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Anesthetic drugs
anesthesia drugs and their properties
24
Veterinary Medicine
Undergraduate 2
08/24/2013

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Term
Butorphanol
Definition
  • Opiod often used as pre-anesthetic 
  • Mild - moderate analgesia
  • Produces sedation
  • Side effects: respiratory depression, miosis(constricting pupils - dogs & horses), euphoria
  • Mixed agonist/antagonist
  • Visceral pain relief
  • Mydriasis: Dialating pupils (cats & pigs)
  • Schedule 4 controlled drug
Term
Phenothiazines (Acepromazine maleate, Chlorpromazine)
Definition
  • Produces sedation
  • Antiemetic 
  • Antiarrhythmic
  • Antihistimine
  • Causes vasodialation
  • NO pain relief
  • Could cause personality changes
  • Penile prolapse
  • Lowers the seizure threshold
Term
Anticholinergics: Atropine
Definition
  • Blocks vegal nerve stimulation
  • Reduces lacrimal and salivary secretions
  • Mydriasis
  • Reduces GI motility
  • Bronchodialation
  • Lasts for 90 minutes
  • Avoid use in horses
  • Crosses the placental barrier
Term
Anticholinergics: Glycopyrrolate
Definition
  • Similar to atropine
  • Lasts 2-3 hours
  • Less tendency to cause tachycardia or arrhythmias
  • Supresses salivation better than Atropine
  • Does not cross placental barrier
Term
Benzodiazepines (Diazepam "Valium", Midazolam, Zolazepam)
Definition
  • Antianxiety: tranquilizers 
  • Skeletal and muscle relaxation
  • Anticonvulsant
  • Appetite stimulant
  • Minimal cardiovascular and respiratory effects

Diazepam: Don't store in plastic, don't store in sunlight, don't mix with other drugs (Ketamine is alright, though)

Term
Barbituates
Definition
  • Three classes:
  • * Ultrashort-acting: methohexital - class 4, lasts for 5-10 minutes, 30 minute recovery
  • * Short acting: thiopental - class 3, lasts for 10-20 minutes, 1 hour recovery
  • * Intermediate acting: pentobarbital (main ingredient in euthenasia) - lasts for 2 hours, 6 hour recovery
 
  • Respiratory and cardiac depression, lipid soluble, binds to plasma proteins, tissue irritation, excitement during recovery or induction, freeform is the most potent, short shelf life, have to reconstitute, don't use in skinny or neonate patients
  • Rarely used, metabolized through the liver and kidney 
Term
Cyclohexamines: Ketamine (generic), Telazol (brand), mix of Zolazepam & Tiletamine
Definition
  • Exaggerated reflexes
  • Persistant laryngeal/pharyngeal reflexes
  • Sensitivity to sound, light, and other sensory stimuli
  • Increased muscle tone
  • Poor visceral analgesia
  • Tachycardia dn vasoconstriction
  • Apnea
  • Increased salivation (especially in cats)
  • Increased CSF pressure
  • Eyes remain open and dialated
  • Have to combine with a sedative or tranq
  • Side effects for when given alone
  • Used a lot in wildlife sedation
  • Don't use in liver compromised
Term
Alpha-2 Agonists: xylazine, dexmedetomidine, detomidine, romifidine
Definition
  • Sedation
  • Muscle relaxants
  • Analgesia
  • Last 20-30 minutes
  • Absorbed through the skin
  • Can be reversed
  • Can cause hypotension, bradycardia, even death in humans
  • Transient hyperglycemia
Term
Xylazine (Rompun *most common*, Gemini, Anased)
Definition
  • Ataxia and sweating in horses
  • Large and small animal 
  • 2% solution for small animals (20mg/ml), 10% for large (100mg/ml)
  • Used alone or in combination: most commonly with ketamine and opioids
  • Cattle require 1/10 the dose a horse would
  • Antagonist: yohimbine
Term
Dexmedetomidine (Dexdomitor)
Definition
  • Greater potency and fewer side effects than xylazine
  • Antagonist: Atipamezor (Antisedan)
  • Dose based on body surface area
  • Leave patients in a quiet area for 10-15 minutes after administration
  • DON'T adiminister IM, give IV
  • Painful
  • DO NOT administer simultaneously with anticholinergics (atropine/glycopyrrolate)
Term
Detomidine (Dormosedan)
Definition
  • Often used in horses
  • Similar to xylazine with twice the duration of action
  • Commonly administered with benzodiazepine for standing sedation
  • Provides analgesia incase of colic
  • Give IM or IV
  • Comes in gel form for sublingual adiminstration - takes 40 minutes to produce effects (last 2 hours)
  • Provides better rear end - less kicking
  • Reverse: atipamezole
Term
Romifidine (Sedivet)
Definition
  • Less ataxia than detomidine or xylazine
  • Used in large animal medicine
  • Less head dropping than detomidine or xylazine = good for dental floating
  • Only available in Canada
Term
Opiods (morphine, oxymorphone, fentanyl)
Definition
  • # 1 side effect: respiratory depression
  • Bradycardia, Hypotension, Analgesia, Euphoria, Excitement, Vomiting, Constipation Miosis in dogs, mydriasis in cats, Sedation, Addiction
  • Reversal: Naloxone
  • Pure, mixed agonist, antagonist, partial antagonist
  • Natural or synthetic
  • IV, IM, SQ, oral, rectal, transdermal, subarachnid, epidural
  • Receptors: mu, kappa, delta
  • 30 min - 3 hrs, some have larger duration effects
Term
Propofol
Definition
  • IV only; given slowly over 30-60 seconds or as a constant rate infusion
  • Transietn excitement upon induction
  • Tachycardia or bradycardia
  • Hypotension
  • Most common side effect: transient apnea
  • Safe for liver and kidney disease patients and sighthounds
  • Decreases intra-ocular and intra-cranial pressure
  • Muscle relaxation
  • No analgesia
  • Lasts 2-5 minutes
  • Antiemetic/anticonvulsant properties
  • Cats: Heinz body anemia, anorexia, lethargy, diarrhea
  • Hypnotic; works well for head trauma
  • White liquid emulsion: dose - 4mg/kg, expensive , 2 formulas
  • 1 egg based emulsion: good for 6 hours, refrigerate, cats & dogs
  • 2-28 day: No light, no fridge, ONLY dogs
Term
Halothane
Definition
  • Fairly rapid induction and recovery
  • Moderate MAC
  • Moderate rubber solubility and mixed with a preservative
  • Sensitizes the heart to catecholamines (epinephrine) and may induce arrhythmias
  • Bradycardia
  • Vasodialation
  • Portion of the dose is retained in body fat stores and metabolized by the liver
  • Increased cerebral blood flow
  • Malignant hypothermia: pigs & dogs is hereditary and very rare (body temp elevated, unregulated - thermoregulatory mechanisms do not operate and animal dies)
  • Not used in vet med, sometimes a board question
Term
Isoflurane
Definition
  • Inhalent anasthetic
  • Minimal cardiovascular effects - well for compromised heart
  • Respiratory depression
  • Muscle relaxation
  • No analgesia
  • Eliminated mostly via the lungs 
  • Maintenance is usually at 1.5%-2.5% (light to surgical anasthesia)
  • Induction at 5%
  • BO partition coefficient - 1.46
  • MAC: 1.3%-1.63%
Term
Sevoflurane
Definition
  • Inhalent anasthetic
  • Vasodialation
  • Hypotension (more than isoflurane)
  • Respiratory depression
  • Muscle relaxation
  • No analgesia
  • Maintenance: 2.5%-4%
  • Induction: 8%
  • #1 inhalent in birds/exotics
  • BO partition coefficient - 0.68
  • MAC: 2.4%
  • Less potent than isoflurane - need increased concentrations for induction and maintenance
Term
Fentanyl Patch ( Duaragesic Patch)
Definition
  • DO NOT CUT
  • DO NOT USE IN AREAS OF HEAT
  • Shave the area the patch will be placed in
  • Dogs: place 12 hrs prior to surgery
  • Cats: place 3-6 hours prior to surgery
  • Available in 25, 50, 75, and 100 micrograms
  • Controlled, pure opiod, 100X more potent than morphine
  • Clients can take off for their own use and swallow
Term
Lidocaine Patch 5%
Definition
  • Pain control
  • Apply only to intact skin
  • CAN be cut to size
Term
Buprenorphine (Buprenex)
Definition
  • Synthetic opiod
  • Can be given IV
  • Quickly absorbed by oral mucosa in cats
  • Analgesia lasts ~8hrs
  • Good for visceral pain
  • Use for 3 days post-op for declaws: sublingual/submucosal/oral
Term
Meloxicam (Metacam)
Definition
  • NSAID
  • Reduces pain, inflammation, and fever by inhibiting prostoglandins COX 1
  • Risks: gastric ulcerations, liver and kidney damage
  • Claims to spare COX 2 which produces gastroprotectants for GI
  • Good for musculoskeletal, not visceral
  • Injectable or oral
Term
Carprofen (Rimadyl)
Definition
  • NSAID
  • Reduces inflammation, pain, and fever by inhibiting prostoglandins
  • Risks: gastric ulcerations, liver and kidney damage
  • Good for musculoskeletal pain
  • Injectable or oral: injectable is thick and should be refrigerated
  • Tablets: 1 mg/lb
Term
Deracoxib (Deramaxx)
Definition
  • NSAID inhibits prostoglandin formations
  • Used post-op for musculoskeletal pain and to reduce swelling
  • Chewable tablets (usually send home 3-5 days of tablets)
  • No injectable form
  • 1 mg/lb
Term
Penicillin
Definition
  • Normally administer to the majority of patients because of the length of anasthesia and multiple individulas handling the animal
  • Dosage: 1ml/15lbs body weight
  • ONLY delivered SQ or IM
  • DO NOT GIVE IV
  • Use different forms - benzathine or procaine
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