Lab Midterm Flashcards
(298 cards)
1
Q
What method of ventilation use requires us to provide more extensive monitoring and nursing care for our patients
A
Mechanical ventilation
2
Q
What is the true first step of resuscitation
A
Alerting other team members to the crisis and move the patient to a centralized area where the crash cart and oxygen are accessible
3
Q
What can be used as a good indicator of effective chest compressions
A
End tidal carbon dioxide (ETCO2) and it should be above 10-15 mmHg
4
Q
T/F it is acceptable to pause chest compressions for catherization and intubation
A
FALSE chest compressions should not be stopped for any reason
5
Q
What does excessive ventilation of the patient during cardiopulmonary resuscitation cause
A
Cerebral vasoconstriction and decreased blood flow to the brain
6
Q
What drugs are safe to administer via the endotracheal tube
A
Naloxone, atropine, vasopressin, epinephrine, lidocaine (NAVEL)
7
Q
What should be monitored in patients that survived CPR
A
Assessments for neurologic signs and for developing organ failure
8
Q
Why should patients be monitored more closely when anesthizied w/ sevoflurane
A
It can cause hypotension and it has a more rapid response time
9
Q
What are general rules of thumb when handling compressed gas cylinders
A
Never leave an unattended compressed gas cylinder unsupported or lying on its side, never attempt to remove the valve or index pins, keep skin and eyes clear of the valve port when opening a tank, and do not use oxygen near any ignition source
10
Q
How much liquid anesthetic should be in the vaporizer for the vaporizer to function properly
A
The quantity of the liquid anesthetic should fill between the upper and lower lines of the window but should be at min 1/2 full at all times
11
Q
What will overfilling the vaporizer w/ liquid anesthetic result in
A
Anesthetic overdose
12
Q
What will underfilling the vaporizer w/ liquid anesthetic result in
A
The inability to keep the patient anesthetized
13
Q
What should be checked if there is a sudden elevation in the patients ETCO2
A
The unidirectional valves
14
Q
What should be checked prior to placing an ET tube
A
The length, diameter, cuff, if the connector is loose, if the tube is damaged, or blocked w/ dried mucus
15
Q
What is anesthesia used for in most veterinary practices
A
To provide anxiolysis, sedation, tranquilization, immobility, muscle relaxation, unconsciousness, and pain control
16
Q
What are the benefits of balanced anesthesia
A
Minimizes adverse effects and gives the anesthetist the ability to produce anesthesia w/ the degree of CNS depression, muscle relaxation, analgesia, and immobilization
17
Q
What must an anesthetist approach every anesthetic procedure w/
A
A genuine willingness to take personal responsibility for the well being of the patient
18
Q
What can decrease unforseen problems during anesthetic procedures
A
Scheduling an appointment several days before the procedure to accumulate a patient database so problems can be addressed before hand
19
Q
What type of questions are the most important when obtaining a patient history
A
Open ended questions
20
Q
WHat are the 4 questions that should be asked when gathering historical information about signs of illness
A
The duration, the volume/severity, the frequency, and the character/appearance
21
Q
What should you always confirm when checking in a patient undergoing an anesthetic procedure
A
The nature of the scheduled procedure
22
Q
What type of patients respond differently to anesthetic procedures
A
Very large, very small, <8 weeks old, or older patients that are >75% of their lifespan
23
Q
What should be collected from every owner prior to the anesthetic event occurs
A
A written estimate of the expected charges and signed consent for the procedure
24
Q
What are the 2 reasons for monitoring our patients under anesthesia
A
To keep the patient safe and to regulate anesthetic depth
25
What is anesthetic monitoring based off of
That in the average patient there is a parameter for what is expected to show to predict the response at any given anesthetic depth
26
What marks the border between anesthetic stages 1 and 2
Loss of consciousness
27
What marks the border between anesthetic stages 2 and 3
Loss of spontaneous muscle movement
28
What marks stage 4 of anesthesia
Loss of all reflexes, widely dilated pupils, flaccid muscle tone, and cardiopulmonary collapse
29
What is stage 1 of anesthesia
The period of voluntary movement
30
What is stage 2 of anesthesia
Period of involuntary movement
31
What is stage 3 of anesthesia
Period of surgical anesthesia
32
What is stage 4 of anesthesia
Period of anesthetic overdose
33
What are the 3 subdivied stages of the 3rd anesthetic stage
Light, surgical, and deep
34
What words are used to describe the status of reflexes verbally or written
Present, decreased, depressed, and absent
35
What is the main indicator of determining when it is safe to remove the ET tube
The swallowing reflex (response to the presence of saliva or food in the pharynx
36
What reflex should be absent in small animals under surgical anesthesia
The palpebral reflex (blink in response to a light tap on the medial or lateral canthus)
37
What reflex is present during light stage 3 anesthesia
The pedal reflex (flexion or withdrawal of the limb in response to vigorous squeezing and twisting or pinching of a digit or pad)
38
When is monitoring for the pedal reflex important
In patients undergoing masked induction
39
What reflex is lost when the anesthetic depth is excessive but is unreliable in small animals
The corneal reflex (retraction of the eyeball w/in the orbit and/or blink in response to stimulation of the cornea)
40
What is the laryngeal reflex
Immediate closure of the epiglottis and vocal cords when the larynx is touched
41
What is the pupillary light reflex
The PLR is a constriction of the pupils in response to shining a bright light onto one of the retinas
42
What is the dazzle reflex
A blink response to shining a bright light on the retinas
43
How can an anesthetist falsely interpret the muscle tone of an induced patient
If the open the patients mouth too wide causing a force of resistance
44
What is the position of the patients eye during light stage 3 anesthesia
Central
45
What is the position of the patients eye during surgical anesthesia
Ventromedial
46
What is the position of the patients eye during deep stage 3 anesthesia
Central
47
T/F HR, RR, Vt, and BP are NOT accurate indications that their is a conscious perception of pain in my patient
True other signs have to be present to indicate a perception of pain
48
What are the objectives of surgical anesthesia
The patient does not move, is not aware, does not feel pain, has no memory of the procedure afterward, and does not have dangerous depression of the cardiovascular and respiratory systems
49
What are the major effects and adverse effects of halogenated inhalation anesthetics
Dose related CNS depression, hypothermia, paddling, excitement, and muscle fasciculations during recovery, variable effect on HR, vasodilation, hypotension, decreased cardiac output, tissue perfusion, dose dependent respiratory depression, hypoventilation, retention of CO2, respiratory arrest, adequate to good muscle relaxation, depression of respiration in neonates, and production of CO when exposed to desiccation CO2 absorbent
50
What type of anesthetics are generally considered safe to give most patients
Halogenated
51
What does the safety of anesthetics depend on
The degree of the care at which the agents are administered and the vigilance in the monitoring of the patient
52
What is vapor pressure
A measure of the tendency of a liquid anesthetic to evaporate in the vaporizer
53
What does the vapor pressure level (number) mean
The higher the vapor pressure the more easily the liquid evaporates the lower the pressure the harder it is for the liquid to evaporate
54
What is the blood gas coefficient
A measure of the solubility of an inhalant anesthetic in the blood as compared w/ alveolar gas
55
What does the blood gas coefficient valuse (number) represent
The lower the blood gas partition coefficient the faster the patients induction and recovery the higher the number the slower their induction and recovery
56
What does MAC stand for
Minimum alveolar concentration
57
What is MAC
The lowest concentration at which 50% of patient show no response to a painul stimulus such as a surgical incision
58
What is MAC useful for
Meausring the potency of the agent used and to determine the average vaporizer setting that must be used to produce surgical anesthesia
59
Why is isoflurane the inhalation agent of choice for patients w/ heart disease
Because it has the fewest adverse cardiovascular effects
60
Why is sevoflurane the inhalant agent of choice for mask and chamber inductions
Because of its high controllability of anesthetic depth
61
Why is desflurane considered the one breath anesthesia
Because the blood gas parition coefficient is significantly lower than other anesthetic agents used it appears the patient becomes anesthetized or wakes up after taking one breath
62
What does 1 drop of doxapram equal
1 mg
63
What quantity of doxapram is required to stimulate respiration from a neonate
1-5 drops under the tongue of a puppy and 1-2 drops under the tongue of a kitten depending of the size of the patient and the degree of depression
64
What should be done at the beginning of the day by the anesthetist
The primary and secondary oxygen tanks should be evaluated to ensure they are full, operational, and turned on
65
What are things to remember when handling compressed gas cylinders
Avoid contact w/ flames, sparks, or other sources of iginition, turn the tank on only when it is attached to the yoke or pressure regulator, store tanks only attached to a yoke, secured in a cart, or rack (specified for this), or chained to a wall, never attempt to attach a tank to a yoke that does not fit, and never tamper w/ the safety system on a tank, line, or pressure reducing valve
66
How can the volume of an oxygen tank be calculated
By multiply the psi of an E tank by 0.3 and an H/J tank by 3
67
How should one turn off a flowmeter
Turn the knob until the bobbin or ball reaches 0
68
What should occur if a bottle of liquid anesthetic accidentally breaks
Vacate the room until it has completely evapoated
69
What is important to do after using a non rebreathing system
Reattaching the port in the common gas outlet
70
What happens to the pop off valve before and after giving a manual breath
Before giving a breath it is closed and is opened immediately after giving a breath
71
How full should the reservoir bag be during a procedure
3/4 of the way full at peak expiration
72
What are the signs of needing to change CO2 granules
Hard/brittle granules, color change to 1/3 to 1/2 of the granules, CO2 level greater than 0 during peak inspiration (measured w/ a capnograph), after 6-8 hrs of use, after 14-30 days, and if oxygen flowmeter was left on overnight or for any equivalent period of time
73
What are the maximum measurements on a pressure manometer that are considered safe
0-3 cm H20 when the patient is breathing spontaneously and 20 cm H2O in small animal when positive pressure ventilation is provided
74
When are pediatric tubes recommended for use on a rebreathng system
When the patient weights 15-30 lbs
75
What does the patients body weight determine when setting up the anesthetic machine
The choice of machine, reservoir bag size, breathing tubes, oxygen flow rates, and breathing circuit
76
Why do we increase the flow rate when changing the anesthetic depth w/ a partial or minimal rebreathing system
Do change the depth quicker
77
How often should a qualified repair professional examine all of the parts on an anesthetic machine
Every 4-12 months
78
Why should technicians double check their CRI calculations regardless of how they were obtained w/ either the CRI calculator provided by the VAPM via website or app
Due to the high risk associated w/ giving drugs via CRI incorrectly
79
Why should a patients ET tube be temporarily disconnected when turning the patient
Because rollowing or twisting the animal while it is still connected may cause the endotracheal tube to twist or collapse resulting in an airway obstruction, or traumatizing/lacerating the trachea
80
How often should a technician administer artifical tear solution to the cornea of a patient
Every 2-4 hrs because general anesthesia decrease tear secretion for up to 24 hrs post op
81
When is the most dangerous period for complicaitons for animals that experienced no problems during induction or maintenance
During recovery
82
Why should a recovering patient be watched continuously at close range
Because they may develop hypoxemia, cardiac arrhythmias, or other complications w/o any signs
83
When should recovering patients be supplemented w/ oxygen
If shivering occurs
84
Why should a patients head be positioned w/ the nose slightly lower than the neck
When the patient is undergoing a COHAT or other oral surgery in which blood or fluids are present in the oral cavity to prevent any from draining in the trachea
85
How often should a recovering patient be turned
Every 10-15 mins to prevent hypostatic congestion
86
What is hypostatic congestion
Pooling of blood in dependent lung and tissues
87
What is the goal of inhalant anesthesia
To deliver a safe concentration of an anesthetic agent w/ oxygen to the patient along w/ providng a method for assisting ventilation
88
What are the different oxygen tank sizes
E tank (660 liters) and H/K tanks (6,600 liters)
89
What color represents oxygen
Green
90
What color represents nitrous oxide
Blue
91
What is the direct safety soure used for compressed gas sources
The pin index safety system that only allows one type of tank to be attached to the yoke
92
What is the central safety source for gas lines
The diameter index safety system only allows for a certain plug shape and diameter to be entered into the wall
93
What is the pressure regulator
Attached to the compressed gas source it reduces pressure from the tank to constant pressure of 50 PSI
94
What is the pressure gauge
It reflects the amount of gas remaining in the tank
95
What is the flowmeter
It controls the rate the oxygen or nitrous is being delivered to the patient's breathing system, takes the pressure from 50 PSI to 15 PSI, is meausred by a bobbin or ball, and is also color coded
96
What is specially about the knob on the flowmeter
It is very sensitive so turn it carefully and ONLY until the bobbin/ball reaches 0 when turning it off
97
What is the oxygen flush valve
It delivers fresh oxygen into the system at 35-75 L/min bypassing the vaporizer and delivers the oxygen directly to the common gas outlet
98
What must happen prior to using the oxygen flush valve
The patient HAS to be detached from the breathing circuit
99
What is the vaporizer
It holds liquid anesthetic and coverts it into a breathable gas these are also color coded (purple = iso and yellow = sevo)
100
What is the difference between a precision and non precision vaporizer
A precision vaporizer has a dial to give a consistent anesthetic rate to the patient while a non precision vaporizer functions based on the patients breathing so it is not consistent
101
How often should a vaporizer have maintenance done
Yearly
102
What is the common gas outlet
The fresh gas outlet is the point of exit from the oxygen and anesthetic gas to enter the patient breathing circuit this is where a non rebreathing system is attached
103
What comprises the breathing circuit
Common gas outlet, inhalation valve, inhlation hose, ET tube, exhalation hose, exhalation valve, reservoir bag, poop off valve, and scavenging
104
What are the parts of the 3 way stop
Pop off valve/scavenging, CO2 absorbent cainster, and reservoir bag
105
What is the pop off valve
The pressure releasing valve allows for the release of excess pressure from the system into the scavenging system this is for our safety
106
What are the 2 types of scavenging systems
Passive and active
107
What is the passive scavenging system
Uses gravity/pressure of gas in the system by using F-air canisters that are filled w/ charcoal and it is the most common type
108
What is the active scavenging system
A vacuum system that pulls the air outside it is significantly more expensive
109
What is the CO2 absorbent canister
It removes the CO2 from the exhaled gases before returing it to the patient and it contains soda lime granules
110
How do we calculate the reservoir bag size
Weight in lbs x 30 = amount in mls then convert to liters
111
What is the pressure manometer
Monitors the pressure w/in the breathing system this is very useful when giving positive pressure
112
What is the PPV range
15-30 average is 20 mmHg to prevent barotrauma
113
What is the rebreathing system
Used for 15+ lb patients it allows for safe rebreathing of exhaled gases, it is more common yet more complicated, it utilizes unidirectional valves, contains more dead space, but is better at maintaining a patient's temperature
114
How do we calculate the oxygen requirement of patients when using a rebreathing system
20ml/lb/min + 250 mls
115
How do we calculate the oxygen requirement of patients using a non rebreathing system
100mls/lb/min
116
What is the non rebreathing system
recommend for patients 15lbs and under, no rebreathing of gases, utilizes a higher oxygen rate, minimizes dead space, allows for a rapid change in depth, wastes more oxygen and anesthetic agent, and has a higher rate of drying out the mucosa and respiratory tract
117
What prevents the risk of increase CO2 in patients using an NRS
A high oxygen flow rate
118
Why is the non rebreathing system better for smaller patients
Because there is a lower resistance of breathing and less effort for the animal to get gas exchange
119
What are the differences between having a pop off valve open or closed
An open pop off valve is more expensive using more oxygen but is safer while a closed pop off valve only uses enough oxygen to meet the patients needs, it is cheaper, but risks an unsafe build up of nitrogen leading ot hypoxia
120
What is the difference between the VOC and VIC system
The vaporizer out of cicle uses a precision vaporizer that is more expensive but much more common while an vaporizer in circle uses a non precision vaporizer which is more dangerous but inexpensive
121
What things on an anesthetic machine should be checked prior to anesthetizing a patient
Flow meter, quantity of iso, oxygen, and soda lime
122
What do you multiple the MAC by to find the approximate vaporizer setting
1.5-2 but things like age, premeds, and body condition can affect this
123
What are the typical properties of isoflurane
Higher vapor pressure, lower solubility, and medium MAC
124
How does isofluarne tend to affect the patients body
Causes vasodilation leading to hypotension, can be irritating causing dry mm, respiratory depression, and metabolisim occurs in the respiratory system so it is safest for liver patients
125
What are the properties of sevoflurane
Higher vapor pressure, lower solubility, and highest MAC
126
What is the primary difference w/ how sevoflurane affects the patients body
It does not typically dry out/irritate the mm
127
How can nitrous gas affect our patient
It doesn't irritate the respiratory tract, can provide analgesic effects, and can cause CO2 poisoning
128
What is the weight range for a pediatric y tube
30-13 kgs
129
What are signs of compensatory shock
Increase HR, inrease in RR/depth, decrease in BP, vasoconstriction, bounding pulse, CRT >1sec, and red mm
130
What are signs of decompensatory shock signs
Pale mm, weak threading pulse, decrease in HR, decrease in RR, and vasodilation
131
Which comes first respiratory arrest or cardiac arrest
Respiratory arrest
132
What are signs of respiratory arrest
Dyspnea, apnea, abnormal CRT, abnormal HR, abnormal pulses, and cyanosis
133
What are signs of cardiac arrest
No palpable pulse, no palpable or audible heartbeat, no muscle tone, dilated pupils, lack of PLR, cyanosis or pale mm, and prolonged CRT
134
What is the equation for a patient needing compression
Unresponsive + apneic = compression
135
What is the difference between BLS and ALS
ALS involves drugs and electrical cardioversion
136
What things can be monitored during CPR
ECG, doppler BP, ETCO2, and blood gas analysis
137
How are you positioned when giving CPR to cats
Fingers on the down side and thumb on the up side
138
What is different about giving a large dog CPR
You compress at the widest portion of chest
139
What is different about giving a barrel chested dog CPR
They are in dorsal recumbency, the anatomy limits the direct effect of compressions, and place your hands 1-2" above the xiphoid process
140
What is the thoracic pump method
When you increase intrathoracic pressure during compression results in forward blood flow
141
How do you evaluate the effectiviness of compressions
Palpable pulse and doppler placed on the cornea
142
What is the preferred method for administer medication during a code
Central line
143
How many tubes should you have ready for intubation
At least 3
144
How do you measure the length of the ET tube
From the tip of the nose to the thoracic inlet
145
What are indications that a patient is ready for intubation
Unconsciciouness, lack of voluntary movement, absent pedal reflex, sufficient muscle tone relaxation to allow the mouth to be held open, and no swallowing reflex
146
What can placing the ET tube in the esophagus and not catching it potentially lead to
Inability to keep the patient anesthetized, airway blockage, and hypoxemia
147
How do you inflate the cuff w/ cats
Use a 3 ml syringe and add air in 0.5mls increments until no leak is heard
148
Why are we extra careful when intubating cats
They have a narrower glottis and random laryngospasms when the larynx is irritated
149
What are tips to intubating a cat successfully
Ensure that the patient is adequately anesthetized, wait for the glottis to open before attempting placement, and try to get it in the first time
150
What are life threatening complications that can occur in a cat if you try and force an intubation
Tracheal rupture, pneumothorax, and pneumomediastinum
151
Why should owners be informed that it is not uncommon for animals to cough 1-2 days post intubation
Because some patients will always develop minor irritation of the trachea or larynx
152
What could happen if a patient is intubated w/ an ET tube that is too long
They could be oxygenated w/ only one lung or the mechanical dead space could be increased both leading to hypoxemia
153
What can be used during the recovery period if an animal is caught chewing or traumatizing various areas
parethesia or e collars
154
What route can bupivacaine not be given
IV
155
What is the max dose of 2% iso given to a 4 kg cat SQ or IV
0.8 mls SQ and 0.1 IV
156
What is the max dose of 0.5% bupivacaine to a 4 kg cat SQ
0.8 mls
157
What is the respiratory volume
The amount of air that moves in and out of the lungs in one minute
158
How can you roughly find the respiratory volume
By taking the Vt and multiplying it by the RR
159
Why do some alveoli in dependent regions of the patients lungs completely or partially collapse
Due to a decreased Vt
160
How can we keep alveoli expanded during a procedure
Giving sighs or manual ventilation every 2-10 minutes
161
What are the principles of patient monitoring
Monitor the patient frequently using your hands, eyes, and ears, always check multiple parameters, never depend on an instrument alone, and do not try to determine the plane of anesthesia based on the drug dose
162
Why do we intubate patients
To maintain an open airway, decrease anatomic deadspace, transportation of the gas to the patient to prevent WAG, prevent aspiration of foreign material into pulmonary system, and monitor and control respiration during anesthesia
163
What are the different things to take into considering when choosing a tube
Clean and dry, cracks, flexibility, cuff or no cuff, sizing, diameter, and construction
164
What are the different materials ET tubes are made of allowing for varying flexibility
PVC (most common), red rubber tubes (most prone to kinking), and silicone (most expensive)
165
What is the ID on the ET tube
The internal diameter is referred to as oral this is the larger bolder of the too numbers
166
What is the OD on the ET tube
The outer diameter is referred to as the nasal this is the small of the too numbers
167
What is the very tip of the ET tube that goes into the patient called
The bevel
168
What piece of the tube greatly makes up the ET tube
The radiopaque line
169
What is the one way valve
Where you screw in the syringe to inflate the cuff
170
What follows the one way valve on the ET tube
The pilot balloon
171
What transports the air from the pilot balloon to the cuff
The pilot line
172
How do you determine the diameter of the ET tube
It should fill the area below the nares w/ the whole of the connector of the tube
173
What are characteristics of the murphys ET tube
Beveled end, side hole known as the murphys eye, and +/- cuff
174
What are the characteristics of the cole ET tube
No side hole, decreased diameter at the patient end, and used in animals that have complete tracheal rings such as birds
175
What are the steps of intubating
Open mouth to visualize the larynx, located the epiglottis, insert tube through the larynx and trachea, tie the tube in place, inflate the cuff, connect to anesthetic machine, and verify placement by auscultation
176
What is the maximum amount of air to place in the cuff of a dog or cat
5 cc for dog and 3 cc for cat
177
What are operator error complications of intubation
Trauma, laryngospasm, and over inflation of cuff
178
What are the steps for extubation
Discontinue inhalant, leave on oxygen for 5 mins, loosen gauze tie, deflate cuff immediately before extubation, remove the tube once the swallow reflex has returned, and inspect tube
179
Why are analgesics needed during anesthetic procedures
Because anesthesia does not provide any anaglesic effects during unconsciousness so the body will feel all the pain once conscious again
180
What two types of drugs cannot mix
water soluble and non water soluble
181
Why should patients be left undisturbed after receiving an IM or SC until peak action is reached
Because excitement or stimulation during the interim can sometimes override the effects of the drug
182
Why do drugs given intravenously should be administered slowly and cautiously
Because potency and the potential for adverse effects are increased when drugs are given by this route
183
What are the major effects and adverse effects of gabapentine
Analgesia typically for neuropathic pain, anxiolysis, anticonvulsant properties, sedation, ataxia, and GI effects
184
What are major effects and adverse of trazodone
Sedation, anxiolysis, drowsiness, ataxia, GI effects, changes in appetite, agitation, excitement, behavioral disinhibition, and serotonin syndrome
185
Why is it important to check the atropine bottle when pulling up the drug
Because there are 2 different forms w/ 2 different concentrations
186
What will high doses of acepromazine lead to
Increased hypotension
187
Why shouldn't diazepam be stored in syringes, IV bags, or other plastic containers
Because it can be absorbed by the plastic
188
What is the only drug diazepam can be mixed w/
Ketamine
189
Where should opioid antagonists be administered
IM or slowly IV
190
How long should normal propofol be left on the shelf
6 hrs
191
What is the concentration limit of volaitle gas anesthetic that is approved when used alone
2 ppm
192
What are the advisments for air filtration in all rooms where anesthetic gas is released
At least 15 air changes/hr 3 of which should be w/ fresh air (21 air changes/hr is preferred)
193
Which inhalent anesthetic agents have the least likely to cause toxicity
Isoflurane and sevoflurane
194
Is the precise amount of gas exposure that is hazardous or the adverse effects associated w/ each agent full known
No
195
How can we minimize risks of WAGs
Using a scavenging system, regular leak checks, personal comprehensive hazard control to minimize personnel exposure
196
Where are conventional passive scavenging system best suited
Rooms that are adjacent to the exterior of the building
197
What pressure test can be used if oxygen is the only thing being given to the patient
A low pressure these should also be done every day
198
What should you make sure occurs before administering anesthesia to any patient
Certain fasting instructions were done
199
What is the formula for finding the volume that should be given of most injectables
Volume = drug dosate (mg/kg) x body weight (kg) / drug concentration (mg)
200
Why should patients be restrained and watched carefully during both mask and chamber inductions
Because they can become compromised suddenly and unexpectedly and cannot be monitored closely under these circumstances
201
What is dose dependent mean
the higher the dose given worse the negative effects
202
What are contraindications
When/something that leads to not being able to use a specific drug
203
What is a complication
Something that happens after giving a drug as a side effect
204
What is the difference between oral vs injectable drugs
Oral has a higher dose and a longer DOA
205
What is anesthesia
State of controlled unconsciousness that affects the whole body or an isolated part or region of the body this is characterized by the absence of pain, memory, and motor response
206
What is the duration of action
How long we see physical effects on the patient
207
What is the on set of action
How long it takes for the drug to do its job this can be related to the route of administration
208
What is neurolep anaglesthia
Sedative/tranquilizer plus an opioid
209
What is a ceiling effect
How much you can increase the dose of the drug before you see a loss in the benefit of the drug
210
What are the anticholinergic agents that we use
Glycopyrrolate and atropine
211
What are the alpha 2 agonists that we use
Dexdomitor and xylazine ONLY in large animals
212
What phenothiazine do we use
Acepromazine
213
What opioids do we use
Morphine, fentanyl, butorphanol, buprenorphine, and hydromorphone
214
What benzodiazepines do we use
Diazepam, midazolam, and zolazepam
215
What dissociative anesthetic agents do we use
Ketamine and tiletamine
216
What inhalant anesthetic agents do we use
Isoflurane, sevoflurane, and nitrous oxide
217
What miscellaneous anesthetic agents do we use
Propofol and alfaxalone
218
What is the onset of action of tiletamine
5 mins IM
219
What is the DOA of tiletamine
30 mins in dogs and 1 hr in cats
220
What are the routes that tiletamine can be given
IM and IV
221
What are cardiovascular effects of dissociative agents
Slight vasoconstriction
222
What are the respiratory effects of dissociative agents
Apneustic breathing that stops at inhalation especially in cats
223
How are dissociative agents metabolized and excreted by the patient
In dogs it is hepatic/kidney and cats renal only
224
Is there a reversal for dissociative agents
Yes partial yohimbine
225
Do dissociative agents provide analgesia
Yes somatic
226
What are contraindications for using dissociative agents
Seizure patients, head trauma, glaucoma, and renal disease
227
What are miscellaneous effects of dissociative agents
CNS stimulant, muscle ridgity, exaggerated reflexes, increased salivation, and eye position central
228
Are dissociative agents controlled
Yes
229
What is the onset of action of propfol
Immediately
230
What is the DOA of propfol
8 mins
231
What route can Propfol be given
IV
232
What are the cardiovascular effects of propfol
Dose dependent or fast given can bring hypotension and vasodilation
233
What is the respiratory effect of propfol
If given too fast can cause apnea
234
How is propfol metabolized and excreted by the patient
Liver and kidney
235
Is there a reversal or analgesic effect from propfol
No
236
What is a contraindication of propfol
Hypoproteinemia will increase potency
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What can happen to propfol if left sitting
Emulsion
238
What are miscellaneous effects of propfol
CNS depression, can cause seizures, tremurs/twitches, and heinz body in cats
239
How long should infusion of propfol take
60-90 seconds
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Which propfol has a 28 day shelf life instead of a 6 hr shelf life
Propfol 28
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What is the onset of actio for bupnenophrine always
30-45 mins
242
What routes can opioids be given
IV, IM, and SQ
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What are miscellaneous effects of opioids
Muscle relaxation and they are receptor driven (MU, kappa, and sigma)
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What are the different receptor affects of opioids
Full MU is the best w/ most side effects, partial MU, and agonist/antagonist
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What partial MU opioid do we use
Bupnenorphine (not good sedatie)
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What agonist/antagonist opioid do we use
Butorphenol
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What is the onset of action of dexdomitor
10 mins IM
248
What is the DOA of dexdomitor
About 3 hours for sedative and 1 hr of anaglesthic
249
What routes can dexdomitor be administered
IV, IM, and SQ
250
What are the cardiovascular effects of dexdomitor
Significant peripheral vasoconstriction, significant bradycardia, hypertension at start, pale mm, prolonged, CRT, weak pulses, and arrhthymias
251
At what HRs do we start to worry about patients when on dexdomitor
40 in canines and 90 in felines
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What are respiratory side effects of dexdomitor
dose dependent depression, bradapnic, relaxation of inspiration/exhalation muscles
253
How is dexdomitor metabolized and excreted by the patient
Liver and kidneys
254
Is there a reversal for dexdomitor
Antisedan/atipamezole
255
Does dexdomitor provide any analgesia
Yes not great for visceral
256
What are contraindications of using dexdomitor
Cardic disease
257
What is the onset of action of benzodiazepines
10 mins IM and immediately IV
258
What is DOA of benzodiazepines
30-60 mins for dogs and 1-3 hrs for cats
259
What routes can midazolam be administered
IV, IM, and SQ
260
Are there any respiratory effects of benzodiazepines
No
261
Are there any cardiovascular effects of midazolam
No
262
How are benzodiazepines metabolized and excreted by patients
Liver and kidney
263
Is there a reversal for benzodiazepines
Yes flumazenial
264
Are there any analgesic effects or contraindications of benzodiazepines
No
265
What are miscellaneous effects of midazolam
Skeletal muscle relaxation, dose dependent disphoria, soluble in plastic, and light sensitive
266
What is the only route diazepam can be given
IV because it is not water soluble so it requires propylene glycol as a carrier
267
What is the brand name of diazepam
Valium
268
What is the only drug diazepam can be mixed w/
Ketamine
269
What is the onset of action of glycoprrolate
30-45 mins regardless of route of administration
270
What is the DOA of glycoprrolate
Up to 3 hrs
271
What routes can anticholinergics be given
IV, IM, and SQ
272
What is the cardiovascular effect of glycopyrrolate
Prevents bradycardia by blocking the vegal stimulation
273
What is the respiratory effect of glycopyrrolate
Vasodilation of bronchi increasing anatomical deadspace
274
How is anticholinergics metabolized and excreted by the patient
Liver and kidney
275
Is there a reversal or anaglesic effects of glycopyrrolate
No
276
What are contrainidcations of anticholinergics
GI issues/sx and tachycardial arrhythmias
277
What are miscellaneous effects of anticholinergics
Decreased salivation, decrease in gastric motility, and decrease in tear formation/production
278
Which anticholinergic does not cross the blood brain barrier
Glycopyrrolate
279
What is the onset of action of atropine
20 mins SQ
280
What is the DOA of atropine
1-1.5 hrs
281
What are cardiovascular effects of atropine
Prevent bradycardia by blocking the vegal stimulation and transient tachycardia
282
What are respiratory effects of atropine
Vasodilation of bronchi increasing anatomical dead space and increase vescosity of respiratory secretion
283
What is the onset of action of acepromazine
10 mins IM and 15-20 mins SQ
284
What is the DOA of acepromazine
3-6 hr sedative w/ a dose dependent hangover
285
What routes can acepromazine be given
OTM, PO, SQ, IM, and IV
286
What are cardiovascular effects of acepromazine
Significant peripheal vasodilation, dose dependent hypotension, and slight tachycardia
287
Are there any respiratory effects of acepromazine
No
288
How is acepromazine metabolized and excreted by the patient
Extensive metabolism by the liver and excreted by kidneys
289
Is there a reversal or analgesia effects of acepromazine
No
290
What are contrainidications of acepromazine
Not healthy, under 3 months, gieatric, liver dysfunction, seizure disorders, and hypotension/cardiac disease
291
What are miscellaneous effects of acepromazine
Muscle relaxation, antiemetic, antihistamine, antiarrhythmic, ceiling effects max 3 mg, causes hypothermia, and decreases animal seizure threshold
292
What is the normal PCV range for dogs and cats
37-55 in dogs and 29-48 in cats
293
What is the normal TP for dogs and cats
6-8 g/dl in dogs and 6.8-8.3 g/dl in cats
294
What is ASA class 1
Normal healthy animal
295
What is ASA class 2
Slight-mild disturbances but can compensate
296
What is ASA class 3
Anemia, fever, and low grade murmur
297
What is ASA class 4
Pre existing physiologic disease
298
What is ASA class 5
Unexpected to survive
