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Exam 1 - premed & induction drugs Flashcards

1
Q

what are the three anticholinergics

A

atropine
glycopyrrolate
butylscopolamine

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2
Q

difference between atropine and glycopyrrolate

A

atropine - quick onset and short duration, cross BBB & placenta
glycopyrrolate - longer onset and longer duration, does NOT cross BBB or placenta

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3
Q

clinical side effect of anticholinergics in horses

A

ileus

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4
Q

anticholinergics in rabbits and ruminants

A

rabbits - atropinase
ruminants - rumen microflora renders atropine ineffective

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5
Q

when to use anticholinergics

A

opioid induced bradycardia
decrease secretions associated with dissociative drugs (ketamine)
bradycardic + hypotensive

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6
Q

what drug is a phenothiazine

A

acepromazine

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7
Q

acepromazine
cardiovascular effects:
resp effects:

A

hypotension
changes in heart rate variable
protects againist E induced dysrrhythmias

resp rate decreased when compounded with other drugs
tidal volume unchanges

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8
Q

contraindications of acepromazine

A

caution with seizure patients bc increase risk of seizures
caution with breeding stallions due to paraphimosis
avoid in shock patients due to hypotension
decreased PCV and TP
prolonged clotting time
weak antihistamine
may predispose regurgitation

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9
Q

5 types of alpha 2 agonist - list from least potent to most

A

xylazine
romifidine
detomidine
medetomidine
dexmedetomidine

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10
Q

how do you reverse alpha 2 agonists

A

atipamezole
yohimbine
idazoxan
tolazoline

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11
Q

alpha 2 agonist effects

A

transient hypertension followed by hypotension
bradycardia
2nd degree heart block
good analgesic
emesis in cats
hyperglycemia
diuresis

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12
Q

what is a peripheral antagonist and what does it do

A

Vatinoxan - partially reverses hypertension/bradycardia while maintaing sedation/analgesia

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13
Q

what is Zenalpha

A

vatinoxan + medetomidine
good for sedation only

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14
Q

what are the 3 types of benzodiazepines

A

diazepam
midazolam
zolazepam

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15
Q

what benzodiazepine is water soluble

A

midazolam
- can give IM

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16
Q

benzodiazepine effects

A

minimal effect on CV and resp
anti-seizure
cross placental barrier and cause neonatal depression
chronic oral use in cats = liver failure

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17
Q

indications for benzodiazepine use

A

Reduce dose requirement for injectable & inhaled drugs
Reduce muscle hypertonicity caused by dissociative drugs
Treat seizures
Appetite stimulant (cats)

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18
Q

benzodiazepine use can cause ____ in small animals and horses and _____ in ruminants, camelids, young animals

A

excitement

calming

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19
Q

benzodiazepine reversal agent

A

flumazenil

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20
Q

opioid antagonist

A

naloxone

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21
Q

morphine

A

mu agonist
least potent

22
Q

hydromorphone

A

mu agonist

23
Q

methadone

A

mu agonist
NMDA receptor antagonist

24
Q

fentanyl

A

mu agonist
most potent

25
buprenorphine
partial mu agonist
26
butorphanol
kappa agonist mu antagonist
27
main opioid effects
bradycardia (but can use anticholinergics concurrently) vomiting (except fentanyl) dysphoria/excitment resp depression with IV or higher doses (less likely with SQ/IM) histamine release w/ morphine ileus in horses
28
define neuroleptanalgesia
opioid + tranquilizer (acepromazine)
29
rank the opioids in order of duration of action (short-long)
fentanyl butorphanol hydromorphone methadone morphine buprenorphine
30
what are 3 hypnotic-sedatives used for induction
propofol etomidate alfaxalone
31
propofol pros
rapid onset 20-30 sec
32
why limit propofol maintenance dose in cats to 30min
decreased glucoronidation metabolism
33
effects of propofol how can you minimize CV and resp effects
decreased ICP,CPP variable effects on IOP anticonvulsant antiemetic CV (vasodilation, decreased contractility) resp (apnea) give slowly
34
indications for propofol use
dog, cat, small ruminants short/minimally invasive procedures liver patients if CV stable (due to extrahepatic metabolism) neuro patients if CV stable hyperthermic syndromes (pigs) greyhounds C-sections
35
alfaxalone effects how can you minimze these effects
less CV effects (no vasodilation) but not as well studied resp depressant give slowly
36
alfaxalone indications
sighthounds C-section OK for patients with mild-moderate cardiac disease
37
alfaxalone MOA
Neuro-active steroid with no glucocorticoid/mineralocorticoid actions inhibits propagation of action potentials by altering Cl flux through GABA channel
38
etomidate effects good and bad
minimal cardiopulmonary depression! hemolysis, hematuria, pain on IV injection adrenocorticol suppression myoclonus, vomiting opsithotonic/stargaze
39
etomidate indications
safest for CV & resp! compromised patients esp in CNS, CV or respiratory disease cats with hypertrophic cardiomyopathy
40
how can you minimize etomidates hemolysis, hematuria, pain on IV injection
dilute the drug or administer with IV fluids caused by hyperosmolar propylene glycol
41
why does ketamine have a longer duration of action in cats vs dogs
cats metabolize to norketamine dogs metabolize to hydroxy-norketamine
42
ketamine indications
healthy or mild-mod compromised patients bronchoconstriction bronchoscopy aggressive animals NOT patients with intracranial disease/seizures, pheochromocytoma, aneurysms, hyperthyroidism, hypertrophic cardiac disease or cats in renal failure
43
Guaifenesin "GG" what happens with >5%? toxicity effects? regular effects?
>5% = hemolysis toxicity = rigid, apnea regular effects = sig ataxia and mental quietening
44
tiletamine-zolazepam indications
safe handling not possible rapid sedation is desired (e.g wild wolves)
45
tiletamine-zolazepam cautions
behavioral changes in tigers/lions nephrotoxic in rabbits similar to ketamine - don't use in hypertrophic cardiac disease patients or renal failure cats
46
tiletamine-zolazepam ____ of the each ____ in combination recommended doses are based on ______
50mg each 100 mg of combination combination
47
for IV induction of opioids you want to select ones that do not cause histamine release, what would be these?
mu agonists: fentanyl hydromorphone methadone NOT morphine
48
opioid as induction drugs indications
dogs with cardiovascular compromise/when CV safety needed analgesia when reversal of effects is important
49
opioid as induction drug cautions
resp depression bradycardia excitation in horses/cats slow induction intubation conditions not ideal
50
inhaled agent indications for induction
fractious patient no catheter small patient
51
pros of using inhaled agents as induction agents
high FiO2 can control depth with vaporizer facilitates ventilation
52
cons of using inhaled agents as induction agents
no airway control stressful environmental contamination high dose required for intubation comes with CV depression

Anesthesia (12 decks)

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