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Anesthesiology > Drug review and controlled substances > Flashcards

Drug review and controlled substances Flashcards

1
Q

What are controlled substances?

A

Drugs dangerous because of their prtential for human abuse or misuse

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2
Q

How are controlled substances classified?

A

Into 5 categories. Higher the number, lower the risk

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3
Q

What are schedule I drugs?

A

Most potential for abuse. No medical purposes for these drugs. Illegal drugs

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4
Q

What are some examples of schedule I drugs?

A

marijuana, heroin, LSD

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5
Q

What are schedule II drugs?

A

High potential for abuse but has accepted medical use. A majority of these are pain medications or anesthesia. Severe restrictions

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6
Q

What are some examples of schedule II drugs?

A

cocaine, morphine, amphetimine, fentanyl, codeine, pentobarbital

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7
Q

What are schedule III drugs?

A

Potential for abuse, less than I or II. Accepted medical uses.

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8
Q

What are some examples of schedule III drugs?

A

tylenol with codeine, ketamine, thiopental, hydrocodone (vicadin)

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9
Q

What are schedule IV drugs?

A

Low potential for abuse

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10
Q

What are some examples of schedule III drugs?

A

diazapam, phenobarbital, butorphanol

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11
Q

What are schedule V drugs?

A

Low potential for abuse

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12
Q

What are some examples of schedule V drugs?

A

buprenophrine, codeine syrups

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13
Q

What does the autonomic nervous system do?

A

Controls smooth muscle activity (heart, salivary glands, other viscera) and checks and balances

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14
Q

What ANS is fight or flight?

A

sympathetic

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15
Q

What ANS is rest and digest?

A

parasympathetic

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16
Q

What are some sympathetic effects?

A

INCREASED respiratory rate, INCREASED heart rate, DECREASED digestion, mydriasis (dilate pupils), bronchodilation

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17
Q

What are some parasympathetic effects?

A

INCREASED digestion, DECREASED respiratory rate, DECREASED heart rate,

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18
Q

How do drugs affect the autonomic nervous system?

A

mimic neurotransmitters, block release, block binding, alter neurotransmitters in the synapse

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19
Q

What are the 4 classes if ANS drugs?

A

Cholinergics, cholinergic blockers, adrenergics, and adrenergic blockers

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20
Q

What drug category mimics the parasympathetic nervous system?

A

cholinergics

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21
Q

What is another name for cholinergic blockers?

A

anticholinergics

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22
Q

What drug category blocks the parasympathetic nervous system?

A

cholinergic blockers (anticholinergics)

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23
Q

What do anticholinergics (cholinergic blockers) do?

A

prevent/treat bradycardia and decrease secretions

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24
Q

What are two anticholinergic (cholinergic blocker) drugs?

A

atropine and glycopyrrolate (Robinul-V)

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25
Q

When using an anticholinergic what do you want to be sure to use (hint: decrease secretions)

A

USE EYE LUBE

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26
Q

What drug category mimic’s the sympathetic nervous system?

A

adrenergics

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27
Q

What drug category are the reversals?

A

adrenergic blockers

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28
Q

What are some adverse effects of cholinergics?

A

bradycardia, hypotension, diarrhea, vomiting, increased secretions (intestinal rupture)

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29
Q

Whate are some adverse effects of anticholinergics?

A

DOSE RELATED; drowsiness, tachycardia, dry eye, constipation

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30
Q

What are some adverse effects of adrenergics?

A

tachycardia, hypertension, nervousness, and cardiac arrhythmias

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31
Q

What are some examples of adrenergics?

A

epinephrine (adrenalin), norephinephrine, dopamine, dobutamine, xylazine (rompun)

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32
Q

What anticholinergic has a longer duration?

A

Glycopyrrolate (Robunul-V)

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33
Q

What does epinephrine (adrenalin) do? And what is it used for?

A

Stimulate heartbeat and vasoconstricion. Used for cardiac resuscitation and anaphylaxis

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34
Q

What does norephinephrine do?

A

vasoconstriction (raise blood pressure)

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35
Q

What does dopamine do? And what does it treat?

A

Increase renal blood flow, support blood pressure. Treats shock and CHF

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36
Q

What does dobutamine used to treat?

A

heart failure

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37
Q

What is xylazine (rompun) used for?

A

analgesic and sedative properties

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38
Q

What are some advers effects of adrenergic blockers?

A

bradycardia, hypotension, worsening of heart failure, bronchoconstriction, heart block, and syncope

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39
Q

What are some examples of adrenergic blockers?

A

Yohimbine (Yobine) and Atipromezole (Antisedan)

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40
Q

What drug is Yohimnine (Yobine) used to reverse?

A

Xylazine

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41
Q

What drug is Atipromezole (Antisedan) used to reverse?

A

Dexmetetomidine (Dexdomitor)

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42
Q

What does hyper- mean?

A

HIGH

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43
Q

What does hypo- mean?

A

LOW

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44
Q

What does brady- mean?

A

SLOW

45
Q

What does tachy- mean?

A

FAST

46
Q

What does tachypnea mean?

A

rapid breathing

47
Q

What anticholinergic is considered a ER drug?

A

Atropine

48
Q

When do you not want to use anticholinergics and why?

A

With alpha 2 drugs because it causes cardiac arrest

49
Q

What can you see when using an anticholinergic?

A

heart arrhythmias and thich respiratory secretions

50
Q

What is a phenothiazine?

A

Tranquilizer

51
Q

What do phenothiazine’s do?

A 
Produce sedation
Relieves fear and anxiety
NO ANALGESIA
Can cause hypotension and lower seizure threshold
Penile prolapse (horse)
52
Q

Would you want to give a phenothiazine to a patient with kidney and liver problems? Why or Why not?

A

No, because it is metabolized slowly

53
Q

Give an example of a phenothiazine

A

Acepromazine

54
Q

What are some side effects of acepromazine?

A

potent anti emetic, depresses thermoregulation center, decreases seizure threshold, hypotension leading to tachycardia, delayed gastric emptying

55
Q

What happens when you give an old or sick animal a benzodiazapine?

A

calm/antianxiety

56
Q

What happens when you give a young or healthy animal a benzodiazapine?

A

disorientation (disphoria)

57
Q

If an animal is activly seizuring will a benzodiazapine help or be used?

A

YES

58
Q

What is the reversal for benzodiazapines?

A

Flamazenil

59
Q

What happens when you give benzodiazapines to cats?

A

prevent hepaticlipidosis (INCREASE APPETITE)

60
Q

What are some examples of benzodiazapines?

A

Diazapam (Valum), Misazolam, Zolazepam

61
Q

What benzodiazapine is not water soluble (viscous/oily)?

A

Diazapam (Valum)

62
Q

T or F you can mix any drug with Diazapam (Valum)

A

False

63
Q

What is the only drug you can mix with Diazapam (Valum)

A

Ketamine

64
Q

Can you store Diazapam (Valum) in plastic?

A

NO!!!

65
Q

What does Diazapam (Valum) do?

A

muscle relaxation

66
Q

What benzodiaapine is water soluble?

A

Midazolam

67
Q

T or F you can mix Midazolam with other drugs.

A

True

68
Q

How do you get Telazole?

A

Mix Zolazepam and Tiletimine

69
Q

What do Alpha 2’s do?

A

Calm/Sedate/Relax

70
Q

What do you commonly see with alpha 2’s?

A

behavioral issues, profound bradycardia due to peripheral vasoconstricion, muddy mm, hypothermia

71
Q

What kind of patient do you want to give a alpha 2 to?

A

Young and healthy

72
Q

When do you not want to give an alpha 2 and why?

A

When giving an anticholinergic because it will cause cardiac arrest

73
Q

Do you want to give an opiod with an alpha 2?

A

yes

74
Q

What are some examples of an alpha 2?

A

Xylazine, Dexdomitor (Medetomidine), and Dexmedetomidine

75
Q

When do you most commonly see Xylazine used?

A

In horses and an emetic for cats

76
Q

What is the reversal for Xylazine?

A

Yohimbine

77
Q

T of F dexdomitor (medetomidine) does not have some analgesia?

A

False

78
Q

What is the reversal for Dexdomitor (Medetomidine)?

A

Antiseden

79
Q

What are some injectible anethetics?

A

Barbituates, Dissociatives, Opioids, and Neuroleptanalgesic

80
Q

What are the uses for barbituates?

A

anesthesia, treat seizures, main ingredient in euthanasias

81
Q

What can barbituates cause?

A

Sloughing outside of vein, severe cns, respiratory, or cardiovascular depression

82
Q

In what breed do you not want to use barbituates?

A

Sight hounds (greyhounds, whippets, etc)

83
Q

What do barbituates need for redistribution?

A

FAT and PROTEIN

84
Q

If you have to use a barbituate in a sight hound what drug would you use? Why?

A

Methohexitol because it metabolizes more quickly

85
Q

What are uses for dissociatives?

A

sedation, restraint, and anesthesia

86
Q

What are some common side effects when using dissociatives?

A

Catalepsy (muslces rigid and tight), amnesia,intact reflexes, some analgesia (visceral), eyes stay open (central and dilated), normal or increased muscle tone, hypersensitive to stimuli, increased heart rate, cardiac output and MAP, apnea with high doses

87
Q

T or F reflexes stay intact when using dissociatives

A

True

88
Q

T or F you always want to use dissociatives alone

A

FALSE

89
Q

What are two examples of dissociatives?

A

Ketamine and Tiletamine

90
Q

Tiletamine + Zolazapam =

A

Telazol

91
Q

What other drugs should you use with ketamine?

A

acepromazine, diazapam and or xylazine

92
Q

What other drug is tiletamine used with? And what is it used for?

A

used with zolazepam to induce anesthesia in cats, dogs, and small ruminants

93
Q

What is another term for opiods?

A

narcotics

94
Q

What are the three opiod receptors?

A

Mu, Kappa, and Delta

95
Q

What are some examples of mu full agonists?

A

Morphine, hydromorphone, fentanyl

96
Q

What is an example of a mu antagonist?

A

Butorphanal

97
Q

What is an example of a partial mu?

A

Buprenorphine (Bupranex)

98
Q

What is an example of an antagonist and what does it do?

A

Naloxone (ER drug). It’s a reversal

99
Q

What opiod receptor is a mu antagonist?

A

kappa

100
Q

What opiod receptor gives the best analgesia?

A

mu

101
Q

Do we use delta a lot in veterinary medicine?

A

NO

102
Q

What are the two subcategory’s of agonist?

A

full/pure and partial

103
Q

What do mixed agonist/antagonist do.

A

Agonist to 1 receptor and antagonist to another receptor

104
Q

What are neruoleptanalgesics?

A

tranquilizer + opioid

105
Q

What are some examples of opioids?

A

Morphine, Hydromorphone, Oxymorphone, Fentanyl (Duragesic), Buprenorphine, Butorphanol (Torbugesic)

106
Q

Name three side effects of opioids.

A

addiction, facial swelling, increased cranial pressure and IOP (intaoccular pressure)

107
Q

What do you typically see when giving opioids?

A

sedation, narcrosis, behavioral changes, analgesia, bradycardia, decreased respiratory rate, decreased tital volume, miosis (horses), mydriosis (cats and dogs), decreased temp in dogs, increased temp in cats, decreased urine prodcution, salivation, vomiting, borbarygmous

108
Q

What are some common drug combinations for neuroleptanalgesics?

A

Acepromazine and oxymorphone

Xylazine and butorphanol

109
Q

What protein do you need when using barbiturates?

A

Albumin

Anesthesiology (6 decks)

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