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ATE2611 > Pre-anesthetic Medications > Flashcards

Pre-anesthetic Medications Flashcards

1
Q

Muscle Relaxants

A
  • Part of balanced anesthesia
  • Used for skeletal muscle relaxation
  • Must provide mechanical respiration and analgesia
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2
Q

Hydromorphone Effects

A
  • Dose-related respiration depression
  • Vomiting / BM
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3
Q

Hydromorphone Use

A
  • Used with cats and dogs
  • Pre/Post anesthetic sedation and analgesia
  • Used for c-sections
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4
Q

Sedative Effects

Diazepam & Midazolam

A
  • Unreliable when used alone
  • Minimal to no analgesia
  • No anti-emetic properties
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5
Q

Torb and Dex Effects

A
  • Moderate-severe respiratory depression (dose-related)
  • Hyper-reactivity to auditory stimuli (opiod related)
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6
Q

Torb Effects

A
  • Use with cats and dogs
  • Antitussive in dogs
  • Slight cardiovascular and respirtatory depression
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7
Q

Guaifenesin

A
  • Gecolate
  • Muscle relaxant
  • Minimal cardiovascular effect
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8
Q

Dex and Rompun

A
  • Alpha-2 adrenergic agonists
  • Non-phenothiazine, non-narcotic
  • Derived from thiazine
  • Chemically similar
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9
Q

Torb

A
  • Narcotic
  • Not good used alone*
  • Analgesic

*use with Ace or Rompun

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10
Q

Torb-Dex Uses

A
  • Use for short procedures
  • Use with greyhounds
  • Not reversed if longer analgesia required
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11
Q

Ace-Torb

A
  • Neuroletanalgesic
  • Sedation + Pain relief
  • Use prior to anesthesia
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12
Q

Anticholinergics

A
  • Don’t provide analgesia
  • Don’t cause CNS or respiratory depression
  • Dilates pupils
  • Treats organophosphate poisonings
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13
Q

Ace and Anesthesia

A
  • Most widely used pre-anesthetic tranquilizer
  • Predictable sedation with a wide margin of safety
  • Lessens excitement phase during induction
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14
Q

Effects on Heart

Dex and Rompun

A
  • Causes bradycardia
  • Depresion of heart muscles
  • Second degree heart block*

*no QRS sometimes after P

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15
Q

Morphine Routes

A

SQ or IM
* no IV due to hyper-excitation

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16
Q

Tranquilizers

A

Diazepam and Midazolam
* benzodiazepine
* not phenothaizine or narcotic
* controlled drugs
* given IV or IM

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17
Q

ACE and Sympathetic Nervous System

A
  • Activity suppressed
  • Blocks nerve receptors and neurotransmitter activity*

*Alpha and Dopamine

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18
Q

Hydromorphone

A
  • Synthetic opioid
  • Like oxymorphone but less $$
  • Can combine with ACE
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19
Q

Reverse Hydromorphone

A

Reverse with Naloxone

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20
Q

Dopamine Receptors

A
  • In brain
  • Neuotransmitters
  • Naturally produced in the body
  • Lack of contributes to sedation
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21
Q

Atropine

A
  • Anticholinergics
  • Injectable
  • IV given in emergencies
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22
Q

ACE Patients

A
  • Use with calm animals; excitable may be resistant to effects
  • Avoid in prediatric and geriatric due to prolonged effects
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23
Q

ACE and Eyelid Effects

A

Cause prolapse of the third eyelid

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24
Q

FDA Approval

Rompun and Dex

in dogs and cats

A
  • Dog: pre-anesthetic
  • Cat: sedative and anesthetic
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25
Q

Alpha Receptors

A

When blocked, protect the heart against epinephrine induced arrhythmias

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26
Q

Fentanyl
Systemic Effects

A
  • Respiration / Cardiovascular Depression
  • May cause bradycardia*

* have Atropine ready

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27
Q

Ace & Skin Tests

A

Avoid use in skin testing
* anti-histamine activity

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28
Q

Diazepam & Midazolam

Patients

A

Good for patients with epilepsy or cardiovascular disease
* Less depressant on heart and vessels
* Minimal cardiopulmonary depression

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29
Q

Hydromorphone

Forms & Routes

A
  • Injectable
  • No oral use
  • SQ or IM
  • IV with dogs if needing immediate action
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30
Q

Buprenorphine

A
  • Narcotic
  • Acts longer than torb
  • Can cause respiratory depression*

*monitor for 2 hours after given

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31
Q

Diazepam

A
  • Not water soluble
  • Poorly absorbed when given IM or SQ
  • Should not be mixed with other water solubles*

*Ketamine is exception

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32
Q

Torb Routes

A
  • IV
  • IM
  • SQ
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33
Q

Diazepam & Midazolam

As anticonvulsants

A
  • Given IV
  • Given in dogs combined with Ketamine
  • Reduces possibilty of seizures
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34
Q

Ace

with horses

A
  • Can cause penile paralysis
  • Leads to prolapse of penis from sheath
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35
Q

Diazepam & Midazolam

Metabolism & Excretion

A

Metabolized by liver

Excreted in urine

36
Q

Morphine

General Effects

A
  • Miosis
  • Vagal Stimulation
  • Bradycardia
  • Vomitting / BM
  • Decreased Body Temp
37
Q

Ace

Metabolization

A

Liver

38
Q

Fentanyl

Forms

A

No oral

Transdermal
* administerd via patch
* don’t use with heating pads due to increased absorption

39
Q

Opioid

SIde Effects

A
  • Respiratory Depression
  • Bradycardia
  • GI Stimulation
  • Excitement
40
Q

Opioid

Excitement Causes

A

Dogs: high dose
Cats: given too fast via IV

41
Q

Morphine

Analgesia & Anesthesia

A

Analgesia = low dose
* minimal effect on myocardium

Anesthesia = high dose
* BP and respiratory depression

42
Q

Ace

Effects on Heart

A
  • Reduces strength of contraction
  • Don’t use in cases of shock, hypotension, or cardiac disease
43
Q

Ace

As a Travel Pill

A
  • Sedation
  • Anti-emetic Properties*

*suppresses chemoreceptor trigger zone

44
Q

Atropine

with Rompun and Dex

A

Atropine used to prevent bradycardia
* must be given 10 minutes before Alpha-2
* bad arrhythmias if given after Alpha-2

45
Q

Diazepam & Midazolam

in cats

A
  • May be used to stimulate appetite
  • May also cause vomiting
46
Q

Anticholinergics

Undesirable Side Effects

A
  • Excessive, thick mucus in respiratory system
  • Increased anotomical dead space*
  • Increased HR = Increased O2 consumption
  • Intestinal paralysis

*Bronchi dilation

47
Q

Glycopyrrolate

A
  • Anticholinergics
  • Lasts two times longer than atropine
  • Less effects on the heart
  • Doesn’t cross placental barrier
48
Q

Diazepam Given out of Vein

A

May cause perivascular irritation

49
Q

Morphine

A
  • Narcotics
  • Schedule II
  • From opium plant
  • Inexpensive
50
Q

Morphine

Reversal

A

Reversed with Nalline
* nalorphine

51
Q

Narcotic Antagonists

A

Only reverses effects of narcotics
* works within 1-2 minutes

Causes CNS arousal

52
Q

Ace with other drugs

A
  • Reduces barbiturate dose by half
  • When combined with ketamine in cats, produces muscle relaxation
53
Q

Phenothiazine Derivatives Tranquilizers

A
  • Acepromazine
  • Chlorpromazine*
  • Promazine

*used an anti-emetic

54
Q

Midazolam

A
  • Water soluble
  • Readily absorbed given SQ or IM
  • Can be mixed with other agents
55
Q

Alpha-2 Agonist Agents

A
  • Causes vasoconstriction
  • Depresses CNS
56
Q

Alpha-2 Agonist Agents

Effects

A
  • Sedation
  • Hypnotic Effects
  • Analgesia
  • Muscle Relaxation
57
Q

Alpha-2 Agonist Agents

Routes

A
  • SQ
  • IM
  • IV
58
Q

Opioid Reversal

A

Specific narcotic reversal agents
* Nalline & Narcan

59
Q

Opioid Reversal

and Atropine

A

Give Atropine prior to counteract vagal effects

60
Q

Narcotics

A
  • Opioids
  • Controlled - mostly II
61
Q

Narcotics

Pre-anesthetic Use

A
  • Provide sedation and analgesia
  • Reduce induction med dose by half
62
Q

Rompun & Dex Reversals

A

Rompun (Xylazine)
* yohimbine

Dex
* antisedan

63
Q

Dex Dose Determination

A

Dogs
* based on body surface area; not weight

Cats
* based on weight

64
Q

Buprenorphine Administration

A
  • Most often given in cats
  • For mild-moderate pain
  • Give on MM
65
Q

Anticholinergics

In Horses

A

Not routinely used
* causes paralytic effects in intestinal tracts
* leads to colic

66
Q

Ace

and Placental Barrier

A

Crosses barrier
* sedates newborn if used during c-sections

67
Q

Anticholinergics and Eyes

A
  • Pupil dilation
  • Reduced tear secretion - leads to drying of cornea*

*use ointment

68
Q

Gallamine

A
  • Muscle relaxant
  • Blocks motor nerve impulse
  • No muscle twitching
69
Q

Neuroleptanalgesia

A

Combination of narcotic and a tranquilizer

70
Q

Nalorphine HCI

A
  • Nalline
  • Narcotic antagonist
  • Synthetically derived from morphine
71
Q

Nalorphine HCI

Narcotic Antagonist

A

Use for morphine and fentanyl

72
Q

Ace and Hypotension

Cause

A

Produced due to site of action of epinephrine on the arterioles being blocked
* give IV fluids

73
Q

Acepromazine

A
  • Phenothiazine derivative tranquilizer
  • Desired action is tranquilization
74
Q

Naloxone

A
  • Narcan
  • Narcotic antagonist
  • Derived from oxymorphone
75
Q

Naloxone

Narcotic Antagonist Use

A

Use for:
* hydromorphone
* fentanyl
* morphine

76
Q

Narcotic Antagonists

Routes

A
  • Fastest = IV
  • IM or SQ via umbilical vein
  • Drop under the tongue
77
Q

Morphine Effects

Cats and Dogs

A

Both hyperactive to sound

Dogs
* unpredicatable excitement

Cats
* use with caution
* give tranquilizer

78
Q

Glycopyrrolate

Routes

A
  • SQ
  • IM
  • IV
79
Q

Fentanyl

A
  • Similar to morphine
  • Great analgesia with low dose
80
Q

Fentanyl

Reversal

A

Reversed with an antagonist
* nalline

81
Q

Ace-Hydromorphone

or Ace-Oxymorphone

A
  • Neuroleptanalgesic
  • Used for C-sections
82
Q

Ace Routes

A
  • Fastest: SQ (used most often)
  • IM
  • IV*

* caution of severe hypotension

83
Q

Ace

Reticular Activating System

A
  • Reduces activity of
  • System responsible for awake state
  • Reduced response to stimuli
  • Sedation
84
Q

Torb

As A Reversal

A

Can be used as narcotic reversing agent for morphine and oxymorphone

85
Q

Anticholinergics

Desired Effects

A
  • Take “brakes off heart”
  • Counteract vagal tone
  • Prevent bradycardia
  • Prevent salivary gland and upper airway secretion
  • Reduce laryngospasm during intubation

ATE2611 (12 decks)

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