2- Drugs for induction

Question 1

Give 3 routes induction drugs can be delivered

Answer 1

IM, IV, Sub cut, Inhalation, Skin, Dart gun

Question 2

Name 4 characteristics of an ideal induction drug

Answer 2

Minimal cardiovascular & respiratory depression
Rapid metabolism
Causes hypnosis & amnesia
Rapid onset
No hypersensitivity reaction
Non-irritant
small volumes needed for induction
Inexpensive
Stable formulation

Question 3

Name 2 induction drugs

Answer 3

Propofol
Alfaxalone
Ketamine
Volatile agents

Question 4

T/F propofol is 98% protein bound

Answer 4

True

Question 5

How is propofol excreted?

Answer 5

Renally

Question 6

Where is propofol metabolised

Answer 6

Liver- glucuronidation

Question 7

Mechanism of propofol

Answer 7

Enhances GABA (inhibitory function)

Binds to GABAA Beta subunit

Increases duration that the cl- channel is open

Question 8

What effects does propofol have?

Answer 8

Respiratory depression
Decreased cerebral metabolic rate of oxygen (CMRO2)
Depresses cardiovascular reflexes

This causes = Decreased heart rate, mean arterial pressure (MAP), systemic vascular resistance & central venous pressure

Question 9

List some propofol side effects

Answer 9

Apnoea common
Twitching, myoclonus can occur- usually passes within 10-15mins

Question 10

What is the mechanism of alfaxalone?

Answer 10

Causes anaesthesia by activating the GABA (inhibitory) receptor

Question 11

What effect does alfaxalone on Cerebral metabolic rate of oxygen (CMRO2)?

Answer 11

Decreases

Question 12

T/F Alfaxalone has minimal effects on HR, Cardiac output & MAP

Answer 12

True

Question 13

T/F Apnoea is more common with alfaxalone than propofol

Answer 13

False- very common in propofol

Question 14

Where is alfaxalone metabolised

Answer 14

Liver, rapid
also lungs and kidney

Question 15

Where is alfaxalone eliminated

Answer 15

renal, and small % in bile

Question 16

Is ketamine water or lipid soluble?

Answer 16

water soluble

Question 17

What receptor does ketamine work at?

Answer 17

NMDA receptor antagonist

Question 18

What induction agent is the only one that provides analgesia?

Answer 18

Ketamine

Question 19

What controlled drug schedule is ketamine under? & what does this mean for storage?

Answer 19

Schedule 2 = locked in cupboard

Question 20

Name the 2 volatile agents

Answer 20

Isoflurane & Sevoflurane

Question 21

Where is ketamine metabolised

Answer 21

liver to norketamine

Question 22

where is ketamine eliminated

Answer 22

renal and small % in the bile

Question 23

Volatile agents are absorbed via…. and excreted via….

Answer 23

lungs and lungs

Question 24

What is the side effect of volatile agents?

Answer 24

Cardiopulmonary depression
- reduced cardiac output
- Reduced HR
- Decreased MAP, SVR, CVP

Question 25

what is the speed of induction of Intravenous induction drugs proportional to

Answer 25

speed of induction is proportional to the cardiac output

Question 26

what is the speed of induction via mask or chamber proportional to

Answer 26

speed of induction is inversely proportional to the cardiac output due to the negative effects of the cardiac output on the alveolar partial pressure.

Question 27

Describe how to use propofol

Answer 27

titrate to effect
give slowely IV over 60secs
Apnoea common

Question 28

Which species is propofol licensed in?

Answer 28

Dogs and cats