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Noninhaled Agents Flashcards

1
Q

Products approved by which branch of the FDA should be used for euthanasia? Can compounded drugs be used?

A

Center for Veterinary Medicine
Yes, if compounded in compliance with applicable guidance documents and compliance policy guides

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2
Q

What is intrahemolymph injection considered?

A

Considered IV

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3
Q

Describe use of neuromuscular blocking agents in euthanasia.

A

Unacceptable as a sole means, as animals remain awake and able to feel pain. May be select circumstances where their administration may be the most rapid and humane means of restraint prior to euthanasia due to their more rapid onset compared with other immobilizing agents. In this case, can only be used if the chosen method of euthanasia can be applied immediately following immobilization.

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4
Q

What is a disadvantage of intraperitoneal/intracoelomic administration of nonirritating solutions?

A

May take longer for vertebrates to pass through stages I and II of anesthesia.

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5
Q

Can the retrobulbar route be used for euthanasia?

A

AWC for anesthetized mice with no more than 200 ul of an injectable anesthetic solution (ket-xyl)

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6
Q

Can the intraosseous route be used for euthanasia?

A

Placement of catheters can only occur in anesthetized or unconscious animals. Administration to awake animals may cause pain due to viscosity, chemical irritation, or other reasons.

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7
Q

What intra-organ routes are acceptable in what species? What are the exceptions?

A

Intracardiac, intrahepatic, intrasplenic, and intrarenal only in anesthetized or unconscious animals.
Exceptions: Intrahepatic in cats, intracardiac for poikilotherms in which this is the standard means of vascular access

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8
Q

What routes are unacceptable for administration of euthanasia drugs? What are the exceptions?

A

IM, SC, intrathoracic, intrapulmonary, intrathecal, and other nonvascular injections
Exceptions: IM of ultrapotent opioids and select injectable anesthetics

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9
Q

How might immersion agents added to the water be absorbed?

A

Across the gills, via ingestion, and/or through the skin

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10
Q

What US FDA-approved drugs exist for the euthanasia of aquatic animals?

A

None

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11
Q

Can US EPA-registered agents for poisoning fish be used for euthanasia? Why not? Name these agents.

A

No, as their mechanisms of action and times to death do not fit the criteria for euthanasia. Also, their use requires a restricted pesticide applicator’s license and extralabel use is a violation of federal law.
Rotenone, antimycin

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12
Q

How are MS 222 and metomidate approved by the FDA?

A

Approved as tranquilizers and anesthetics

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13
Q

Describe topically applied euthanasia agents. Which ones are US FDA approved?

A

Slow and variable, making it unacceptable for most species. Exceptions are animals with highly permeable skin to which nonirritating, rapidly absorbed agents are applied.
No US FDA approved agents.

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14
Q

Why is the oral route unacceptable as a sole means of euthanasia? (4)

A
  1. Lack of established drugs and doses
  2. Variability in agent bioavailability and rate of absorption
  3. Potential difficulty of administration
  4. Potential for agent loss through vomiting or regurgitation
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15
Q

Describe how barbituric acid derivatives cause death.

A

Depress CNS in descending order, beginning with cerebral cortex with loss of consciousness progressing to anesthesia. With an overdose, deep anesthesia progresses to apnea due to depression of the resp center, followed by cardiac arrest.

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16
Q

What is the most widely used barbituric acid derivative?

A

Sodium pentobarbital

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17
Q

What are advantages of barbiturates? (4)

A
  1. Speed of action; 2. Smooth euthanasia; 3. Less expensive than many other ET agents; 4. FDA-approved solutions are readily available
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18
Q

What are disadvantages of barbiturate use for euthanasia?

A
  1. Terminal gasp may occur in unconscious animals
  2. Some animals may go through an excitatory phase
  3. Tissue artifacts (splenomegaly)
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19
Q

What components make up tributame?

A

Embutramide, chloroquine phosphate, and lidocaine dissolved in water and ethyl alcohol. Denatonium benzoate added as a bittering agent.
Teal blue in color

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20
Q

What is tributame approved by the FDA for?

A

IV euthanasia of dogs as a schedule III controlled substance.

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21
Q

What is the method of action of embutramide? Why was chloroquine phosphate and lidocaine added?

A

Embutramide is a derivative of gamma-hydroxybutyrate. Chloroquine phosphate, a drug with profound CV depressant effects, was added to shorten the time until death. Lidocaine was added to eliminate the response to IV injection of the drug experienced by cats. The addition of both drugs also lowered the dose of embutramide needed for anesthesia.

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22
Q

How does tributame cause death?

A

Severe CNS depression, hypoxia, and circulatory collapse

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23
Q

What is the major reason tributame is not used for euthanasia?

A

It is not available.

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24
Q

What are the components of T-61? What is the impact of each?

A

Embutramide, mebozonium (mebenzonium ) iodide, and tetracaine hydrochrloide.
Embutramide - Narcosis and resp depression
Mebozonium - Nondepolarizing muscular paralysis

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25
What is a concern regarding the MOA of the components of T-61? What has research shown?
Concern that paralytic effect of mebozonium occurs before embutramide-induced unconsciousness. Electrophysiologic studies have shown that loss of consciousness and motor activity occur simultaneously.
26
Why is T-61 no longer available in the US?
Animals demonstrate muscular activity and vocalization on injection, which may be similar to the dysphoria stage seen on induction, but is still distressing to personnel who witness it. Thus, T-61 was voluntarily pulled from the market and is no longer available in the US, but is available in Canada and other countries.
27
What component of IV barbiturate euthanasia is not seen in animals euthanized with T-61?
Terminal/agonal gasps
28
How must T-61 be given to avoid dysphoria prior to unconsciousness?
Slow injection IV
29
What ultrapotent opioids have been used to euthanize? What are they FDA approved for? What is their potency relative to morphine sulfate?
Etorphine hydrochloride and carfentanil citrate Approved for immobilization of wildlife 10,000x more potent
30
How do ultrapotent opioids cause death?
Act on mu opioid receptors to cause profound CNS depression with death secondary to resp arrest.
31
What are unique routes of administration of ultrapotent opioids compared to other methods of euthanasia?
IM and transmucosally
32
How are dissociative agents and alpha2-adrenergic receptor agonists used in euthanasia?
Induce loss of consciousness and sometimes muscle relaxation. May be given prior to minimize animal distress, facilitate restraint, and provide a more aesthetic environment for owners. May be given as an overdose, but the doses that consistently produce death have not been established.
33
When can potassium chloride, magnesium chloride, or magnesium sulfate be used for euthanasia?
IV or intracardiac in an animal that is unconscious or under general anesthesia.
34
How does potassium cause death when used as a euthanasia agent?
Potassium ion is cardiotoxic and causes cardiac arrest.
35
When are potassium chloride and magnesium salts primarily used?
Injectable technique for livestock or wildlife species that may reduce the risk of toxicosis for predators or scavengers.
36
What is an alternative route of use for magnesium salts? How does it cause death when provided via this route?
Mixed in water and used as an immersion agent for some aquatic invertebrates. Induces death through suppression of neural activity.
37
What are the disadvantages of potassium chloride or magnesium salt euthanasia?
Rippling of muscle tissue and clonic spasms may occur upon or shortly after injection, they are not approved by the FDA for euthanasia, and saturated solutions are required to obtain suitable concentrations for rapid injection in large animals.
38
What is the full name of chloral hydrate?
1,1,1-trichloro-2,2,-dihydroxyethane.
39
How was chloral hydrate historically used?
In combination with magnesium sulfate and sodium pentobarbital as an economical anesthesia and euthanasia agent for large animals, now rarely used for this in vet med.
40
How is alpha-chloralose different from chloral hydrate?
A longer-acting derivative that has been used for anesthesia of lab animals, particularly for study of cerebrovasculature.
41
Describe anesthesia and euthanasia by chloral hydrate and alpha-chloralose.
When given IV, almost immediate sedative action, but unless combined with other anesthetics the onset of anesthesia is delayed. Death from hypoxemia resulting from progressive depression of the resp center and may be preceded by gasping, muscle spasms, and vocalization.
42
What were the two main advantages to the use of chloral hydrate?
1. Inexpensive 2. Schedule IV
43
What are the disadvantages of the use of chloral hydrate?
1. Depresses the cerebrum slowly, so restraint may be an issue 2. No longer available as an FDA-approved drug in the US, so it must be compounded from bulk drug
44
How do alcohols induce euthanasia?
Increase cell membrane fluidity, alter ion channels within neural cells, and decrease nerve cell activity. Induce death through nervous system and resp depression, resulting in anesthesia and anoxia.
45
How have alcohols been used in euthanasia?
In some fish species and as primary injectable euthanasia agents in lab mice 35 days of age and older. Young mice experienced prolonged time to death. Not for rats due to volume of alcohol required and prolonged time to resp effects.
46
What alcohol is used as an anesthetic agent in lab rodents?
Tribromoethanol. Not commercially available as a pharmaceutical grade product and must be compounded
47
What is tricaine methanesulfonate FDA approved for?
Tempraory immobilization of fish, amphibians, and other aquatic, cold-blooded animals.
48
What is MS-222 a derivative of?
Benzoic acid.
49
When does MS 222 need to be replaced?
Monthly, and any time a brown discoloration is noted.
50
How is potency of MS 222 impacted by water temperature?
Potency is increased in warm water and decreased in cold water.
51
What is the withdrawal time for MS 222 in the US?
21-day withdrawal.
52
How does MS 222 cause death?
Rapidly enters the CNS and alters nerve conduction through blockade of voltage-sensitive sodium channels. Also accumulates in ventricular myocardium and results in decreased CV function. Death due to decreased nervous and CV function.
53
How can MS 222 be used for euthanasia of frogs?
Immersion in 5g/L required at least one hour of immersion. Intracoelomic injection at the highest possible dose did not result in reliable euthanasia.
54
How can MS 222 be used for euthanasia of reptiles?
2-stage method, whereby the first step entails intracoelomic injection with loss of consciousness, followed by a second injection of unbuffered MS 222
55
What type of water is MS 222 soluble in?
Both salt and fresh
56
Why can MS 222 not be administered to fish via injection?
Rapid excretion via the gills renders it ineffective
57
Occupational exposure to MS 222 is associated with what?
Retinal toxicity
58
What is the impact of MS 222 residues in euthanized fish on the environment and scavengers?
Undetermined
59
How is benzocaine hydrochloride used?
Anesthesia or euthanasia of fish or amphibians. Topical application of 7.5% or 20% product on an amphibian's ventrum.
60
What is the method of action of benzocaine hydrochloride?
Similar to MS 222 - Blockage of voltage-gated sodium channels within the CNS and heart, resulting in depression of the nervous and CV system
61
What risk does benzocaine hydrochloride pose to the environment?
Little risk, as it is readily filtered by use of activated carbon and breaks down in water w/i 4h
62
How must benzocaine base be prepared?
Not water soluble, and must be prepared as a stock solution with acetone or ethanol, which can be irritating to tissues
63
What essential oils do cloves contain?
Eugenol, isoeugenol, and methyeugenol. Eugenol predominant
64
How is eugenol classified?
"Generally regarded as safe" food additive by the FDA and an exempted least-toxic pesticide active ingredient by the US EPA
65
How does eugenol compare to MS 222?
Eugenol has a more rapid induction, prolonged recovery, and narrow margin of safety.
66
What is the mechanism of action of clove oil?
Poorly studied, but appear to act similarly to other local anesthetics with inhibition of voltage-sensitive sodium channels w/i the nervous system. May cause paralysis in addition to anesthetic effects.
67
Can animals euthanized with clove oil be used for human consumption?
No
68
What is 2-phenoxyethanol used for?
Anesthesia and euthanasia of fish
69
How is the solubility of 2-phenoxyethanol impacted by water temperature?
Solubility is reduced in colder water
70
What is the mechanism of 2-phenoxyethanol?
Poorly understood, but death is thought to occur from hypoxia secondary to CNS depression.
71
What behavior can 2-phenoxyethanol cause?
Some species exhibit hyperactivity prior to loss of consciousness.
72
How must quinaldine be prepared prior to use in euthanasia?
Has a low solubility in water, so must be first dissolved in acetone or alcohol and buffered with bicarbonate.
73
How does quinaldine act?
Depression of sensory centers of the CNS.
74
What is metomidate? How does it act?
Highly water-soluble, nonbarbiturate hypnotic. Causes CNS depression. Acts rapidly when used at 10x the upper limit of the recommended anesthetic dose.
75
How is metomidate currently listed?
As a fish sedative and anesthetic in the FDA Index of Legally Marketed Unapproved New Animal Drugs for Minor Species, which prohibits off-label use
76
How does bleach act?
Sodium hypochlorite and calcium hypochlorite act as solvents and oxidants in tissue, resulting in saponification of fatty acids, denaturation of proteins, and derangement of cellular processes.
77
How does formaldehyde act?
Causes cellular damage through oxidative injury and formation of cross-linkages with DNA, RNA, and proteins.
78
How can formaldehyde be used?
Euthanize and preserve Porifera
79
How does lidocaine hydrochloride act?
Blocks the movement of sodium into the cell, resulting in failure of nerve conduction due to inability to generate action potentials. Additional alteration of nerve transmission occurs due to lidocaine-induced inhibition of G-protein-coupled receptors and N-methyl-D-aspartate receptors.
80
Why are local anesthetics incorporated into IV barbiturate or embutramide-based euthanasia solutions?
Cardiodepressant effects.
81
What occurs when lidocaine is administered intrathecally to anesthetized animals?
Relatively rapid loss of cerebrocortical function
82
What is an advantage of lidocaine anesthesia?
Leaves relatively low tissue residues and is not expected to pose hazards to scavenging animals
83
What agents are unacceptable for use as euthanasia agents in conscious vertebrates?
Magnesium sulfate, potassium chloride, and neuromuscular blocking agents.

Euthanasia Guidelines (4 decks)

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