Term
| What opioid is NOT used in cats? |
|
Definition
Morphine
Cats unable to tolerate. Have adverse rxn. Makes them hyper-feeling. |
|
|
Term
| 2 main drugs that can cause allergic reactions |
|
Definition
|
|
Term
| What do anesthesia drugs suppress? |
|
Definition
Cardiopulmonary system
-Bradycardia
- Decrease RR
- Hypotension
- Hypothermia |
|
|
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Halothane (OUTDATED)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
| 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
| Monitoring techniques for HR and rhythm |
|
Definition
a. Stethoscope
b. Esophageal stethoscope
c. ECG
d. Palpation of chest wall for movement |
|
|
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
Dog: 10-30 br/min
Cat: 25-40 cat
May drecrease with GA (8-20 br/min) |
|
|
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 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
|
Definition
| Partially collasped aveoli. Can be prevented by "bagging" |
|
|
Term
| What phase of anesthesia can increase RR and/or breath holding? |
|
Definition
|
|
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
| A weak pulse may indicate what? |
|
Definition
|
|
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
|
Definition
1. Excessive anesth. depth
2. Excessive vasodilation
3. Cardiac insuff. from prior heart diease
4. Hypovolemia (dehydration, blood loss)
Watch for low blood pressyre |
|
|
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
| 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
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
| What is are primary goal for patients under anesthesia? |
|
Definition
| Want them at Stage 3/Plane 2 |
|
|
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
| Which drug prevents one from testing reflexes? |
|
Definition
Ketamine
Immobilizes the limbs |
|
|
Term
| What are some considerations related to procedure? |
|
Definition
1. What kind of procedure is being performed? (surgical vs diagnostic exam)
2. How long is the procedure?
3. Will the procedure result in any anesthetic complications? Ex: thoracic surgery, blood loss from tumor removal
4. Will the positioning of the patient interfere with normal resp or Cardiovascular status?
5. If applicable, what kind of general anesthetic, tranquillizer, or narcotic will be used? (Heart/ECC patients dont use drugs that drop blood pressure!)
6. Can we use a local anesthestic vs general anesthesia?
7. Pain prediction (esp. in the eye, orthropedics) |
|
|
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
| Factors that cause patients to require higher dosages of drugs |
|
Definition
1. Excited/scared animals
2. Animals at puberty
May metabolize drug more rapidly and require subsequent doses |
|
|
Term
| Why do brachycephalic animals have a difficulty breathing under GA? |
|
Definition
| Due to short nasal passages, long soft palates, hypoplastic tracheas |
|
|
Term
| Why do brachycephalic animals require anticholinergic PA drugs? |
|
Definition
| To reduce salivary and tracheal secretions. Intubate and always delay extubation as long as possible |
|
|
Term
| Stages of anesthetic management |
|
Definition
1. Pre-anesthesia
2. Induction
3. Maintenance
4. Recovery
5. Post-op pain management |
|
|
Term
|
Definition
Drug that is administered within one hour of general or local anesthesia.
Ex: Pre-med, PA, pre-op |
|
|
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
| Most commonly used PA-drugs |
|
Definition
1. Acepromazine (lightest)
2. Atropine
3. Glycopyrrolate
4. Diazapam
5. Opioids
Administered via SQ or IM routes |
|
|
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
| What can lead to airway obstruction? |
|
Definition
Use of ketamine and thiobarbituates. Increase respiratory secretion
Intubation increase airway mucus production in cats. |
|
|
Term
| When do we reduce dosages? |
|
Definition
|
|
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
|
Definition
Type of anticholinergic drug that increases HR, flight/fight
mimic sympathetic nervous system |
|
|
Term
|
Definition
| Type of anticholinergic drug that inhibits vagus nerve. Inhibits vegetative response |
|
|
Term
|
Definition
1. Awake
2. Light sedation
3. moderate sedation
4. Deep sedation
5. Hypnosis (sleep-like, can be aroused)
6. Narcosis (effects of opioid)
7. Light (surgical anes.)
8. Moderate
9. Deep
10. Anesthestic overdose |
|
|
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
|
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? YES
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? YES
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
| How far of an angle can a surgery table be tilted? |
|
Definition
15 degrees
Any greater would push the abdominal organs against the diaphragm, which can compromise heart and lung function. |
|
|
Term
|
Definition
1. Reflex tachycardia
2. Weak pulse
3. Prolonged CRT |
|
|
Term
|
Definition
1. Alpha
2. Beta
3. Dopaminergic
Stimulates fight or flight |
|
|
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
| 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) |
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Term
| What drugs are considered pure-m agonist? |
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Definition
| Morphine. Most powerful analgesic |
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Term
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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! |
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Term
| What drug causes meiosis in canines and mydriasis in felines/LA? |
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Definition
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Term
| Butorphanol (Torbugesic, Torbutrol) |
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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. |
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Term
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Definition
| Combination of sedative/opioid |
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Term
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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. |
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Term
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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. |
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Term
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Definition
| Use in wildlife species. Most potent of all opioids. Controlled, Absorbed thru skin CAUTION |
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Term
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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. |
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Term
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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. |
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Term
| List of opioid reversal drugs |
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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 |
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Term
| Which drugs are considered as alpha-2 agonists? |
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Definition
1. Xylazine
2. Detomidine
3. Dexmedatomidine |
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Term
| Which drugs are considered as alpha-2 antagonists? |
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Definition
1. Antesedan
2. Yomhimbine
3. Talazoline |
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Term
| Which drugs are considered as Benzodiazapenes? |
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Definition
1. Diazepam
2. Midazolam
3. Zolazepam |
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Term
| Which drugs are considered as Opioids? |
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Definition
1. Butorphanol (Torb)
2. Tramadol
3. Buprenorphine
4. Morphine
5. Oxymorphone, hydromorphone
6. Fentanyl (patch)
7. Etorphine (m-99) |
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Term
| Which drugs are considered as a Pure-M agonists? |
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Definition
1. Morphine
2. Fentanyl
3. Etrophine
4. Oxymorphone/hydromorphone |
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Term
| Which drug is considered as a partial-M agonist? |
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Definition
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Term
| Which drugs are considered as a synthetic M-agonist? |
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Definition
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Term
| Which drugs are considered as mixed agonist/antagonist? |
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Definition
1. Butorphanol
2. Nalorphine
3. Levalloprhan |
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Term
| Which drug is considered as a pure opioid agonist? |
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Definition
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Term
| Which drug is considered as a pure opioid antagonist? |
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Definition
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Term
| 2 basic types of anesthetic systems |
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Definition
1. Rebreathing system
2. Nonbreathing system |
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Term
| Specific tasks of the anesthetic machine |
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Definition
1. Vaporize anesthetic liquid -> gas form
2. Move exhaled gases away from patient (dipose or recirculate)
3. Remove exhaled CO2 gas from recirculated gas
4. Delivery of 100% O2 to patient |
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Term
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Definition
1. Allows recirculation of exhaled gases back to patient
2. Used for animals over 10 lbs
3. Each inspiration contains exhaled gas that has had the CO2 removed. Fresh O2 and anesthetic drug added |
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Term
| What are some advantages of rebreathing systems? |
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Definition
1. Less O2 and anesthetic gases used due to lower flow rates
2. Less waste gas produced
3. Conservation of heat and moisture produced by patients respiration. May combat hypothermia. Moisture may be good/bad thing. |
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Term
| Parts of the anesthesia machine. |
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Definition
1. Oxygen source with pressure guage
2. Pressure reducing valve
3. Flowmeter
4. Oxygen flush valve
5. Vaporizer
6. Inhalation valve
7. Inhalation hose
8. Connecting port
9. Endotracheal tube
10. Exhalation hose
11. Exhalation valve
12. Rebreathing (reservoir) bag
13. Pop-off valve
14. Scavanger hose
15. CO2 absorption canister
16. Pressure manometer |
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Term
| What is another kind of carrier gas used? |
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Definition
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Term
| What color is the central vaccuum? |
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Definition
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Term
| What color is the scavageous? |
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Definition
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Term
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Definition
| Central O2 source. H-cylinder. Gases exit out of the building through a main port in the wall. |
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Term
| Oxygen source with pressure guage |
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Definition
O2 supplied to patient. GREEN oxygen tank. Have a distinctive pin configuration to prevent wrongful attachment.
No anesthetic can be delivered to patient if O2 not present as carrier gas. |
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Term
| How do we remove an oxygen tank? |
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Definition
| Remove via wingnut. Left loosey righty tighty |
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Term
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Definition
Decreases high pressure from oxygen tank (2000 psi) to a useable level approx 50 psi. Total volume of gas present in tank.
No maintenance required. Snoopy's nose |
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Term
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Definition
| Determines rate of oxygen flow to patient (L/min) Work dial gently. |
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Term
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Definition
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Term
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Definition
Allows oxygen bolus to flow directly to anesthetic machine bypassing the vaporizer. Used to quickly give patient O2 and decrease anesthesia in system.
Done at end of anesthesia or if patient is too deep |
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Term
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Definition
| Converts liquid anesthetic --> gas form. Adds controlled amounts of gas anesthestic to oxygen flowing in machine. "fresh gas" (black tube) |
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Term
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Definition
One-way unidirectional valve that allows inhaled gases to flow only towards patient and not back into vaporizer.
Part of breathing circuit "rebreather"
Clean out of moisture, debris, dont clean with soap, dry with soft cloth |
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Term
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Definition
| Hose carries gases to patient |
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Term
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Definition
Y-piece on rebreathing system which connects inhlation hose, endotracheal tube, and exhalation hose.
Traps moisture, allows flexibility |
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Term
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Definition
| Tube placed in patient's trachea to allow delivery of O2 and anesthestic gases directly into respiratory system |
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Term
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Definition
| Carries gases the patient breathed out back to the anesthetic machine |
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Term
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Definition
| One-way directional valve that allows exhaled gases to flow only towards anesthetic machine, not back to patient. |
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Term
| Rebreathing (reservoir) bag |
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Definition
Inflatable rubber back which allows accumulation of fresh and expired gas during exhalation to allow gas to be avail. for the next breath
Acts as a safety device to prevent rapid pressure increases in system. Can be squeezed to deliver fresh gas to patient (positive pressure ventilation) |
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Term
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Definition
| Scrubs anesthetic gas, not CO2. Weighed upon intake, more weight as it becomes spent |
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Term
| When should granules be changed? |
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Definition
1. When granules acheive 50g weight = throw out
2. When granules change color (pink/purple)
3. When granules cannot be crushed
4. When 12 hrs of surgery time has passed |
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Term
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Definition
Pressure relief valve for entire system.
When open: releases gases and extra pressure from system --> scavenger hose.
When closed: All gas remains in machine
DONT maintain pop-off valve in closed position as pressure will build up in the system and can potentially harm the patient! |
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Term
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Definition
Hose carries waste gases out of the system and out of the building.
Blue hose. |
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Term
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Definition
Exhaled gases are direction thru CO2 absorption canister. Removes CO2 from gases.
Absorption capacity reached when granules change color, texture change (hardness).
Watch for temporary color changes over-time. |
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Term
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Definition
Located usually on top of CO2 absorption canister.
Measures pressure of gasses within anesthestic system (cmH20 or mmHg)
Gauges how much pressure to apply to the rebreathing bag when "bagging" the patient. |
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Term
| If pressure manometer reads over 15cmH20 or 11mmHg, what does this indicate? |
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Definition
Indicates build-up of pressure within the system.
Pop-off valve not sufficiently open or O2 gas flow too high |
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Term
| Why should pressure not exceed 15-20 cm H20 or 11mmHg? |
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Definition
| Can rupture alveoli of patient, not good! |
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Term
| How do we handle resevoir bags? |
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Definition
By the collar. The more the bag is used, the longer it will last.
Watch for tears around rim of bag |
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Term
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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
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. |
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Term
What is marked by A?
[image] |
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Definition
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Term
What is marked by B?
[image] |
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Definition
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Term
What is marked by C?
[image] |
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Definition
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Term
What is marked by D?
[image] |
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Definition
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Term
What is marked by E?
[image] |
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Definition
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Term
What is marked by F?
[image] |
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Definition
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Term
What is marked by G?
[image] |
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Definition
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Term
What is marked by H?
[image] |
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Definition
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Term
What is marked by I?
[image] |
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Definition
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Term
What is marked by J?
[image] |
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Definition
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Term
| When applying ECG leads, where should white clip be placed? |
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Definition
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Term
| When applying ECG leads, where should black clip be placed? |
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Definition
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Term
When applying ECG leads, where should red
clip be places? |
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Definition
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