Pharmacology of Barbiturates and Non-Barbiturates

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Questions and Answers

Which of the following barbiturates is commonly used for euthanasia?

  • Thiopental
  • Phenobarbital
  • Pentobarbital (correct)
  • Methohexital

Which anesthetic is a phencycline derivative and acts as an NMDA antagonist?

  • Propofol
  • Alfaxalone
  • Etomidate
  • Ketamine (correct)

Which of the following is NOT a disadvantage of using propofol as an anesthetic?

  • Short duration of action
  • Potential for apnea
  • Pain on injection
  • High potential for allergic reactions (correct)
  • Muscle twitching during administration

Which of the following drugs is considered a carboxylate imidazole derivative and enhances GABA activity?

<p>Etomidate (C)</p> Signup and view all the answers

Which inhalant anesthetic is known for its rapid induction and short recovery time?

<p>Isoflurane (B)</p> Signup and view all the answers

Which of the following is a disadvantage of using barbiturates as anesthetics?

<p>Potential for respiratory depression (D)</p> Signup and view all the answers

Which of the following anesthetics is known for its rapid onset, short duration, and wide safety margin?

<p>Alfaxalone (B)</p> Signup and view all the answers

Which of the following anesthetics is considered "ultra-short-acting"?

<p>Thiopental (C)</p> Signup and view all the answers

Which of the following anesthetics can increase intracranial pressure and may be contraindicated in patients with head trauma?

<p>Isoflurane (B), Sevoflurane (E)</p> Signup and view all the answers

Which of the following anesthetics is known to induce apnea?

<p>Ketamine (A), Propofol (B), Alfaxalone (C)</p> Signup and view all the answers

Which anesthetic is a carboxylate imidazole derivative and enhances GABA activity?

<p>Etomidate (A)</p> Signup and view all the answers

Which of the following is NOT a disadvantage of using Barbiturates?

<p>Rapid onset of action (C)</p> Signup and view all the answers

Which anesthetic has a rapid onset of action and short duration, with a wide safety margin?

<p>Alfaxalone (D)</p> Signup and view all the answers

Which of the following is NOT a common indication for the use of Barbiturates?

<p>Pain management (B)</p> Signup and view all the answers

Which anesthetic is an NMDA antagonist and known for its ability to induce a cataleptic state?

<p>Ketamine (A)</p> Signup and view all the answers

Which inhalant anesthetic is metabolized by the lungs and can cause vasodialation and hypotension?

<p>Isoflurane (A)</p> Signup and view all the answers

Which anesthetic is known for its rapid recovery time and is often considered less expensive than other inhalant anesthetics?

<p>Isoflurane (A)</p> Signup and view all the answers

Which of the following is an advantage of using Ketamine as an anesthetic?

<p>Analgesic properties (B)</p> Signup and view all the answers

Which anesthetic is most commonly used for euthanasia?

<p>Pentobarbital (A)</p> Signup and view all the answers

Which anesthetic is a phenol derivative and directly stimulates GABA receptors?

<p>Propofol (D)</p> Signup and view all the answers

What is a key advantage of Etomidate as an anesthetic?

<p>Minimal cardiovascular and respiratory depression (A)</p> Signup and view all the answers

Which of the following statements about Nitrous oxide is correct?

<p>It will rapidly diffuse across tissues when discontinued. (B)</p> Signup and view all the answers

What primary concern is associated with the use of Ketamine in patients with compromised kidney function?

<p>Potential for ocular effects (D)</p> Signup and view all the answers

What is a significant disadvantage of using Propofol as an anesthetic?

<p>Apnea and hypotension (A)</p> Signup and view all the answers

Which barbiturate is known for its use as a long-term anti-convulsant?

<p>Phenobarbital (C)</p> Signup and view all the answers

What is a primary characteristic of Alfaxalone compared to other anesthetics?

<p>It has a wide safety margin. (D)</p> Signup and view all the answers

What common effect does isoflurane have on the cardiovascular system?

<p>Causes vasodilation and hypotension (B)</p> Signup and view all the answers

Which type of anesthetic is characterized by minimal residual sedative effects and a rapid recovery time?

<p>Propofol (D)</p> Signup and view all the answers

Which anesthetic is contraindicated in head trauma due to its potential to increase intracranial pressure?

<p>Isoflurane (D)</p> Signup and view all the answers

What is a unique feature of Sevoflurane when compared to Isoflurane?

<p>Faster recovery time (B)</p> Signup and view all the answers

Flashcards

Barbiturates

Controlled substances that enhance GABA activity, depressing the CNS.

Indications of Barbiturates

Used for anesthesia, anticonvulsants, sedation, anti-anxiety, and euthanasia.

Disadvantages of Barbiturates

Low therapeutic index, risk of cardiovascular and respiratory depression, and necrosis.

Etomidate

An ultra-short acting anesthetic that enhances GABA activity with minimal CV and respiratory depression.

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Alfaxalone

Rapid acting IV anesthetic enhancing GABA activity with a wide safety margin.

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Propofol

Phenol derivative anesthetic stimulating GABA; short duration and rapid recovery.

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Ketamine

NMDA antagonist providing dissociative anesthesia; causes nervous system activation and muscle rigidity.

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Isoflourane

Inhalant anesthetic with rapid induction; leads to vasodilation and hypotension.

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Sevoflourane

Fast recovery inhalant anesthetic, metabolized by the liver, contraindicated in head trauma.

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Nitrous Oxide

Also known as laughing gas, used for MAC sparing and faster induction.

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Ultra-short acting Barbiturates

Barbiturates like Thiopental and Methohexital used for rapid effects.

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Short-acting Barbiturates

Pentobarbital, commonly used for euthanasia, provides short duration effects.

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Long-acting Barbiturates

Phenobarbital used for long-term antiepileptic management.

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Etomidate Disadvantages

Ultra-short acting with potential for muscle rigidity or twitching.

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Alfaxalone Benefits

Rapid onset, short duration, with a wide safety margin.

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Propofol Side Effects

Includes apnea, hypotension, and pain on injection.

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Ketamine Advantages

Short action, increases heart rate, and has some analgesic effects.

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Isoflourane Contraindications

Can increase intracranial pressure, contraindicated in head trauma.

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Sevoflourane Recovery Speed

Offers faster recovery than isoflurane, metabolized by the liver.

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Nitrous Oxide Features

Also known as laughing gas, aids in faster inductions and MAC sparing.

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Mechanism of Barbiturates

Enhance GABA by binding to GABA-A receptors, increasing chloride flow.

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Barbiturate Indications

Utilized for anesthesia, anticonvulsants, sedation, anti-anxiety, and euthanasia.

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Etomidate Advantages

Minimizes cardiovascular and respiratory depression while enhancing GABA.

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Alfaxalone Action

IV anesthetic that enhances GABA activity with rapid onset and a wide safety margin.

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Propofol Characteristics

Phenol derivative that stimulates GABA receptors with rapid onset and recovery.

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Ketamine Functions

NMDA antagonist causing dissociative anesthesia; maintains reflexes but may cause rigidity.

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Isoflourane Effects

Causes rapid induction but leads to hypotension and respiratory depression.

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Sevoflourane Benefits

Faster recovery than isoflurane, liver metabolized, can affect intracranial pressure.

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Nitrous Oxide Properties

Fast acting anesthetic that’s also known as laughing gas, contraindicated in lung issues.

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Barbiturates Disadvantages

Risk of low therapeutic index, cardiovascular and respiratory depression, and necrosis.

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Study Notes

Barbiturates

  • Bind GABA-A receptors, increasing chloride flow, depressing the central nervous system.
  • Controlled substance.
  • Indications: anesthesia, anticonvulsants, sedation/hypnosis, anti-anxiety, euthanasia.
  • Disadvantages: low therapeutic index, cardiovascular (CV) and respiratory depression, perivascular necrosis.
  • Types:
    • Ultra-short acting (thiopental, methohexital)
    • Short-acting (pentobarbital)
    • Long-acting (phenobarbital)
  • Primarily used for euthanasia.
  • Phenobarbitals can be used for long-term management as an anticonvulsant.

Non-Barbiturates

  • Etomidate:
  • Carboxylate imidazole derivative.
  • Enhances GABA activity.
  • Minimal CV and respiratory depression.
  • Disadvantages: ultra-short acting, muscle rigidity/twitching, potential rough recovery.
  • Alfaxalone:
  • Enhances GABA activity.
  • Administered IV, titrated to effect.
  • Advantages: rapid onset, short duration, short recovery.

Propofol

  • Phenol derivative.
  • Direct stimulation of GABA receptors.
  • IV administration, titrated to effect
  • Short duration and rapid onset
  • Minimal residual sedative effects.
  • Rapid recovery.
  • Disadvantages: apnea, hypotension, short shelf-life, pain/muscle twitching, short duration.

Ketamine

  • Phencyclidine derivative.
  • NMDA antagonist.
  • Peak action 1-2 minutes IV.
  • Nervous system activation.
  • Reflexes are maintained in animals, although muscle rigidity can occur.
  • Avoid use in kidney-compromised animals, muscle rigidity is a concern.
  • Advantages: short action, increased heart rate and vasoconstriction, cataleptic state (immobilization).
  • Disadvantages: no reversal, apnea, ocular effects, potential muscle rigidity.

Inhalant Anesthetics

  • Isoflurane:
  • Metabolized by lungs.
  • Rapid induction.
  • Short recovery.
  • Inexpensive.
  • Vasodilation and hypotension.
  • Respiratory and cardiovascular depression.
  • No analgesia.
  • Can increase intracranial pressure in head trauma patients—significant contraindication.
  • Sevoflurane:
  • Faster recovery than isoflurane.
  • Metabolized by the liver.
  • Can increase intracranial pressure in head trauma patients—significant contraindication.
  • Nitrous Oxide:
  • AKA laughing gas.
  • MAC sparing (minimal alveolar concentration).
  • Faster induction.
  • Gravitates to gas-filled compartments.
  • Contraindicated in patients with compromised lungs or gastrointestinal (GI) tract.
  • When the anesthetic is discontinued, oxygen is diluted by nitrous oxide released from the body; oxygen must be given for 5–10 minutes after discontinuing nitrous oxide.
  • Exists in liquid and gaseous states.

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