Anesthesiology - Quiz 1-5

drraythe's version from 2016-02-23 20:27

Injectables: Tiletamine+Zolazapam, TIVA

Question Answer
Does Ketamine or Tiletamine have a longer duration of action?Tiletamine
What is Tiletamine always combined w/? What is this combination commercially called? What is the ratio?Zolazapam. Combo is called "Telazol" (Zoletil in Europe) & is in a 1:1 ratio (usually 250mg each). Reconstitute by adding 5mL saline to powder
What is the pH of Telazol?2 - 3.5 (acidic)
Tiletamine + Zolazepam is similar to Ketamine + ____, but the difference is...Similar to Ketamine+Benzodiazepine, but the Telazol is LONGER ACTING
What is recovery like from Tiletamine+Zolazapam? Sp differences?Recovery can be long...recovery can be rough esp. in dogs!
Which effects wear off 1st - Tiletamine or Zolazapam?Zolazepam wears off 1st, which means recovery might end up w/ mm rigidity, excitations & seizures
What are the clinical uses for Tiletamine+Zolazapam?Induction agent for many species & can be the sole anesthetic for short diagnostic & surgical procedures
How can you administer Tiletamine+Zolazapam? Notes about this? What should you know about dosing?IV, IM administration. However, IM can be painful (very low pH). Know that you CANNOT REDOSE
How long is a solution of Tiletamine+Zolazapam good for once reconstituted?7 days if kept at under 5°C
What are the 7 contraindications of Tiletamine+Zolazapam?SAME AS KETAMINE
(1) PTx w/ CV dz (↑ CV activity)
(2) PTx w/ hepatic insufficiency (metabolized by liver into active metabolites)
(3) PTx w/ renal insufficiency (Excreted via kidney)
(4) Hyperthyerosis (hyperthyroid) PTx, or PTx w/ high blood pressure
(6) PTxs w/ ↑ intraocular pressure
(7) C-section
Explain TIVATotal IntraVenous Anaesthesia. It is the induction & maintenance of anesthesia by IV drugs only & is usually a combination of an anesthetic & an analgesic
What are the 2 options for maintaining TIVA?Intermittent bolus or CRI
What is TCI?Target-Controlled Infusion
What GI-related side effect might you see w/ Telazol?Hypersalivation
What are the pros of TIVA?Less anesthetic equipment is needed
You can endoscopy airways
Less air pollution from gas anesthetics
What are the 3 drugs youd wanna use for TIVA when you want: HYPNOSISPropofol
What are the 3 drugs youd wanna use for TIVA when you want: ANALGESIAOpioids (Fentanyl)
α-2 agonists
What are the 2 drugs youd wanna use for TIVA when you want: MM RELAXATIONBenzodiazepines


Question Answer
Priapism in horsesAce
Bad for boxersAce
Poikilothermia (temp dysregulation)Ace
SEQUESTERS RBCs to spleen (not splenic relaxation, that's the Barbiturates)Ace (Peggy has a selfish spleen)
Kickass pig sedativeAzaperone
Abortion in 3rd trimester of cows (category of drugs)α-2 agonists (AA MY BABY, AA I WAS STARTLED! AA I HAVE TO PEE)
Inhibits platelet aggregationAce
Category that czs hypoxemia/pulmonary edema in sheepα-2 agonists
Rumis 10xs more sensitive to this drug than other animalsXylazine
Romifidine is what kinda drug?α-2 agonist
Inhibit insulin release → hyperglycemia are what drugs?α-2 agonists (AA sugar! I wanna eat once my visceral pain is gone)
Premeds where the biggest prob is the CV effects (bradycardia & bradyarrythmias)α-2 AGONISTS (just think about how 2 will easily drop your beating heart) (AA!! MY HEART!!)
Which sedative/premed is awesome for transporting horses w/ due to minimal ataxia?Romifidine
AV blocks is a side effectThis is the bradyarrythmias seen from α-2 agonists (AAV is 1 too many 'a's so the heart got blocked...this is apparently happening when going from vasoconstriction to vasodilation)
Startle response czd by...α-2 agonists (AA! sorry I was startled)
What speed do you give Atipamezole at & why? (Note: what does this drug do again?)SLOW bc it is a α-2 agonist ANTAGONIST & α-2 agonists cz analgesia, so you'll reverse the analgesia titrate slowly enough to bring them back but keep some analgesia (α-2 is the TIP of the ABC iceburg)
Which drugs have it so sedation lasts longer than the analgesia, so you need to be aware of this?α-2 agonists (my 2 choice is sedation longer than analgesia. Not my number 1) (it HAS analgesia, so this narrows it down)
What is Tolazoline?Reversal of Xylazine (Yohimbine also does this)
What is Yohimbine?Reversal of Xylazine (Tolazoline also does this)
What is AtipamazoleReversal for Medetomidine/Dexmedetomidine (can do other α-2s but off label) (DEX TIPPED ME off)
Potent visceral analgesia?α-2 agonists (AA, no organ pain feels great)
Which drug reacts w/ potentiated sulfonamides in horses?Detomidine (deto-AA! sorry saw sulfur hurting you)
Inhibit ADH, leading to diuresisα-2 agonists (AA I GOTTA PEE! AA MY HEART!!)
What is Flumazenil?Competitive Benzo antagonist (ben wanted to reverse his flu)
These drugs don't provide good sedation in healthy adults, only the very young/old/sickBenzos (ben is such a hearty adult that the drugs dont make him sleepy!)
Hemolysis & thrombophlebitis as side effectsGuaifenesin
Mild sedation in dogs, but excitement/ ↑ locomotor activity in cats & horsesOpiates
Hyperthermia in cats & horses, hypothermia in dogsOpiates
In dogs, large therapeutic window. In cats & horses, small therapeutic windowOpiates
Only opiate not metabolized by the liverRemifentanil
Shortest acting opiate? Longest?Shortest = Remifentanil
Longest = Buprenorphine
Opiate w/ added NMDA antagonismMethadone (meth heads are crazy...yep.)
Anticholinergic of choice for rabbitsGlycopyrrolate
How to treat opioid induced bradycardia?Anticholinergics (ONLY DO IF THEIR BP IS LOW TOO, WHICH MAY NOT BE THE CASE IN α-2 AGONISTS)
Czs pupil dilation what makes horses & cats freak outAnticholinergics (Atropine)
Which czs too much salivation? Which czs too little?Too much = Ketamine (dissociatives)
Too little = Atropine (anticholinergics)
Ventricular bigeminyThiopental
Which category of drugs matters a lot if the animal is thin or fat?Barbiturates (barb cares about being skinny)
Drug precipitates out of LRSThiopental (Theo is lactate-intolerant)
Repeated injxns will lead to zero order kinetics (prolonged recovery)Thiopental (Theo has zero potential for repeated insult)
Bad for greyhoundsThiopental (thio would put my greyhound’s in the ground)
Regular or repeated use of this drug will cz a Heinz body anemia in a catPropofol (Michael Jackson loves to kill cats by ruining their blood)
Dont use in hyperlipidemia/pancreatitis PTxsPropofol
Inhibits adrenocortical fxnEtomidate (ET loves your heart...but wants to punch you right in the adrenal glands)
Drugs w/ lipid emulsionPropofol
(ET & Michael Jackson got fat)
HemolysisGuaifenesin, Etomidate, (in cats, Propofol czs oxidative damage which I assume can lead to hemolysis) (remember that guai only will relax your mm at the cost of your blood & ET will destroy your blood & adrenals)
Good for high-risk cardiac PTx/critical PTxEtomidate
Drug that loves to accumulateTHIOOOOOOPENTAL! (Theo hangs around even when he's unwanted)
Prolonged recoveries in catsMorphine & Propofol
NOT hepatic metabolismRemifentanil
Extravascular tissue necrosis/tissue irritantGuaifenesin
(DIAZEPAM is irritating to the vessels when IV admin & that's the only admin allowed)
Thiopental (It's SUPER alkaline)
Classical preparation of Etomidate (Etomidate & Diazepam both have propylene glycol which is a big irritant)
Ketamine/Telazol czs pain on injxn (pH low)
Can cz anaphylaxisMorphine/Meperidine IV
Mm relaxAlfaxalone
(Al & Ben eating Guai fruit)
Drug not affected by plasma protein levelsAlfaxalone (Al dont need no steak!)
Excreted via bileAlfaxalone (al has bile stones)
Myoclonus (spasmodic jerky contraction of groups of muscles) & Opisthotonus (severe state of hyperextension) in CATSAlfaxalone (al stretched the cat over his knee into extension & it was twitching)
CV stimulation effects overpower the myocardial depression effectsKetamine
Maintained reflexesKetamine (dissociative)
↑ Ocular pressureKetamine
Analgesicsα-2 agonists
IM injectablesKetamine/Telazol, Alfaxalone (I’m' watching AL abuse KETAMINE)
Mortality in fetus...reduced vigor in fetusMortality is Barb
Reduction in vigor is Ketamine
(barb gets abortions bc she wants to stay thin)
Shouldnt use in hyperthyroid PTxsKetamine (it'll wind them up more)
↑ Intracranial pressureKetamine
Rough recovery in dogsTelazol
Rough induction phase in horsesPropofol (prop up horses or else)
What ↓ anesthetic risk in horses?Premed w/ Ace & TIVA

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