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Pharmacology > Anesthesia - Premeds > Flashcards

Anesthesia - Premeds Flashcards

1
Q

Alpha 1 receptor location/function?

A

Vascular smooth muscle to control BP

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2
Q

Alpha 2 receptor location/function?

A

Brain and periphery; modulates sympathetic outflow in brainstem

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3
Q

Acepromazine drug class?

A

Phenothiazine

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4
Q

Acepromazine MOA?

A

Central dopamine R antagonist

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5
Q

Acepromazine reversal?

A

NONE; lasts 4-6 hours

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6
Q

Acepromazine effect?

A

Decrease alertness, increase tolerance

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7
Q

Acepromazine analgesic effects?

A

None

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8
Q

Acepromazine side effects/other considerations?

A

Vasodilation via a1 antagonism (potential reflex increase in HR)
Transient reduction in PCV d/t fluid shifts
Non-reversible

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9
Q

Acepromazine is commonly used in which species?

A

Dogs, cats, horses

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10
Q

Commonly used a2 adrenergic R agonists?

A

Dexmedetomidine, xylazine, romifidine, detomidine

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11
Q

Dexmedetomidine drug class?

A

a2 R agonist

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12
Q

Xylazine drug class?

A

a2 R agonist

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13
Q

Detomidine drug class?

A

a2 R agonist

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14
Q

Romifidine drug class?

A

a2 R agonist

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15
Q

Effects of alpha-2 adrenergic R agonists?

A

Sedation (rousable)
Analgesia
Anxiolysis (dec. central sympathetic tone)
Muscle relaxation
Potent drug sparing (up to 90%)

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16
Q

Alpha 2 R agonist reversal?

A

Alpha-2 antagonist (yohimibine, atipamazole, or tolazoline)

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17
Q

Common a2 antagonists for reversal?

A

Yohimibine
Tolazoline
Atipamazole

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18
Q

What species are alpha-2’s commonly used in?

A

All domestic species

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19
Q

A2 R agonist CV effects/considerations?

A

Initial vasoconstriction increases BP, reflex bradycardia, then dec. central sympathetic output further dec. HR but vasoconstriction disappates
Decreases CO
May inc. or dec. SVR over time

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20
Q

Alpha-2 agonist side effects?

A

Diuresis (decreases ADH and insulin release so glucose increases –> osmotic diuresis)
Vomiting
Reduced GI motility
Vasoconstriction

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21
Q

Alpha 2 species considerations?

A

Cats: may be used as an emetic drug
Sheep: pulmonary edema due to activation of pulmonary intravascular macrophages
Cattle: 10x more sensitive to xylazine than horses are

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22
Q

Species considerations with xylazine?

A

Cattle require 1/10th the dose of horses

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23
Q

What drug class is atropine?

A

Anticholinergic

24
Q

Commonly used anticholinergics?

A

Atropine and glycopyrrolate

25
Q

What species are anticholinergics used as a premed in?

A

Dogs and cats

26
Q

Anticholinergics MOA?

A

Muscarinic acetylcholine R antagonists (parasympatholytics, dec. vagal tone)

27
Q

Effects of anticholinergics?

A

Inc HR
Bronchodilation
Dec. secretions (oral, GI)
Dec. GI motility
Mydriasis

28
Q

Anesthetic properties of anticholinergics?

A

None

29
Q

Analgesic properties of anticholinergics?

A

None

30
Q

What happens if you give an a2 R agonist and an anticholinergic together?

A

a2 casues high SVR/high BP, anticholinergic increases heart rate

31
Q

What benzodiazepines are commonly used?

A

Diazepam and midazolam

32
Q

Benzodiazepine MOA?

A

GABA R agonist
(GABA: inhibitory neurotransmitter in CNS)

33
Q

Benzo analgesic effects?

A

None

34
Q

Do benzos have sedative effects?

A

Sometimes - small ruminants, calm pet pigs, sick dogs/cats, and neonates of most species

35
Q

Effects of benzodiazepines?

A

Anxiolytic
Amnesic
Anticonvulsant
Muscle relaxant
Mild drug sparing

36
Q

Are benzos reversible?

A

Yes (flumazenil)

37
Q

Reversal agent for benzos?

A

Flumazenil

38
Q

CV/resp effects of benzodiazepines?

A

Minimal

39
Q

What drug class is gabapentin?

A

Gabapentinoid

40
Q

Gabapentin MOA?

A

Voltage gated Ca channel inhibitor - effects neurotransmitter release

41
Q

Gabapentin effects?

A

Anxiolytic, mild sedation

42
Q

Behavioral considerations of benzodiazepines?

A

Un-inhibition of behavior

43
Q

Commonly used mu opioid receptor agonists?

A

Morphine, hydromorphone, methadone

44
Q

MOR agonist behavioral effects?

A

Sedation: dog, rabbit, somewhat ruminants
Euphoria: cat, horse (inc. activity, manic)
Dysphoria: possible in all species

45
Q

MOR agonist CV/resp effects?

A

Minimal CV effects; dose dependent respiratory depression

46
Q

How would you reverse morphine, hydromorphone, or methadone?

A

MOR antagonist - naloxone

47
Q

MOA of morphine and hydromorphone?

A

Mu opioid receptor agonist

48
Q

Butorphanol MOA?

A

MOR antagonist, KOR agonist

49
Q

Sedative effects of butorphanol?

A

Good sedation, used for mildly uncomfortable procedures (ex. penn hip rads)

50
Q

Analgesic effects of MOR agonists vs. MOR antagonists/KOR agonists?

A

MOR agonists: analgesia for moderate - severe pain (morphine, hydro, methodone)
MOR antagonists/KOR agonists: mild - mod pain (butorphanol)

51
Q

Butorphanol duration?

A

~1 hr SA
~2-4 hrs horse

52
Q

Buprenorphine MOA?

A

MOR partial agonist

53
Q

Buprenorphine duration?

A

Slow onset (~45 min), longer duration (6-8 hrs)

54
Q

Reversability of buprenorphine?

A

Difficult due to high affinity for MOR

55
Q
A

Pharmacology (2 decks)

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