pre anaesthetic drugs Flashcards
acepromazine drug class
phenothiazine
ace mode of action
dopamine receptor antagonist in the CNS
ace indication
Sedation
-muscular relaxation
-reduction in spontaneous activity
ace side effects
Hypotension
-Bradycardia
-Decreased tear production (cats)
ace Contraindications/ precautions/ warnings
-Hepatic, cardiac disease
-Aggressive animals
-Dogs with MDR1 mutation more profound sedation
-Most will require lower anaesthetic doses
midazolam drug class
benzodiazepine
midazolam mode of action
CNS depression results in muscle relaxation and sedation
-anxiolytic
midazolam indication
Premedication for GA
-Treatment of seizures
midazolam side effects
-Respiratory depression
-Can cause excitability in cats
midazolam Contraindications/ precautions/ warnings
Cautious use in sick/ debilitated patients
-Hypersensitivity
medetomindine drug class
a2-adrenergic agonist
medetomindine mode of action
blood pressure is initially increased due to peripheral (vesssels to arms/legs) vasoconstriction and thereafter drops to normal or slightly below normal levels
medetomidine indication
-sedation
-analgesia
medetomidine side effects
Bradycardia and hypotension
-Hypothermia
-vomiting
medetomidine Contraindications/ precautions/ warnings
Systemic disease (cardiac, respiratory, renal, hepatic)
-Can make aggression worse in some animals (rare)
atipamezole drug class
a2 adrenergic antagonist
atipamezole mode of action
Competitively inhibits α2- adrenergic receptors, thereby acting as a reversal agent for α2- adrenergic agonist
atipamezole indication
reversal of sedation
atipamezole side effects
-Vomiting and diarrhoea
-Hypersalivation
-Tremours
-excitation
atipamezole Contraindications/ precautions/ warnings
Not recommended in pregnant or lactating animals
-Caution in elderly or debilitated animals
tiletamine-zolazepam drug class
NMDA antagonist- benzodiazepam
Tiletamine- zolazepam (a.k.a zoletil)* mode of action
Injectable anaesthetic/ tranquiliser combination
Tiletamine- zolazepam (a.k.a zoletil)* indication
Dissociative anaesthetic
-Analgesia
-Protective reflexes retained (eg. Swallowing)
-Good for short, minor painful procedures
Tiletamine- zolazepam (a.k.a zoletil)*side effects
Ptyalism (hypersalivation)
-Respiratory depression
-Tachycardia
Tiletamine- zolazepam (a.k.a zoletil)*Contraindications/ precautions/ warnings
Pancreatic disease
-Renal disease
-Severe cardiac and respiratory disease
-Pregnant animals
which of the sedative drugs are reversible
medetomidine (meds think)
which of the drugs are controlled
all
what type of receptors are opioid receptors
G-protein coupled receptors
what are the two different types of opioid receptors
μ (Mu) receptor- PAIN
κ (Kappa) receptor- SEDATION
methadone drug class
opioid agonist
methadone mode of action
Full μ (mu)- agonist
Powerful analgesic; minimal sedation
Lasts 4-6 hours
methadone indication
Often used pre- anaesthetic in combination with ACP
-pain
methadone side effects
Panting
Whining
Sedation
Cardiorespiratory depression
methadone Contraindications/ precautions/ warnings
Pancreatic disease
Renal disease
Severe cardiac and respiratory disease
Pregnant animals
can methadone be reversed and is it controlled drug
reversable drug and is a controlled drug
naloxone drug class
opioid antagonist
naloxone mode of action
μ (mu)- and κ (kappa)- antagonist
Cometitivelty binds to opioid receptor sites
Reverses respiratory and CNS depression associated with overdoses of opioids
naloxone indication
opioid overdose
naloxone side effects
may reverse analgesic effect
naloxone Contraindications/ precautions/ warnings
Caution in cardiopulmonary disease
Known hypersensitivity
is naloxone reversable and controlled
non reversable, controlled
drug class of atropine
anticholinergic
atropine mode of action
Competitively inhibits acetylcholine in neurons (to increase heart rate).
Low doses- inhibit salivation and bronchial secretions
Moderate doses- pupil dilation, increases HR
atropine indications
hypersalivation
bradycardia
atropine side effects
Dry mouth, thirst
Pupil dilation
CNS stimulation-> seizures
atropine Contraindications/ precautions/ warnings
Some eye conditions
Cardiac disease
Known GI infections
Caution with systemic disease
is atropine reversable or controlled
no for both
buprenorphine drug class and mode of action
drug class: opiod drug
mode of action: partial u agonist
provides analgesia for mild-moderate pain
lasts 6-8hrs
minimal pain relieft (usually for exotics,cats)
butorphanol drug glass and mode of action
drug class: opiod
mode of action: u antagonist, partial k agonist
provides anagesia for mild pain, some sedation
analgesia: 1hr
sedation: 2-4 hr
why are drug protocol necessary (FYI)
-standard approach to anesthesia for the clinic
-ensure patient is provided suffucent analgesia and tranquiliser/sedation
-protocols are based on published drug info (doses, indication and precautions) ensuring better safety for patients (alr tested so we know the possible side effects)
when is healthy patient protcol used and the different pre med combi
ASA status 1-2
patients undergoing elective/ routine procedures (spay/casteration)
not agrresive
combi 1: acepromozine (sedation) + methadone (analgesia)
combi 2: medetomidine (sedation+ mild analgesia) + methadone (analgesia) +/- atrophine (hypersalivation/bradycardia)
how long does pre med take to take effect
15-30 mins, need to wait so can have full effect, less GA needed
what is a sick/debilitated pet protocol and the drug combi
ASA status: II-IV , high anesthetic risk
-may need to provide o2 is have respiratory disease
examples of patients: cardiac, respiratory, renal, heaptic disease, emmergency, geriatric
combi 1: midazolam (sedation) + butorphanol (mild sedation, analgesia)
combi 2: methadone (analgesia) (heart disease, no sedation but comportable)
What is fractious pet protocol and the drug combin
ASA status I-II
No ACE
Combi 1: tiletamine zolazepam (sedation+ dissociative) + butorphanol (mild sedative, analgesia)
Combi 2: Medetonidine (sedation) , butorphanol (analgesia, mild sedation) , ketamine (dissociative anesthetic)
Cats: kitty magic: medetonidine, butorphanol, ketamine (different dose than dogs, slightly higher)
