Jr. Sx- Anesthesia Know Hows 2

kelseyfmeyer's version from 2016-03-05 14:28


Question Answer
MOA?Blocks D2 receptors (sedative effect) AND Blocks α1 adrenoceptors (vasodilation, hypotension)
IV ace onset of action?up to 20min
routes of admin for ace?IV/IM/PO
IM/SC ace onset of action?up to 45min
how is ace metabolized?liver
how long is Ace's duration of action?LONG!!! 4-6 hours (longest acting)
does ace make them vomit?no, it's anti-emetic
what condition might make you think twice about using ace?might dec seizure threshold
how does ace affect BP?the antagonism of the alpha 1 receptors means there is VASODILATION which DEC BP (so dont use in shocky or dehydrated pts)
what should you know about ACE'S affects on the PCV?DONT USE if PCV is low-- causes erythrocytes to be sequestered in the spleen
what is a positive affect ace has on the heart?Stabilises,heart,against,catecholamineDinduced, arrhythmias
if the animal is super excitable or hyper, what might you want to consider with ACE?Epinephrine reversal: paradoxical vasodilation with epinephrine
should you admin epinepherine with ace?no..will cause MORE vasodilation (bc ace is taking up the alpha 1s, so epi goes to Beta 2s, which causes more vasodilation)
which breed should you look out for with ace?boxers
how does ace affect the HR?stays the same or slight inc
overall how does ace affect the CV system?same/inc HR, dec BP, dec PCV
how does ace affect their temp regulation?Poikilothermia (loss of normal thermal regulation) so yay bearhuggers!
how does ace affect blood clotting?inhibits platelet aggregation (so don't give if already low platelets)
ace is usually given in combo with..opioids
CONTRAINDICATIONS FOR ACE?animals with hypotension, anemia, bleeding disorders/platelet probs, shocky animals
how does ace affect resp system?minimal effects
what group of drugs does ace belong to?phenothiazines
will ace cause an allergic rxn?no, actually anti-histamine effects


Question Answer
why don't we like the A2 agonists?all the nasty heart things
MOA of dexmedetomidine?alpha 2 AGONISTS. (also does some alpha-1 agonism)
how does demedetomidine affect BVs/BP?vasoCONSTRICTION at first, and then a dec in BP from there
how does dex affect HR? rhythem?bradycardia (reflex from vasoconstriction, and also bc dec sympathetic tone and inc vagal tone)....causes bradyarrythmias (1st and 2nd degree AV block)
does dex make them vomit?yes, can induce emesis
how does dex affect the resp system?resp depression at higher doses
how does dex affect CO?dec it :(
how does dex affect blood glucose?inhibition of insulin release--> hyperglycemia
antagonist?atipamezole (equal volume to reverse-- note, reverses analgesia too)


Question Answer
MOA of morphine?full Mu agonist
analgesia?YES. all of the analgesia
how does morphine affect emesis?morphine causes vomiting (esp when admin preemptively)
what should you know about IV morphine?can cause histamine release-- DO NOT IV QUICKLY (can lead to hypotension and reflex tachcardia)
how does morphine affect the CV system?minimal affects
even though opioids are usually for analgesia, why do we use them with premeds often?potentiate effects of premeds
what are the major effects of the Mu receptor?analgesia, euphoria, resp depression, inhibits GIT
how does morphine affect the resp system?dose dependent resp depression
how does morphine affect temperature of pt?HYPOTHERMIA for dogs (hyperthermia in cats)
how does morphine affect pupil size?MIOSIS in dogs (mydriasis in cats...because cats)
is there antagonist?YES! naloxone/naltrexone
how is morphine metabolized?liver


Question Answer
what kinda drug is atropine?anti-cholinergic
MOA of atropine?(anticholinergic) block the AcH receptors in the PARASYMPATHETIC nervous system (so rest and digest doesnt work--> more fight or flight)
how does atropine affect HR?inc
how does atropine affect the gut?dec motility
how does atropine affect the resp system?relax bronchioles (get more air)
how will atropine affect the pupils?dilate (upper=dilated pupils)
when is the only time atropine is effective in tx bradycardia?only tx bradycardia causes by vagal stimulation
does atropine affect the CNS?YES!! can cross BBB (and placenta!)
do you want to dose atropine cautiously?actually, give HIGH END of dose because initially causes a DEC in HR (followed by an inc)'
when do you want to give atropine?When there is dec HR AND dec BP together
how long is the duration of action on the heart for atropine?about 20min


Question Answer
MOA of propofol?Interaction at GABA-A receptor (agonist)
onset of action for propofol?30 sec (FAST)
duration of action for propofol?10min
metabolism/excretion of propofol?metabolized by liver (glucoronidation), excreted by kidney...there is minimal accumulation (might contribute to short duration of action)
how does propofol affect BP?HYPOTENSION
how does propofol affect the resp system?RESP DEPRESSION AND APNEA!!!!
what things should you be mindful of when you start to inject propofol?might have apnea, might have excitatory signs (like paddling)
in what manner should you inject propofol?SLOWLY inject to effect
contraindications of propofol?NO hypovolemic pts (bc causes hypotension), no pts in heart failure (dec BP and dec breathing)
which conditions should make you avoid giving propofol?lipid dz like hyperlipidemia/ pancreatitis (bc lipid emulsion formula)


Question Answer
MOA?neuroactive steroid that potentiates GABA-a receptors (provides hypnosis and mm relaxation)
how can you admin alfaxolone?IV/IM
metabolized? excreted?metabolized in liver and excreted in bile
how much accumulation of alfaxalone?minimal :) good for CRI
how does alfaxalone affect the resp system?Minimal respiratory changes (dose and injection rate dependent!) [can cause apnea if fast admin]
how does alfaxalone affect the CV system?Hypotension (mainly by myocardial depression) --> reflex tachycardia
how should you admin alfaxalone?SLOW injection and induction of dose (over 60sec)


Question Answer
conc of iso needed for anesthesia?1.5% (this is why we need a vaporizer--- because at standard temp and pressure it is in the air at a conc of 32%)
what is the MAC?minimum alveolar concentration (standard index of potency)
what is the MAC of iso?1.3% - 1.6%- very potent! (and higher oil:gas PC)
how does iso affect the resp system?resp depressant
how does iso affect BP?dec
how does a low CO affect iso's effects?low co--> inc time for blood:gas--> faster diffusion into blood (and then has a high oil:gas so is potent)
how much of iso is metabolized?<1%
how does iso affect the CV?dose dependent depression

carprofen + meloxicam

Question Answer
MOA for carprofen?COX2 selective in dogs
diff between COX1 and COX2?COX1 is the housekeeping COX (help with platelet aggregation, renal blood flow, protect GI mucosa). COX2 is the cox that...(induced as a response to tissue damage, facilitates the inflammatory process. might lead to platelet aggregation, vasoconstriction, thromboembolism)
adverse affects of NSAIDs?irritate/ulcerate GI, platelet dysfunction and prolonged bleeding, impair renal fxn due to dec blood flow bc hypotension
how do NSAIDS affect the resp?dont
how do NSAIDS affect the CV?(only cause hypotension in renal blood flow, she says no CV side effects...note platelet dysfunction)
you should avoid NSAIDs if what two organs arent doing well?liver and kidney
avoid NSAIDs if what is going on with your blood volume?avoid if hypovolemia/dehydration
if your pt has low platelets, should you be concerned with your NSAIDs?yes-- bc cause coagulopathies
how is meloxicam metabolized/excreted?liver meta, and fecal excretion
does meloxicam affect COX 1 or COX 2 more?COX2 selective
what drug shouldnt you combine NSAIDs with?NOT WITH STEROIDS (inc acid production and inhibit cox so dec mucus production--> ulcers)
carprofen has what 3 properities?analgesic, anti-inflammatory, anti-pyretic
carprofen metabolized where?liver
meloxicam has what 3 properities?analgesic, anti-inflammatory, anti-pyretic

Local anesthetics (lidocaine and bupivicaine)

Question Answer
how do LAs affect the BVs?vasoDILATION
what is the MOA for local anesthetics?BLOCK Na+ channels, which blocks propagation of APs along the nerve
why might you want to add epi to your LA?causes vasoconstriction--> inc duration of action
what type of LAs are lidocaine and bupivicaine?AMIDES
how are amide LAs metabolized and excreted?metabolized via liver, excreted via kidney
what are the toxicities/systems affected by tox of LAs?Neurotox and cardiotox(bupivicane)
which is the cardiotox one?bupivicaine (vasodilation)
onset of lidocaine? duration?faster onset (3-5min)...duration of 1-2 hours (so shorter duration also)
onset of bupivicaine? duration?longer onset (20min)...duration of 3-8 hrs (longer duration with longer onset)
which is more potent- lidocaine or bupivicaine?bupivicaine (bc more lipophilic)
which is faster to work- lidocaine or bupivicaine?lidocaine
when are LAs not that effective?in inflamed tissue (bc acidic tissue--> ionize--> then not effective)
normal dose range of lidocaine, and toxic dose range?normal is 2-5mg/kg, toxic is 10mg/kg
normal dose range of bupivicaine, and toxic dose range?dose: 1-2mg/kg, toxic is 4mg/kg


Question Answer
reason to use ace and duration?mild to moderate sedation, duration of 4-6 hours (longest acting premed!)
reason to use dex and duration?moderate to intense sedation and analgesia, duration of 1-1.5hr
morphine- use and duration?sedation in dogs, and moderate to intense analgesia. 3-4hr
buprenorphine- use and duration?mild to moderate analgesia, 6-8hr
atropine- use and duration?antisialogogue (dec salivation), and to inc HR. 30min (to 45min)
propofol- use and duration?general anesthesia (induction agent), 10-15min
alfaxalone- use and duration?general anesthesia (induction agent), 5-10min
morphine- use and duration?moderate to intense analgesia, 3-4hr
carprofen- use and duration?mild to moderate analgesia, 24hr
lidocaine- use and duration?local analgesia, 1.5-2hr
bupivicaine use and duration?local analgesia, 4-6hr
epinepherine- use and duration?vasoconstriction, inc myocardial perfusion, inc HR, 2min
lidocaine- use and duration AS AN EMERGENCY DRUG?dec AV nodal conduction, 15-20min
methadone- use and duration?sedation in dogs and moderate to intense analgesia, duration of 1-1.5hr