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Anesthesiology > Anesthesia premed drugs > Flashcards

Anesthesia premed drugs Flashcards

1
Q

What are the anticholinergic drugs used? (2 total)

A

Atropine and Glycopyrrolate

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2
Q

What class of drug is acepromazine?

A

Phenothiazine (Major tranquilizer)

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3
Q

What are the benzodiazepine drugs? (2 total)

A

Midazolam and Diazepam

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4
Q

What are the opioid drugs? (9 total)

A

Butorphanol, Hydromorphone, Morphine, Fentanyl, Oxymorphone, Buprenorphine, Remifentanyl, Methadone, Tramadol

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5
Q

What is used to reverse opioid drugs in small animals? In wild animals?

A

Small animals: Naloxone

Wild animals: Naltrexone

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6
Q

What are the A-2 agonists? (4 total)

A

Xylazine, Dexmedetomidine, Detomidine, Romifidine

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7
Q

What is used to reverse an A-2 agonist?

A

Atipamezole

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8
Q

What muscle relaxants are used in premedication? (2 total)

A

Guaifenesin (GG) and Dantrolene

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9
Q

CV effects of anticholinergics? Side effects?

A

Tachycardia; cardiac arrest, hypertension

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10
Q

Respiratory effects of anticholinergics?

A

Bronchodilation (increases airway dead space)

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11
Q

Other possible effects of anticholinergics?

A

Regurgitation, acute glaucoma, dries airway secretions, intestinal paralysis (colic in horses); Atropine can cause sedation/coma (crosses BBB)

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12
Q

Indications for use of an anticholinergic?

A

Prevention/treatment of bradycardia, young animals or brachycephalic breeds

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13
Q

Contraindications for use of anticholinergics?

A

Tachycardia, hyperthyroidism, most heart dz, narrow angle glaucoma

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14
Q

CV effects of A-2 agonists?

A

Strong vasoconstriction (leads to reflex bradycardia)

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15
Q

Respiratory effects of A-2 agonists?

A

Mild respiratory depression; increase upper airway resistance (nasal edema in horses); low V/Q in horses (decreased PaO2); Bronchoconstriction, V/Q mismatch, lung edema, hypoxemia in ruminants

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16
Q

Other possible effects of A-2 agonists?

A

Sedation, analgesia, reduce stress response; vasoconstriction; inhibit lipolysis; inhibit insulin release (hyperglycemia); sedative effect (dog, cat, horse, ruminant > pig), muscle relaxation; decreased salivation

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17
Q

Indications for use of A-2 agonists?

A

Sedation of aggressive animals or in ICU, to manage post op airway obstruction; prevention/treatment of seizures

18
Q

Contraindications of A-2 agonists?

A

Too young or too old; hemodynamic instability; severely debilitated; not suitable for high risk patients

19
Q

Side effects of xylazine?

A

Vomiting most likely to occur in cats; may cause uterine contractions and abortions in cattle; less preferred in dogs

20
Q

What is the most commonly used A-2 agonist in small animals?

A

Dexmedetomidine

21
Q

What A-2 agonist is used for large animals?

A

Detomidine

22
Q

CV effects of phenothiazines?

A

Vasodilation and hypotension (especially in hypovolemic patients)

23
Q

Respiratory effects of phenothiazines?

A

Mild depression

24
Q

Other effects of phenothiazines?

A

No analgesia; antiemetic; antihistamine; anti-arrhythmogenic; inhibit platelet fxn; penile prolapse in horses

25
Q

Indications for phenothiazines?

A

Mild sedation for premed or post OP; prevention/treatment of opioid dysphoria; sedation for dogs w/ laryngeal paralysis; enhance sedative effects of xylazine in horses

26
Q

Contraindications for phenothiazines?

A

Hypovolemia, hemodynamic instability; very young or old patients; Von-Willebrand dz; breeding stallions; Boxers may be sensitive (bradycardia)

27
Q

CV effects of benzodiazepines?

A

Minimal effects

28
Q

Respiratory effects of benzodiazepines?

A

Minimal effects

29
Q

Other effects of benzodiazepines?

A

GABA receptor agonist; sedative, anticonvulsant, muscle relaxant effects; no analgesia

30
Q

Indications for benzodiazepines?

A

Treatment of seizures; for premed, combine w/ opioids, A-2 agonist, or both; for induction, combine w/ ketamine, barbiturates, or propofol

31
Q

T/F: Medazolam is more potent and has a longer duration of action than Diazepam

A

False. More potent, but shorter acting than Diazepam

32
Q

CV effects of opioids?

A

Minimal CV effects; may indirectly reduce BP by reducing sympathetic outflow from the brain; may cause bradycardia (increase parasympathetic tone; treat w/ atropine); improves CV fxn by reducing the doses of anesthetics needed (decrease MAC of inhalants)

33
Q

Respiratory effects of opioids?

A

May depress respiration; antitussive effect

34
Q

Other effects of opioids?

A

Analgesia (good for acute pain, not as good for chronic pain); nausea, vomiting, defecation, obstipation; hypothermia, post OP hyperthermia (cats), myosis (dogs), mydriasis (cats), inhibition of urination, noise sensitivity

35
Q

Which of the following opioids is most likely to cause vomiting? Least likely to cause vomiting?

Morphine
Hydromorphone
Methadone
Fentanyl
Butorphanol
Buprenorphine
Tramadol
A

Most likely: morphine (enters brain slowly)

Least likely: fentanyl (enters brain quickly)

36
Q

Indications for opioids?

A

Alone or in combination w/ benzodiazepines, benzodiazepines and ketamine (cats, small dogs), acepromazine, A-2 agonists (xylazine, dexmedetomidine); preoperative analgesia; treatment of acute and chronic pain

37
Q

What receptors do the different opioids affect?

A 
Butorphanol: kappa agonist, mu antagonist
Hydromorphone: full mu agonist
Fentanyl: full mu agonist
Oxymorphone: full mu agonist
Buprenorphine: partial mu agonist
38
Q

Contraindications for opioids?

A

Avoid morphine in CNS patients (vomiting increases ICP); caution in renal dz (decrease GFR)

39
Q

CV effects of muscle relaxants?

A

Minimal effects

40
Q

Respiratory effects of muscle relaxants?

A

Minimal effects

41
Q

Other effects of muscle relaxants?

A

Causes skeletal muscle relaxation; improve the muscle relaxation effects of other drugs (e.g. xylazine)

42
Q

Indications for muscle relaxants?

A

Part of TIVA infusion protocols in horses (“triple drip”; GG + A-2 agonist + ketamine

Anesthesiology (10 decks)

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