.
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II III
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What 3 things categorize *dissociative* anesthesia?
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1. catalepsy 2. amnesia/hallucinating 3. analgesia (superficial)
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*Dissociative* agents should be avoided in patients with a history of _________.
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seizures
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*Dissociative agents* work by doing what to the neurotransmitter?
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altering nt activity
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Name a topical *dissociative* agent used for eyes:
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atropine (cycloplegic)
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Name two *dissociative anesthesia* drugs: What class of controlled substance:
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1. Ketamine HCl 2. Tiletamine HCl III
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Two Ketamine trade names:
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1. Ketaset 2. Vetalar
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Ketamine HCl is usually *combined* with (2 examples)_______ which are all a________.
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Xylazine, Valium Tranquilizer
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Are dissociative drugs controlled substances?
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yes
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_________is a dissociative anesthetic that comes in a *combo pack* with __________. What is the trade name for this combo? Fridge this sucker.
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Tiletamine HCl Zolazepam *Telazol®*
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What must be used in cats before using a dissociative anesthesia?
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*eye lube*
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________ is a short acting milky white anesthetic. It is smooth, rapid and safe but a controlled substance class_____ thanks to Michael Jackson overdosing and inducing his own apnea.
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Propofol IV
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Name two trade names of *propofol*:
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Rapinovet® Propoflo ®
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Propofol is aka "______ ____ _______".
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milk of amnesia
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Dissociative agents are painful at ____injection site.
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IM
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________ is a short acting hypotonic sedative. It is a *poor analgesic* and *not controlled*. It has minimal CV and resp side effects. It is expensive.
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Etomidate
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_____ is a *neurosteroid* that works as an anesthetic at induction and/or maintenance. It is compatible with all premeds, has minimal side effects, not controlled, and has *no preservatives*
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Alfaxan
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________ _____/_______ drugs are used for *equine* general anesthesia. They may be used as 5% to 10% solution *5% dextrose*.
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glyceryl guaiacolate/*gauifenesin*
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*Guairfenesin* can be mixed with _____ and ______ *(GKX)* to extend duration.
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xylazine ketamine
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______ aka _______ are controlled substances used for analgesia, sedation, and restraint. They are used pre & post anesthetic. They ALSO act as *antitussives* and *antidiarrhetics*
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opiods narcotics
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What are some *acute side effects* in using narcotics? (name 3) What is a chronic side effect?
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1. v/d 2. respiratory depression 3. excitement in cats or horses 1. constipation
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Name two *natural* narcotics: Identify their controlled substance status:
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opium- II morphine-III
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Name 4 *synthetic* narcotics: Identify their controlled substance status:
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1. Meperidine-II 2. Oxymorphone-II 3. Butorphanal-IV 4. Fentanyl-II
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Meperidine is usually used for ______ _____. Name it's trade name:
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acute pain Demerol®
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Oxymorphone is used as a _______.
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restraint
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_______ is the approved Butorphanal product used in dogs as an antitussive, analgesic and preanesthetic agent.
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Torbutrol
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_______ has 100 times the analgesic properties of morphine. Can be used as transdermal patches for those with chronic pain.
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Fentanyl
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_____ ; _____ are both synthetic opioids and act as neuroleptanalgesias.
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oxymorphone meperidine
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Name 4 other synthetic opioids and briefly what they are most known for:
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Lotomil-diarrhea M99-zoo Talwin-foals Apomorphine-induce vomit/eyelids
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Name TWO *opioid antagonists*: One pure, the other partial:
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1. Naloxone 2. Nalorphine
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Name a *CNS Stimulant* used as a *last resort* for newborns with cardiopulmonary arrest. This drug can be given 3 ways:
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doxapram (Dopram-V) 1. IV 2. under tongue 3. umbilical
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Neuroleptanalgesics are ____+_____or_____.
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opioids + tranquilizer or sedative
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Propofol lasts for about ____to____minutes and is used for anesthesia how?
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induction/maintenance CRI
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Propofol is a _____type drug.
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hypnotic
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______is a short acting hypnotic drug that is a poor analgesic by itself but has minimal side effects and is good for older dogs but is *painful at injection* even IV. It is not a controlled substance.
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Etomidate
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Etomidate is used for anesthesia how?
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induction and maintenance CRI
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_____is a *new* anesthetic and a *neurosteroid*. It is not a controlled substance and less expensive than Etomidate.
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Alfaxan
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GG is a skeletal muscle relaxant used for equine anesthetics. What can it be mixed with for longer duration?
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ketamine ; xylazine (GKX)
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Do not use morphine in which species due to excitement:
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cats/horses
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Name 3 of morphines *beneficial* side effects:
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1. sedative 2. lowers resp. at brain=antitussive 3. lowers GI tract motility=antidiarrheal
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What is a chronic side effect of morphine?
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constipation
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At induction of morphine, what are the side effects:
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v/d, pant, salivation then it all mellows out and opposite actions occur
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Morphine should be used *when*?
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before (preemptive) and after anesthesia
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What controlled substance class is morphine?
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C-II
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What is morphine? Just throw out everything you know about it
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a preemptive/post analgesic narcotic/opiod C-II not preferred for cats and horses antitussive, antidiarrhea too much=constipation
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Name two synthetic opioids that are neuroleptanagelsia:
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Demerol® (Meperidine) Oxymorphine
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1. Name a synthetic opioid used for kennel cough. Identify the trade names and doses for 2. SA and 3. LA
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1. Butorphanal 2. Torbutrol-0.5mg/ml 3. Torbugesic- 10mg/ml
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Butorphanal is used a lot in vet medicine as an analgesic _______.
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predmedicine
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______is a CII injectable analgesic that also comes as a patch/transdermal that is 1000xmore concentrated than the injectable.
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Fentanyl
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Name the two C-III barbiturate euthansia agents:
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phenobarbital+phentoin
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What two *inhalant anesthesias* are commonly used in practices today?
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Isoflurane Sevoflurane
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Vapor pressure= the amount of liquid that will evaporate at _____degrees _____ to a gas.
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20 C
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1. High vapor pressures need what? 2. Name some examples:
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precision vaporizers isoflurane, sevoflurane, halothane
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Name a low vapor pressure anesthetic. What kind of vapor is used for low vapors?
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Methoxyflurane wick
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High blood-gas coefficient means the gas likes what? Is this quick or slow? Name an example:
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blood slow Methoxyflurane
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Low blood gas means what?
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quick
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The lower the MAC, the _____.
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more potent
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The induction settings on the machine are based on the ______. They need to be set 2x higher than the _____.
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MAC
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Why did methoxyflurane and halothane fall out of favor?
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meth-kidney toxin halo-hepatitis, arrythmias
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_____is made from foxglove plant and used for heart dz:
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digoxin
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Phenobarbital class IV is used for: Needs ____ and _____ tests done.
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seizures kidney/liver
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ALT and ALKP are for the ______ BUN and CREA are for the ______
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liver kidneys
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*BONUS* what is Benadryls generic name?
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di phen hydra mine
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*MAC*is the ____concentration.
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*alveolar*
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1.0 x MAC= 1.5 X MAC= 2.0 X MAC=
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light anesthesia surgical deep/induction
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3 inhalant anethestic agents:
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vapor pressure MAC blood-gas
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List 3 *pre-anesthesia agents*:
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1. anticholinergics 2. opioids 3. tranq/sedatives (2+3=neuroleptanalgesic)
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List 5 *anesthesia induction* agents:
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1. ketamine/valium 2. ketamine/xylazine (LA) 3. Telazol 4. Propofol 5. inhalants
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List 4 *anesthetic maintenance agents*:
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1. inhalants 2. Propofol 3. Etodimate 4. Alflaxin
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List 4 *anethetic recovery* agents:
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1. Torbugesic (Butorphanol) 2. Morphine 3. NSAID 4. tranquilizers (antianxiety)
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Opioids can be reversed with:
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Naloxone
