Anesthesia and Analgesia in Laboratory Animals: Chapter 1: Pharmacology of Injectable Anesthetics

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Anesthesia and Analgesia in Laboratory Animals: Chapter 1: Pharmacology of Injectable Anesthetics

Summary: Chapter 1, after a brief caution about interpretation of the literature regarding the efficacy of individual agents and/or classes of anesthetics, the authors provide information on the different classes of compounds to be discussed. Included in this chapter are agents (tranquilizers, sedatives, analgesics) that have no anesthetic potential of their own. These agents are discussed because they are used in combination for induction and/or for providing balanced anesthesia. In most cases the authors cover the pharmacokinetics and pharmacodynamics of at least a representative from each of the groups and in some cases all of the currently used members. There are not doses given though much information is given concerning the “besting of one agent by another”’; “potency” of one agent over another. The reader must refer back to the original literature if they are to interpret this information correctly.

  1. Barbiturates currently used in veterinary medicine for anesthesia are divided into short acting and ultra-short acting. Of the list below, _______________- is not considered an ultra shorting acting agent.

  1. pentobarbital

  2. hexobarbital

  3. thiopental

  4. thiobarbital

  1. The lipophilic barbiturates are associated with prolonged recovery and sometimes a “hangover” effect because of ___________________

  1. renal tubular reabsorption of filtered metabolite

  2. slow release from fat stores back into the blood for excretion

  3. delayed hepatic metabolism if a maximum total dose has been given

  4. inhibition of hepatic microsomal enzymes systems by the agent

  1. Barbiturates can protect the brain from hypoxia-driven events by ______________________________.

  1. accumulating in brain fat and blocking neuronal traffic

  2. suppressing brain metabolism and oxygen need

  3. exciting the beta-endorphins whose release is associated with neuronal protection

  4. driving respirations to the point of respiratory alkalosis and constriction of brain blood vessels.

  1. Barbiturates decrease the sensitivity of the hypoxia and hypercarbia receptors for increasing breathing activity. This would have the effect of _________________________,

  1. producing respiratory acidosis and perhaps hypoxemia

  2. producing respiratory alkalosis

  3. rapidly producing a state of respiratory alkalosis

  4. reduction in erythropoietin secretion from the kidney

  1. T/F. In almost every species studies, all of the barbiturates have proved to be generalized myocardial depressants and vasodilators.

  1. T/F. Barbiturates are “notorious” for provoking a reduction in core temperature, especially if the patient is not provided with water-circulating heating pad on which to lay.

  1. Alpha-Chloralose is especially valued by physiologists in biomedical research because it is associated with ____________________________________.

  1. an exceptionally short, smooth induction phase

  2. an exceptionally short, smooth recovery phase

  3. minimal effects on reflexes and baroreceptors

  4. exceptional analgesic properties

  1. The hypnotic sedative, urethane (ethyl carbamate) is not unlike alpha-chloralose in terms of the anesthesia produced in most species but urethane is associated with __________________________________- that is not seen with alpha-chloralose.

  1. analgesic activity

  2. cardiac arrhythmias

  3. increased growth hormone release

  4. decerebrate rigidity

  1. Cremaphor, the emulsion vehicle for intravenous propofol administration, is noted for ______________________________.

  1. anaphylaxis in the rat and pig

  2. pain at the injection site

  3. provoking histamine release in the dog

  4. no adverse effects

  1. Propofol is not suitable for use in the rabbit because _______________________________________.

  1. rabbits recover even while the drug is in the alpha (distributional) phase

  2. the rabbits can not metabolize the drug

  3. urinary excretion is slowed due to distal renal tubular reabsorption.

  4. It causes venous thrombosis in this species

  1. A neurolept analgesic combination would include only _______________ of the following.

a. acetylpromazine and valium

b. midazolam and xylazine

c. buprenorphine and acetylpromazine

  1. xylazine and pentobarbital sodium

12. Ketamine is a ______________________________.

a. anesthetic only

b. sedative only

c. sedative and anesthetic

d. neither sedative or anesthetic

  1. 13. Another cyclohexamine, combined with a benzodiazepine for commercial use in swine, cattle and other species, is

a. phenertamine

b. monoacetic acid

c. tiletamine

d. regitine

    1. Ketamine is metabolized in the liver and ________________________

a. there is no difference between males and females in rate of metabolism

b. unweened rats sleep much longer than adults given the same dosage

c. the geriatric dog patient has a longer sleep time than a year old dog of the same breeding given the same dose

d. the metabolites are lacking in pharmacological effect.

    1. Ketamine and tiletamine may cause seizures in _____________________ but increase the seizure threshold in ______________________.

a. cats/dogs: guinea pigs and rabbits

b. guinea pigs and rabbits; cats and dogs

c. cats; mice and rats

dogs/cats: rats and mice

16. T/F. Ketamine is considered a more potent analgesic for musculoskeletal pain than abdominal (visceral) pain.
17. T/F. The sympathomimetic action of ketamine leads to mild transient if any depression of respiration rate and volume in most species and is a bronchial dilator.

  1. The positive iontropic and chronotropic effects of ketamine in the cardiovascular system suggest that there is____________________________________________

  1. an increase in strength and rate of ventricular contraction

  2. an increase in impulse conduction rate and rate of contraction

  3. a decrease in conduction time and an increase in conduction rate

  4. an increase in rate and ventricular contraction

19. Cardiovascular effects of ketamine can be blocked by _________________.

a. dopaminergic antagonists

b. gabaminergic antagonists

c. yohimbine

d. alpha and beta adrenergic antagonists

20. T/F. Tiletamine, though not anesthetic for rabbits, possesses histologic renal nephrosis at “low doses”.
21. T/F. Alphaxalone and alphadalone used in fixed combination provides for a rapid anesthetic in nonhuman primates.
22. Alphaxalone has a _________________________biological half-life and is excreted by ___________________________ and experience ___________________________.

a. long >60 min): kidney ; no enterohepatic recirculation

b. short (<10 min): kidney and liver ; enterohepatic recirculation

c. intermediate (>30 min but <60 min): liver; enterohepatic recirculation

d. long (>60 min): kidney and liver; enterohepatic recirculation

  1. 23. Alphaxalone has a mechanism of action related to enhancing membrane chloride channels mediated by _________________.

a. GABA 11, RC

b. alpha adrenergic receptors

c. serotoninergic receptors

d. cholinergic receptors.

24. Alphaxalone administration to primates is associated with ___________.

a. tachypnea and hyperthermia

b. bradyarrhythmias and tachypnea

c. hypotension and hypothermia

d. hypothermia 12Lc
25. The area of the brain where alpha-2 noradrenergic agonists can block neurons in the _____________________________ and reduce “vigilance” and promote sedation in animals.

  1. cyngulate nucleus

  2. medulla oblongata

  3. locus coeruleus 12, LC

  4. dentate nucleus

  1. Alpha-2 adrenergic agonists activity in the peripheral nervous system leads to _____________________ and __________________.

  1. vasoconstriction: increased insulin release

  2. reduce urinary output: increased gastrointestinal motility

  3. vasodilation; increased insulin release

  4. diuresis ; decreased gastrointestinal motility 12RC

27. Xylazine use has been associated with a decrease in serum levels of ADH which accounts for the ______________ associated with the use of this agent.

a. lipolysis b. vomition c. decreased serum cortisol d. diuresis

    1. Xylazine produces it s sedative/analgesic effects by acting as an _______________ at appropriate receptor sites.

    1. pure agonist c. partial agonist

b. antagonist d. agonist-antagonist
29. In most species, xylazine is metabolized _________________ by the liver with the production of _______________ products that are _______________.

a. rapidly; less than three metabolic ; inactive

b. slowly; more than five metabolic; active

c. rapidly; more than twenty metabolic; inactive

d. rapidly; less than six metabolic; inactive
30. Several newer alpha2 agonist sedative/analgesics include ___________ and _________________.

    1. propranolol and esmalol

b. detomidine and medetomidine

c. glycopyrrolate and azopyrrolate

d. butorphanol and orphaned

  1. In most species, detomidine and medetomidine are bound to plasma protein at the rate of > 90%. This has the effect of ______________________.

    1. increasing the elimination rate constant

    2. increasing the first pass effect in the liver

    3. enhancing glomerular filtration rate of the agent

    4. enhancing penetration into the CSF

  1. T.F. The feces is the primary route of elimination of medetomidine and detomidine from animals after parenteral administration.

  1. Medetomidine an detomidine, after parenteral administration, achieve approximately a 6:1 brain:serum ratio after about 10 min. This is quickly reversed so that with another 30 minutes the ratio is less than 1:1. This phenomenon occurs because of ____________________

    1. redistribution from fat depots

    2. brain metabolism

    3. preferential brain binding

    4. active transport out of the brain

  1. T/F. Tranquilizers are administered to animal patients to induce sleep and provide analgesia.

  1. Phenothiazine tranquilizers rely on ________________ receptors for central pharmacologic action but also affect peripheral _________________ receptors causing the epinephrine reversal phenomenon.

    1. opiate : GABAnergic

    2. dopaminergic: alpha-adrenergic

    3. beta-adrenergic: beta-adrenergic

    4. GABAnergic: serotoninergic

  1. A butyrophenone in combination with an opioid, termed a neuroleptanalgesic, would be exemplified by ___________________.

    1. acetylpromazine; buprenorphine

    2. midazolam: morphine

    3. xylazine: butorphanol

    4. droperidol; fentanyl citrate

  1. Of the following, ____________________ is not appropriate synonym for a tranquilizer.

a. ataractic b. psychotropic agent c. neuroleptic d. somnofacient

  1. The proper match of agonist with receptor is correct for all of the following except -_____________________________.

    1. butorphanol: opiate

    2. ketamine: phencyclidine

    3. xylazine: alpha2-adrenergic

    4. butyerphone: GABAA

  1. An agent very commonly associated with immobilization, sedation and anesthesia in fish , is _____________________.

    1. tricaine (metacaine)

    2. phenylpropylamine

    3. bis-2-6, tetracaine

    4. MS 444

  1. A benzodiazepine suitable for infusion anesthesia protocols because of its rapid elimination from the body is __________________.

    1. telazol

    2. zolazepam

    3. diazepam

    4. midazolam

  1. The benzodiazepine ______________, is combined with _____________ in a preparation marketed under the trade name, Telazol.

    1. zolazepam; tiletamine

    2. diazepam; phencyclidine

    3. midazolam; ketamine

    4. Tetrazole; tiletamine

  1. Included in the myriad of pharmacologic effects of benzodiazepine, are skeletal muscle relaxation, anticonvulsant action; anxiolytic activity, would be _________________.

    1. malignant hypertension

    2. malignant hypotension

    3. sedation

    4. hyperesthesia

  1. Benzodiazepines interact with ___________________ receptors to effect their distinct pharmacological activity.

    1. Alpha2-adrenergic

    2. GABA

    3. GABAA

    4. serotoninergic

  1. Benzodiazepines, in general and in most species, ________________.

    1. have pronounced respiratory depressive effects, even at low doses

    2. have minimal cardiorespiratory effects, even at moderate doses

    3. provoke bradyarrhythmias, even at low doses

    4. potentate the arrhythomgenic activity of catecholamines.

  1. A specific antagonist to the benzodiazepines is found in the agent ______.

    1. phentolamine

    2. flumazenil

    3. yohimbine

    4. nalloxone

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