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FCP - Anaesthesia Week > Analgesic Drugs > Flashcards

Analgesic Drugs Flashcards

1
Q

What types of drug are available for analgesia?

A

NSAIDs
Paracetamol
Opioids
Local Anaesthetics
Alpha-2 agonists
Ketamine

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2
Q

How do NSAIDs work?

A

Non-steroidal anti-inflammatory drugs
1. When a cell is damaged, COX is activated
2. This stimulates the cell to produce prostaglandins which cause signs of inflammation (pain, redness, swelling)
3. NSAIDs target COX peripherally or centrally
NSAIDs also target descending pain pathways

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3
Q

Examples of SA licensed NSAIDs

A

Meloxicam
Carprofen
Robenacoxib
Fibrocoxib

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4
Q

Examples of Equine licensed NSAIDs

A

(DON’T USE IF HORSE IS GOING INTO FOOD CHAIN)
Phenylbutazone
Flunixin
Meloxicam

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5
Q

Examples of FA licensed NSAIDs

A

Meloxicam
Ketoprofen

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6
Q

Contraindications of NSAIDs in patients with…

A
  • Renal or hepatic insufficiency
    • Hypovolaemia
    • Congestive heart failure & pulmonary disease
    • Coagulopathies, active haemorrhage
    • Spinal injuries
    • Gastric ulceration
    • Concurrent use of steroids
    • Shock, trauma
    • Pregnancy
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7
Q

Contraindications of NSAIDs in patients with…

A
  • Renal or hepatic insufficiency
    • Hypovolaemia
    • Congestive heart failure & pulmonary disease
    • Coagulopathies, active haemorrhage
    • Spinal injuries
    • Gastric ulceration
    • Concurrent use of steroids
    • Shock, trauma
    • Pregnancy
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8
Q

When should NSAID use be limited?

A

Animals with co-morbidities
Long term use
Not in horses going into food chain

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9
Q

Side effects of NSAIDs

A

Vomiting
Diarrhoea
Renal Problems
Clotting disruption

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10
Q

What is grapiprant (Galliprant)?

A

New class of NSAID
More selective than other NSAIDs
Does NOT block COX
Works lower down inflammatory pathway
Blocs some activity of specific Prostaglandin
Targets oestoarthritis pain

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11
Q

Is paracetamol an NSAID?

A

Not anymore

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12
Q

How does paracetamol work?

A

Blocks peripheral and central COX
antipyretic action

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13
Q

What species can you use paracetamol in?

A

Off license - Horses
Off license - Dogs (unless with codeine)
NEVER CATS

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14
Q

How do opioids work?

A

Act on 4 key receptors:
Mu - most analgesic
Kappa
Delta
Orphanin

Should be used pre-emptively (pre surgery)

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15
Q

Examples of opioids

A

Morphine - not licensed
Methadone - SA
Butorphanol - SA, horses
Buprenorphine (partial Mu agonist) - SA
Pethidine - SA, horses
Fentanyl (50% stronger) - SA

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16
Q

What schedule are opioids?

A

Schedule 2
Except buprenorphine (3)

17
Q

What are local anaesthetics?

A

Amides or esters
Very versatile

18
Q

What is important to note about local anaesthetics?

A

Small therapeutic window
Easy to overdose

19
Q

How do local anaesthetics work?

A

All clinically useful local anaesthetics are weak bases
Exist in equilibrium between the neutral, non‐ionized, lipid‐ soluble form (B) and the ionized, water‐soluble form (BH+)
Formulated as acidic solutions of hydrochloride salts (pH 4–7)
Which are more highly ionized and thus water soluble
The receptor for local anaesthetics is located within the pore of the Na+ channel close to the cytoplasm
Only the ionized, charged form of the local anaesthetic can interact with this receptor

20
Q

Local anaesthetics used in horses

A

Mepivacaine
Lidocaine
Lignocaine
Procaine - not often used - can change colour of fur
Bupivacaine - not licensed

21
Q

Local anaesthetics used in FA

A

Procaine (contraindicated for epidural or IV use)
Lignocaine - used off license

22
Q

Local anaesthetics used in SA

A

Lidocaine
Procaine
Bupivacaine - used off license (longer lasting)

23
Q

How do alpha-2 agonists work?

A

Bind to alpha-2 receptors on presynaptic terminal
Prevent release of noradrenaline and ACh
Short lived but potent analgesia
Can be antagonised with atipamezole

24
Q

SA alpha-2 agonists

A

Medetomidine
Dexmedetomidine

25
Q

FA alpha-2 agonists

A

Romifidine
Xylaxine

26
Q

Equine alpha-2 agonists

A

Xylazine

27
Q

What is ketamine?

A

NMDA antagonist

28
Q

How does Ketamine work

A

Blocks NMDA receptor activity
this prevents signal transduction of NA and Ca ions going through channel
Blocks glutamate action

FCP - Anaesthesia Week (26 decks)

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