Large Animal Sedation/Premedication Flashcards
T/F horses stay standing while sedated
T
what is unique about giving drugs to ruminants (and other food animals)
need to consider drug approval and drug withdrawal times
what are the 3 general considerations for protocol design for large animals
1) patient
2) procedure
3) place (facilities)
what are some patient considerations when designing a drug protocol for large animals
1) signalment
2) pregnancy status
3) drug residues
4) local/systemic illness, including pain
what are some procedure considerations when designing a drug protocol for large animals
1) duration
2) degree of analgesia needed
3) position
4) risks
what are some place (facility) considerations when designing a drug protocol for large animals
1) personnel
2) chutes/stocks
3) field vs stall
4) padding/positioning
what are the 6 most commonly used drug categories for equine sedation/analgesia
1) phenothiazines
2) alpha 2 agonists
3) benzodiazepines
4) opioids
5) NSAIDs
6) local anesthetics
what is the order of introduction of the following alpha 2 agonists:
- romifidine
- detomidine
- xylazine
- xylazine (70s)
- detomidine (80s)
- romifidine (90s)
what alpha 2 adrenergic agonists are NOT licensed for use in HORSES (but may be used off label)
- dexmedetomidine
- medetomidine
what is the potency (from most to least) of the alpha-2 agonists in horses
dex/medetomidine > detomidine > romifidine = xylazine
what are some disadvantages of using alpha-2s in horses
1) upper airway relaxation
2) ataxia
3) ileus
4) cardiovascular effects: bradycardia, arrhythmias, drop in CO
what are some advantages of alpha-2 agonists in horses
- fast onset
- predictable and reliable sedation
- reversible
- IV or IM
- dose-dependent effects
- provides analgesia
what are the 2 phenothiazines used on horses
- acepromazine (parenteral)
- promazine (oral)
what are some advantages of phenothiazines in horses
1) long-acting
2) anti-arrhythmic
3) mild tranquilizer
4) IV or IM
what are some disadvantages of phenothiazines in horses
1) long time to effect
2) penile prolapse
3) hypotension and hypothermia
4) only mild-moderate sedation
5) no analgesia
what is the onset and duration of action of phenothiazines in horses
onset: 10-15min
duration: ? 1-2 hours?
what are two benzodiazepines used in horses
midazolam and diazepam
what are some advantages of benzodiazepines in horses
- little CVS depression
- muscle relaxant
- great in foals < 2 weeks
what are some disadvantages of benzodiazepines in horses
- no analgesia
- unpredictable sedation
- ataxia
what are 3 opioids used in horses
- metadone
- morphine
- butorphanol
what are advantages of using opioids in horses
- improves quality of sedation
- analgesic
- IV or IM
- can sedate a compromised foal
what are disadvantages of opioids in horses
- short acting
- ILEUS
- potential excitation (if they stimulate
what alpha-2 agonist is used in ruminants
xylazine
what are advantages of alpha-2 agonists in ruminants
- predictable sedation
- analgesia
- IV or IM
what are disadvantages of alpha-2 agonists in ruminants
- respiratory - hypoxemia
- regurgitation
- ataxia/recumbancy
- abortion
what size vial of xylazine (Rompun) do you want to use in ruminants ALWAYS
the SMALL vial (20mg/ml)
what benzodiazepines are used in ruminants
diazepam and midazolam
what are advantages of benzodiazepines in ruminants
- sedation in calves and small rumies
- muscle relaxation
- little CVS depression
what are disadvantages of benzodiazepines in ruminants
- ataxia
- poor sedation in adult cows
- not used in lactating cows
- 30-day withdrawal time
what are the advantages of phenothiazines in ruminants
- IV or IM
- less likely to become recumbant
what are the disadvantages of phenothiazines in ruminants
- slow onset with long duration
- no analgesia
- hypotension
- regurgitation
in general, what can we give as a sedative/opioid combo in large animals and what is one additional option for small ruminants
in general:
alpha 2 + opioid + NSAID/local
additional option for small ruminants:
benzo + opioids + NSAID/local
what are the opioids used in ruminants
- butorphanol
- methadone
- morphine
what are advantages of opioids in ruminants
- analgesia
- better quality of sedation
- sedation in compromised adults/young ruminants
- IV or IM
what are disadvantages of opioids in ruminants
- only IV or IM routes (only parenteral)
- short acting
