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Drugs- Pain, Pre-med > Drugs- Pain, Pre-med > Flashcards

Drugs- Pain, Pre-med Flashcards

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1
Q

Acepromazine

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A 
phenothiazine
IV/IM
onset 5-20 min IV.        30-45min IM
Duration: 6-8 hours
metabolized by liver, excreted by urine
- sedation, anti-emetic, lowers seizure threshold, hypotension, anti-arrhythmic, anti spasmodic, anti emetic, increase risk of regurg., anti histamine, hypothermia
- paralysis of retractor penis muscle horse
- no reversile agent
-overdose: NO adrenaline, give fluids
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2
Q

Xylazine

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A
  • alpha 2 agonist
  • IM, IV, SC, PO, Intranasal, perineurally, epidurally
  • duration of action 15 minutes
  • metabolized by liver, excreted by urine/feces
  • good spasmolytic analgesic for colic in horse
  • No small ruminants, small animal
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3
Q

Detomidine

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A
  • alpha 2 agonist
  • give IV, oral in horses
  • longer acting, 40 min duration of action
  • liver metabolism and urine/fecal excretion
  • suitable for pregnant cattle
  • no small animal
  • do not use with sulphonamides in horses
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4
Q

Romifidine

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A
  • alpha 2 agonist
  • IV
  • longest duration of action
  • least ataxia in seen in horses, good analgesia
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5
Q

Dexmedetomidine

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A
  • alpha 2 agonist
  • IV, IM
  • sedation is dose dependent and can taper to desired effect IV. 1-2 ug/kg (40min), 5ug/kg (60min)
  • analgesia, vomiting
  • reduces larygeal fxn
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6
Q

Medetomidine

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A
  • alpha 2 agonist
  • IV, IM
  • sedation without severe cardiovascular effects
  • do not use in dogs
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7
Q

Diazepam

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A
  • benzodiazepines
  • IV, PO, PR, IM (not emulsion prep)
  • rapid onset IV
  • hepatic metabolism
  • decreases neuronal transmission via GABA receptor
  • anxiolysis, sedation, little respiratory depression, muscle relaxant, anti-convulsant, appetite stimulant in cats, anti convulsant
  • reversed with Flumazenil
  • overdose CS: long lasting sedation, CNS depression and coma
  • can be used with ketamine premed, diazepam induction in horses
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8
Q

Midazolam

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A
  • benzodiazepine
  • IV,IM,SC, intanasal
  • rapid onset, short duration
  • metabolism by liver
  • anxiolytic, sedation, little resp depression, muscle relaxant, anti convulsant, appetite stimulant in cat, no analgesia
  • reversed with Flumazenil
  • overdose - long lasting sedation, CNS depression, coma
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9
Q

Azaperone

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A
  • butyrophenones
  • onset of action 5-10 min IM (pigs)
  • duration 2-4 hours
  • metabolism via liver, excreted in urine and feces
  • anti-emetic, sedation, alpha 1 receptor blockade may result in hypotension. Antiarrhythmic. may protect against catecholamine induced arrhythmias, no analgesia, excitement in horses
  • ## AE: pigs can have transient salivation, piling, panting, and shivering
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10
Q

Morphine

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A
  • full Mu agonist opioid
  • IV, IM, SC, oral, epidural, intrathecal, intra-articular
  • onset 30 min IM, faster IV
  • duration 4-6 hours
  • analgesia, sedation, bradycardia, bronchospasm (no asthma patients), nausea, vomiting, constipation
    AE: hypotension, dysphoria, sedation, constipation
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11
Q

Methadone

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A
  • full Mu agonist
  • IV, IM, SC
  • onset of action IM 10-20 min
  • duration of action 4 hours
  • NMDA antagonist, analgesia, sedation, bradycardia, NO histamine release, panting, vomiting if there is no pain present
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12
Q

Pethidine

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A 
full Mu agonist
IM ONLY, IV large histamine release
onset of action 15-20min
duration 90min
causes mydiasis, sedation, increased HR, severe hypotension if histamine release, no vomiting, spasmolytic effect in block cats, decreased salivary and respiratory secretions
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13
Q

Fentanyl

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A 
pure mu agonist
metabolized by lungs and liver
give IV, IM, SC
onset of action <2 min IV
duration of action 20 min 
analgesia, sedation, excitement (cats), anti-emetic, bradycardia, hypoventilation
No horses
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14
Q

Buprenophine

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A 
partial Mu agonist
IM,IV,SC, OTM
onset slow 20min IV, 40 min IM
duration 6-8hrs
metabolism hepatic
sedation, bradycardia, weak base (pKa 8.4), feline saliva pH is high --> unionized fraction of drug is high, good absorption no first pass metabolism
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15
Q

Butorphanol

  • drug type
  • route of administration
  • onset of action
  • duration of action
  • metabolism and excretion
  • pharmodynamics
  • cautions
A 
mixed agonist/antagonist opioid 
IM, IV
Duration: 1.5-2hrs
hepatic metabolism, renal excretion
good sedation, potentiates axn of acepromazine and alpha 2 agonsit, some analgesia, less depression than morphine
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16
Q

Tramadol

A 
atypical opioid - NOT opioid 
IV, IM, epidural, PO 
t1/2 life in dog 4-6hrs, longer cats
centrally acting analgesia
sedation, analgesia, trembling, ataxia, seizures, bradycardia, nausea, anorexia
AE: serotonin
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17
Q

Phenylbutazone “Bute”

A 
NSAIDS
PO, IV, irritating to tissue
non selective COX inhibitor
used common for acute pain
horse analgesia (colic), anti-inflammatory, anti-endotoxic
NO food animal or dog
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18
Q

Flunixin

A

NSAID
PO, IV
non selective COX inhibitor
use in horses - colic

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19
Q

Meloxicam

A

PO, SC
COX2 selective
chronic pain management
licensed dogs, cats, horses, cattle

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20
Q

Carprofen

A

PO,IV, IM, SC
COX2 selective
dogs, cats, horses
idiosyncratic liver failure in dogs- labs

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21
Q

Robenacoxib

A

PO,SC
high oral bioavailability
long duration
highly COX2 selective
perioperative use in dogs and cats- ensure good BP
decrease renal affects if given loop diuretic

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22
Q

Paracetamol/acetaminophen

A

NSAID like drugs
oxidative metab –> NAPQi active metabolite AM404
weak COX1 and COX2 inhib
antiarrhythmic
can cause hepatic necrosis
cats have limited glutathione pathway that is rapidly overcome by paracetamol

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23
Q

Gabapentin

A 
NSAID like drug
PO bioavail good >80% oral
duration 6-9hrs
hepatic met, renal excretion
anti epileptic, works on neuropath pain, useful pre-med for cats.
No pregnant animals
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24
Q

Amitriptyline- tricyclic antidepressant

Study These Flashcards
A

antidepressant
PO only
hepatic metabolism, renal excretion
SSRI –> increase serotonin and noradrenaline –> improved descending pain control
causes: hypersalivation, sedation, serotonin syndrome, tachycardia, fatal ventricular tachycardia, Vomiting, wt gain, FLUTD, neuropathic pain and chronic laminitis
CI: serotonin syndrome: excessive amounts cause change in mentation/aggression, confusion, coma, autonomic dysfunction (hypertension, tachycardia, hyperthermia), neuromuscular signs (muscle rigidity, tremors)
Tx for SS: gastric lavage, defecation promotion, supportive care

25
Amantadine
PO only slow onset minimal hepatic metabolism, renal excretion Dopamine agonist , NMDA antagonist, Na channel blocker overestimation, serotonin syndrome risk Used for chronic pain, weight gain, arthritis, neuropathic pain, NO IR
26
Memantine
PO only min hepatic metabolism, renal excretion non competitive inhibitor of NMDA receptors - reduces abnormal NT mediated activation of the R used for cognitive dysfunction in dog, similar to amantadine but in IRE AE: serotonin syndrome
27
Procaine/ adrenocaine
``` LOCAL SQ duration of action: 30-60min rapid hydrolysis in blood can be combined with adrenaline Uses: LA- horn blocks, line blocks also used with penicillin to extend effect NOT for extremities ```
28
Lidocaine
``` LOCAL IV (no cats) extradural, epidural, IVRA, topical onset 2-5 min duration 90 min 2x potent then procaine hepatic metabolism, renal excretion uses: analgesia, neuropathic pain, nerve blocks, IV for visceral pain, anti arrhythmic class 1 (ventricular arrhythmia), prokinetic, anti-inflammatory, anti endotoxic, intubation of cat, REDUCE MAC ```
29
Lidocaine + adrenaline | in EMLA
LOCAL injectable used for dehorning NO distal limb-- necrosis
30
Prilocaine
``` LOCAL EMLA cream topical numbing takes 60min for full effect infiltrated peripheral nerves, IVRA in LA ```
31
Prilocaine and Lidocaine =
EMLA cream No MM very toxic keep animals from licking 60min to take effect topical
32
Mepivacaine
``` LOCAL onset of action 11min duration of action 130 min hepatic metabolism Diagnostic limb blocks, NOT food animals in IRE ```
33
Bupivacaine
``` LOCAL NO IV infiltration, extradural, epidural, spinal anesthesia onset 30 min duration 8 hrs (95% protein bound) hepatic metabolism vasoconstriction, reduced motor blockade intensity, reduced cardiotoxicity, toxicity at 2.5mg/kg low dose for cats cardiotoxic if given IV ```
34
Ropivacaine
``` LOCAL onset moderate duration 8 hrs hepatic metabolism used in IR with special license given via epidural catheter less toxic ```
35
Propofol
``` Injectables- PHENOL IV ONLY, can give CRI onset 1 min duration short metabolism hepatic and extrahepatic renal excretion enhances inhibitory effect of GABA act on CA channel blockers --> vasodialtion --> hypotension causes: CNS depression, NO analgesia, anticonvulsant, antioxidant decrease O2 consumption, decrease intracranial pressure, hypotension, central depression, bronchodilation, apnea, CROSSES placenta SA and Horse uses AE: cats can get Heinz body anemia, NO cardiac patients will decrease resistance with no compensation ```
36
Alfaxalone
``` Injectable- NEUROSTERIOD IV or IM induction agent onset rapid duration short renal and biliary metabolism, CP450 enhance inhibitory effects of GABA CS: rapid relaxation, induction, poor recovery, no hypotension, mild tachycardia (response to vasodilation), Resp depression if injected fast, muscle relaxant, increase intraocular pressure SA, cat, neonates not metabolized by glucuronidation in cats so no heinz body anemia like propofol ```
37
Ketamine
injectable- CYCLOHEXAMINE IV, IM< PO onset of action and duration longer then Propofol and alfaxalone metabolized by liver to active form excreted renal antagonist of NMDA causes: dissociative anesthesia, increases CMR, CBF, excites, increases HR, BP, increase ICP, negative inotrope to heart, increase salivation, bronchodilation, sound sensitivity, muscle rigidity NO cats with renal dysfucntion, never used alone for anesthesia, ulcerative cystitis
38
Tiletamine
ketamine analogue with zolazepam recover can be violent only use in darts for wildlife
39
Thiopentone
Barbiturate IV via catheter only short acting 15 min metabolized hepatic CYP450, renal excretion binds GABA, enhances inhibitory action, increases chloride channel opening uses: induction agent, gradual depression of CNS, hypnosis, decrease oxygen demand, decrease CMR, decrease CBF, decrease ICP, vasodilation, hypotension, tachycardia (reflex), arrhythmias, respiratory depression (INTUBATE), decrease renal blood flow used in small and large medicine for quick procedures IV admin, emergency management of moving anesthised horse, convulsions, increase ICO, snail pellet toxicity high pH so skin slough if extravascular
40
Pentobarbitone | Euthasol
``` barbiturates IV slow onset 2 min duration longer then thiopentone extensive hepatic metabolism cs: loss of consciousness, anticonvulsant, hypotension, tachycardia, depression can be used for euthanasia toxicity in dogs fed with euthanized animal meat ```
41
Phenobarbitone
PO, IV oxybarbiturate anticonvulsant NOT for anesthesia
42
Etomidate
``` Imidazole IV- be carful! onset fast duration short transient depression of HPA- inhibits conversion of cholesterol to cortisol can paddle during induction used for EXOTICS no IRE ```
43
Atropine
``` anticholinergic IV, IM onset 1-5 min duration 2--40min hydrolysed to inactive form increases ACh --> decrease RRm mydriasis, decrease salivation, tachycardia, increase HR (reflex to decrease BP) crosses BBB, placenta can use glycopyrrolate and neostigmine to reverse AE: can cause 2nd degree AV Block ```
44
Glycopyrrolate
``` anticholinergic onset slower then atropine duration 1-2 hours controlled increase HR, cannot cross BBB no mydriasis good for increasing BP ```
45
Dopamine
CRI only - IV hepatic met and renal dose dependent effects. acts on adrenergic and dopaminergic receptors effects: increase perfusion hear, increase HR, increase inotropy, vasodilation, improve O2 delivery, bronchodilation, increased renal and mesenteric blood flow, risks of ventricular fib
46
Adrenaline
sympathomimetic IV or IM, bolus or CRI, Nebulization hepatic and renal met stimulates alpha and beta receptors increase HR, inotropy, promotes coronary arterial flow during diastole --> determines survival of arrest, bronchodilation, increases glucose, lactate, FFA Uses: CPR, anaphylaxis, severe hypotension (sepsis), added to local anesthetic to increase duration, splash to decrease bleeding, decrease airway edema
47
Noradrenaline (NA)
only give with invasive BP monitoring stimulates alpha and beta receptors causes: profound vasoconstriction, increase BP, decrease CO, increase O2 consumption, can cause increase vasoconstriction in lungs, tissue ischemia reflex bradycardia AI: necrosis at pt of administration
48
Ephedrine
sympathomimetic cats can be bolus directly stim alpha 1 and beta 2 indirectly stim beta1 increase BP, positive inotrope some bronchodilation, decrease blood flow, decrease GFR AE: tachyphylaxis- indirect mechanism from noradrenaline depletion
49
Dobutamine
Positive inotope excreted in urine non selective beta receptor agonist no change TPR, increase conduction velocity through nodal tissue. arrhythmias rare, arrhythmias rare
50
Phenylephrine
``` vasopressor IM- onset 1hr nasal spray for horses - most common NEED invasive BP monitor hepatic metabolism alpha 1 agonist vasoconstriction, decrease perfusion, reflex bradycardia, nasal edema, splenic contraction, correct neophrosplenic entrapment AE: reflex bradycardia, hypoperfusion special license needed in IR ```
51
Vasopressin
simulates the release of catecholamines increased contractility and refractory hypotension most potent vasopressor NOT IN IRE
52
Salbutamol
bronchodilator inhaled rapid onset, slow metabolism so long duration of action hepatic met and renal excretion beta2 agonist in lungs and heart Na/K + ATPase stim --> K decrease CS: tachycardia at high dose, bronchodilation, relaxes smooth muscle of lungs, reversed hypoxic pulmonary vasoconstriction (horses), can cause tremors AE: tachycardia. can increase shunting of blood from heart and may cause hypoxia --> always admin with O2 when nebulizing
53
Terbutaline
bronchodilator injectable, inhaled injectable used for BAL or bronchoscopy
54
Doxapam
sympathomimetic IV onset <2 min, duration short hepatic met, renal excretion CNs simulant at all levels, direct stim of medullary resp centers transient increase minute ventilation but no increase arterial oxygen tension. Not a substitute for approp respiratory support --> doesnt fix hypoxia AE: dont use in hypertensive patients, can cause persistant fetal circulation --> hypoxia
55
Succinylcholine
neuromuscular blocker- depolarizing agent IV duration 3 min, recovery in 10-12 min metabolized in blood cs: bradycardia (stimulation of muscarinic receptor in SA node); increase K --> arrhythmias, increase intra ocular pressure Used to stop breathing for thoracic surgery Lots of undesired effects
56
Atracurium
no AP generation, paralysis w/o musc cxn does nto cross BBB other non depolarizing agents: cis-atracurium, mivacurium, vecuronium, rocuronium
57
Edrophonium
``` anticholinesterase ADMIN with atropine onset fast, duration short hepatic metabolism used to diagnose myasthenia gravis Ach esterase antagonist ```
58
Neostigmine
admin with glycopyrrolate, onset slower, duration longer | same as edrophonium
59
Sugammades
``` fast acting gamma cylodextrin, hydrophilic surface use to reverse aminosteriods avoid muscarinic effects cost prohibitive- NOT USED ```

Drugs- Pain, Pre-med (2 decks)

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