VT131 Anesthetic Drugs I & II
As a rough guideline, to maintain surgical anesthesia safely, the vaporizer should be set at about: 0.5 x MAC 1 x MAC 1.5 x MAC 2 x MAC
1.5 x MAC
No more than ____ nitrous oxide should be delivered to an anesthetized patient. 40% 50% 60% 70%
70%
The preanesthetic mix abbreviated BAA contains: Buprenorphine, atropine, acepromazine Butorphanol, atipamezole, atropine Buprenorphine, atropine, atipamezole Butorphanol, acepromazine, atropine
Butorphanol, acepromazine, atropine
An anesthetic agent that has a low blood-gas partition coefficient will result in ______ induction and recovery time. Slow Moderate Fast
Fast
Propofol: Is a potent analgesic Can be given via the IM and IV routes Is best administered as a single bolus Can be given in incremental doses
Can be given in incremental doses
Adverse effects common with isoflurane include: Hepatic toxicity Accumulation in body fat stores Depression of respiration Seizures during recovery
Depression of respiration
The adverse effects of anesthetic compounds are: Nothing to worry about Never present with smaller doses Dose dependent Not dose dependent
Dose dependent
True or False: Most preanesthetic drugs will not cross the placental barrier
False
Which species is most sensitive to opioids? Sheep Horse Dog Pig
Horse (and cats)
What describes a Schedule I Controlled Substance? High potential for abuse Less potential for abuse No currently accepted medical use No potential for abuse
No currently accepted medical use
Which of the following is not seen when ketamine is administered IV rather than IM? Lower dose rate used Quicker onset of effects Longer duration of effects Less pain on injection
Longer duration of effects
What is defined as the lowest concentration at which 50% of patients show no response to painful stimulus? Anesthetic depth Blood-gas coefficient Mean Alveolar Content Vapor pressure
MAC
When comparing inhalation anesthetics, you should use the minimum alveolar concentration (MAC) as a guide in assessing: Respiratory depression Potency of the agent Cardiovascular effects Solubility coefficients
Potency of the agent
_________ analgesia is the administration of an analgesic before the pain develops. Somatic Preemptive Visceral Referred
Preemptive
Controlled substances with no accepted medical use are classified as: Schedule I Schedule II Schedule III Schedule V
Schedule I
Opioids may be reversed with: Atipamezole Naloxone Atropine Yohimbine
Naloxone
Propofol sometimes causes transient apnea. To avoid this, the anesthetist should: Give it by infusion only Premedicate with opioids Administer in intravenously only Titrate this drug in several boluses
Titrate this drug in several boluses (Propofol is potent respiratory depressant. Give O2 for 3-5 min then titrate Propofol)
A cow is accidentally dosed with an equine dose of xylazine. What drug should be immediately administered? Epinephrine Yohimbine Naloxone None; the equine and bovine dose are the same
Yohimbine (reversal agent for xylazine)
How long, at minimum, should controlled substance logs be kept on file? 6 months 1 year 2 years 5 years
2 years
Unused portions of PropoFlo28 can be stored at room temperature for up to how many days? 7 days 14 days 28 days 56 days
28 days
The effect of intravenous administration of any anesthetic drug is usually detected in: 30 to 60 second 3 to 5 minutes 15 to 20 minutes 1 hour
30 to 60 second
If 180 ml of a 5% solution of guaifenesin is administered to a 150-kg foal, how many mg/kg would be administered? 30 60 90 15
60 (5% = 50 mg/ml; 180ml x 50 mg/ml = 9000mg / 150 kg = 60 mg/kg)
Which of the following statements regarding MAC is incorrect? The MAC expresses the potency of an anesthetic. A patient at the MAC value is at a surgical plane of anesthesia. Patient factors, such as pregnancy and disease, may influence the MAC. Isoflurane has a lower MAC than sevoflurane
A patient at the MAC value is at a surgical plane of anesthesia. (MAC = 50% patients show no reaction to pain)
A CNS side effect commonly seen with propofol use is nystagmus; nystagmus is defined as: Disease or injury of a peripheral nerve Low tissue oxygen level Dilation of the pupil A rhythmic, involuntary oscillation of both eyes
A rhythmic, involuntary oscillation of both eyes
What drugs will not slow the heart rate? Anticholinergics Phenothiazine tranquilizers Alpha-2 agonists Gas anesthetics:
Anticholinergics
Which of these opioids is an agonist/antagonist? Oxymorphone Mederidine Butorphanol Fentanyl
Butorphanol
Which of the following preanesthetic drug classes does not have an effect of induction and recovery? Opioids Benzodiazepines Acepromazine Anticholinergics
Anticholinergics
Which drug should be avoided in the stallion because it may cause permanent prolapse of the penis? Acepromazine Glycopyrrolate Xylazine Diazepam
Acepromazine
All are controlled substances except: Acepromazine Ketamine Fentanyl Diazepam
Acepromazine (Ketamine C-III Fentanyl C-II Diazepam C-IV)
A neuroleptanalgesic is a combination of: An opioid and an anticholinergic An anticholinergic and a tranquilizer An opioid and a tranquilizer An anticholinergic and a benzodiazepine
An opioid and a tranquilizer
Xylazine is a sedative as well as an ____. Antibiotic Anticonvulsant Antiseptic Analgesic
Analgesic
Opioid drugs are used in anesthetic protocols as: Anesthetics Analgesics Anti-inflammatories Antihistamines
Analgesics
Any drug used to induce a loss of sensation with or without consciousness: Antagonists Reversal agent Agonists Anesthetic agent
Anesthetic agent
All of the following are appropriate uses of anticholinergic drugs except: As an antidote for organophosphate poisoning As an agent to increase intestinal peristalsis AS an aid in the treatment of corneal ulcers As treatment for bradycardia
As an agent to increase intestinal peristalsis
Severe bradycardia caused by dexmedetomidine is best treated with: Atropine Naloxone Epinephrine Atipamezole
Atipamezole
A drug classified as an antagonist may exert its influence by: Mimicking the activity of the neurotransmitter used in the impulse Preventing the breakdown of the neurotransmitter used in the impulse Blocking the neurotransmitter receptor on the effector organ Enhancing the release of the neurotransmitter used in the impulse
Blocking the neurotransmitter receptor on the effector organ
Atropine works primarily by: Stimulating the sympathetic nervous system Blocking the sympathetic system Stimulating the parasympathetic system Blocking the parasympathetic actions
Blocking the parasympathetic actions
What is described as a measure of the solubility of an inhalant anesthetic in blood as compared with alveolar gas? Anesthetic depth Blood-gas partition coefficient Mean Alveolar Content Vapor pressure
Blood-gas partition coefficient (BGPC)
Nitrous oxide cylinders are painted what color? Purple Orange Green Blue
Blue (O2 = green)
In the United States, xylazine is not approved for use in: Dogs Cats Horse Cattle
Cattle (Xylazine causes abortions in last trimester for cattle)
Which of the following is classed as a Schedule II Controlled Substance? Codeine Alfaxalone Ketamine Buprenorphine
Codeine
Anticholinergic drugs should not be used in which species? Horse Cat Mouse Cow
Cow
Glycopyrrolate is an anticholinergic with all of the following advantages over atropine except: Longer duration of action Crosses the placental barrier Less likely to cause cardiac arrhythmias Smaller dose volume
Crosses the placental barrier
Controlled substances are regulated by the: Drug Enforcement Agency (DEA) Food and Drug Administration (FDA) United States Department of Agriculture (USDA) American Animal Hospital Association (AAHA)
DEA
Use of nitrous oxide in anesthesia: Increases the amount of inhalation anesthetic required Slows the induction process Has no effect on the time or amount of anesthetic required Decreases the amount of inhalation anesthetic required
Decreases the amount of inhalation anesthetic required
What inhalant anesthetic has the lowest blood-gas partition coefficient and is sometimes referred to as "one-breath anesthesia"? Sevoflurane Methoxyflurane Desflurane Isoflurane
Desflurane (lowest BGPC)
All of the following drugs are antagonists, used to reverse the effects of another drug except: Yohimbine (Yobine) Detomidine (Dormosedan) Atipamezole (Antisedan) Naloxone (Narcan)
Detomidine (Dormosedan)
Which medication should not be mixed in the same syringe as water-soluble drugs? Buprenorphine Diazepam Butorphanol Xylazine
Diazepam (lipid-soluble)
Which of the following are alpha-2 agonists? Atipamezole Diazepam Acepromazine Dexmedetomedine
Dexmedetomedine (Dexdomitor)
Which one of the following drugs will precipitate out when mixed with other drugs or solutions? Atropine Acepromazine Diazepam Butorphanol
Diazepam (precipitate = separate) (Diazepam is lipid soluble, does not mix well w/ many drugs)
________ is a concern when recovering a patient from anesthesia if nitrous oxide has been used. Solubility Diffusion hypoxia Biotransformation Inflammation
Diffusion hypoxia
Define mydriasis: Muscle disease Dilatation of the pupil of the eye Disease or injury of a peripheral nerve Constriction of the pupil of the eye
Dilatation of the pupil of the eye (Miosis = constriction of pupil)
________ can cause convulsions when administered alone at high doses. Dissociative anesthetics Barbiturates Benzodiazepine tranquilizers Propofol
Dissociative anesthetics
________ can cause convulsions when administered alone at high doses: Dissociative anesthetics Barbiturates Benzodiazepine tranquilizers Propofol
Dissociative anesthetics
Opioids can cause CNS excitement in all of the following species, except: Dog Horse Cow Cat
Dog
________ may occur because of rapid recovery from isoflurane anesthesia. Diffusion hypoxia Second gas effect Biotransformation Emergence delirium
Emergence delirium
Which of the following is not an effect associated with atropine administration? Tachycardia Excessive salivation Decreased gastrointestinal motility Mydriasis
Excessive salivation (Anticholinergics reduce salivation)
One problem frequently associated with recovery from tiletamine-zolazepam in dogs is: Excitement Bradycardia Hypotension Laryngospasm
Excitement
Which of the following is (are) not characteristic(s) of propofol? Rapid induction and recovery Absence of "hangover effect" with repeated injections Good post anesthesia analgesia Smooth recoveries
Good post anesthesia analgesia (Propofol is not an analgesic)
Malignant hyperthermia is a phenomenon associated with the use of what inhalant anesthetic? Nitrous oxide Sevoflurane Halothane Isoflurane
Halothane
Which inhalant anesthetic drug is most likely to cause cardiac arrhythmias in dogs? Isoflurane Halothane Sevoflurane Nitrous Oxide
Halothane
Which inhalant anesthetic is associated with the longest induction and recovery times? Nitrous oxide Isoflurane Halothane Sevoflurane
Halothane
Isoflurane is mainly eliminated from the body by the: Renal system GI system Respiratory system Hepatic system
Hepatic system
Phenothiazines may cause: Bradycardia Hypotension Tachycardia Excitement
Hypotension
An overdose of a barbiturate anesthetic can appropriately be treated with all of the following except: Respiratory stimulant Fluid therapy Ventilator support Increase the concentration of isoflurane
Increase the concentration of isoflurane
Atropine is often given as a preanesthetic agent. It is classified as an anticholinergic drug. That means that it will likely have the following effects on an animal receiving the drug: Decreased heart rate, decreased salivation, and decreased GI motility Increased heart rate, increased salivation, and increased GI motility Increased heart rate, decreased salivation, and decreased GI motility Decreased heart rate, increased salivation, and increased GI motility
Increased heart rate, decreased salivation, and decreased GI motility
Epinephrine: Increases the heart rate Decreases the blood pressure Decreases the heart rate Should be used to reverse the effects of the acepromazine
Increases the heart rate
Which of the following is not a good reason to use a preanesthetic? Calms the patient Minimized the dose of induction agent needed Smooths induction and recovery Increases vagal activity
Increases vagal activity
Which inhalant anesthetic is considered to have the fewest adverse cardiovascular effects? Sevoflurane Desflurane Isoflurane Nitrous oxide
Isoflurane (ideal for cardiac patients)
Which of the following is not a valid reason for administering a preanesthetic medication? It reduces the amount of general anesthetic for induction. It may calm and excited animal. It may reduce the possible noxious side effects from the general anesthesia. It increases patient safety by allowing the animal to stay under the general anesthetic for a longer time.
It increases patient safety by allowing the animal to stay under the general anesthetic for a longer time.
Which statement concerning the use of intravenous anesthesia in large animals is least accurate? It is routinely used for cast applications, castrations, and umbilical hernias. It works well on procedures that require complete immobilization of the patient. It should not be used on procedures that require more than 45 to 50 minutes to complete. It requires use of preanesthetic for sedation and a barbiturate.
It works well on procedures that require complete immobilization of the patient.
An alpha-2 agonist that provides sedation, muscle relaxation, and analgesia is: Acepromazine Xylazine Diazepam Ketamine
Ketamine
Apneustic breathing patterns are frequently seen in cats with use of: Pentobarbital Thiamylal Ketamine Guaifenesin
Ketamine
What agent is excreted largely intact by the cat kidney? Atropine Ketamine Halothane Acetylpromazine
Ketamine
Which drug is a dissociative anesthetic? Thiopental sodium Xylazine Acepromazine Ketamine
Ketamine
Which of the following is an example of a dissociative anesthetic? Thiopental sodium Pentobarbital sodium Ketamine hydrochloride Propofol
Ketamine hydrochloride
The drug used for epidural anesthesia is: Thiopental Ketamine Propofol Lidocaine
Lidocaine (local anesthetic)
All of the following drugs predispose the animal to bloat, except: Atropine Medetomidine Glycopyrrolate Midazolam
Midazolam
Anticholinergic drugs such as a tropine block the release of acetylcholine at the: Muscarinic receptors of the parasympathetic system Nicotinic receptors of the parasympathetic system Muscarinic receptors of the sympathetic system Nicotinic receptors of the sympathetic system
Muscarinic receptors of the parasympathetic system (Muscarinic receptors are located on target organs; nicotinic receptors are located on postganglionic neurons)
Which drug is a narcotic antagonist? Droperidol Atropine Naloxone Pancuronium
Naloxone (antagonist = reversal agent; Naloxone reverses opioids)
Which of the following does not cross the placental barrier in significant amounts? Acepromazine Neuromuscular blocking agents Diazepam Isoflurane
Neuromuscular blocking agents
Which inhalant anesthetic is biotransformed to the greatest extent in the animal body? Isoflurane Desflurane Sevoflurane Nitrous Oxide
Nitrous Oxide
Propofol is a/an: Xylazine antagonist Ultrashort-acting barbiturate Ketamine-like dissociative Nonbarbiturate, intravenous anesthetic with hypotensive potential
Nonbarbiturate, intravenous anesthetic with hypotensive potential
Which of the following preanesthetic drug classes has analgesic properties? Acepromazine Opioids Anticholinergics Benzodiazepines
Opioids
The MAC of an anesthetic agent will change for all the following reasons except: Preanesthetic drug administration Patient's age Patient's breed Anemia
Patient's breed (Min Alveolar Concentration (MAC = Lowest dose at which 50% patients show no response to painful stimulus)
Sevoflurane is primarily eliminated from the body by: Respiration Liver metabolism Feces Kidney excretion
Respiration (inhalant anesthetic)
Doxapram is a stimulant to the ______ system. Hepatic Respiratory Endocrine Nervous
Respiratory
An anesthetist should be aware of the effects of anesthetic agents on the patient. When used as preanesthetics, atropine and acepromazine can cause all of the following, except: Prolapse of the nictitating membrane Respiratory depression Reduced salivation and tear production Pupil dilation in cats
Respiratory depression
Benzodiazepines are excellent to prevent: Hypothermia Vomiting Hunger Seizures
Seizures (anti-convulsant)
What gas anesthesia demands the greatest degree of patient monitoring, because anesthetic depth changes occur most rapidly? Nitrous oxide Sevoflurane Halothane Isoflurane
Sevoflurane
Which of the following is the anesthetic with the lowest blood-gas coefficient? Halothane Isoflurane Sevoflurane Nitrous oxide
Sevoflurane
Which inhalant anesthetic is the best choice for mask and chamber inductions? Sevoflurane Methoxyflurane Isoflurane Nitrous oxide
Sevoflurane (more pleasant odor, patients don't struggle as much)
Inhalant anesthetics with low ________ have short induction and recovery periods. Toxicity Solubility coefficient Vapor pressure Biotransformation
Solubility coefficient
Phenothiazine tranquilizers: Cause nausea Increase the seizure threshold Cause vasoconstriction Suppress the sympathetic nervous system
Suppress the sympathetic nervous system
The following general anesthetic agents can be delivered to effect except: Isoflurane Telazol given IM Ketamine/diazepam IV Thiopental IV
Telazol given IM
Define 'pharmacokinetics': The effects a drug has on the body The effect the body has on a drug Partial agonists Stimulates receptors
The effects a drug has on the body ?
Which is not true of preanesthetic agents? They reduce the required dose of general anesthetics They ease induction and recovery They reduce the level of sedation They reduce patient discomfort and stress
They reduce the level of sedation
What is defined as a measure of the tendency of a liquid anesthetic to evaporate? Anesthetic depth Blood-gas coefficient Mean Alveolar Content Vapor pressure
Vapor pressure
What agent should be avoided in geriatric patients? Atropine Xylazine Ketamine Diazepam
Xylazine (Alpha2-Agonists only safe for healthy patients)
Depressant preanesthetic medication may have what effect on the anesthesia procedure? Shorten the recovery time prolong the recovery time Leave the recovery time unaltered Necessitate increasing the dose of induction agent
prolong the recovery time
