Term
| When should you take temperatures? |
|
Definition
| Before drugs, during and after surgery |
|
|
Term
| What should you do if temps fall below 97? |
|
Definition
| Warm up animal, fleece, heated cage, warm bottles, warm IV fluids, baer-hugger etc. |
|
|
Term
| Normal temp range for dogs and cats |
|
Definition
Dogs: 99.5-102.5
Cats: 100.0-102.5 |
|
|
Term
| All tranquilizers, narcotics and Ga's do what to body temp? |
|
Definition
| Decrease it (hypothermia) |
|
|
Term
| What effects does hypothermia have on the body? |
|
Definition
Slows rate of liver metabolism, slows down effect of drugs, prolongs recovery.
Cardiac instability, shivering. Can also mess with enzyme and pH configuration
Can result in delayed, rough recovery |
|
|
Term
| Areas where you can observe mucus membrane color |
|
Definition
Gingiva
Conjuctiva
Tongue
Lip and cheek
Prepuce/penis
Vulva
Inner margin of rectum
Surgical incision |
|
|
Term
|
Definition
Blood loss
Anemia
Poor perfusion (prolonged anesthesia)
Hypothermia |
|
|
Term
|
Definition
There is upper airway obstruction or resp. failure during anesthesia
Stagnant blood flow
Decrease O2 in blood/tissues |
|
|
Term
| Capillary refill time (CRT) |
|
Definition
Rate of return color to a MM after application of gentle digital pressure. Reflects perfusion of peripheral tissues
Normal: 1-2 sec
Prolonged: > 2 sec |
|
|
Term
|
Definition
1. Vasoconstriction/epinephrine release
2. Decrease in blood pressure due to drugs
3. Hypothermia
4. Heart failure
5. Excessive anesthesia depth
6. Shock |
|
|
Term
|
Definition
| Contraction of the pupil on exposure of the retina to light |
|
|
Term
|
Definition
| Small pupil. Constricts as a normal response to light. |
|
|
Term
|
Definition
| Big pupil. Dilates as a normal response to darkness. |
|
|
Term
| Direct vs indirect (consensual response) |
|
Definition
Direct: Constriction of the illuminated pupil
Indirect: Constriction of the opposite pupil
|
|
|
Term
| Why is the pupillary light reflex important for indicators of vital CNS function? |
|
Definition
1st area to receive damage due to hypoxia/decreased circulation.
Diminishes before cardiac arrest. |
|
|
Term
|
Definition
Dilated pupils with no sign of PLR.
Atropine may cause Mydriasis in dogs |
|
|
Term
|
Definition
| Pressure within globe of eyeball. Decreases HR due to vagus nerve stimulation. Use caution with bradycardia or cardiac patients |
|
|
Term
|
Definition
|
|
Term
|
Definition
1. Palpebral reflex
2. Corneal reflex
3. Oral-pharyngeal reflex
4. Laryngeal reflex
5. Ear pinna reflex
6. Pedal reflex (toe pinch)
7. Patellar reflex |
|
|
Term
|
Definition
| Lightly tap medial or lateral canthus of eye. Response should be a blink. |
|
|
Term
|
Definition
| Touch cornea with sterile object. Response should be a blink or withdraw of eye into the orbital fossa |
|
|
Term
|
Definition
Try to open/place object in the mouth, while touching pharyngeal region.
Normal response should be for patient to close mouth. |
|
|
Term
|
Definition
Touch the larynx.
Normal response is immediate closure of the epiglottis and arychnoid cartilage.
Easily dilated in cats, use laryngeal scope. Can have laryngeal spasms |
|
|
Term
|
Definition
| Lightly touch along inner surface of pinna. Normal response is a twitch of the ear. |
|
|
Term
|
Definition
Extend rear limb while simultaneously pinching middle toe.
Normal response should be withdrawing of the limb as a response to deep pain. |
|
|
Term
|
Definition
Striking the straight patellar tendon lightly with percussion hammer.
Normal response is reflexive extrension of the stifle.
Reflex occurs under anesthesia due to spinal reflex arc. |
|
|
Term
| What is are primary goal for patients under anesthesia? |
|
Definition
| Want them at Stage 3/Plane 2 |
|
|
Term
| Which drug prevents one from testing reflexes? |
|
Definition
Ketamine
Immobilizes the limbs |
|
|
Term
| Things to consider when a patient is in dorsal recumbancy |
|
Definition
1. Pressure on aorta?
2. Partially open airway?
3. Does the patient have a heard time breathing? |
|
|
Term
| What positions are safer than dorsal recombancy? |
|
Definition
1. Lateral recombancy
2. Sternal recombancy |
|
|
Term
| Why should Barbituates not be used in patients less than 3 months of age? |
|
Definition
| Due to immature liver function. |
|
|
Term
|
Definition
| Less drug protein-bound so more drug gets to site of action. Check PCV/Tp |
|
|
Term
|
Definition
Involves administration of low does of several PA and GA drugs in combination to achieve save and satisfactory anesthesia
-Multiple drugs
-Lower dose
-Multiple effects
-Safety |
|
|
Term
| What does Ga's and PA's do to the respiratory rhythm/breathing pattern? |
|
Definition
Reduces mL of air taken in/out
Reduces breaths to 10-15 br/min
Reduces intercostal muscle ability to expand thorax
Causes Decreased minute volume aka hypoventilation |
|
|
Term
| How much time should you allow PA to go into effect? |
|
Definition
15-20 minutes
Dont disturb patient |
|
|
Term
|
Definition
1. To calm and sedate excited/scared/vicious patients
2. Provide analgesia
3. To provide muscle relaxion
4. To decrease salivary secretions
5. To eliminate or reduce excitatory phase for a smoother recovery
6. To minimized vagal-mediated reflexes (bradycardia, laryngospasm, excess salivation)
7. Decrease amt of drug used, overall smoother procedure. |
|
|
Term
| All PA drugs are CNS depressants except for? |
|
Definition
| Anti-cholinergics (Adjunct!) |
|
|
Term
| Abbreviations you need to know |
|
Definition
1. AAP: Academy of Pediatrics
2. SaO2: Hemoglobin saturation
3. NIBP: Non-invasive blood pressure monitoring
4. ETCO2: End-tidal CO2
5. ECG: Electro-cardio-gram
6. PaO2: O2 tension in plasma |
|
|
Term
| What do anesthesia drugs suppress? |
|
Definition
Cardiopulmonary system
-Bradycardia
- Decrease RR
- Hypotension
- Hypothermia |
|
|
Term
|
Definition
1. Propofol
2. Ketamine (vallium alternative) |
|
|
Term
| What does atropine interfere with? |
|
Definition
Interpretation of pupil size.
Can be fatal if excessive amts given. |
|
|
Term
| What are some side affects of anticholinergic drugs? |
|
Definition
| 1. Paralysis of ciliated epithelial cells in trachea and bronchl, cause mucus buildup, may interfere with ability to clear secretions |
|
|
Term
| What do anticholinergic drugs do? |
|
Definition
Protect heart from bradycardia and decrease salivary secretions.
They are an adjunct, meaning no anesthesia effect.
Can be sympathomimetric or parasympatholytic.
Work by blocking ACH at target organs at terminals and parasympathetic nervous system. Primary nerve transmitter |
|
|
Term
| Advantages of anticholinergics |
|
Definition
1. Stabilize HR. Protection from bradycardia
2. Decrease secretions
3. Antiemetic effect (minimal)
4. Decreased GI motility (minimal) |
|
|
Term
| Disadvantages of anticholinergic drugs |
|
Definition
1. Thick mucus production possible (atropine in cats)
2. Increase anatomical dead space caused by dilation of bronchial airways.
3. Decreased tear production (keratinitis)
4. May cause colic in horses
5. Mydriasis (dogs more than cats) |
|
|
Term
| 2 main drugs that can cause allergic reactions |
|
Definition
|
|
Term
|
Definition
1. CNS excitability or drowsiness
2. Delirium
3. Coma
4. Death |
|
|
Term
|
Definition
Generic name: Atropine
When appropriate to use: Emergency use for bradycardia, IV,IM SQ. Organophosphate poisoning. Premed
Drug class: Belladonna alkaloid
Mech of action: Block ACH at muscaremic receptor terminal ends of PNS. Block stimulation of vagus nerve by other drugs.
Desired effect: Decrease salivation and protection from bradycardia. Antidote for organophosphate poisoning. Premed
Reversible? NO
Controlled substance? NO
Analgesic? NO
Dont use in sheep/goats due to seizures. No effect on rabbits. Dangerous in animals with cardiac disease. Small and Lg animal injectable types |
|
|
Term
| Glycopyrrolate (Robinu-V) |
|
Definition
Generic name: Glycopyrrolate
When appropriate to use: Emergency use for bradycardia, IV,IM SQ. Organophosphate poisoning. Premed. Longer lasting.
Drug class: Synthetic derivative of Atropine
Mech of action: Block ACH at muscaremic receptor terminal ends of PNS. Block stimulation of vagus nerve by other drugs.
Desired effect: Decrease salivation and protection from bradycardia. Antidote for organophosphate poisoning. Premed
Reversible? NO
Controlled substance? NO
Analgesic? NO
Dont use in sheep/goats due to seizures. No effect on rabbits. Dangerous in animals with cardiac disease. Small and Lg animal injectable types. Prefered but costs $ |
|
|
Term
|
Definition
Generic name: Acepromazine
When appropriate to use: Potent, but wide margin sedative. Premed for balanced anesthesia. Reduces post-op anxiety. Use for penile muscle relaxation in horses. Can give SQ, IM, IV, PO
Drug class: Phenothiazine sedative
Mech of action: Depresses reticular activation system (RAS) of brain, thus producing sedative effect. Metabolized by liver.
Desired effect: Premed for balanced anesthesia. Has antihistamine, sedative, antiemetic, antiarrythmic vasodilation (give slowly via IV) effects.
Reversible? NO
Controlled substance? NO
Analgesic? NO.
Light sensitive. Easier to work with when diluted. Can be mixed with Glycopyrrolate and opioids. May decrease IOP and cause 3rd eyelid prolapse.
Side effects: Hypotension (give slowly IV), excitement, lowers seizure threshold, decrease dosage for boxers, collies. |
|
|
Term
|
Definition
| Adjucts. 1. Atropine 2. Glycopyrrolate 3. Acepromazine |
|
|
Term
|
Definition
| 1. Phenothiazines (ace, chloropromazine) 2. Benzodiazepines (diazapam, midazolam) 3. alpha-2 agonists (Dextormator, Xylazine) 4. Dissociatives |
|
|
Term
| What must you consider when mixing drugs? |
|
Definition
Can only mix water-water or lipid-lipid soluble drugs. Loses potential effect and can be dangerous. Dont do unless asked/verified.
Most anesthestic agents H2O soluble.
Exceptions: Ketamine, Vallium |
|
|
Term
| Examples of tranquilizers/sedatives |
|
Definition
1. Acepromazine
2. Xylazine
3. Diazapam
4. Medotomadine |
|
|
Term
|
Definition
1. Effects may include sedation, muscle relaxation, analgesia
2. Contributes to balance anesthesia when used as Pre-anes.
3. Decreased possibility of excitment during recovery
4. No physical dependence
5. Not controlled substance |
|
|
Term
| Disadvantages of sedatives |
|
Definition
1. Various effects on physiology
2. Can't be used for animals being slaughtered for human consumption
3. Will cross placental barrier
4. Can't leave patient unattended on exam table |
|
|
Term
| Overdose signs of sedatives |
|
Definition
1. Restlessness
2. Disorientation
3. CNS induced convulsions
4. Coma
5. Death |
|
|
Term
| 4 classes of controlled substance drugs |
|
Definition
1. Benzodiazepenes
2. Dissociatives
3. Barbituates
4. Most opioids |
|
|
Term
|
Definition
Generic name: Xylazine
When appropriate to use: Given IV, IM
Drug class: Alpha-2 agonist sedative
Mech of action: Stimulates alpha-2 adrenoreceptors on sympathetic nerves in the brain and spinal cord (CNS), causing a decrease in the release of the neurotransmitter noepinephrine. Metabolized by liver, excreted in urine.
Desired effect: Potent sedative, analgesic, muscle relaxer. Induce vomiting in cats. Combined with another traq/narcotic (Ex: atropine) for minor sx or dx procedures.
Reversible? YES Alpha-2 antagonists (Yohimbine [dogs/cats/horse] and Tolazoline* [cattle only])
Controlled substance? NO
Analgesic? YES
Side effects: Cattle extremely sensitive. Emesis in cats. Peripheral vasoconstriction (appear cynotic, pale mm). Avoid use in patients with respiratory or cardiovascular issues. Severe bradycardia, hypotension. Potentiates with barbituates. Sensitizes heart to epinephrine-induced arrhythmias
Sa: 20mg/ml soln. La: 100 mg/soln. |
|
|
Term
| What can be given with Xylazine to help prevent bradycardia? |
|
Definition
|
|
Term
|
Definition
Generic name: Detomidine (Dormosedan)
When appropriate to use: Given IV, IM
Drug class: Alpha-2 agonist sedative
Mech of action: Stimulates alpha-2 adrenoreceptors on sympathetic nerves in the brain and spinal cord (CNS), causing a decrease in the release of the neurotransmitter noepinephrine. Metabolized by liver, excreted in urine.
Desired effect: Potent sedative, analgesic, muscle relaxer for horses only. Longer duration than Xylazine.
Reversible? YES Alpha-2 antagonists (Yohimbine [dogs/cats/horse] and Tolazoline* [cattle only])
Controlled substance? NO
Analgesic? YES
Side effects: May cause bradycardia, AV block (atropine helps prevent this). Don't use in horses with renal or cardiopulmonary disease. May respond to stimuli. Used for colic pain.
Horses: 10mg/ml soln. |
|
|
Term
| Dexmedetomidine (Dexdomitor) |
|
Definition
Generic name: Dexmedetomidine (Dexdomitor)
When appropriate to use: Given IM
Drug class: Alpha-2 agonist sedative
Mech of action: Stimulates alpha-2 adrenoreceptors on sympathetic nerves in the brain and spinal cord (CNS), causing a decrease in the release of the neurotransmitter noepinephrine. Metabolized by liver, excreted in urine.
Desired effect: Potent sedative, analgesic, muscle relaxer for short dx/treatments. Fewer side effects than Xylazine. Comined with Butorphanol (Turbugesic) in same syringe. Use in dogs, cats, horses, exotics.
Reversible? YES Alpha-2 antagonists. Atipamazole (Antesedan).
Controlled substance? NO
Analgesic? YES
Side effects: Use in young, healthy patients. May cause bradycardia, AV block (atropine helps prevent this), reduced cardiac output. May respond to stimuli, use in quiet environment. May be absorbed thru skin CAREFUL!
Use 1/2 reversal dose in cats via IM. Use 1/2 IM dose in dogs when given again IV (crisis only).
Dose: Antesedan: 5mg/ml Dexdomitor: 0.5mg/ml |
|
|
Term
| What does antesedan do to cats? |
|
Definition
| Makes the super excited. Increase in epinephrine and HR. |
|
|
Term
| How much of Antesedan should a cat receive? |
|
Definition
|
|
Term
|
Definition
Generic name: Diazapam (Vallium) "squirtgun"
When appropriate to use: Given IV (slowly), PO, IM + SQ (painful)
Drug class: Benzodiazepine sedative
Mech of action: Increases the action of GABA, an inhibitory neurotransmitter in brain, thus causing tranquilization and skeletal muscle relaxation.
Desired effect: Balance anesthesia when mixed with Ketamine. Mild traquilizer with skeletal muscle relaxation. Min. cardiopulmonary depression. Appetite stimulator for cats and ruminants. Seizure control.
Reversible? YES Flumazeni (rarely stocked, light sensitive)
Controlled substance? YES
Analgesic? NO
Side effects: May cause idiosyncratic liver failure in cats. Cannot be stored in IV bags. Light sensitive. Can be painful if given IM or SQ. Cause excitement if given alone. Give slowly IV. Decrease I.O.P. |
|
|
Term
| How much should the dose be if we have to give Diazapam orally to a seizuring dog/cat? |
|
Definition
|
|
Term
| What can Diazapam only mix with? |
|
Definition
|
|
Term
|
Definition
Generic name: Midazolam (Versed)
When appropriate to use: Given IV (slowly), PO, IM (preferred), SQ
Drug class: Benzodiazepine sedative
Mech of action: Increases the action of GABA, an inhibitory neurotransmitter in brain, thus causing tranquilization and skeletal muscle relaxation.
Desired effect: Balance anesthesia when mixed with ketamine, opioids, benzos. Potent traquilizer (2-3x diazepam) with skeletal muscle relaxation. Min. cardiopulmonary depression. Appetite stimulator for cats and ruminants. Seizure control.
Reversible? YES Flumazeni (rarely stocked, light sensitive)
Controlled substance? YES
Analgesic? NO
Side effects: May cause idiosyncratic liver failure in cats. Cannot be stored in IV bags. Light sensitive. Cause excitement if given alone. Give slowly IV. Decrease I.O.P. 2-3x more potent than diazepam, shorter half life. |
|
|
Term
| What are the component drugs found in Telazol? |
|
Definition
Zolazepam and Tiletamine
For use in feral/wild animals |
|
|
Term
|
Definition
When appropriate to use: Given SQ, IM, other routes: epidural, rectal, intra-articular
Drug class: Opioids/Opiates
Mech of action: Create analgesic and sedative effects by binding to natural opioid receptors in the brain and spinal cord. Receptors respond to natural opiods such as endorphins and enkalphins, which are responsible for pain relief and euphoria. Reacts on 4 different types of receptors, causing each drug's unique effect
Desired effect: Most effective agents for treating pain. Provide analgesia in conscious and unconscious patient during pre-intra-post op surgery. PA sedation when used with other agents, use less GA. Can be used alone for high risk patient. Stimulate upper+ lower GI evacuation.
Reversible? YES (Naloxone*best), butorphanol nalorphine, levallorphan, nalmefene, nalbuphine
Controlled substance? YES
Analgesic? YES
Side effects: Respiratory depression at higher doses(rare), effects on GI, excitement in cats. Crosses placental barrier. Bradycardia, histamine release, ptyalism, increased sensitivity to noise. Fatal drug rxn with MAO inhibitors and tricyclic antidepressants |
|
|
Term
| What are the body's natural opioids? |
|
Definition
|
|
Term
| What are the 4 type of opioid receptors? |
|
Definition
1. Mu
2. Kappa
3. Sigma
4. Delta |
|
|
Term
| These can cause a fatal drug reaction if opioids are mixed with what kind of drugs? |
|
Definition
| MAO inhibitors and tricyclic antidepressants. |
|
|
Term
| What causes physical dependence? |
|
Definition
| When body is unable to make its own endorphins and/or enkalphins |
|
|
Term
| What occurs when there an increase usage in exogenous corticosteroids? |
|
Definition
|
|
Term
| What opioid is NOT used in cats? |
|
Definition
Morphine
Cats unable to tolerate. Have adverse rxn. Makes them hyper-feeling. |
|
|
Term
| List of opioids from least to most potent |
|
Definition
1. Butorphanol (Torb): weakest
2. Tramadol: weakest
3. Buprenorphine: weakest
4. Morphine: (1)
5. Oxymorphone, hydromorphone (10)
6. Fentanyl (patch) (100)
7. Etorphine (m-99) (10,000) |
|
|
Term
|
Definition
Generic name: Morphine`
When appropriate to use: Given SQ prn, IM, other routes: epidural, rectal, intra-articular
Drug class:Opioid Pure-M agonist
Mech of action: Create analgesic and sedative effects by binding to natural opioid receptors in the brain and spinal cord. Receptors respond to natural opiods such as endorphins and enkalphins, which are responsible for pain relief and euphoria. Reacts on 4 different types of receptors, causing each drug's unique effect
Desired effect: Provide analgesia for moderate-severe pain. 4-6 hr duration. PA sedation when used with ace, atropine, glycopyrrolate, use less GA. Can be used alone for high risk patient. Stimulate upper+ lower GI evacuation. Inexpensive. Calms patients, useful in debiliated patients. Cough suppressant.
Reversible? YES (Naloxone*best), butorphanol, nalorphine, levallorphan, nalmefene, nalbuphine
Controlled substance? YES
Analgesic? YES
Side effects: Respiratory depression at higher doses(rare), effects on GI causing pre-op vomiting, diarrhea, constipation. Causes excitement. Crosses placental barrier. Bradycardia, histamine release, ptyalism (drooling), increased sensitivity to noise. Fatal drug rxn with MAO inhibitors and tricyclic antidepressants. Not good for patients with instestinal obstruction or diaphragmatic hernia.
Give less dose to cats! |
|
|
Term
| What drug causes meiosis in canines and mydriasis in felines/LA? |
|
Definition
|
|
Term
| Butorphanol (Torbugesic, Torbutrol) |
|
Definition
Generic name: Butorphanol (Torbugesic, Torbutrol)
When appropriate to use: IV, IM, SQ
Drug class: Mixed agonist/antagonist
Mech of action: Stimulates opioid kappa receptors to produce analgesia for mild-moderate pain. Mixed with acepromazine or with medetomidine (Domitor) for PA use in cats.
Desired effect: Mild analgesia for mild-moderate pain. 1-2 hr duration. PA sedation for cats when used with acepromazine, medetomidine, use less GA. Cough suppressant. Colic control. Stimulate upper+ lower GI evacuation. Inexpensive. Calms patients, useful in debiliated patients. Cough suppressant.
Reversible? YES (Naloxone*best), butorphanol, nalorphine, levallorphan, nalmefene, nalbuphine
Controlled substance? YES (In Oregon)
Analgesic? YES
Side effects: Respiratory depression at higher doses. Bradycardia and decrease in blood pressure if given alone. Short duration. Monitor patient if given with dexmedetomidine. |
|
|
Term
|
Definition
| Combination of sedative/opioid |
|
|
Term
|
Definition
Generic name: Buprenorphine (Buprenex)
When appropriate to use: IV, IM, PO
Drug class: Partial M-agonist
Mech of action: Stimulates opioid kappa receptors to produce analgesia for mild-moderate pain.
Desired effect: Mild analgesia for mild-moderate pain. 6-12 hr duration. Less effective analgesic than morphine, delayed onset of action 20-30 min via IM.
Reversible? YES (Naloxone*best), butorphanol, nalorphine, levallorphan, nalmefene, nalbuphine
Controlled substance? YES
Analgesic? YES
Side effects: Respiratory depression at higher doses. Difficult to reverse with naloxone. |
|
|
Term
|
Definition
Generic name: Fentanyl
When appropriate to use: Transdermal patch, IV (very slowly)
Drug class: Pure M-agonist
Mech of action: Stimulates opioid kappa receptors to produce analgesia for moderate-severe pain.
Desired effect: Potent analgesia for moderate-severe pain. Delayed onset of action 12-18 hr. Dry and clean skin, no residue alcohol. Used as CRI, fluid support. Can be mixed with Ketamine. For painful injury/fracture surgery
Reversible? YES (Naloxone*best), butorphanol, nalorphine, levallorphan, nalmefene, nalbuphine
Controlled substance? YES
Analgesic? YES
Side effects: Respiratory depression at higher doses. |
|
|
Term
|
Definition
| Use in wildlife species. Most potent of all opioids. Controlled, Absorbed thru skin CAUTION |
|
|
Term
|
Definition
Generic name: Tramadol
When appropriate to use: PO.
Drug class: Synthetic M-agonist
Mech of action: Stimulates opioid kappa receptors to produce analgesia for mild pain.
Desired effect: weak analgesia for mild pain. Onset of action 12 hr.
Reversible? YES (Naloxone*best), butorphanol, nalorphine, levallorphan, nalmefene, nalbuphine
Controlled substance? YES
Analgesic? YES
Side effects: Respiratory depression at higher doses. |
|
|
Term
|
Definition
Used to reverse severe respiratory depression, sedation, adverse drug rxn of any opioid drug.
Drug class: Opiod receptor antagonists.
Expensive drugs, only used in emergency. |
|
|
Term
| List of opioid reversal drugs |
|
Definition
1. Naloxone (Narcan): Pure antagonist worst best. Given IV, IM, SQ q 2 hrs prn
2. Nalmefene: Pure agonist
3. Nalorphine: Mixed agonist/antagonist
4. Levalloprhan: Mixed agonist/antagonist
5. Butorphanol: Mixed agonist/antagonist |
|
|
Term
| Which drugs are considered as alpha-2 agonists? |
|
Definition
1. Xylazine
2. Detomidine
3. Dexmedatomidine |
|
|
Term
| Which drugs are considered as alpha-2 antagonists? |
|
Definition
1. Antesedan
2. Yomhimbine
3. Talazoline |
|
|
Term
| Which drugs are considered as Benzodiazapenes? |
|
Definition
1. Diazepam
2. Midazolam
3. Zolazepam |
|
|
Term
| Which drugs are considered as Opioids? |
|
Definition
1. Butorphanol (Torb)
2. Tramadol
3. Buprenorphine
4. Morphine
5. Oxymorphone, hydromorphone
6. Fentanyl (patch)
7. Etorphine (m-99) |
|
|
Term
| Which drugs are considered as a Pure-M agonists? |
|
Definition
1. Morphine
2. Fentanyl
3. Etrophine
4. Oxymorphone/hydromorphone |
|
|
Term
| Which drug is considered as a partial-M agonist? |
|
Definition
|
|
Term
| Which drugs are considered as mixed agonist/antagonist? |
|
Definition
1. Butorphanol
2. Nalorphine
3. Levalloprhan |
|
|
Term
| Which drug is considered as a pure opioid agonist? |
|
Definition
|
|
Term
| Which drug is considered as a pure opioid antagonist? |
|
Definition
|
|
Term
|
Definition
Generic name: Ketamine C-III
When appropriate to use: Used for fractious cats via IM, Dogs IV for pain. CRI use. Used commonly with Diazapam/Vallium as alternative induction agent. Given IM, IV (dose for each different), PO (extra-label)
Drug class: Dissociative
Mech of action: Heavy sedative. Inhibits some parts of the CNS while exciting others. Metabolized by liver in dogs (varies by function), excreted by the kidneys in cats. Increases HR, cardiac output, and RR.
Desired effect: Pain/sedation effect.
Reversible? NO
Controlled substance? YES
Analgesic? YES (Somatic pain, not visceral)
Side effects: Contraindicative for liver failure, tachycardia, cardiac-prone patients. Causes, excitement, muscle rigidity and dilated pupils. Increased salivary secretions
Dose: 100mg/mL, 100mg/5kg |
|
|
Term
| What can lead to airway obstruction? |
|
Definition
Use of ketamine and thiobarbituates. Increase respiratory secretion
Intubation increase airway mucus production in cats. |
|
|
Term
|
Definition
| Pulses are the result of blood pressure, which is the force exerted by a volume of flowing blood on arterial walls. Should be strong and synced with heartbeat |
|
|
Term
| What should always be equal? |
|
Definition
|
|
Term
| Which places can you palpate an arterial pulse? |
|
Definition
1. Femoral artery (inner thigh)
2. Carotid artery (Neck)
3. Lingual artery (Under tongue)
4. Dorsal pedal artery ("ankle in dogs) |
|
|
Term
| Normal Systolic and Diastolic BP |
|
Definition
Systolic: 100-180 mmHg
Diastolic: 70-90 mmHg
Hypotension: S > 150; D > 95
Anything going below 70 should be watched carefully. |
|
|
Term
| How do you calculate MAP? |
|
Definition
(diastolic + [systolic - diastolic] /3) |
|
|
Term
|
Definition
A heart beat without associated pulse. Occurs when cardiac output no sufficient to produce a palpable pulse. Indicates failing heart. BAD
Want to feel pulse after "lub dub" |
|
|
Term
|
Definition
Mean arterial pressure.
70mmHg or above |
|
|
Term
| When MAP falls to 60 mmHg |
|
Definition
Decreased organ perfusion in kidneys, liver, brain. BAD
Ajdust anaesthetic depth, ventilate patients
Decrease amt of anesthetic gas
Increase fluid rate |
|
|
Term
| HR + Rhythm bpm in dogs/cats |
|
Definition
Dogs: 60-180 bpm
Cats: 110-220 bpm |
|
|
Term
| What should we expect in HR when patients are under gen. anesthesia? What drugs are the exemptions? |
|
Definition
10% HR drop occurs due to CV depressant effects of drugs.
Exception: Ketamina, tiletamine, atropine, glycopyrolate
Initially slow rate may not change
HR may increase during exciatory stage, can avoid with smooth induction. |
|
|
Term
| Ranges of bradycardia in the dog and cat |
|
Definition
Dog: <60 bpm (varies by size, bigger = lower)
Cat: <100 bpm or when too fast to count
Brady = slow
Tachy = fast
Changes in rhythm may be a sign of impending Cardiac arrest even with normal anesthetic doses. |
|
|
Term
| What drugs can predipose the heart to arrhythmias? |
|
Definition
Halothane (OUTDATED)
Medetomadine (Dextomador)
Xylazine (dogs + lg animals) |
|
|
Term
|
Definition
Dog: 10-30 br/min
Cat: 25-40 cat
May drecrease with GA (8-20 br/min) |
|
|
Term
| Monitoring techniques for HR and rhythm |
|
Definition
a. Stethoscope
b. Esophageal stethoscope
c. ECG
d. Palpation of chest wall for movement |
|
|
Term
| What happens when there is a gradual increase in end-tidal CO2? |
|
Definition
| < 44 mmHg = can't burn off CO2 fast enough. Metabolic acidosis from poor ventilation. Shallow breathing (hypoventilation). Bad for enzymes, protein denaturation. Decreased pH |
|
|
Term
| What does it mean when End tidal CO2 is below 44 mmHG? |
|
Definition
| Animal is ventilating enough. Range: 35-45mmHg |
|
|
Term
|
Definition
| Mechanical process of moving air in and out (inhalation and exhalation) |
|
|
Term
|
Definition
| Same as ventilation, with addition of binding O to hemoglobin, release to tissues, uptake of CO2 by blood that will be returned to lungs. |
|
|
Term
| Tidal volume (Vt)/ Depth of respiration |
|
Definition
| Normal volume on air inspirated. Depth of respiration. |
|
|
Term
|
Definition
|
|
Term
| Min Volume of respiration (mL) |
|
Definition
| Vt x RR = Ve = Min. Volume of resp. (mL) |
|
|
Term
|
Definition
Temporal relationship between inspirations and exhalations
Inspiration: 1-1.5 sec
Expiation: 2-3 sec |
|
|
Term
|
Definition
"Breath holding"
Inspiration, long pause, expiration. May be observed with ketamine |
|
|
Term
| What phase of anesthesia can increase RR and/or breath holding? |
|
Definition
|
|
Term
| When applying ECG leads, where should white clip be placed? |
|
Definition
|
|
Term
| When applying ECG leads, where should red clip be placed? |
|
Definition
|
|
Term
When applying ECG leads, where should black
clip be places? |
|
Definition
|
|
Term
| How are inhalation/gas anesthestics metabolized? |
|
Definition
By creating a steep concentration gradient. O2 diffuses from lungs (aveoli) --> bloodstream, while CO2 diffuses into alveoli (gas exchange) Moves to the brain via blood supply, increase in GABA receptors
Breathing maintains this. |
|
|
Term
| Where are anesthetic non-gas drugs metabolized and excreted? |
|
Definition
| Metabolize in liver, excreted in kidney |
|
|
Term
| Where are most gas anesthetic drugs metabolized? |
|
Definition
| Through the lungs. Makes it very safe to use in high risk patients. |
|
|
Term
| How can the concentration of the inhalant anesthetic drug in the bloodstream be adjusted and thus alter anesthetic depth? |
|
Definition
| By adjusting concentration of gas delivered to the lungs during INSPIRATION. |
|
|
Term
| What are the advantages of gas anesthesia? |
|
Definition
1. Drug elimination/recovery not dependent upon distribution to tissus, hepatic metabolism or renal excretion
2. Agents rapidly exhaled. Able to control depth of anesthesia |
|
|
Term
| What are the disadvantages of gas anesthesia? |
|
Definition
1. Constant monitoring needed at all times
2. Agents may be explosive or flammable
3. Agents may irritate tisues
4. Chronic exposure to agents hazardous |
|
|
Term
| Mechanism of action of gas anesthestics |
|
Definition
Agents enhance the activity of GABA, inhibiting nerve function in brain.
May also dissolve into nerve cell membranes, loss of ability to conduct action potentials |
|
|
Term
| Physiological affects of gas anesthestics |
|
Definition
1. Hypoventilation. Decrease in tidal volume and RR
2. Hypotension, poor tissue + organ perfusion, Cardiovascular depression.
3. Most agents eliminated thru lungs, but some undergo liver metabolism.
4. All cause dose-dependent/reversible CNS depression
5. Min. muscle relaxation, NO analgesia |
|
|
Term
| What is the diffusion rate for gas anesthestics dependent upon? |
|
Definition
1. Concentration gradient between the alveoli and bloodstream.
2. Lipid solubility. |
|
|
Term
| What organs by order are effected by the saturation of gas anesthetics? |
|
Definition
| Tissues of the brain, heart, kidneys. Then skeletal muscle and fat tissue. |
|
|
Term
|
Definition
| By keeping anesthetic gas flows and partial pressures high enough. Related to anesthesia depth. |
|
|
Term
| What are some physical properties affecting gas anesthetic drugs? |
|
Definition
1. Vapor Pressure
2. Blood:Gas Solublity Coefficient
3. Min. Alveolar Concentration (MAC) |
|
|
Term
|
Definition
Measure's tendency for a molecule of liquid to be converted to gas state.
Agent and temperature dependent! |
|
|
Term
| What are agents with high vapor pressure called? |
|
Definition
| Volatile. Enters gas phase easily. |
|
|
Term
| How can we control how much gas agent is being converted from liquid --> gas state? |
|
Definition
| By using the settings on precision vaporizer. |
|
|
Term
| Why are agents color coded? |
|
Definition
| Agent specific. Cannot put Iso in a Sevo vaporizer. |
|
|
Term
| Which agent is purple colored? |
|
Definition
|
|
Term
| Which agent is yellow colored? |
|
Definition
|
|
Term
| Blood:Gas Solubility Coefficients |
|
Definition
| Measure of the distribution of an inhalation agent between the blood and alveolar gas phases in the body |
|
|
Term
| Gas with low solubility coefficients |
|
Definition
Rapid induction and recovery times
LOW = FAST |
|
|
Term
| Gas with high solubility coefficients |
|
Definition
Slower induction and recovery times
HIGH = SLOW |
|
|
Term
| Which gas agents have low gas soubility coefficients? |
|
Definition
Isoflurane
Sevoflurane
Desflurane |
|
|
Term
| How does a low gas solubility coefficient affect our patients? |
|
Definition
Allow patients to respond to changes in vaporizing settings rapidly (1-2 min)
Allow faster recovery |
|
|
Term
| Min. Alveolar Concentration (MAC) |
|
Definition
Lowest concentration of anesthetic drug that produces no response in 50% of patients exposed to a painful stimulus.
Low MAC = more potent
High MAC = less potent |
|
|
Term
| Order of MAC from less ---> more potent |
|
Definition
1.Nitrous Oxide (MAC 200)
2. Sevoflurane (MAC 2.5)
3. Isoflurane (MAC 1.3)
4. Halothane (MAC 0.8)
5. Methoxyflurane (MAC 0.2) |
|
|
Term
| Which anes. gas is always going to be at higher MAC levels compared to Isoflurane? |
|
Definition
| Sevoflurane. 1-2x mac for main. |
|
|
Term
| How can MAC values be influenced by? |
|
Definition
Age, body temp, metabolic activity, disease, obesity, various drug treatments.
All responses dependent upon concentration of drug in patient brain |
|
|
Term
| Propofol (Propflo, Rapinovet, Diprivan) |
|
Definition
Generic name: Propofol
When appropriate to use: Transdermal patch, IV (very slowly)
Drug class: NA. Liquid emulsion of soybean oil, egg lecithin, glyverol.
Mech of action: Short active sedative/hypnotic drug unrelated to other GA agents.
Desired effect: Sedative, CRI, Induction agent
Controlled substance? NO
Analgesic? NO. No muscle relaxant either.
Side effects: Contraindicative in patients with food allergies or pancreatitis, have to give slowly, hypotension, bradycardia, seizure-like symptoms at induction. Caution in hypoproteinemic patients (low TP). |
|
|
Term
| `What are some common uses for propofol? |
|
Definition
1. Anes. induction agent for cats/dogs, puppies/kittens, avians
2. Brief anes. for outpatient + minor diagnostics.
3. Maintain GA uses CRI or incremental doses
4. Safer choice than barbituates in sighthounds
5. Extra label use in foals pre-medicated with xylazine for MRI |
|
|
Term
| Advantages of using propofol |
|
Definition
1. Rapid, smooth, excitement-free induction in 30-60 secs. Rapid unconsciousness.
2. Sub-anesthetic doses produce sedation, restraint, unawareness.
3. Rapid, smooth recovery, repeated doses do not effect recovery in canine patients
4. Safe use in sighthounds, neonates
5. No irritation at injection site.
6. No reversal agent, Not a controlled substance
7. Quickly metabolized by liver, not much absorption, has wide safety of margin |
|
|
Term
| Disadvantages of using propofol |
|
Definition
1. Can cause rate-induced apnea (pre-O2 patient). Hypotension
2. Negative ionotrope, bradycardia/hypotension may follow
3. No analgesia, No muscle relaxant
4. Short shelf-life, expensive, dont use after the day its been open, bacteria growth (sepsis)
5. Seizure like symptoms at induction.
6. Heinz body formation in repeated use in cats.
7. Highly plasma bound (Dont give to patients with low TP)
8. Sensitizes heart to epinephrine-induced arrhythmias
9. Side effects: Contraindicative in patients with food allergies or pancreatitis, have to give slowly, hypotension, bradycardia, seizure-like symptoms at induction. Caution in hypoproteinemic patients (low TP). Watch for rate-induced apnea. |
|
|
Term
| Which drugs increase heart rate (Postive Chronotrope)? |
|
Definition
1. Glycopyrrolate
2. Atropine
3. Ketamine
4. Epinephrine |
|
|
Term
| How do we administer propofol? |
|
Definition
Dog/cat: 4-6mg/kg IV (single dose last 6-7 mins)
1. Give calculated dose IV slowly over 20-60 seconds, beware of rate-induced apnea
2. 1/2 of calculated dose can be given as an initial IV bolus, then remainder tritrated every 30 secs.
Titrate more if dog is resisting entubation
Place liquid lidocaine in cats throat if they are resisting. Watch for larynospasms |
|
|
Term
Parts of the endotracheal tube
[image] |
|
Definition
A. Valve
B. Pilot balloon
C. Machine end
D. Connector
E. Tie
F. Meas. of length from patient end (cm)
G. Meas. of internal diameter (mm)
H. Inflated cuff
I. Patient end
J. Murphy eye |
|
|
Term
[image]
Endotracheal tubes (ET tubes) |
|
Definition
Flexible tube placed in the trachea that allows anes. gases be delivered directly from machine --> lungs.
|
|
|
Term
| Advantages of using an endotracheal tube |
|
Definition
1. Opens patient airway
2. Less anatomical dease space
3. Precision admin of anes. agent
4. Prevents pulmonary aspiration
5. Reponse to respiratory emergencies
6. Allow attachment of ETCO2 meter |
|
|
Term
| What happens when there is too much mechanical dead speace? |
|
Definition
| ET tube too long. Sticks out too far, causing an increase of CO2 that is trapped. |
|
|
Term
| How can we determine the right size of ET tube for our patient |
|
Definition
| Measure tip of incisors --> thoracic inlet |
|
|
Term
|
Definition
1. Murphy tubes
2. Cole tubes
Materials: PVC, red rubber, silicone |
|
|
Term
|
Definition
Beveled end and side hole (murphy eye)
+/- cuff |
|
|
Term
|
Definition
No side hole or cuff
Abrupt decrease in diameter of tube
Used in birds and reptiles due to having complete tracheal rings. (more rigid) |
|
|
Term
| Properties of ET tubes (Materials: PVC) |
|
Definition
|
|
Term
| Properties of ET tubes (Materials: Red rubber) |
|
Definition
| Flexible, less traumatic, absorbent, may kink of collaspe |
|
|
Term
| Properties of ET tubes (Materials: Silicone) |
|
Definition
| Piliable, strong, less irritating, resist collaspe |
|
|
Term
| How are ET tube sizes determined? |
|
Definition
Measured by internal diameter (ID) of tube
Range from 1mm to 30 mm. |
|
|
Term
| How are ET tube length sizes determined? |
|
Definition
Standard lengths.
Scale marks distnce from patient end in CM |
|
|
Term
| How to we tie the ET tube in place? |
|
Definition
Dogs: maxilla
Cats: behind head
If too tight can cause hematoma, edema |
|
|
Term
| Why do we lube the cuff of the ET tube? |
|
Definition
Smoother placement, reduced trauma
Lube cuff while infated, then deflate it to create a go seal when it is re-inflated |
|
|
Term
[image]
Parts of the Laryngoscope |
|
Definition
| battery powered handed, light source, blade, |
|
|
Term
|
Definition
| Used to increase visibility of larynx while intubating. Use at base of tongue |
|
|
Term
|
Definition
1. Miller (straight)
2. Macintosh (Curved) |
|
|
Term
| What are the 3 main parts of the laryngoscope? |
|
Definition
Handle containing batteries
Blade to depress tongue and epiglottis
Light source to illuminate the orophaynx |
|
|
Term
|
Definition
Small animal: 0-5 in
Large animal: up to 18-inch |
|
|
Term
| How can we determine if a ET tube is placed sucessfully? |
|
Definition
Flip back, lower draw bridge
1. Visualizing with laryngoscope
2. Feel if breath coming out of tube
3. Palpate neck for placement. Should only feel 1 firm tube-like structure. (Not 2) |
|
|
Term
| Common problems associated with ET tube placement |
|
Definition
1. Laryngospasm (cats esp)
2. Functional upper airway obstruction
3. Pressure necrosis
4. Obstruction, occluded, kinked
5. Transmission of infection
6. Chewing of the tube prior to extubation |
|
|
Term
| When can an animal manage their own airway? |
|
Definition
| Once they can manage swallow, have swallowing reflexes, etc. |
|
|
Term
| What happens if ET tube is too long? |
|
Definition
Tube will go beyond base of trachea, enter one of the tubes.
Cause hypoxia, analectasis |
|
|
Term
| What specific ET common are cats prone to |
|
Definition
| Tracheal pressure necrosis resulting from the cuff. |
|
|
Term
| Technique for inflating ET tube cuff |
|
Definition
1. Document total volume of fully inflated cuff prior to intubation
2. After placing ET tube add air with syringe (1-2 CC), leave syringe attached to pilot balloon/valve
3. Bag patient listening for air escape around cuff
4. Add air to cuff incrementally while bagging/listening for air escape.
5. Cuff is properly inflated when no air is heard escaping around cuff.
6. Cuff may need additional inflation approx. 20 min into anes. maintenance. |
|
|
Term
| Why must we check inflation cuff on our patients during surgery? |
|
Definition
Trachea relaxes within 20 min, causing it to expand.
Bag patient, check to hear breathing |
|
|
Term
| What are two things you can check to ensure your patient is breathing |
|
Definition
1. Unidirectional valve: is the flapping?
2. Ventilation bag, is it full? |
|
|
Term
| How can we remove gas anesthesia completely from the patient after surgery? |
|
Definition
1. Place patient on 100% O2 gas (2-3L)
2. Turn vaporizer off to stop anesthesia gas
3. Remove Y piece, and empty the resevoir bag
4. O2 flush aggressively, reconnect Y piece, O2 flow meter on
5. Close pop-off valve. Bag patient x2-3 to ensure alveoli are full of O2
Helps patients recovery smoother and faster. Removes iso completely from system and replaces it with O2 much faster. |
|
|
Term
|
Definition
1. Make sure O2 tank is on and O2 flow is off
2. Close pop-off valve, put finger on end piece of patient breathing tube. Press O2 flush
3. Take up to 30-35 cmH20 on manometer. Count to 10 while holding O2 flush button and pop-off valve (if a banfield version pop-off valve)
4. Watch for manometer to keep steady above 30 cm H20
5. Re-open popoff valve and watch manometer drop to zero to prevent/check for inclusions of the system. |
|
|
Term
| What should you do if the adapter portion of the ET tube falls off? |
|
Definition
Create a temporary seal with your hand, have propofol handy just in case animal wakes up.
Know tube size, grab another adapter from same size ET tube. |
|
|
Term
| How can we make our anes. equipment last longer? |
|
Definition
Take breathing tubes off, hang them to ensure moisture and other material can fall down. Take off reservoir bag and hang it.
Can soap with chlorhex, let it sit 5-10 min, rinse very well, hang to dry. |
|
|
Term
| If pressure manometer reads over 15cmH20 or 11mmHg, what does this indicate? |
|
Definition
Indicates build-up of pressure within the system.
Pop-off valve not sufficiently open or O2 gas flow too high |
|
|
Term
| Why should pressure not exceed 15-20 cm H20 or 11mmHg? |
|
Definition
| Can rupture alveoli of patient, not good! |
|
|
Term
| How do we handle resevoir bags? |
|
Definition
By the collar. The more the bag is used, the longer it will last.
Watch for tears around rim of bag |
|
|
Term
|
Definition
Outdated. Not used much. Some use in equine to keep costs down.
1. Moderate rubber solubility. Leeches into resv. bag + tubbing, exposes patient.
2. Thymol preservative can affect vaporizer |
|
|
Term
|
Definition
1. Volatile vapor pressure req. precision vaporizer. 240 mmHg.
2. Blood:gas solubility coefficient low. 1.46%. Rapid induction/recovery
3. 1.5-2.5% maintain most patients
4. Low rubber solubility
5. Min. Fat solubility
6. Safe choice for renal/hapatic disease patients, neonates. Safest for heart, esp for birds, herps, rodents.
7. Vapors are irritant when masked/chamber induced.
8. Respiratory depressant.
9. Good muscle relaxation, no-little postanesthetic analgesia. |
|
|
Term
| Sevoflurane (2.5%) YELLOW |
|
Definition
1. Lower vapor pressure than isoflurane requiring different precision vaporizer. 160 mmHg
2. Blood:gas solublity coefficient very low. 0.65%. More rapid induction/recovery.
3. Faster patient response.
4. Best agent for mask/chamber induction (unless heart issues present/unknown)
5. $$$$$
6. Higher MAC, less potent
7. 2.5-4% maintains most patients
8. Adequate muscle relaxation, NO analgesic effect.
5. |
|
|
Term
|
Definition
Research drug. Very $$$ in price and equipment.
1. Highest vapor pressure. Need electronic precision vaporizer. 700 mmHg
2. Lowest solubility coefficient of all gas anesthetics. 0.42% |
|
|
Term
| What happens if there are expired or spent granules in the CO2 canister? |
|
Definition
Produces carbon monoxide. BAD
Signs: cherry red mm, with decreased respiratory. |
|
|
Term
|
Definition
Respiratory stimulant. Reverses respiratory depression. For neonates and patients who are not breathing
Increase recovery in ER anesthesia.
Route: sublingual. 1 drop = 1 mg
1-2 drop kitten
1-5 drop puppy |
|
|
Term
| Stages/Planes of anesthesia |
|
Definition
1. Stage 1
2. Stage 2
3. Stage 3
- Plane 1
- Plane 2
- Plane 3
- Plane 4
4. Stage 4 |
|
|
Term
| Where is are ideal Stage and plane of anesthesia? |
|
Definition
|
|
Term
| What occurs when patients pass through Stage 1 -> Stage 3 + 4 |
|
Definition
Progressive loss of pain perception, motor coordination, conscousness, reflexes, muscle tone and cardiopulmonary function.
Based on human-construct. May vary by patient. |
|
|
Term
| What is considered the best anesthetic depth? |
|
Definition
| When no surgical stimulus is perceived by patient, while avoiding excessive depth. Be as light as possible on anes. |
|
|
Term
| What can you do if patient is on the verge of waking up? (Resp rates increase) |
|
Definition
1. Crank up vape 4-5%
2. Bag patient
3. Inject more propofol |
|
|
Term
| What kind of effects does ketamine and tiletamine have on the CNS |
|
Definition
Both inhibit and activiate different parts of CNS at the same time. Can make Stages and Planes of anes. difficult to recognize.
Solid MAP, watch ETCO2, resp. trends, PLR, other reflexes to determine where we are on the plane spectrum |
|
|
Term
|
Definition
Propofol or inhalation drug induction. Patients are conscious, but appear disoriented and show reduced sensitivity to pain.
HR: normal Respiration: Normal/increased. All reflexes present |
|
|
Term
|
Definition
Loss of consciousness. Patient is able to chew and swallow, may yawn. Involuntary excitement may occur. Can be unpleasant for patient and dangerous to personel. Self injury and induced arrythmias occur here. Ends when patient has muscle relaxation.
HR: Decreased Respiration: Decreased. Decrease in reflex presence. |
|
|
Term
|
Definition
| Subdivided into 4 planes/depth of anesthesia. Known as the working stage. |
|
|
Term
| Why should we avoid getting the patient excited (dogs)? |
|
Definition
| Due to epinephrine induced arrythmias. |
|
|
Term
|
Definition
Light depth of anesthesia. Unconscious but cannot tolerate surgical stimulus.
Eyes: Globes rotate ventrally, pupils may partially constrict. PLR diminishes.
Reflexes: Palprebral and other reflexes present. Depressed laryngeal + swallowing reflex allows for endotracheal intubation. |
|
|
Term
|
Definition
Medium depth of anesthesia. Most surgical procedures performed here. Relaxed skeletal muscles.
Respiration: shallow HR/BP: Mildly decreased.
Eyes: Globes central in position. Pupils slightly dilated. PLR delay
Reflexes: Protective reflexes (palpebral, pedal) diminished/gone. |
|
|
Term
|
Definition
Deep depth of anesthesia. Significant cardiovascular and pulmonary depression.
HR: Decreased. Respiration: decreased. BP: decreased. Relaxed skeletal muscles. Lack of jaw tone.
Eyes: Globes central, pupils dilated. PLR diminished/absent.
Reflexes: Absent |
|
|
Term
|
Definition
Overdose plane. "Rocking" ventilatory pattern created when abdominal muscular becomes responsible for ventilation.
Signs of cardiovascular depression, hypotension, pale MMs and delayed CRT. Flaccid muscle tone. Patient in danger of respiratory and cardiac arrest.
Eyes: Fully dilated. PLRS absent. |
|
|
Term
|
Definition
| Respiration ceases in this stage, may be followed by circulatory collapse and death. Immediate resuscitation is needed to save patient's life. |
|
|
Term
| What two reflexes diminish as you go deeper into the planes? |
|
Definition
1. PLR
2. Palpebral reflex |
|
|
Term
| What are 2 types of breathing circuits? |
|
Definition
1. Rebreathing circuit
2. Non-rebreathing circuit |
|
|
Term
| Types of rebreathing tubes |
|
Definition
1. Standard small animal tubes: Use in patients over 15 lbs.
2. Pediatric tubes: Use in patients that weight 5.5 lbs-15 lbs
3. Large animal tubes: Use only in large animal machine. Coke-can diameter.
4. Universal F-Circuit: Tube within a tube. Patient inhales into colored inner tube, exhale within outer clear tube. |
|
|
Term
| Advantages of rebreathing systems |
|
Definition
1. Less O2 and anesthetic gas used
2. Less waste gasses
3. Conserves patients heat and moisture from respiration. Warms inhaled gases with exhaled gases. |
|
|
Term
| Non-rebreather system (Bain circuit) |
|
Definition
Use in patients under 6.5 lbs. Little-no exhaled gases returned to patient, but instead are evacuated by a scavenger typically connect to pop-off valve.
Fresh gas routed directly to ET tube and patient. Higher O2 flow rates. Quicker changes in anesthestic depth.
-No unidirectional valve
-No pressure manometer
-No CO2 canister |
|
|
Term
| Why shouldnt the O2 flush valve NEVER be used in a non-rebreather system? |
|
Definition
| Due to location of fresh gas inlet. Don't want to over-power patient with a bolus of O2 |
|
|
Term
| Why is not having a pressure manometer risky? |
|
Definition
| Unable to gauge how much fresh O2 going into aveoli. |
|
|
Term
| Advantages of a non-rebreather system |
|
Definition
-Use in very small patients
-Fresh gas directly from ET tube to patient
-Patient does not have to breathe exhaled gas |
|
|
Term
| Disadvatages of a non-rebreather system |
|
Definition
-No unidirectional valve
-No pressure manometer
-No CO2 canister
-Wastes more gas
-Decreases heat conservation |
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Term
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Definition
Monitoring of the concentration of partial pressure and CO2 in respiratory gases
Normal: 35-40 mmHg |
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Term
[image]
What does this trend indicate (High EtCO2)? |
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Definition
Higher plateau = more CO2 in body
-Anes. drugs (opioids)
-Hypoventilation, abnormal breathing
-Too deep in anesthesia |
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Term
[image]
What does this trend indicate (Low EtCO2)? |
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Definition
| Caused by aggressive bagging -Burning too much CO2 -Too light in anesthesia |
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Term
[image]
What does this trend indicate (Sloping EtCO2)? |
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Definition
| Occlusion blocking airway (kinked hose) Buildup in CO2 overtime Extubate to check. Be fast! |
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Term
[image]
What does this trend indicate (Increasing baseline)? |
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Definition
| Collect CO2 overtime. -ETCO2 in breathing circuits -Soda lime is spent. patient breathing in non-scrubbed CO2 -Malfunctioning valves |
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Term
[image]
What does this trend indicate (Occilations)? |
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Definition
| Weird pattern @ inhalation. Common in big dogs. Heart beat. |
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Term
[image]
What does this trend indicate (Sudden drop in EtCO2)? |
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Definition
| Stop producing CO2: cardiac/pulmonary arrest -Hypothermia -Blood loss, hypotension |
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Term
[image]
What does this trend indicate (Weird low readings-flatline)? |
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Definition
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Term
[image]
What does this trend indicate (Notch in plateau)? |
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Definition
| Breath holding. "bucking the respiration" -Put deeper in anesthesia -Inject propofol/more drug. |
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Term
[image]
What does this trend indicate (Flatline)? |
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Definition
| BAD. Animal in cardiac arrest, no breathing, no pulse. Or hose came off. |
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Term
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Definition
| Due to poor husbandry, water quality |
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Term
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Definition
Skin scrape, gill or fin biopsy, blood collection, surgery (wen trim, mass removal)
Beak trim (pufferfish)
Radiography: swim bladder disorder, fractures, foreign bodies |
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Term
| How is anesthetic dosage for fish determined by? |
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Definition
| Dosage based on amount of water the fish is in, not weight! Drugs added to the water. |
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Term
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Definition
Fish anesthetic drug. Acidifying agent, add NaCO3 to counteract the pH change.
Standard sedative dose: 50-100 mg/L of Ms-222 (80 ppm- 120 ppm). |
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Term
| NaHCO3 (Sodium Bicarbonate) |
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Definition
| Added as a buffer to MS-222. Double the amount based on how much MS-222 used |
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Term
| How can we increase oxygen for anestheized fish? |
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Definition
| By adding aerated bubbles/air stone |
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Term
| How can you "bag" a fish patient? |
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Definition
| By moving them in a figure 8 pattern. Allow water to flow into gills |
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Term
| What plane of anesthesia should we keep fish? |
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Definition
| Stage 4-5 (not too far into 5) |
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Term
| Stages of anesthesia [fish] |
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Definition
Stage 1: Start to notice crashing into tank, unable to maintain level in water column and will sink to the floor
Stage 2: Less response to prodding, slight decrease in resp rate. Deeply sedated
Stage 3: Loss of equilibrium and muscle tone. Re-directed swimming and increase in resp rate. Responds only to deep pressure. Excitatory stage
Stage 4: No rxn to pressure on tail.
Stage 5: Resp rate slow and irregular, bad if fish goes too far in this stage. Cardiac arrest |
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