CleverOrca Analgesia Module Flashcards
what effect does untreated pain have on the body?
suppresses immune system, increases inflammation, and delays healing
how is analgesia achieved?
by acting on the central nervous system (centrally) or acting on the site of inflammation (locally)
what is the Visual Analogue Scale (VAS)?
a pain scale used for humans that tries to measure a characteristic or attitude that is believed to range across a continuum of values and can’t easily be directly measured
it uses subjective ratings
what is the order of the nociception process?
transduction, transmission, modulation, perception
what is transduction?
conversion of a noxious stimulus into electrical energy by a peripheral nociceptor
what can be used to inhibit transduction?
NSAIDs, opioids, local anesthetics
what happens in transmission?
pain impulse from transduction moves along peripheral nervous system via first-order neurons to the spinal cord
which nerve fibers are involved in transmission?
A-delta: fast fibers responsible for initial sharp pain
C-beta: slow fibers that cause dull pain
A-beta: tactile fibers that have a lower threshold of stimulation
what can be used to reduce transmission?
local anesthetics and alpha-2 agonists
what happens during modulation?
first-order neurons synapse with second-order neurons in the dorsal horn cells of the spinal cord
what can be used to influence modulation?
local anesthetics, alpha-2 agonists, opioids, NSAIDs, tricyclic antidepressants (TCAs), NMDA receptor antagonists
what is involved in perception of pain?
cerebral cortical response to nociceptive signals projected by third-order neurons to the brain
what can be used to inhibit perception of pain?
general anesthetics, opioids, alpha-2 agonists
what can Methadone be used as?
analgesic and antitussive
what species can oxymorphone not be used in?
horses
what does the COX enzyme that NSAIDs block normally do?
facilitates the production of prostaglandin G2 which is involved in a variety of enzymatic processes to make compounds necessary for physiological processes and production of prostaglandin E2 (which has a role in the central nervous system with the perception of pain)
COX-1 enzyme
expressed in all body tissues and catalyzes prostaglandins
what can occur with repeated inhibition of COX-1?
gastric ulceration and renal toxicity
COX-2 enzyme
activated in damaged and inflamed tissues and catalyzes the formation of prostaglandins associated with intensifying the inflammatory response
involved in thermoregulation and pain response to injury; and responsible for the antipyretic, analgesic, and anti-inflammatory actions of NSAIDs
what is the trade name of Aspirin?
Acetylsalicylic acid (ASA)
what is inhibited by Galliprant (trade name: Grapiprant)?
the activity of prostaglandin EP4
it’s a non-COX inhibiting NSAID
what are NMDA antagonists?
blocks N-methyl-D-aspartate receptors
they bind to the phencyclidine site of the NMDA receptor decreasing the excitability of neurotransmitter glutamate at the dorsal horn of the spinal cord
what is an NMDA receptor?
glutamate receptor and ion channel protein found in nerve cells
what is an example of an NMDA antagonist drug?
ketamine
which drug type does Flumazenil reverse?
benzodiazepines
which drug does Yohimbine reverse?
xylazine
which drugs make up Telazol?
Tiletamine (dissociative anesthetic drug) and Zolazepam (benzodiazepine anxiolytic drug)
what class of drugs is Telazol part of?
dissociative hypnotics
what is the function of the drug Telazol and what procedures is it usually used for?
disrupts the central nervous system and induces a cataleptic state
used for dog restraint and minor procedures lasting < 30 minutes
which species is xylazine most commonly used in?
horses and dogs
or cats for its emetic properties
which species is more sensitive to xylazine?
ruminants
1/10th the dose used in horses is used in ruminants since they are a lot more sensitive
what are common adverse effects of ketamine?
tachycardia, hypertension, arrhythmias, increased muscle tone
what causes the bradycardia seen with alpha-2 agonists?
the initial peripheral vasoconstriction followed by relaxation
why should cats not have acetaminophen?
it causes Heinz body anemia, methemoglobinemia, hepatic failure, and death
which teeth does the mental medial nerve block affect?
mandibular incisors, canines, first 3 premolars, and tissue on the side it’s performed on
do local anesthetics have MAC sparing effects?
yes
which teeth does the alveolar nerve block affect?
all mandibular teeth and tissue on the side it’s performed on
which teeth does the infraorbital nerve block affect?
only as far caudal as the third premolars on the side it’s performed
which anesthetic block would be used to provide analgesia/anesthesia to the perineum, penis, and urethra?
coccygeal epidural
which anesthetic block would be used to provide anesthesia for intraocular procedures?
retrobulbar block
why is Lidocaine used for testicular blocks?
the testes are highly vascular
what are functions of the COX enzyme?
regulation of blood flow to the kidneys and GIT, promotion of platelet aggregation, and begins the inflammation process (vasodilation and increased vascular permeability)
what does histamine release cause?
histamine release causes vasodilation and hypotension
what are the phases of Dexmedetomidine?
phase 1: initial vasoconstriction and hypertension —> bradycardia and decreased cardiac output
phase 2: ~ 20 minutes after administration; blood vessels are relaxed and hypotension occurs along with continued bradycardia due to prolonged reduction in sympathetic tone in the CNS
which NSAID is only available in oral formulation?
Deracoxib
which anesthetic block is not considered regional anesthesia?
splash block
what is a splash block?
a local block that bathes small wounds or surgical incisions in local anesthetics to anesthetize the nerve endings
how long does phase 1 of Dexmedetomidine administration last?
20-40 minutes
which analgesic drug is commonly used as a cough suppressant in dogs?
Butorphanol
where are epidurals placed?
lumbosacral intervertebral space
needle placed between L7 and S1
which of the following drugs is an NSAID?
a. Betamethasone
b. Hyaluronate
c. Methocarbamol
d. Etodolac
Etodolac
what is Etodolac?
an NSAID drug commonly used for osteoarthritic pain
what is Methocarbamol?
a muscle relaxant drug
what adverse effect is associated with the equine NSAID Phenylbutazone?
right dorsal colitis
what is Phenylbutazone commonly used for?
relief of inflammatory conditions associated with the musculoskeletal system in horses
which anesthetic induction agent is dangerous to use on horses and cattle?
Etomidate
can lead to muscle rigidity or seizures
what is Etomidate?
a short-acting drug used for anesthetic induction in some animals
which tranquilizer drug can be used to sedate an animal for surgery and prevent vomiting?
acepromazine
what is Flunixin meglumine?
a non-narcotic NSAID used to provide analgesia and reduce inflammation in horses, cattle, and pigs
brand name: Banamine
must be administered IV
what is a Bier block?
regional anesthesia block that anesthetizes the distal aspect of a limb
what is the most common drug used in a Bier block?
Lidocaine
which of the following drugs is a sedative, analgesic, and muscle relaxant?
a. Diazepam
b. Xylazine
c. Acepromazine
d. Propofol
Xylazine
mainly used in horses or to induce emesis in cats
besides Butorphanol, what is an example of an opioid mixed agonist-antagonist?
Pentazocine
stimulates kappa receptors and blocks mu receptors
what is the most common use of butyrophenones used in (species)?
swine and exotic animals
which of the following drugs should be avoided during corticosteroid therapy?
a. Meperidine
b. Gabapentin
c. Etodolac
d. Fentanyl
Etodolac
corticosteroids shouldn’t be given concurrently with NSAIDs due to an increased risk of GI upset and ulcers
