VT131 Anesthetic Drugs I & II

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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


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