Fentanyl or hydromorphone bolus ↓ HR and ventilation No myocardial depression Reversible Analgesic Short acting (fentanyl)

Similar effects of Ket/val Smaller volume Associated with rough recoveries w/o premeds Can be reconstituted with Ketamine and alpha2

Injectables Flashcards by Brenda Righter

Which injectable anesthetics may be given IM?

Ketamine
Telazol
Alfaxalone

How well did you know this?

Not at all

Perfectly

General qualities shared by injectable anesthetic drugs (6)

• Very liposoluble
• Highly protein bound
• Reach the Brain rapidly
• Redistributed to other tissue
• Accumulation in fat
• Decrease in drug
plasmatic 
concentration

How well did you know this?

Not at all

Perfectly

Opiods review (6)

Fentanyl or hydromorphone bolus
↓ HR and ventilation
No myocardial depression
Reversible
Analgesic
Short acting (fentanyl)

How well did you know this?

Not at all

Perfectly

2 injectable opiods

Fentanyl

- Hydromorphone

How well did you know this?

Not at all

Perfectly

5 CV effects of Ketamine

• Sympathetic Stimulation
• ↑ HR and BP
• Careful in HCM
• Direct myocardial
depressant
• May ↑ IOP

How well did you know this?

Not at all

Perfectly

Injectable anesthetic drugs (6)

Propofol
Ketamine
Telazol
Etomidate
Alfaxalone
Opioids (Fentanyl and Hydromorphone)

How well did you know this?

Not at all

Perfectly

Etomidate acts on _________ receptors and is _________ based. It is a ________ derivative and may cause _________.

GABA A receptors
propylene glycol
Imidazole
hemolysis

How well did you know this?

Not at all

Perfectly

Ketamine undergoes Hepatic metabolism in ____ and _____ and is eliminated unchanged by ____

dogs and horses

- cats

How well did you know this?

Not at all

Perfectly

Propofol acts on the _________ to cause _________ resulting in _________

GABA receptors
↑ influx of Cl
hyperpolarization

How well did you know this?

Not at all

Perfectly

2 shelf lives of Propofol formulations once opened

6 hours

- 28 days (2% Benzyl-alcohol)

How well did you know this?

Not at all

Perfectly

Alfaxalone acts on _____

GABA

How well did you know this?

Not at all

Perfectly

5 Neurologic effects of Propofol

Decrease CMR02
Decrease ICP
Protective for brain ischemia
Treatment for seizures
Decrease EEG activity

How well did you know this?

Not at all

Perfectly

Alfaxalone Review (6)

Fast acting
No problem if given perivascular
Short cardiovascular depression
Apnea, respiratory depression
CNS friendly
Can be given intramuscularly

How well did you know this?

Not at all

Perfectly

What is the main drawback to Etomidate use?

adrenal suppression (Addisonian crisis)

How well did you know this?

Not at all

Perfectly

Telazol Review (4)

Similar effects of Ket/val
Smaller volume
Associated with rough recoveries w/o premeds
Can be reconstituted with Ketamine and alpha2

How well did you know this?

Not at all

Perfectly

3 Respiratory effects of Ketamine

• Apneustic breathing
• Apnea
• Maintained laryngeal
reflexes and PaO2

How well did you know this?

Not at all

Perfectly

Neurologic effects of opiods

• Increase in intracranial pressure (if hypoventilation
occurs)
• May affect heart
automaticity and
conduction

The formulation of Propofol with the long opened shelf life is FDA approved only in _____

dogs

Characteristics of Propofol induction (6)

Induction in 30 sec
Excitation (bolus)
Apnea
Duration 10-15 min
Cumulative
Splenic engorgement

Neurologic effects of Etomidate

CNS friendly
Myoclonus
Poor muscle relaxation
Usually combined w/ benzo or opiods

Etomidate Review (6)

Minimal cardiovascular changes
Adrenal supression
Poor muscle relaxant
Combined with opioid or benzo for induction
Expensive
Good for cardiac patients

Neurologic effects of Alfaxalone

• CNS friendly
• Potential protective effect in premature fetus when labor is induced by glucocorticoids
(Betamethasone)
• Excitation in cats during recovery (IM route)

Propofol anesthesia lasts for ____-___ minutes after induction dose

10-15

Neurologic effects of Telazol

• Maintained reflexes
– Coughing
– Swallowing
– corneal reflexes

3 Neurologic effects of Ketamine

``` • ↑ ICP and CBF • Somatic analgesia • Excitement at emergence – Motor activity – Sensitivity to touch – Violent recovery ```

Ketamine is a _________ compound

cyclohexamine

Ketamine causes dissociation between the __________ and __________

- thalamus | - limbic system

What is the benefit of adding 2% Benzyl-alcohol to the Propofol formulation?

Extends opened shelf life from 6 hours to 28 days

CV effects of Etomidate

Cardiovascular and respiratory stability

CV and respiratory effects of Telazol

• Similar to ketamine • ↑ HR, BP and SVR due to sympathetic stimulation

Telazol comes as a ____ which is reconstituted with ________

- lyophilized powder | - sterile water

Once saturation occurs, plasma concentration only decreases with _______

drug elimination

Propofol review (6)

``` • Fast acting • No problem if given perivascular • Short cardiovascular depression • Apnea, respiratory depression • CNS friendly • Contamination after 6 hours opened – Benzyl alcohol prolongs shelf-life and decrease contamination ```

4 Clinical effects of Ketamine

* ↑ Salivation and mucus * Poor muscle relaxation * Reflexes are maintained * Rough recoveries

3 most important distribution tissues of the body

* Splanchnic viscera * Muscles * Fat

Cardiorespiratory effects of Alfaxalone

``` • Minimal cardiovascular effects – ↑HR and C.O. – ↓ BP (vasodilation) • Dose dependent respiratory depression – Apnea after bolus ```

Propofol is an __________ compound

alkylphenol

Ketamine Review (8)

* Increase sympathetic tone * Poor muscle relaxant * Combine with Benzodiazepines for induction * Increase myocardium work load * Increase ICP, CBF, IOP, â seizures threshold * Rough recoveries * Apneustic breathing, apnea * Maintained reflexes

4 CV effects of Propofol

* Myocardial depression * Decrease in CO * Decrease in BP * Increase HR

3 Respiratory effects of Propofol

* Decrease in Vt * Hypoventilation * Apnea

Cardiorespiratory effects of Opioids

``` • Cardiovascular friendly • ↓ HR • Dose dependent respiratory depression • Analgesia ```