Induction Anesthetics Flashcards Preview

Anesthesiology > Induction Anesthetics > Flashcards

Flashcards in Induction Anesthetics Deck (23):
1

Purpose of induction

Transition from a conscious/semiconscious animal to unconsciousness

2

Injectable induction anesthetics

Dissociative anesthetics: ketamine, tiletamine, phencyclidine
Propofol
Barbituates: thiopental, pentobarbital
Imidazole derivatives: etomidate, metomidate
Neurosteroids: alphaxalone, alphadolone

3

Ketamine cardiovascular effects

1. Direct negative inotropy
2. Catecholamine release: increases HR and contractility (if depleated, negative inotropy dominates)

4

Ketamine respiratory effects

- minimal depression
-Apneustic breathing
-Bronchodilation
- Upper airway reflexes decreased

5

Factors that increase cerebral blood volume

1. Hypercapnia, hypoxia
2. Hypertension
3. Drugs

6

Ketamine CNS effects

1. Cerebral vasodilation (may increase ICP)
2. May worsen cerebral perfusion and cause herniation in cerebral injury
3. Cerebral metabolic O2 needs increase
4. May be seizurogenic (also used to treat seizures)

7

Ketamine other effects

1. Increased salivation
2. Open eyes
3. Muscle tone retention (rigidity)
4. Increased IOP

8

Indications for ketamine

1. Hypovolemic shock
2. Asthma
3. Risk patients will tolerate small doses
4. Aggressive animal sedation

9

Contraindications for ketamine

1. Brain trauma or tumor
2. Perforating eye injury
3. HCM and mother other heart diseases
4. Epilepsy

10

Telazol is a mix of which two drugs

Tiletamine and zolazepam

11

Telazol is _____ acting than diazepam-ketamine.

Longer

Aggressive animals

12

Propofol characteristics

1. Fast onset/duration/metabolism
2. No accumulation
3. Smooth induction and recovery
4. Ideal for TIVA
5. Give only IV
6. Does not contain preservative

13

Propofol Cardiovascular effects

1. Vasodilation/hypotension
2. Mild negative inotropy
3. No reflex tachycardia

14

Propofol respiratory effects

1. Respiratory depression (hypoventilation, apnea, decreased tidal volume)
2. No laryngeal paralysis

15

Propofol CNS effects

1. Cerebral vasoconstriction
2. Increased ICP and blood volume
3. Metabolic O2 consumption decreased
4. Anti-epileptic
5. May cause muscle twitches

16

Barbituate drugs w/ duration

Short acting: Thiopental

Middle duration: Pentobarbital

Long acting: Phenobarbital

17

T/F: Thiopental has a slow metabolism rate and may accumulate after repeated dosages.

True

18

T/F: Thiopental should not be given extravenously.

True

19

Thiopental Cardiovascular effects

1. Negative inotropy
2. Vasodilation
3. Reflex tachycardia

Similar to propofol

20

Etomidate characteristics

1. Propylene glycol or lipid emulsion
2. Fast onset, short duration
3. No cummulation
4. Minimal CV effects

21

Etomidate cardiovascular effects

Almost none, best drug for hemodynamically unstable patients

22

Etomidate other effects

1. CNS similar to propofol
2. Inhibit cortisol secretion
3. Vomiting
4. Excitement and twitching
5. Give soon after fentanyl
6. Difficult drug, needs experience

23

Alfaxalone characteristics

1. Steroid anesthetic
2. Minimal CV effects
3. Slower onset than propofol, duration ~20min
4. Tough recovery at high doses
5. no allergic reaction
6. NEW