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Anesthesia > Pharmacology II: Sedatives & Induction Agents > Flashcards

Pharmacology II: Sedatives & Induction Agents Flashcards

1
Q

Phenothiazine
Drug: Acepromazine
Action: (2)
Possible side-effects: (6)

A
  1. Action:
    - Tranquilizer –> sedation, antiemetic
    - No analgesia!
  2. Side effects:
    - Hypotension/hypothermia
    - Prominent nictitans membrane
    - Prolonged sedation (6-8hrs)
    - Penile prolapse
    - Idiosyncratic aggression
    - Increased risk for seizures historically reported (not confirm w/follow up studies)
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2
Q

Common sedatives used before surgery (4)

A
  1. Phenothiazines
  2. Benzodiazepines
  3. Alpha2 agonists
  4. Opiates
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3
Q

Phenothiazines should not be given to patients… (7)

A

With…
1. Epilepsy or Hx of seizures
2. Liver disease
3. Heart disease
Who are…
4. Geriatric or pediatric
5. In dehydration/hypotension/shock
6. Breeding stallions (penile prolapse)
7. Receiving eye exams

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4
Q

Benzodiazepines
The drugs (4)
Action (3)

A
  1. Drugs:
    - Diazepam (valium)
    - Midazolam (versed)
    - Alprazolam (xanax)
    - Zolazepam (part of telazol)
  2. Action:
    - Tranquilizer
    - Muscle relaxant
    - Antiseizure by enhancing GABA effects in brain
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5
Q

Benzodiazepines
Advantages: (4)
Possible side effects: (4)

A
  1. Advantages:
    - Reversal agent (flumazenil)
    - Min depression of resp or cardio systems
    - Short-acting (20min)
    - Can be combined with ketamine or tiletamine
  2. Side effects:
    - Appetite stim
    - Liver failure if given orally to felines
    - Hypotension if IV inj too rapid
    - Diazepam is painful & not well absorbed if given IM
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6
Q

Alpha2 Agonistis
The drugs: (3)
Actions: (2)

A
  1. Drugs:
    - Xylazine (rompun)
    - Dexmedetomidine (dexdomitor)
    - Medetromidine (domitor)
  2. Action:
    - Sedative that decreases norepinephrine release (inhibits sympathetic nerve system)
    - Analgesia (shorter than sedation)
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7
Q

Alpha2 Agonist
1. Possible side effects: (5)
2. Reversal agent: (2)

A
  1. Side effects:
    - Profound bradycardia; AV heart block
    - Maintains BP thru vasoconstriction
    - Vomiting (esp cats)
    - Risk of bloat in deep chested dogs
    - Cattle very sensitive
  2. Reversal:
    - Yohimbine
    - Atipamezole
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8
Q

T/F: Use of Alpha2 Agonist is mostly limited to healthy, young dogs & horses being closely monitored

A

True

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9
Q

Opioids
The drugs: (7+)
Action: (1)

A
  1. Drugs:
    - Butorphanol
    - Morphine
    - Buprenorphine
    - Hydromorphone
    - Oxymorphone
    - Hydrocodone
    - Codeine
    - Etc
  2. Action
    - Sedation & analgesia by binding to opiate receptors of CNS
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10
Q

Opioids
Possible side effects: (5)
Reversal agent: (1)

A
  1. Side effects:
    - Resp depression
    - Excitement if given rapidly IV
    - Excitement if used alone in cats or horses
    - Vomiting
    - Impaired thermoregulation
  2. Reversal
    - Naloxone (narcan)
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11
Q

Induction Agents are drugs used to…
They are sometimes used alone for…

A
  1. Facilitate smooth & rapid transition from consciousness to unconsciousness
  2. Short anesthetic procedures
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12
Q

Injectable vs Mask Down
FYI: Quiz question!!

A
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13
Q

Induction agents (5)

A
  1. Alfaxalone
  2. Propofol
  3. Barbiturates
  4. Dissociative agents (ex keta)
  5. Guaifenesin
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14
Q

Alfaxalone (Alfaxan)
Actions: (3)
Advantages: (3)

A
  1. Actions:
    - Neuroactive steroid: anesthesia by GABA enhancement
    - IV inj should be administered slowly over 60sec
    - Short acting anesthetic for both procedures & induction (IV & IM)
  2. Advantages:
    - Metabolized rapidly by liver
    - Cardiovascular sparing: heart safe
    - Safe to use as a continuous rate infusion
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15
Q

Alfaxalone
Disadvantages: (3)
Controlled substance or not?

A
  1. Disadvantages:
    - Apnea
    - Hyperexcitability on recovery (minimal)
    - Not analgesic
  2. Controlled substance
    - Schedule IV drug
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16
Q

Propofol
Actions: (3)
Advantages: (3)

A
  1. Actions:
    - Phenolic compound unrelated to any other general anesthetics
    - Not water soluble: soybean oil, egg lecithin, & glycerol
    - IV use only!!
  2. Advantages:
    - Good muscle relaxation
    - Quality of anesthesia good
    - Quality of recovery is excellent
17
Q

Propofol
Disadvantages: (5)

A
  1. Disadvantages:
    - No analgesia
    - If given rapidly, can cause apnea: pre oxygenate!!
    - Contains no preservative (except propofol28 - 28day it’ll last)
    - Only licensed for dogs
    - Use with caution in cats
18
Q

Barbiturates
Drugs: (3)
Action: (1)
Advantages: (3)

A
  1. Drugs
    - Thiopental (ultra-short)
    - Pentobarital (short)
    - Phenobarbital (long)
  2. Action: Unknown
  3. Advantages
    - Least expensive inj anesthetics
    - No specialized equipment for administration
    - Rapid onset of action, provide predictable response, & rapid recovery following single dose administration.
19
Q

Barbiturates precautions when using ultra-short acting:
The drug must be given ___ because of its high alkaline pH and perivascular inj will cause tissue ___.
There is a small margin of safety between ___ and ___ dose, especially in debilitated patients.
___ and profound ___ depression following IV bolus inj often occur.

A
  1. IV
    - Only give with secured IV access
  2. Necrosis
  3. Effective
  4. Lethal
  5. Apnea
  6. Respiratory depression
20
Q

Barbiturates should not be used in ___ & ___ patients.
They are all ___ substances.

A
  1. Sighthounds
  2. Hypoproteinemic animals
    - Redistribution in brain vs fat stores
    - Poor liver metabolism
  3. Controlled
21
Q

Dissociative agents (2)

A

Ketamine
Tiletamine (telazol)

22
Q

Ketamine & Tiletamine
Action: (5)
In dogs, what is it often combined with? Horses?

A
  1. Action:
    - N-methyl-D-aspartate (NMDA) antagonist
    - Anesthesia
    - Amnesia
    - Catalepsy
    - Analgesia
  2. Combined with
    - Dogs: diazepam or midazolam
    - Horses: Xylazine or detomidine
23
Q

Ketamine & Tiletamine
Advantages: (3)
Disadvantages: (5)

A
  1. Advantages
    - Tend to maintain normotension
    - Analgesia achieved
    - Amnesia
  2. Disadvantages
    - Eyes open (w/nystagmus)
    - Hallucination or delirium w/o sedative used WITH it
    - Hypo-/hyperthermia
    - Can be hypertensive
    - Sting IM inj
24
Q

Guaifenesin is an intravenous central-acting ___ that potentiates anesthetic agents, commonly used in ___ animals.
It is also used as an ___ in small animals & humans.
This should be given through an ___ ___ because of risk of perivascular tissue ___.

A
  1. Relaxant
  2. Large
  3. Expectorant
  4. IV catheter
  5. Necrosis

Anesthesia (14 decks)

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