Injectable Anaesthesia and Analgesia Quiz

WIKIQUIZ

Questions reviewed by:

Juliet Duncan BVM&S MSc DipECVAA MRCVS

1

Naloxone is a reversal agent for which group of drugs? Butyrophenones Benzodiazepines Alpha-2 agonists Opioids Phenothiazines Please select an option Incorrect. Alpha-2 agonists can be antagonised with atipamazole. Naloxone is an antagonist to exogenous and endogenous opioids. It is frequently used in human medicine to antagonise opioid narcotics in the incidence of overdose. Naloxone may be administered intravenously, intramuscularly, intrathecally or subcutaneously. It has a short duration of action (1-2 hours) and so repeated administrations may be necessary. Although diprenorphine (LA Revivon) is the licensed reversal agent for LA Immobilon in animals, naloxone should also be drawn up in case of accidental self-injection which can be rapidly fatal in man.WikiVet Article: opioids. Incorrect. Alpha-2 agonists can be antagonised with atipamazole. Naloxone is an antagonist to exogenous and endogenous opioids. It is frequently used in human medicine to antagonise opioid narcotics in the incidence of overdose. Naloxone may be administered intravenously, intramuscularly, intrathecally or subcutaneously. It has a short duration of action (1-2 hours) and so repeated administrations may be necessary. Although diprenorphine (LA Revivon) is the licensed reversal agent for LA Immobilon in animals, naloxone should also be drawn up in case of accidental self-injection which can be rapidly fatal in man.WikiVet Article: opioids. Correct! Naloxone is an antagonist to exogenous and endogenous opioids. It is frequently used in human medicine to antagonise opioid narcotics in the incidence of overdose. Naloxone may be administered intravenously, intramuscularly, intrathecally or subcutaneously. It has a short duration of action (1-2 hours) and so repeated administrations may be necessary. Although diprenorphine (LA Revivon) is the licensed reversal agent for LA Immobilon in animals, naloxone should also be drawn up in case of accidental self-injection which can be rapidly fatal in man.WikiVet Article: opioids. Incorrect. Phenothiazines have no reversal agent. Naloxone is an antagonist to exogenous and endogenous opioids. It is frequently used in human medicine to antagonise opioid narcotics in the incidence of overdose. Naloxone may be administered intravenously, intramuscularly, intrathecally or subcutaneously. It has a short duration of action (1-2 hours) and so repeated administrations may be necessary. Although diprenorphine (LA Revivon) is the licensed reversal agent for LA Immobilon in animals, naloxone should also be drawn up in case of accidental self-injection which can be rapidly fatal in man.WikiVet Article: opioids.

2

In which dog breed can acepromazine cause fainting and syncope? Cavalier King Charles Spaniel Doberman St Bernards Boxer German shepherd dogs Please select an option Incorrect. Acepromazine has not been associated with fainting and syncope in Cavalier King Charles Spaniels. In Boxers given acepromazine, spontaneous fainting and syncope can occur due to sinoatrial block caused by excessive vagal tone. Acepromazine should be used at low doses or avoided in this breed. WikiVet Article: phenothiazines. Incorrect. Acepromazine has not been associated with fainting and syncope in Dobermans. In Boxers given acepromazine, spontaneous fainting and syncope can occur due to sinoatrial block caused by excessive vagal tone. Acepromazine should be used at low doses or avoided in this breed. WikiVet Article: phenothiazines. Incorrect. Acepromazine has not been associated with fainting and syncope in Cavalier King Charles Spaniels. In Boxers given acepromazine, spontaneous fainting and syncope can occur due to sinoatrial block caused by excessive vagal tone. Acepromazine should be used at low doses or avoided in this breed. WikiVet Article: phenothiazines. Correct! In Boxers given acepromazine, spontaneous fainting and syncope can occur due to sinoatrial block caused by excessive vagal tone. Acepromazine should be used at low doses or avoided in this breed. WikiVet Article: phenothiazines.

3

Which injectable anaesthetic should be avoided in sighthounds? Propofol Ketamine Alfaxalone Fentanyl-fluanisone Thiopentone Please select an option Incorrect. Propofol is an appropriate induction agent in sighthounds. Initial recovery from anaesthesia induced by thiopentone is dependent on redistribution of thiopentone from the plasma to the fat. Greyhounds and other sight hounds may exhibit longer recovery times than other breeds. This may be due to these breeds low body fat levels or differences in the metabolic han­dling of the thiobarbiturates. Both propofol and alfaxalone are preferable induction agents in sighthounds.WikiVet Article: thiopentone. Incorrect. Propofol is an appropriate induction agent in sighthounds. Initial recovery from anaesthesia induced by thiopentone is dependent on redistribution of thiopentone from the plasma to the fat. Greyhounds and other sight hounds may exhibit longer recovery times than other breeds. This may be due to these breeds low body fat levels or differences in the metabolic han­dling of the thiobarbiturates. Both propofol and alfaxalone are preferable induction agents in sighthounds.WikiVet Article: thiopentone. Incorrect. Fentanyl-fluanisone is not licensed in dogs, it is only licensed in rabbits, guinea pigs, rats and mice. Initial recovery from anaesthesia induced by thiopentone is dependent on redistribution of thiopentone from the plasma to the fat. Greyhounds and other sight hounds may exhibit longer recovery times than other breeds. This may be due to these breeds low body fat levels or differences in the metabolic han­dling of the thiobarbiturates. Propofol and alfaxaolne are preferred induction agents in sighthounds. WikiVet Article: thiopentone. Correct! Initial recovery from anaesthesia induced by thiopentone is dependent on redistribution of thiopentone from the plasma to the fat. Greyhounds and other sight hounds may exhibit longer recovery times than other breeds. This may be due to these breeds low body fat levels or differences in the metabolic han­dling of the thiobarbiturates. Propofol and alfaxalone are preferable induction agents in sighthounds. WikiVet Article: thiopentone.

4

Which drug is commonly used for total intravenous anaesthesia (TIVA) in dogs? Propofol Ketamine Thiopentone Alfaxalone Fentanyl-fluanisone Please select an option Correct! Propofol has a very high volume of distribution and so a rapid re-distribution. It also has a very fast clearance by the liver metabolism in dogs therefore it is non-cumulative and can be used for TIVA. This is not true in cats, they can not metabolise propofol as effectively and so repeated doses can cause Heinz body anaemia, anorexia, diarrhoea and prolonged aneasthetic recovery.WikiVet Article: propofol. Incorrect. Thiopentone is cumulative following repeated doses so is not suitable for TIVA in any animal. Propofol has a very high volume of distribution and so a rapid re-distribution. It also has a very fast clearance by the liver metabolism in dogs therefore it is non-cumulative and can be used for TIVA. This is not true in cats, they can not metabolise propofol as effectively and so repeated doses can cause Heinz body anaemia, anorexia, diarrhoea and prolonged aneasthetic recovery.WikiVet Article: propofol. Incorrect. Thiopentone is cumulative following repeated doses so is not suitable for TIVA in any animal. Propofol has a very high volume of distribution and so a rapid re-distribution. It also has a very fast clearance by the liver metabolism in dogs therefore it is non-cumulative and can be used for TIVA. This is not true in cats, they can not metabolise propofol as effectively and so repeated doses can cause Heinz body anaemia, anorexia, diarrhoea and prolonged aneasthetic recovery.WikiVet Article: propofol. Incorrect. Fentanyl-fluanisone is not licensed for use in dogs in the UK. Propofol has a very high volume of distribution and so a rapid re-distribution. It also has a very fast clearance by the liver metabolism in dogs therefore it is non-cumulative and can be used for TIVA. This is not true in cats, they can not metabolise propofol as effectively and so repeated doses can cause Heinz body anaemia, anorexia, diarrhoea and prolonged aneasthetic recovery.WikiVet Article: propofol.

5

Which injectable anaesthetic increases intracranial pressure and central nervous system (CNS) excitement? Fentanyl-fluanisone Propofol Thiopentone Alfaxalone Ketamine Please select an option Incorrect. Fentanyl-fluanisone does not increase intracranial pressure. Ketamine increases intracranial pressure and CNS excitement which is not usually a problem in healthy animals, but it should be avoided in cases where increasing intracranial pressure may be detrimental or those with a history of seizures. WikiVet Article: ketamine. Incorrect. Thiopentone actually reduces intracranial pressure and is excellent at treating and preventing seizures so it is often selected for anaesthetising animals with seizures or intracranial disease. Ketamine increases intracranial pressure and CNS excitement which is not usually a problem in healthy animals but it should be avoided in cases where increasing intracranial pressure may be detrimental or those with a history of seizures. WikiVet Article: ketamine. Incorrect. Thiopentone actually reduces intracranial pressure and is excellent at treating and preventing seizures so it is often selected for anaesthetising animals with seizures or intracranial disease. Ketamine increases intracranial pressure and CNS excitement which is not usually a problem in healthy animals but it should be avoided in cases where increasing intracranial pressure may be detrimental or those with a history of seizures. WikiVet Article: ketamine. Correct! Ketamine increases intracranial pressure and CNS excitement which is not usually a problem in healthy animals but it should be avoided in cases where increasing intracranial pressure may be detrimental or those with a history of seizures. WikiVet Article: ketamine.

6

Which local anaesthetic also has anti-arrhythmogenic properties? Mepivicaine Proxymetacaine Procaine Bupivicaine Lidocaine Please select an option Incorrect. Bupivicaine does not have anti-arrhythmogenic properties. Lidocaine is an amide-linked local anaesthetic, which also has anti-arrhythmic properties. Lidocaine has class 1b antiarrhythmic actions; decreasing the rate of ventricular firing, action potential duration and absolute refractory period, and increasing relative refractory period. However do not give lidocaine preparations containing adrenaline intravenously. WikiVet Article: lidocaine. Incorrect. Proxymetacaine does not have anti-arrhythmogenic properties. Lidocaine is an amide-linked local anaesthetic, which also has anti-arrhythmic properties. Lidocaine has class 1b antiarrhythmic actions; decreasing the rate of ventricular firing, action potential duration and absolute refractory period, and increasing relative refractory period. However do not give lidocaine preparations containing adrenaline intravenously. WikiVet Article: lidocaine. Incorrect. Bupivicaine does not have anti-arrhythmogenic properties. Lidocaine is an amide-linked local anaesthetic, which also has anti-arrhythmic properties. Lidocaine has class 1b antiarrhythmic actions; decreasing the rate of ventricular firing, action potential duration and absolute refractory period, and increasing relative refractory period. However do not give lidocaine preparations containing adrenaline intravenously. WikiVet Article: lidocaine. Correct! Lidocaine is an amide-linked local anaesthetic, which also has anti-arrhythmic properties. Lidocaine has class 1b antiarrhythmic actions; decreasing the rate of ventricular firing, action potential duration and absolute refractory period, and increasing relative refractory period. However do not give lidocaine preparations containing adrenaline intravenously. WikiVet Article: lidocaine.

7

Which local anaesthetic has the longest duration of action? Bupivicaine Lidocaine Procaine Proxymetacaine Mepivicaine Please select an option Correct! Bupivicaine has a time to onset of 20-30 minutes and it has a duration of action of around 8 hours. WikiVet Article: bupivicaine. Incorrect. Lidocaine has a time to onset of action of 3-10 minutes and a duration of action of 60-90 minutes. Bupivicaine has a time to onset of 20-30 minutes and it has a duration of action of around 8 hours. WikiVet Article: bupivicaine. Incorrect. Proxymetacaine has an onset of action of 10 seconds and a duration of action of 10-20 minutes. Bupivicaine has a time to onset of 20-30 minutes and it has a duration of action of around 8 hours. WikiVet Article: bupivicaine. Incorrect. Lidocaine has a time to onset of action of 3-10 minutes and a duration of action of 60-90 minutes. Bupivicaine has a time to onset of 20-30 minutes and it has a duration of action of around 8 hours. WikiVet Article: bupivicaine.

8

Atipamazole is the reversal agent for which group of drugs? Opioids Butyrophenones Alpha-2 agonists Benzodiazepines Phenothiazines Please select an option Incorrect. Benzodiazepines can be antagonised by flumazenil and sarmazenil, not atipamazole. Atipamazole is licensed for the reversal of the sedative effects of dexmedetomidine and medetomidine, however it will also reverse other alpha-2 agonists to provide a quick recovery from anaesthesia and sedation. WikiVet Article: alpha-2 agonists. Correct! Atipamazole is licensed for the reversal of the sedative effects of dexmedetomidine and medetomidine, however it will also reverse other alpha-2 agonists to provide a quick recovery from anaesthesia and sedation. WikiVet Article: alpha-2 agonists. Incorrect. Benzodiazepines can be antagonised by flumazenil and sarmazenil, not atipamazole. Atipamazole is licensed for the reversal of the sedative effects of dexmedetomidine and medetomidine, however it will also reverse other alpha-2 agonists to provide a quick recovery from anaesthesia and sedation. WikiVet Article: alpha-2 agonists. Incorrect. Phenothiazines have no reversal agent. Atipamazole is licensed for the reversal of the sedative effects of dexmedetomidine and medetomidine, however it will also reverse other alpha-2 agonists to provide a quick recovery from anaesthesia and sedation. WikiVet Article: alpha-2 agonists.