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Pharmacology > Anesthesia Drugs (Final) > Flashcards

Anesthesia Drugs (Final) Flashcards

1
Q

Tranquilizer action

A

induces a state of behavioral change wherein anxiety is relieved and the patient is relaxed although aware of their surroundings

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2
Q

Sedative action

A

induces a state characterized by CNS depression and drowsiness, decreased awareness of surroundings

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3
Q

Hypnotic action

A

induces sleep

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4
Q

Narcotic action

A

induces stupor bordering on general anesthesia

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5
Q

Methocarbamol

  • type of drug
  • administration
  • actions
A
  • muscle relaxant (anesthetic)
  • oral or injectable (don’t use IM/SC)
  • injectable only in emergency
  • causes mild to moderate muscle relaxation
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6
Q

Methocarbamol

  • uses
  • adverse effects
A
  • used to treat acute inflammatory and traumatic conditions of the skeletal muscles, and to reduce muscular spasms
  • intervertebral disk disease, poisoning
  • adverse: sedation, salivation, weakness, lethargy, ataxia
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7
Q

Acepromazine

  • drug class
  • MOA
  • administration
A
  • phenothiazine
  • blocks dopamine receptors in the CNS
  • IV, IM, SQ, or PO
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8
Q

Acepromazine

- effects

A
  • good sedation, anti-emetic
  • moderate muscle relaxation
  • hypotension (blocks alpha 1)
  • reduced hematocrit
  • antihistamine
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9
Q

Acepromazine cautions

A
  • do not use if vasodilation is contraindicated
  • boxers/large breeds/sight hounds/MDR1 mutants are more sensitive
  • penile prolapse and injury in stallions
  • not approved in food animals
  • aggressive dogs may startle easily
  • functional liver disease
  • concurrent with epinephrine
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10
Q

Benzodiazepines MOA

A

bind to and activate benzodiazepine binding site on GABAa receptors to cause hyperpolarization of neurons

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11
Q

Benzodiazapine clinical uses

A
  • anxiolytic
  • anticonvulsant
  • pre-anesthetics
  • sedation
  • muscle relaxation
  • appetite stimulation
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12
Q

Pharmacokinetics of Benzodiazapine

  • distribution
  • metabolism/excretion
A
  • lipid soluble
  • crosses BBB, protein bound
  • metabolized in liver
  • excreted in urine
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13
Q

Cautions of Benzodiazepines

A
  • hepatotoxicity seen in cats with oral diazepam
  • muscle fasciculations in horses
  • paradoxical excitement
  • propylene glycol (diazepam injection) painful with IM
  • may be teratogenic
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14
Q

What is Flumazenil used for?

A

benzodiazepine reversal

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15
Q

Alpha 2 agonist effects

A
  • very good sedation
  • good muscle relaxation
  • mild analgesia
  • biphasic cardiovascular effects
  • mild resp depression
  • emetic in cats
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16
Q

What type of drug is Xylazine?

Which species are more sensitive, less sensitive?

A

alpha 2 agonist

cattle > small ruminants > cat/dog/horse > swine > rodents

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17
Q

What type of drug is Dexmedetomidine?

A

alpha 2 agonist

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18
Q

What type of drug is Yohimbine?

A

alpha 2 antagonist

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19
Q

What type of drug is Atipamezole?

A

alpha 2 antagonist

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20
Q

MOA of alpha 2 agonists

A
  • activate alpha 2 adrenergic receptors
  • negative coupling of Gi/o protein to adenylyl cyclase to decrease cAMP
  • increases outward K+
  • decreases release of NE
21
Q

Alpha 2 agonist effects

A
  • sedation
  • analgesia
  • muscle relaxation
  • emesis
  • initial peripheral vasoconstriction, then central vasodilation, hypotension
22
Q

Define neuroleptanalgesia

A

combination of a sedative with an analgesic, which results in synergistic effects

23
Q

What are the endogenous ligands for u receptors, and what are the main effects?

A
  • B endorphins, endomorphins

- analgesia, sedation, respiratory and GI depression

24
Q

What is the endogenous ligand for k receptors, and what are the main effects?

A
  • dynorphin

- analgesia, sedation

25
Q

Which drugs are in each of the 4 drug schedules?

A
  • 1: heroin
  • 2: most full u agonists (morphine)
  • 3: buprenorphine
  • 4: butorphanol, tramadol
26
Q

Describe the MOA of opioid agonists

A
  • activation of Gi/o coupled receptors
  • reduces adenylate cyclase activity
  • hyperpolarizes neurons by increasing K+ efflux
  • reduces neurotransmitter release by decreasing calcium influx
  • inhibit neurotransmission
27
Q

Effects of opioid agonists

  • sedation/analgesia/resp/CV/other
  • what CNS effects?
A
  • neuroleptanalgesia (not sedation)
  • excellent analgesia
  • respiratory depression, min CV effects
  • antitussive, vomiting, decrease intestinal motility, urinary retention, histamine release
  • CNS depression, decrease motor, hypothermia, miosis (dogs, humans)
  • CNS stimulation, increase motor, hyperthermia, mydriasis (cats, horses, ruminants)
28
Q

Opioid agonists

  • administration
  • distribution
  • metabolism
  • excretion
A
  • usually IM or IV
  • some PO, IV CRI, epidural, transdermal, oral transmucosal
  • distributed well throughout body
  • metabolized by liver
  • excreted in urine
29
Q

Clinical uses of opioid agonists

A
  • analgesia, epidurals
  • preanesthetic (neuroleptanalgesia)
  • antitussive
  • emesis
  • antidiarrheal
30
Q

Opioid agonist cautions

A
  • head injuries
  • any time decreased GI motility is contraindicated
  • cardiac or resp disease, or acute renal failure
  • hyperthermia seen in cats
31
Q

Morphine

  • type of drug
  • use
  • onset/duration
  • caution
A
  • opioid full u agonist
  • used in epidurals: analgesic
  • onset 5-15min, duration hours
  • risk of histamine release in IV use
32
Q

Hydromorhpone

  • type of drug
  • use
A
  • opioid full u agonist

- used IV in place of morphine

33
Q

Fentanyl

  • type of drug
  • use
  • onset/duration
A
  • opioid full u agonist
  • CRI analgesic
  • onset 1 min, lasts 30 mins
34
Q

Carfentanil/Etorphine

  • type of drug
  • use
A
  • opioid full u agonist
  • used in wildlife, very potent
  • specialized training required
35
Q

Buprenorphine

  • type of drug
  • onset/duration
  • administration
  • use
A
  • semisynthetic opioid partial u agonist
  • onset 45min, lasts 8 hrs
  • IV, IM, SC, transmucosal
  • at-home analgesia
36
Q

Butorphanol

  • type of drug
  • administration
  • use
A
  • opioid synthetic k agonist and u antagonist
  • IV, IM, SC, PO
  • analgesic in cats, dogs, and horses
  • antitussive in dogs
  • better for visceral pain than somatic
37
Q

Naloxone

  • type of drug and use
  • onset/duration
A
  • full opioid antagonist
  • competitive receptor antagonist used for reversal of opioid-induced adverse affects
  • will also reverse analgesic effects
  • rapid onset (minutes) and short duration (1-2 hours)
  • repeat doses until opioid is gone
38
Q

Hydrocodone

  • type of drug
  • use
  • what schedule drug
  • caution
A
  • semisynthetic opioid
  • used orally as an antitussive, not usually as an analgesic
  • schedule 2 drug
  • human formulations contain other drugs
39
Q

What are the stages of anesthesia?

A

1) analgesia
2) excitement phase
3) surgical anesthesia (light, med, deep)
4) medullary paralysis
5) death

40
Q

Propofol

  • type of drug
  • two formulations and their features
  • administration
  • onset/duration
A
  • injectable anesthetic
  • Propoflo: egg lecithin and soybean oil, use within 24 hrs
  • Propoflo 28: benzyl alcohol preservative, stable for 28 days, not labeled for cats
  • IV slowly
  • rapid onset, short duration
41
Q

Propofol

  • distribution
  • metabolism
  • excretion
A
  • widely distributed, lipid soluble
  • rapid metabolism, hepatic and extrahepatic
  • excreted in urine
42
Q

Propofol effects

A
  • dose-dependent CNS depression
  • vasodilation without relfex tachycardia
  • dose-dependent resp depression
  • laryngeal reflexes decreased
  • appetite stimulant
  • myoclonus on induction
43
Q

Alfaxalone

  • type of drug
  • administration
  • onset/duration
A
  • injectable anesthetic
  • neurosteroid, an analog of progesterone
  • labeled for IV only (off-label IM), CRI
  • rapid onset, short duration
  • use within 24 hrs
44
Q

Alfaxalone effects

A
  • dose dependent CNS depression
  • no significant analgesia
  • good muscle relaxation
  • myoclonus on induction
45
Q

What is dissociative anesthesia?

A

drugs that dissociate the thalamiocortical and limbic systems resulting in a catatonic state where eyes remain open and swalling reflexes function

  • skeletal muscles maintain tone
  • sensory input dissociated from perception
46
Q

Ketamine

  • type of drug
  • MOA
  • uses
A
  • injectable dissociative anesthetic
  • NMDA receptor channel blockade
  • restraint and anesthesia for minor procedures
  • induction of anesthesia
  • kitty magic (ket, dexmed, bupren)
  • part of triple drip in large animals
  • analgesia MLK drip
47
Q

Ketamine effects

A
  • thalamocortical and limbic system depression
  • catalepsy
  • analgesia
  • increased sympathetic tone
  • bronchodilation
  • stimulation of salivary secretion
48
Q

Ketamine cautions

A
  • pain with IM injection
  • lubricate open eyes
  • resp depression at high doses
  • rough recovery
  • contra: increased ICP or IOP, seizures, cardiac disease, hypertension, hepatic or renal insufficiency
  • muscle tremors, CNS stimulation, vomiting

Pharmacology (14 decks)

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