Lecture 7: Cardiovascular disease and anesthesia

Question 1

Systolic function relates to ___power, __shortening, and __

Answer 1

contractility power, % shortening, ionotropy

Question 2

lusitropy is related to __function

Answer 2

diastolic

Question 3

what is equation for Cardiac output

Answer 3

CO= SV xHR

Question 4

what is % shortening

Answer 4

difference between max chamber volume during diastole vs systole

Question 5

what is normal % shortening For dogs and cats

Answer 5

dogs: 28-45%
Cats: 30-50%

Question 6

if % shortening is <30% what drugs can you give to improve contractility

Answer 6

dobutamine, dopamine

Question 7

what is MOA of acepromazine and how does it affect systemic vascular resistance

Answer 7

alpha 1 adrenergic receptor antagonist
Vasodilation/ decreases SVR

Question 8

why is the vasodilatory effects of acepromazine good as long as not excessive in our cardio patients

Answer 8

promotes blood flow and oxygen delivery—> anti-arrhythmic effect

Question 9

t or f: acepromazine has sparing effect on induction and inhaled drugs

Answer 9

true

Question 10

Presence of __agents is considered contraindicated for acepromazine

Answer 10

vasodilatory agents

Question 11

how does acepromazine affect left ventricular function

Answer 11

decrease ventricular shortening fracture

Question 12

how does acepromazine affect CO and HR in dogs

Answer 12

decrease CO but not HR

Question 13

t or f: acepromazine is reversible

Answer 13

false

Question 14

t or f: acepromazine has analgesic properties

Answer 14

false

Question 15

how long does ace last

Answer 15

6hrs

Question 16

how does ace affect the lungs

Answer 16

bronchodilator- great for some pulmonary diseases

Question 17

how does ace affect platelets

Answer 17

decrease platelet aggregation

Question 18

how do benzos affect cardiovascular system

Answer 18

minimal to no cardio effects

Question 19

how do benzos affect the dose for induction and maintenance drugs

Answer 19

reduce

Question 20

benzos help anesthetize the __without anesthetizing the __

Answer 20

CNS, cardiovascular system

Question 21

how does diazepam affect HR, SV

Answer 21

no changes

Question 22

how does midazolam affect HR, CO, SVR, and contractility

Answer 22

increase HR and CO
Decrease BP/SVR
No changes in contractility

Question 23

t or f: alpha 2 adrenergic agonist have profound cardiovascular effects

Answer 23

true

Question 24

how do alpha 2 agonists affect HR, sV, CO, % shortening, SVR

Answer 24

decrease HR, SV, CO, % shortening
Increase SVR

Question 25

adding anticholinergics with alpha 2 agonists causes significant decrease in __ with normal __.

Answer 25

Cardiac output, normal HR

Question 26

t or f: alpha 2 adrenergic agonists are safe to use in patients with cardio dz

Answer 26

false- only for healthy patients

Question 27

how do opioids affect contractility, SV, CO, MAP and SVR

Answer 27

minimal effects

Question 28

what opioid commonly results in hypotension and why

Answer 28

morphine—> histamine release—> vasodilation—> hypotension

Question 29

opioids have a dose dependent decrease in __

Answer 29

HR

Question 30

why are opioids good choices for patients with cardiac disease

Answer 30

1. Short acting 2. Reversible

Question 31

t or f: opioids help decrease the other drugs side effects

Answer 31

true

Question 32

what is reversal for opioids

Answer 32

naloxone

Question 33

How does thiopental affect HR, SV CO, contractility, and SVR

Answer 33

increase HR Decrease SV No change in CO, contractility, and SVR

Question 34

what is an adverse effect of thiopental

Answer 34

bigeminy (VPC-sinus-VPC-sinus)

Question 35

Does bigeminy caused by thiopental require tx

Answer 35

no tx

Question 36

How does etomidate affect cardiovascular system

Answer 36

zero effects

Question 37

what is drug of choice for induction for cardio compromised patients

Answer 37

etomidate

Question 38

Etomidate has __ and __ homeostasis, maintains CO without increasing myocardial oxygen consumption

Answer 38

cerebral and hemodynamic

Question 39

adverse effect of etomidate

Answer 39

adrenal cortical suppression

Question 40

how does propofol affect CO, SVR, arterial BP, and left ventricular force

Answer 40

mild decreases

Question 41

what is alfaxalone used for

Answer 41

induction agent

Question 42

alfaxalone can cause a short transient period of __

Answer 42

apnea

Question 43

how does alfaxalone affect aterial BP

Answer 43

decrease

Question 44

How does ketamine affect HR, CO, BP, left ventricular work, oxygen delivery and consumption

Answer 44

increases

Question 45

is SNS or PNS tone increased with ketamine

Answer 45

SNS

Question 46

If you give 30mg/kg ketamine after isoflurane what is the effect on BP, CO, left ventricular contractility, and SVR

Answer 46

decrease

Question 47

what patients is ketamine contraindicated in

Answer 47

1. HCM or RCM (increase HR and decrease preload) 2. Mitral regurgitation (increase afterload) 3. Increase ICP or IOP

Question 48

what cardiac patients is ketamine indicated for

Answer 48

1. Cardiogenic shock- poor contractility 2. Myocardial failure- DCM

Question 49

how does isoflurane and sevoflurane affect CO and SVR

Answer 49

decrease

Question 50

why is mask induction or tank induction not ideal

Answer 50

stress of induction leading to catecholamine release, arrhythmias

Question 51

what anticholinergics increase HR

Answer 51

atropine, glycopyrolate

Question 52

anticholingerics are not good for what cardiac patients

Answer 52

hypertrophic heart

Question 53

what is the relationship between fluid bolus and frank starling forces

Answer 53

more myocyte stretch leads to higher contractility power