Analgesia for the critically ill Flashcards
list the 5 major classes of analgesia drugs used in veterinary medicine
- Opiods
- NSAIDS
- Alpha 2 agonists
- NMDA-receptor antagonists
- Local anesthetics
adverse effects of opiods
possible respiratory depression and GI upset (big limiting factor)
adverse effects of NSAIDs
GI ulceration, should not be used in patients with dehydration or hypovolemia, not reversible
adverse effects of alpha 2 agonists
significant decrease in CO, profound sedation, respiratory depression, parenteral administration mostly (limits to hx use)
adverse effects of NMDA receptor antagonists
Behavioral changes, inconsistent analgesia, best if used prior to painful stimulus, muscle rigidity, not reversible
adverse effects of local anesthetics
These are not useful as solo agents, cause GI upset, relatively short term effects with regional, unless repeat admin or catheter in place
opioids aren’t as good for __ pain management
opioids aren’t as good for chronic (24-48 hours) pain management
why might you choose an opioid?
It provides excellent analgesia with minimal cardiovascular effects and is relatively inexpensive
why might you choose an NSAID for analgesia?
It provides excellent analgesia and with oral and parenteral formulations that are relatively inexpensive
Describe the effect of NSAIDs on the kidney
Renal auto regulation is mediated by prostaglandins and PG’s production is blocked by NSAIDs -> the kidneys are not able to adjust in the face of hypotension
don’t use nsaids if they BP is going to be swinging
when is an alpha 2 agonist a good choice for analgesia?
when profound sedation is also desirable
why might you choose an NMDA receptor antagonists?
Its relatively inexpensive and provides good sedation with minimal to no GI effects and is excellent for multi modal analgesia
