Exam 2: Analgesics 4: Neuroleptics Flashcards
What are the 2 Categories of Neuroleptics
- Phenothiazines
2. Benzodiqazepines
What is the phenothiazine derivative we learned about
Acepromazine
What are the two subcategories of Benzodiazepine derivatives and what are the drugs in those categories?
1. Agonists Diazepam Midazolam Alprazolam 2. Antagonists Flumazenil
Induces a state of behavioral change wherein anxiety is relieved and the patient is relaxed although aware of the surroundings
Neuroleptic
Induces a state characterized by CNS depression and drowsiness, decreased awareness of surroundings
Sedativ
Induces sleep
Hypnotic
Attenuate nociceptive input leading to reduction in pain sensation
Analgesics
Dec. central sensitization to pain
Antihyperxalgesics
Diminished ability to perceive pain
Antinociception
Induces analgesia and stupor bordering on general anesthesia
Narcotic
Analgesia and amnesic state produced by admin of a neuroleptic and narcotic
Neuroleptanalgesia
What are the 4 consederations when creating a sedation plan?
- Anti-convulsant
- Sedation
- m. relaxation
- Analgesia
What are the 2 categories of CNS neurotransmitters
- Excitetory NTs
2. Inhibitory NTs
What is the NMDA receptor for CNS
Glutamate
Where do neuroleptics act on the nociception pathway?
- Perception (B and P)
2. Modulation ( B only)
What are the 4 main effects of Neuroleptics
- Sedation & hypnosis
- Emotional Quietness
- Dissociation from surroundings
- m relaxation
T/F. Neuroleptics are not considered true anesthetics
T. have anesthetic effects
What is the most commonly used neuroleptic
Acepromazine
What spp. can have acepromazine
Horse, dog, cat
T/F. Acepromazine is a controlled substance
F
What is the MOA of Acepromazine
Competitive antagonist of Central Dopamine receptors and Alpha 2 receptors
Acepromazine blocks central Excitatory/inhibitory Dopamine receptors
Excitatory
T/F. Acepromazine works on the Vomiting center
T
T/F. Oral bioavailability of Acepromazine is high in dogs
F. Low
40%
T/F. Acepromazine can cross the BBB
T
Where is Acepromazine Metabolized?
Liver
Where is Acepromazine excreted
Urine
What is the most common affect of Acepromazine on the CNS
Sedation/neuroleptic effects
T/F. Acepromazine is given to patients to induce vomiting?
F. Anti-emetic
What is the MOA of Acepromazine on the CVS?
Alpha 1 receptor antagonism
What are the effects of Acepromazine on the CVS
Peripheral vasodilation leading to hypotension
What breeds are sensitive to the CV effects of Acepromazine
Boxers/Bracycephalics, Herding breeds, large breeds, sighthounds
T/F. Acepromazine is Prohibited in Food animals
T
What is the MOA of Benzodiazepine Derivitives
GABA receptor competitive agonism
What is the main inhibitory NT of the CNS
GABA
T/F. Benzodiazepine derivatives can cross the BBB
T
Which benzodiazepine derivative has the longest duration of Action
Alprazolam
Where are Benzodiazepine derivatives metabolized
Liver
T/F Diazepam cannot be given IV
F. Cannot be given IM
Why cant you give oral Diazepam to cats?
causes hepatic necrosis
Which Benzodiazepine Derivative can be given as an anti-convulsant
Midazolam
Which Benzodiazepine Derivative is the choice to give to dogs during thunder storms
Alprazolam
What are the Neuroleptic effects of Benzodiazepine derivatives
Anxiolytics
T/F. Benzodiazepine derivatives are commonly given for sedation
F. Not good on own
Indicated for specific reversal of benzodiazepine receptor agonist
Flumazenil
What is the MOA of Flumazenil
Competitive antagonism
binds and inactivates Benzodiazepine binding site on GABA receptor
T/F. Benzodiazepines are often Most reliable as sedatives in very young, very old, or very sick patients
T
T/F. Acepromazine has tranquilizing and analgesic effects
F
What is the most important Cardiovascular side effect of acepromazine
Hypotension
Why is oral Diazepam contraindicated in cats
Hepatotoxicity