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anesthesiology > Drugs > Flashcards

Drugs Flashcards

1
Q

Anticholinergic drugs

A

Atropine - (BBB & BPB)

Glycopyrolate - longer

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2
Q

Uses of Anticholinergics

A

Tx of Bradycardia caused by vagal stimualtion

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3
Q 
Anticholinergics Effects
CNS
CV
Resp
Analgesia 
Reversible
A 
CNS - No effects
CV - Vasoconstriction --> dumps blood into central compartment --> Increase SV --> increase HR
Resp - Increase via Bronchodilation
Analgesia - NO
Reversible - NO
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4
Q

Other facts about Anticholinergics

A

Increase sphincter tone
mydriasis (dilation of the pupil)
** Decrease GI Motility **
decrease mucus secretions

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5
Q

Phenothiazine drugs

A

Acepromazine (4-6hrs)

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6
Q

Uses of Phenothiazines like Ace.

A

Pre-med

Sedation in combo w/opioids or alpha 2 agonists

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7
Q 
Phenothiazine (Ace.) Effects
CNS 
CV
Resp 
Analgesia
Reversible
A 
Ace - D2 antag/ A1 antag
CNS - Anti-emetic; No ataxia; Sedation
CV- vasodilation --> decrease BP; protects heart from catecholamine induced arrhythmias; adrenaline reversal;  if act on B2 receptors --> double vasodilation --> severe decrease in BP
Resp- NO
Analgesia - NO
Reversible - NO
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8
Q

Other facts about Phenothiazine (Ace.)

A

Antiemetic
negative thermoregulation (poikilothermic)
Paraphimosis
Priapism
decrease PCV –> RBC sequestering in spleen

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9
Q

Butryophenone drugs

A

Azaperone

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10
Q

Butyrophenone uses

A

Sedation ONLY in pigs

in combo with ketamine for anx

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11
Q 
Butyrophenone effects
CNS
CV
Resp 
Analgesia
Reversible
A 
CNS- sedation with no ataxia
CV- Vasodilation; decrease BP
Resp- NO
Analgesia - NO
Reversible- NO
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12
Q

Other facts about Butyrophenone (Azaperone)

A

Like Ace

S/E less pronounced

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13
Q

Alpha 2 Agonists - Drugs

A 
shortest acting to longest acting
Xylazine 
Detomidine
Ramifidine
Medatomadine
Dexdomitor
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14
Q

A2 agonists Uses

A

Premed - alone or in combo with opioids
Sedation - +/- opioids
Balanced Anx
Periop Anx

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15
Q 
A2 Agonist Effects
CNS
CV 
Resp 
Analgesia
Reversible
A

CNS- sedation; muscle relax; CAVE- horses and aggressive dogs
CV- Vasoconstriction –> increase BP –> decrease HR; bradyarrhythmia; centrally mediated hypotension
Resp- decrease RR; Lung edema in ruminants esp sheep
Analgesia- Yes
Reversible - Yes; Atipamazole (dexmedetomidine and medetomidine); Yohimbine (xylazine) ; Tolazaline (xylazine)

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16
Q

Other facts about A2 agonists

A 
***Emetic***
Hypothermia
decrease GI motility
increase urine production
***Hyperglycemia***
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17
Q

Benzodiazepine drugs

A

Diazepam
Midazolam
Zolazepam

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18
Q

Benzodiaz. uses

A

Sedation
Muscle relax
good in compromised pts

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19
Q 
Benzodiaz. effects
CNS
CV
Resp 
Analgesia
Reversible
A

CNS- sedation, muscle relax, anticonvulsant
CV- NO
Resp- Minimal but increase resp depression caused by anesthetics
Analgesia- Minimal
Reversible - Flumazenil

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20
Q

Other facts about Benzos

A

CAVE horses
In healthy adults +/- paradoxic runs
Only good in young/old

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21
Q

Central Muscle Relaxants drugs

A

Guaifenesin

Zolazepam ?????

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22
Q

Guaifenesin (central mus. relax.) uses

A

ONLY in horses to improve muscle relax in combo with ketamine

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23
Q 
Guaifenesin (central mus. relax.) effects
CNS
CV 
Resp 
Analgesia
Reversible
A 
CNS- Central MM relax.; Anticonvulsant; Ataxia
CV- NO
Resp- Minimal 
Analgesia - NO
Reversible - NO
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24
Q

Other facts - Guaifenesin (central mus. relax.)

A

Very irritating
Hemolytic @ [high]
Useful dose rate –> high vol. in inj.

25
Q

Opioids - Pure Agonist drugs

A 
Morphine
Pentidine
Hydromorphine
Methadone
Fentanyl
Remifentanil
Alfentanil
26
Q

Opioids - Partial Agonists

A

Buprenorphine

27
Q

Opioids - Agonist/Antagonist

A

Agonist (Kappa recep)
Antagonist (Mu recep)
Butorphenol

28
Q

Opioids - Pure Antagonist

A

Naloxone

Naltrexone

29
Q

What Opioid reverses Opioid Pure Agonists

A

Naloxone

which is an opioid - pure antagonist

30
Q

Opioid uses

A

Premeds/just sedation
In combo w/sedatives –> additive/synergistic effects
Periop analgesia
Intraop analgesia (balanced anx)

31
Q

Opioid –> mostly visceral; very low S/E

A

Butorphenol

opioid - agonist/antagonist

32
Q

Opioid –> commonly used in zoos

A

Naloxone

opioid - pure antagonist

33
Q 
Opioids Effects
CNS
CV
Resp 
Analgesia
Reversible
A

CNS- Mild sedation; analgesia; behavioral changes (horse/cat)
CV- Histamine release after IV (Not Hydromorphine or Methadone); Decrease HR; Decrease BP; Vagal +
Resp- Decrease RR; decrease sensitivity to increase arterial ppCO2; Most dangerous effect at high dose (pure ag.)in resp decrease
Analgesia - YES
Reversible- Buprenorphine (partial agonist) is difficult to antagonize –> strong affinity for mu receps; Naloxone (pure antag) reverses pure agonists and has shorter 1/2 t than most opioids

34
Q

other facts about opioids

A

*Crosses placenta –> decrease resp rate in neonate
excreted in milk
*Emetic –> anti-emetic
increase bladder sphincter tone
antitussive (But.)
primary –> constipation
*Dogs –> Miosis (constriction of the pupil) and decrease temp
*Cats –> Mydriasis (dilation of the pupil) and increase temp
*Auditory sensitivity increase with fentanyl in cats
can build up tolerance

35
Q

Barbituate drugs

A

shortest - Thiopental
middle - Pentobarbital
longest - Phenobarbital

36
Q

Barbituate Contraindications

A 
Hepatic dz
Neonates 
Grey hounds
Cachexia (wasting syndrome)
Splenectomy 
C-section
37
Q 
Barbituate Effects
CNS
CV
Resp 
Analgesia
Reversible
A

CNS- Fast induction; strong hypnosis (decrease ICP); neuroprotectant (anti-eleptics)
CV - Arrhythmias; Decrease BP; Decrease CO –> tachyarrhythmia; MM relax
Resp - NO
Analgesia- NO
Reversible - NO

38
Q

Barbituates other factors

A

*Quickest onset of action - shortest duration
Extremely irritant
Precipitates in LRS
Hypothermia
Slow recovery due to redistribution –> cumulates in fat

39
Q

Propofol drugs

A

Propofol

40
Q 
Propofol effects
CNS
CV
Resp 
Analgesia
Reversible
A

CNS- decrease ICP; short acting; anticonvulsant; good hypnosis
CV- decrease BP; decrease contractility; repeated doses –> heinz bodies in cats; anemia
Resp depression (worst drawback)
Analgesia - NO
Reversible - NO

41
Q

Barbituate uses

A

Induction

42
Q

Propofol uses

A

Widely used
IV sedation
Good in small ruminants
Good with liver and kidneys

43
Q

Propofol other facts

A

Give slowly to effect (resp -)
Minimal accumulations
Two formulas
Myoclonus (sudden, involuntary jerking of a muscle or group of muscles) after induction

44
Q

Alfaxalone drugs

A

Alfaxalone

45
Q

What kind of drug is Alfaxalone

A

Neuroactive steroid

46
Q

Alfaxalone uses

A

Rapid anx onset
Min accum
good for CRI

47
Q 
Alfaxalone effects
CNS
CV
Resp 
Analgesia
Reversible
A

CNS- decrease ICP; short acting; anticonvulsant; MM relax
CV - decrease contractility –> decrease BP –> reflex tachycard
Resp- depression (less than propofol)
Analgesia- NO
Reversible - NO

48
Q

Etomidate drugs

A

Etomidate

$$$

49
Q

Etomidate uses

A

Fast indction
min CV
Necrosis perivasc.

50
Q

Alfaxalone other facts

A

Can be IM
Give slowly to effect
Muscle twitching following induction
Stormy recovery despite sedation in cats

51
Q 
Etomidate effects
CNS
CV
Resp
Analgesia
Reversible
A 
CNS- GABA; decrease ICP
CV- NO effect
Resp - minimal
Analgesia - NO
Reversible - NO
52
Q

Other factors - Etomidate

A

Myoclonus if no premeds –> give w/ mm relax

Decrease syn. of cortisol

53
Q

Dissociative drugs

A

Ketamine

Tiletamine

54
Q

Dissociative drug uses (ketamine and tiletamine)

A

Induction in many species
Maintenance for short procedures
CRI
IM inj. +/- pain

55
Q

Contraindications for Dissociatives (ketamine and tiletamine)

A 
Increased IOP
Head trauma
Epilepsy
Brain tumor
Myelogram
C-section
56
Q 
Dissociatives effects
CNS
CV
Resp
Analgesia
Reversible
A

CNS- No hypnosis; Catalepsy (trancelike state of consciousness that is marked by a loss of voluntary motion); Reflexes maintained; Increased IOP; Increased ICP; increase O2 consumption –> increase HR and BP
CV - Sympathetic stimulation; Increase HR and increase BP
Resp- Mild resp depression; bronchodilation
Analgesia- Yes (somatic)
Reversible - NO

57
Q

Other facts - Dissociatives (Ketamine and Tiletamine)

A 
Cataleptic state
IV, IM, SQ, PO, recall (?)
Increase salivation
Increase/Decrease temp
NEVER USE ALONE!!!!!!
Anesthetic depth is hard to assess
58
Q

Extra facts about Tiletamine

A

Longer DOA - combo with Zolazepam (decrease 1/2t)
+/- long recovery (rough)
Muscle rigidity, excite, seizure
No redose
Good in hard to anesthetize patients (wild animals)

anesthesiology (15 decks)

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