Guaifenesin Flashcards

1
Q

Where is guaifenesin most commonly utilized?

A

in large animal anesthesia

(can find it in small animal medicien as an expectorant combined with dextromethorphan - Cough Tabs)

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2
Q

How is guaifenesin most commonly supplied?

A

as a bacteriostatic-bactericidal powder. It is dissolved in 5% dextrose, sterile water, or saline. It can EASILY precipitate out of solution and is compatible in solution with other anesthetic drugs

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3
Q

What is the MoA of guaifenesin?

A
  • centrally acting skeletal muscle relaxant
  • binds to specific inhibitory neurotransmitter sites (GABA) in the brain and spinal cord
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4
Q

Where exactly does guaifenesin suppress in the CNS?

A
  • selective depression or blockade of nerve impulse transmission at internuncial neuron level of spinal cord, brainstem, and subcortical areas of the brain
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5
Q

How and where is guaifenesin metabolised and excreted?

A
  • metabolized in the liver
  • glucuronidation
  • excretion in the urine
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6
Q

What is the pharmacokinetic profile of guaifenesin?

A
  • IV alone, recumbency may occur within 2 minutes and last 6 minutes without unconsciousness
  • sedation could last 15-30 minutes
  • rapid elimination in horses
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7
Q

Has a gender difference been identified in regards to guaifenesin’s pharmacokinetic profile?

A

yes! female poines have a shorter half-life compared to male ponies (60 min vs 85 min)

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8
Q

What is the terminal half life of guaifenesin in horses?

A

t1/2 = 84.5min, clearance of 8.2mL/kg/min

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9
Q

Does guaifenesin have a toxicity profile?

A

while it has a wide therapeutic margin, concentration of drug is species important

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10
Q

in horses, what is the dose to produce recumbency?

A

100-150mg/kg, which is ~20-30% of the dose to cause cardiopulmonary depression. Overdose COULD cause respiratory depression and muscle rigidity.

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11
Q

What are the CNS effects of guaifenesin?

A
  • centrally acting skeletal muscle relaxant, CNS depressant effects
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12
Q

What are the CV effects of guaifenesin?

A

Minimal to no CV effects at clinical dosages

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13
Q

What are the respiratory effects of guaifenesin?

A

minimal to no respiratory depressant effects at clinical dosages: PaCO2 is unchanged, PaO2 decreased after administration to achieve lateral recumbency in horses.

NOTE: respiratory depression noted in donkeys

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14
Q

What are the musculoskeletal effects of guaifenesin?

A

skeletal muscle relaxation with no effect on cardiac or smooth muscle

NOTE: 33-88 mg/kg IV for muscle relaxation in dogs, 100-160mg/kg IV in horses

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15
Q

GI effects of guaifenesin?

A

high doses may result in vomiting

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16
Q

What are the urinary effects of guaifenesin?

A

no known renal effects

17
Q

What is a major side effect of guaifenesin?

A

hemolysis!! Solutions greater than 5% can induce hemolysis in cattle and greater than 10% can induce hemolysis in horses

18
Q

Can analgesia result from guaifenesin?

A

Very minimal per a 1973 Funk study

19
Q

Can you give guaifenesin to a pregnant patient?

A

guaifenesin crosses the placental barrier with fetal concentration being approximately 30% of maternal circulation. Foals at birth do not show significant depression

20
Q

Anything special about donkeys and guaifenesin?

A

donkeys have a lower clearance and therefore a longer half life than horses