Term
| 5 benefits of preanesthetic drugs: |
|
Definition
-tranquilize or sedate
-decrease dose of maintenance drugs
-smoother induction/recovery
-analgesia (residual after Sx)
-prevent problems (eg decrease secretions, keep up HR) |
|
|
Term
| 6 categories of common preanesthetic drugs: |
|
Definition
-anticholinergics
-phenothiazine derivs (tranqs)
-benzodiazepines
-opioids
-other |
|
|
Term
| Atropine and glycoyrrolate are what type of drug? |
|
Definition
|
|
Term
| Anticholinergics are highly recommended for: |
|
Definition
-young
-brachycephalic
-ophthalmic/head/neck Sx |
|
|
Term
| Effects of anticholinergics: |
|
Definition
-increase HR by preventing "rest"
-decrease secretions of resp/GI/oronasal
-decrease GI motility, bladder contractions |
|
|
Term
| How do anticholinergics function? |
|
Definition
| block parasympathetic NS stimulation |
|
|
Term
| Stimulation of Parasympathetic NS causes: |
|
Definition
-bradycardia
-vasodilation |
|
|
Term
| What breeds are more at risk of parasympathetic stimulation? |
|
Definition
|
|
Term
| Parasympathetic NS is stimulated by: |
|
Definition
-traction on visceral organs
-pressure on eyes/head
-drugs, acidosis, hyperkalemia |
|
|
Term
| Anticholinergics can be given by what method/s? |
|
Definition
|
|
Term
| It is advisable to use ____(drug type) for opthalmic or head/neck Sx. Why? |
|
Definition
---anticholinergics
-secretions can plug ETT -eye/head/neck manipulation can precipitate vagal events or ileus |
|
|
Term
|
Definition
-fast onset, short duration
-crosses BBB and placenta
-antidote for organophosphate toxicosis
-best for emergency use
-good for C-sections |
|
|
Term
| Traits of Glycopyrrolate: |
|
Definition
-slower onset, longer duration
-does not cross BBB/placenta |
|
|
Term
| How to phenothiazine derivatives function? |
|
Definition
| CNS depression, suppression of sympathetic NS |
|
|
Term
| Phenothiazine derivs can be given: |
|
Definition
|
|
Term
| Effects of phenothiazines: |
|
Definition
-vasodilation > hypotension
-varying anti-emetic, tranquilizing effects |
|
|
Term
| Most commonly used phenothiazine in vet med? What is used more in people? |
|
Definition
Vet- acepromazine
Ppl- chlorpromazine (more anti-emetic, less sedative) |
|
|
Term
| Advantages of phenothiazine derivs: |
|
Definition
-anti-emetic
-anti-arrhythmic
-water-soluble (can mix w/like drugs)
-potentiates opioid analgesia/sedation |
|
|
Term
| Boxers are more sensitive to what drug? What is this condition called? |
|
Definition
| Acepromazine; Ace-associated bradycardic collapse |
|
|
Term
| Disadvantages of phenothiazine derivs: |
|
Definition
-vasodilation > hypovolemia
-disinhibition rarely (mainly PO- act berserk)
-may lower seizure threshold
-CI w/organophosphates (flea products)
-Boxer Ace syndrome |
|
|
Term
|
Definition
-small doses (0.02mg/kg) can be hard to draw up
-try TB syringe
-dilute 1:10 with sterile water/saline |
|
|
Term
| Benzodiazepines can be given: |
|
Definition
|
|
Term
| Effects of benzodiazepines: |
|
Definition
-mild sedation, muscle relaxation, anticonvulsant, anti-anxiety
-minimal hypotension, respiratory depression (safe for sick pts)
-appetite stim in small doses
-behavior modification |
|
|
Term
| Are phenothiazine derivatives controlled substances? |
|
Definition
|
|
Term
| Are benzodiazepines controlled substances? |
|
Definition
|
|
Term
| Are anticholinergics controlled substances? |
|
Definition
|
|
Term
| Name the 3 benzodiazepines discussed in class: |
|
Definition
-diazepam (Valium)
-midazolam
-alprazolam (Xanax) |
|
|
Term
|
Definition
-benzodiazepine
-Valium
-IV, PO
-propylene glycol base
-not well-absorbed IM
-can mix ONLY with ketamine (precipitates w/others)
-don't store in plastic or light |
|
|
Term
|
Definition
-benzodiazepine
-IV, IM
-water-soluble, good absorption IM
-can mix with ketamine and others
-amnesic effect |
|
|
Term
|
Definition
-Xanax
-benzodiazepine
-PO
-behavior mod |
|
|
Term
|
Definition
| drug that binds to receptor and causes activity |
|
|
Term
|
Definition
| drug that binds to receptor and blocks activity |
|
|
Term
|
Definition
| tightness with which drug binds to receptor |
|
|
Term
| How do alpha-2 agonists function? |
|
Definition
| bind to alpha-2 receptors of sympathetic nervous system, suppressing norepi by negative feedback |
|
|
Term
| Effects of alpha-2 agonists? |
|
Definition
-profound sedation, analgesia, muscle relaxation
-vasoconstriction (first hypertension, then hypotension)
-bradycardia, cardiac arrhythmias, hypothermia, weak pulse, pale MM |
|
|
Term
| Notable feature of alpha-2 agonists? |
|
Definition
|
|
Term
| Name the 5 Alpha-2 Agonists: |
|
Definition
-xylazine (Rompun, Anased)
-detomidine (Dormosedan)
-romifidine (Sedivet)
-medetomidine (Domitor)
-dexmedetomidine (Dexdomitor) |
|
|
Term
| Alpha-2 agonists can be given: |
|
Definition
|
|
Term
|
Definition
-emesis esp. in cats
-horses sweat and twitch |
|
|
Term
| Are alpha-2 agonists controlled? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Antagonist of detomidine? |
|
Definition
|
|
Term
| Antagonist of (Dex)domitor? |
|
Definition
|
|
Term
| When using Antisedan as an antagonist / reversal agent for _____, what is the dose? |
|
Definition
| reverses (Dex)domitor, use same volume as Dex |
|
|
Term
| Alpha-2 agonists can be given to patients... |
|
Definition
-with normal CV system
-normal liver function
-older than 4mo |
|
|
Term
| Never give an anticholinergic after ___(drug class) has taken effect. |
|
Definition
|
|
Term
| How do alpha-2 agonists affect patient monitoring? |
|
Definition
-HR 40-60 Bpm
-periph pulse hard to feel
-MM pale or blueish |
|
|
Term
| Opioids are also known as... |
|
Definition
|
|
Term
| Are opioids a controlled substance? |
|
Definition
|
|
Term
|
Definition
| SQ, IM, IV, PO, IT, transdermally, transmucosally |
|
|
Term
| Notable feature of opioids? |
|
Definition
|
|
Term
| Opioids affect many _____, but __ and __ mediate analgesia. |
|
Definition
| many receptors, but mu and kappa regular analgesia |
|
|
Term
|
Definition
-excellent analgesia
-sedation
-reduce MAC
-emetic
-can be antitussive |
|
|
Term
| Disadvantages of opioids: |
|
Definition
-pronounced resp. depression
-panting
-dysphoria (morphine mania)
-urine retention, constipation
-emetic (apomorphine)
-bradycardia |
|
|
Term
|
Definition
-usu. cheapest
-least potent
-resp. depression
-transient hypotension
-can be given PO |
|
|
Term
| What opioid can cause hyperthermia in cats? |
|
Definition
|
|
Term
|
Definition
| more potent than morphine |
|
|
Term
|
Definition
-IV CRI (short acting), or patch
-previously combined w/droperidol (InnovarVet) |
|
|
Term
| Morphine acts on what receptor? |
|
Definition
|
|
Term
| Hypomorphone acts on what receptor? |
|
Definition
|
|
Term
| Oxymorphone acts on what receptor? |
|
Definition
|
|
Term
| Fentanyl acts on what receptor? |
|
Definition
|
|
Term
| Term for administering a sedative and narcotic together? |
|
Definition
|
|
Term
|
Definition
-less analgesia, sedation, and SE than pure mu agonists
-kappy receptor agonist
-short-lasting (4hr analgesia)
-ceiling effect
-antitussive effects
-SA or non-SA concentrations |
|
|
Term
| What is the ceiling effect? |
|
Definition
| describes a drug in which, after a certain point, increasing the dose does not increase the analgesia/sedation effect |
|
|
Term
| What opioid is not currently a controlled substance? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Name the partial mu agonist opioid/s. |
|
Definition
|
|
Term
|
Definition
-less analgesia, sedation, SE than pure mu agonists
-slow onset
-ceiling effect
-transgingivally
-don't use as pre-med if other mu agonists used |
|
|
Term
| Don't mix buprenorphine with ____ because of ____. |
|
Definition
| Don't used buprenorphine as pre-med if other mu agonists used, because of competitive inhibition. Buprenorphine will bind to receptor and block more potent mu agonists from attaching. |
|
|
Term
| The mu receptor antagonist opioid is called ___. |
|
Definition
|
|
Term
| What pre-anesthetic is in a class of its own? |
|
Definition
|
|
Term
|
Definition
-short acting, may need to redose
-reversal agent for mu agonists (it is an antagonist)
-only partially reverses butorphanol or buprenorphine |
|
|
Term
|
Definition
-anticonvulsant
-analgesic
-OK for animals that seizure from Ace |
|
|
Term
| How are IV induction anesthetics administered? |
|
Definition
| to effect for ET intubation using up to a maximum calculated dose |
|
|
Term
| Can IV induction anesthetics produce general anesthesia? |
|
Definition
|
|
Term
| 4 Most commonly used IV induction anesthetics: |
|
Definition
-ValKet
-Telazol
-Propofol
-Thiopental |
|
|
Term
| What induction drugs are dissociative? |
|
Definition
|
|
Term
|
Definition
-somatic (not visceral) analgesia
-apnea likely (less than propofol)
-some stimulating effects
-can mix with diazepam |
|
|
Term
| Stimulating effects of ketamine: |
|
Definition
-^muscle tone
-salivation
-^cardiac output
-retained swallow reflex
-CNS stim or seizures |
|
|
Term
| Ketamine is contraindicated in patients with: |
|
Definition
-seizures
-renal Dz
-cardiac Dz
-intracranial Dz/trauma |
|
|
Term
|
Definition
|
|
Term
| Rules of thumb for Ket/Val: |
|
Definition
-combo with Valium 1cc/20# dog
-equal doses Ket/Val |
|
|
Term
| When making a syringe of KetVal, which do you draw up first? |
|
Definition
| Valium (don't want seizure-inducing drug in Valium!!!) |
|
|
Term
| What did Dr. Keller describe as a "KetVal wannabe"? |
|
Definition
|
|
Term
|
Definition
-rougher recovery for dogs than KetVal
-cats metabolize dissociative (tiletamine) first
-dogs metabolize sedative (zolazepam) first |
|
|
Term
| What drugs are used in date rape? |
|
Definition
| dissociative agents like ketamine or telazol |
|
|
Term
| Ketamine and Telazol can be given... |
|
Definition
| IV or IM, but they stings! |
|
|
Term
| What induction druga are in a class of their own? |
|
Definition
|
|
Term
| Brand names for ketamine? |
|
Definition
|
|
Term
| Propofol is metabolized by... |
|
Definition
| the muscle, so it's OK for liver/kidney pts |
|
|
Term
|
Definition
| IV, despite its milky opacity, over 60 sec |
|
|
Term
|
Definition
-ultrashort-acting, nonbarbiturate
-emulsion, no preservatives (except maybe the new one?)
-recovery not prolonged when you top-off |
|
|
Term
| Does propofol provide analgesia? |
|
Definition
|
|
Term
| How long does propofol last once opened? |
|
Definition
-6 hours (refrigerate)
-PropoFlo28 lasts 28 days, but must refrigerate |
|
|
Term
| Is propofol a controlled substance? |
|
Definition
|
|
Term
|
Definition
-short-acting
-no harm to liver/kidneys
-no GI effect
-good substitute for ketamine |
|
|
Term
| Disadvantages of propofol: |
|
Definition
-profound resp. depression (apnea)
-hypotension
-not approved in cats in US yet |
|
|
Term
|
Definition
-ultrashort-acting, nonbarbiturate
-best for cardiac pts
-$$$ |
|
|
