Dare to do Drugs Flashcards
Butorphenol
kappa agonist/ mu antagonist
mild sedation: 1-2 hours
analgesia: ~90 min.
Compared to mu agonist butorphenol has less:
respiratory depression panting bradycardia less analgesia, MAC sparing Nausea, no vomiting
How do we use butorphenol for dogs/cats?
alone or with a sedative/tranquilizer
non/mild painful procedures
pre-med to avoid comiting
How do we use butorphenol for horses?
with an alpha- 2 agonist
How do we use butorphenol for RMTS?
Large- during/after induction
small- as premed w/ benzodiazepine
Buprenorphine is a ____ agonist… it provides what in terms of sedation/analgesia?
Partial mu agonist
little sedation, mild-moderate analgesia
Buprenorphrine has a fast/slow onset?
slow onset: 30-45 minutes
How long does Buprenorphrine last in dogs/cats?
Dogs- 4-10 hours
Cats 6-12 hours
has a ceiling effect
When is Buprenorphrine contraindicated and why?
Strong affinity for Mu receptor,
will antagonize other opioiods
do not use as pre-med in painful procedures, difficult to reverse
Compared to mu agonists Buprenorphrine exerts:
Less
respiratory depression, panting, bradycardia analgesia MAC sparing
Nausea, no vomiting
What is simbadol?
long acting Buprenorphrine in cats
When comparing mixed, partial and full mu agonists what is the order to remember?
MU provides the most: respiratory depression/panting bradycardia analgesia, MAC sparing nausea and vomiting
Then partial MU
Then mixed
What drugs are the full MU agonists? (4)
hydromorphone morphine oxymorphone methadone Fentanyl
What are the side effects of full mu agonists?
moderate- severe analgesia
no ceiling effect/ dose dependent MAC sparing
minimal CV effects- bardycardia
nausea/vomiting (except methadone)
What is special about Fentanyl?
full mu agonist
used for moderate-severe pain
short acting 15-30 min
requires IV catheter; CRI- constant rate of infusion
same side effects as others but has greater respiratory depression, no vomiting
How do we use Fentanyl?
Induction agent in critically ill SA patients
intra/post op CRI
available as patch or transdermal formualtion
What drugs are available as sedatives/tranquilizers?
Acepromazine
Alpha-2 agonists
Benzodiazepans
Dissociatives
What are the Alpha-2s available?
SA- dexmedetomidine
LA- Xylazine, detomidine, romifidine
What are the 2 commonly used benzodiazepines?
Midazolam/diazepam
What are the common dissociatives?
Ketamine
Telazol
Acepromazine
Phenothiazine, alpha-1
mild-moderate sedation
slow onset 20-30min
LONG duration
NO reversal
Does acepromazine have analgesic effects?
NO, but has a synergistic effect w/ opioids
significant decrease in induction dose/ MAC of inhalant
T/F
Acepromazine causes seizures?
FALSE
What is dexmedetomidine?
alpha 2 agonist
potent sedative + analgesia
**DOSE dependent
rapid onset / short duration
What effects does dexemedetomidine have on patients?
decrease CO, reflex bradycardia due to vasoconstriction
RESERVE for healthy/very painful/fearful/aggressive patients
What do you use to reverse dexmedetomidine?
Atiamazole
What are the hemodynamic effects of dexemedtomidine?
initial hypertension response due to alpha 2 b stimualtion w/ vasoconstriction
central alpha 2 a stimulation leads to decreased NE causing hypotension due to bradycardia and peripheral vasodialtion
T/F
Diazepam and midazolam are not good sedatives in young, healthy dogs and cats
TRUE
T/F
diazepam/midazolam can cause paradoxical excitement and hyporresponsiveness
FALSE
paradoxical excitement and hyperresponsiveness
Do diazepam/medazolam provide analgesia?
NO
What species are indicated in diazepam/medazolam use?
small ruminants / neonatal foals
What is the difference between diazepam/medazolam?
diazepam contains propylene glycol
painful on injection, not well absorbed, toxic at high doses
used to be cheaper
What are the effects of anti- cholinergic drugs?
decrease vagal effects, salivary secretions
modern drugs not as irritating to resp tract
still used to counter vagal effects of other anesthetic drugs
What is atropine?
used to save animals with organophosphate poisoning
crosses BBB/placenta
side effects- sinus tachycardia, secondary A-V block
DOA: 60-90 min
Glycopyrrolate
does NOT cross BBB/placenta
inset of action 3-5 minutes
DOA- 2-4 hours
What are the side effects of glycopyrrolate?
sinus tachycardia, 2 AV block, increases w/ IV administration
so give alittle, wait give second dose
tachycardia is slef limiting, but be careful on old dogs
Not indicated for LA
What is Guaifenesin?
GG
central muscle relaxant, similar to NZ, not available in US
part of triple drip
What are the disadvantages of GG?
cant use above 5%, causes hemolysis in cattle, thrombophlebitis in horses
What is propofol used for, and what is its mech of action?
induction of SA, sedation, CRI to maintain anesthesia
NOT analgesic
works via GABA-a receptors
Advantages of using propofol?
rapid onset, metabolism, destruction
non-cumulative, extra hepatic metabolism
anticonvulsant, neuroprotective
What is Ketamine?
NMDA receptor agaonist
dissociative anesthetic
What are the advantages of ketamine?
indirect sypathomimetic CV stimualtion (increase HR, CO, BP
good analgesia
metabolized in the liver
What are the uses of ketamine?
IM pre med- need to use in combo w/ sedative/muscle relaxant
IV- induction
What premedication combo would you give to cats?
Dexmedetomidine + opioid
What premedication combo would you give to a horse?
Butorphanol + alpha-2 agonist
What two classes of drugs should you avoid when premedicating a horse?
Benzodiazepines and mu agonist opioids
What can you give cattle for premedication?
Xylazine (1/10 of equine dose) and butorphanol
What is a drug you would only give a healthy goat?
Xylazine; can possibly cause hypoxia
What are advantages of using Etomidate?
Minimal myocardial depression and hypotension
What is the mechanism of action for Alfaxalone? What are advantages of this drug?
Interacts with GABA-A receptors
Rapid induction and recovery
What are disadvantages of using Alfaxalone?
Hypotension, apnea, and vasodilation in high doses
A dog presents with a GDV; what combo would you use to induce him?
Opioid and benzodiazepine
Does Etomidate have analgesic effects?
NO
