Final Exam Quick and Dirty Flashcards
Isoflurane
Inhalent anesthetic
Most common
Sevoflurane
Inhalation anethetic
reacts with soda lime CO2 absorbent
Desflurane
Inhalation anesthetic
lowest blood gas coefficient
need special vaporizer $$$
Nitric Oxide
Inhalation anesthetic adjuvant GAS
good ANALGESIC
2nd Gas and Fink efx
Stop a seizure in progress
benzodiazepines
Diazepam, Midazolmam, Lorazepam
How to benzodiazepines work
Brain has many bzd receptors that are part of GABA complex (main inhibitory neurotransmitter in the brain)
How to stop a seizure in progress at home
Dispense diazepam to give rectally (or IN) via cannula, don’t put in plastic binds to plastic
How to stop SE
Dizepam CRI w/ 5% dextrose/9% saline Lorazopam- longer duration Midazolam- doesn't adhere to plastic Levetiracetam (Kepra) Phenobarb IV Propofol (intubate Inhalation anesthesia
Phenobarbitol
anti-convulsant, DoC in dogs and cats potentiates GABA-a receptor SS: 10-14 days T1/2: 100 hours Cytochrome p450 Induction Don't use serum separator tubes during monitoring/dose adjustment
Halothane
Inhalent anesthetic
Resp and CV side effects
Bromide
Anticonvulsant
Long 1/2 life, 24 days, 4 mo to reach SS
Can use w/ hepatopathy patients
Causes asthma in CATS
Levetiracetum/Keppra
Anticonvulsant
770-90% excreted in urine, remainder hydrolyzed in serum
Gabapentin
Anticonvulsant
Synthetic analog of GABA
Need frequent dosing, TID-QID
Oral solution contains XYLITOL (toxic in dogs!)
Pregabalin (Lyrica)
Anticonvulsant
Synthetic analog of GABA
Used as an add on, potentiates release and actions of GABA
Amide LA
Lidocaine Bupivicaine Mepivacaine Ropivicaaine Prilocaine and dicucaine
Ester LAs
Procaine
Proparacaine
Benzocaine, Teracaine, Cocaine
MoA of LA
Block VG-Na+ channels (some other MoAs too)
PK of LAs
Topical/local infiltration/peripheral nerve block/intra-articular/epidural/intra-thecal/intra-venous regional anesthesia (brier’s block)
What is pattern for onset of blockade for LAs?
Onset of blockade: AD fibers (s myelinated) ->C fibers (unmyelinated) -> Aa fibers (motor, l. myelinated)
Pain and sympathetic transmission is blocked before motor transmission
What is Frequency Dependant block?
Rapidly firing nerves will be preferentially blocked
How can you increase the potency of a LA?
Increase lipid and water solubility of the drug
Lipophilicity=increases penetration into cell and binding with Na channels
Hydrophilicity=increases diffusion to site of action
Adverse effects of LA and how to tx
CNS stimulation: muscle twitcing, tremors, seizures. Tx w/ diazepam
CNS/CV depression: unconsioussness, respiratory arrest. Tx w/ artificial respirations
Procaine
Ester LA
used in penicillan G preperations
Toxic to Horses- CNS stimulation, excitement and seizures
Lidocaine
Amide LA rapid onset,medium duration Uses: 1B Antiarrhytmic (Vtach), feline intubation, adjunctive analgesic, GI prokinetic/anti-inflammatory Banned in europe food animals SHEEP most sensitive species
Bupivicaine
Uses: infiltration, nerve blocks, epidural
Slow onset 20 min, long duration 8 hrs
Most cardiogenic of LAs, pro-arrythmogenic
Proparacaine
topical ophthalmic formulation
rapid onset 30 sec, short duration 10-20 min
corneal and conjunctival manipulation
less irritating than other eye drops
Difference between COX1 and COX2?
Cox 1 is “normal” cox, txa2 promotes platelet aggregation, pge1=gi maintenance and vasodilation in kidney
Cox2= inducable, prostaglandins produced during inflammation. Contribute to inflammation and pain, propagating pain signals.
Anti-inflammatory effects of nsaids?
Good for acute inflammation
Inhibit synthesis of eicosanoids
Analgesic effects of nsaids
decrease PG sensitization of neurons, to bradykinin peripherally, centrally (interactions of PG with nociception)
Antipyretic effects of nsaids
Reduce fever- won’t reduce normal temp or hyperthermia, works on cytokines
Antithrombotic effects of nsaids
inhibition of AS (TXA2)
Asprin/Acetylsalicilic acid
preferential, irreversible inhibition of COX (TXA2 and PGI2) in platelets
increased clotting time
Antineoplastic effects of NSAIDS
cox2 expressed by cancers, nsaids inhibit cox
commonly transitional cell carcinoma and osteosarcoma
piroxicam often used
Fluxin Meglumine
NSAID
Large animal only
no IM, causes muscle necrosis
Phenybutazone “Bute”
Horses
Banned in dairy cattle
tx of MS pain
PO only
Carprofen
cox-2 preferential nsaid
small animal analgesic and anti-inflammatory
oral and inj
Fibrocoxib
cox2 selective nsaid
oral paste for horses, chew tabs for dogs
Robenacoxib
cox2 preferential multiple doses (SID for 3 days) in cats
Tramadol
weak u agonist
oral analgesic
may lower seizure threshold
Pilocarpine
direct acting, causes miosis in 2-6 hrs
tx of glaucoma
dx of PNS lesions (eg CNIII)
Atropine
direct acting Mydiatic
onset 1 hr, lasts 120 hrs
indications (opth)- reduce pain from orneal or iris dz (uveitis), break up synechea in uveitis
Don’t use in primary glaucoma, cycloplegia=horse pani, very bitter taste=cats froth
Tropicamide
direct acting mydriatic
causes mydriasis and cycoplegia
faster onset than atropine
indication: dilate pupil for eye exam, prevent adhesions post cataract sx
cautions- less effective pain control than atropine, less bitter but cats still foam, avoid in gluacoma, may alter schirmer tear test
Phenyephrine
Mydriasis
Dx horner’s syndrome
some cv side effects
Timolol
opthalmic nonselective b-antagonist
used in gluacoma management- prevent glac. in contralateral eye
decrease aqeuous formation
may cause some miosis
Corsopt- timolol + dorzolamide: carbonic anhydrase inhibitor
Dorzolamide
Reversable inhibition of CA which decreases aqueous humor production -> decreased pressure in eye
Latanoprost
Prostaglandin agonist increases uveoscleral outflow by stimulating FP receptors in the eye
tx gluacoma and reduce IOP
Tx Canine KCS
Cyclosporine
monitor by STT
local immunosupression-wear gloves
Tacrolimus
Decreases t cell activation
alternative to cyclosporine- tx KCS
potential cancer-> wear gloves
Opthalmic topical steriods
Desamethase, prednisolone
Don’t use if corneal ulcer, infection or diabetus
Opthalmic topical NSAIDS
Flurbiprofen, Diclofenac
manage uveitis and some keratitis
manage cataract inflammation (diabetes patients)
contraindicated- ulcer, glaucoma and coagulopathies
Opthalmic antibiotics
aminoglycosides flquinolones chloramphenicol NBP Oxytetracycle
Proparacaine
ophthalmic topical anesthetic
MoA: blocks Na channels preventing axonal depolarization
used for tonometry
Hydrocodone
Cough suppressive
Sometimes formulated with acetominophen
Sometimes formulated with homatropine as an abuse deterrent in humans
Albuterol
inhalant beta adreneric agonist
bronchodilator
has b-1 effects
Aminophyline and Theophylline
Bronchodilators
am- parenteral
theo- oral
Phosphodiesterase inhibitors, inhibid mast cell degranulation
stimulate catecholamine release from adrenals
increase cns sensitivity to PCO2
Adverse effects: cardiac stimulation (+ino and chronotrope), Gi irritation, pu/pd
