Pre-med Drugs Flashcards

1
Q

Acepromazine MOA

A

Phenothiazine sedative

Dopamine antagonist

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2
Q

Acepromazine Use

A

Tranquilizing/sedative
Antiemetic
Antispasmodic
Hypothermic

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3
Q

Acepromazine disadvantages

A

No analgesia
Can cause Hypotension
Avoid in animals prone to seizures (CNS stim and aggression)

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4
Q

Atropine MOA

A

Antimuscarinic

Inhibits ACh or other cholinergic stimulants at parasympathetic sites

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5
Q

Atropine Use

A

Preanesthetic to prevent or reduce resp secretions

Treat sinus bradycardia, SA arrest, incomplete AV block

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6
Q

Atropine Disadvantages

A

Contraindicated in certain conditions: narrow angle glaucoma, tachycardia, ileus, UO
Adverse effects: Dry secretions, initial bradycardia then tachycardia, slowed gut and urinary tract, mydriasis

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7
Q

Buprenorphine (Buprenex) MOA

A

Partial mu opiate agonist

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8
Q

Buprenorphine Use

A

Injectable analgesic, good in cats. Can admin transmucosally
Well tolerated
Mild to moderate pain

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9
Q

Buprenorphine Disadvantages

A

Can decrease BP and HR

Resp depression possible

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10
Q

Butorphanol (Torb) MOA

A

Partial opiate agonist/antagonist

Will antagonize full agonists (morphine, meperidine, oxymorphone)

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11
Q

Butorphanol Uses

A

Analgesic, premed, antitussive, or antiemetic
Minimal analgesia, good for non-painful procedures
Reversal for full mu agonists

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12
Q

Butorphanol Disadvantages

A

Contraindications: Liver dz, hypothyroidism, renal insufficiency, Addison’s, Head trauma, increased CSF pressure (most opioids)
Reduce Dose in MDR1 mutation dogs
Adverse effects: sedation, ataxia, anorexia, diarrhea (rare)

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13
Q

Detomidine MOA

A

Alpha-2 adrenergic agonist

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14
Q

Detomidine Uses

A

Sedative analgesic used primarily in horses

More potent than xylazine

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15
Q

Detomidine Disadvantages

A

Contraindications: heart block, cerebrovascular and resp Disease, CKD
Initial BP increase, then bradycardia/heart block
Piloerection

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16
Q

Dexmedetomidine MOA

A

Alpha-2 adrenergic agonist

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17
Q

Dexmedetomidine Uses

A

Preanesthetic, sedation and analgesia

Emetic in cats

18
Q

Dexmedetomidine Disadvantages

A

Contraindications: cardiac dz, liver/kidney dz, shock, severe debilitation, stressed animals, caution with seizure disorders
Adverse effects: bradycardia, AV block, decreased resp, hypothermia

19
Q

Diazepam (Valium) MOA

A

Benzodiazepine
Depress CNS subcritical levels (lambic, thalamic, hypothalamic)
Binds to GABA receptors and increases affinity of receptor for GABA, causing hyperpolarization

20
Q

Diazepam Uses

A

Anxiolytic, muscle relaxant, hypnotic, appetite stimulant, anticonvulsant
Decreases amount of induction agents needed, like propofol

21
Q

Diazepam Disadvantages

A

Can cause thrombophlebitis, hypotension, agitation, ataxia, sedation
May have contradictory CNS excitation
Can cause hepatotoxicity in cats
Use caution in p with hepatic or renal Disease, debilitated, geriatric

22
Q

Glycopyrrolate MOA

A

Anticholinergic (antimuscarinic)
Competitively inhibit ACh at parasympathetic neuroeffector sights
High doses may block nicotinic receptors
Dose dependent effects

23
Q

Glycopyrrolate Uses

A

Used for premed, bradycardia, antidote
May be useful in animals where CO is dependent on HR or when potent opioids are used
Tx bradycardia, siniatrial arrest, incomplete AV block
Simultaneously admin with cholinergic (neostigmine) to prevent peripheral muscarinic effects

24
Q

Glycopyrrolate Disadvantages

A

Contraindications: narrow angle glaucoma, tachycardia, ileus, UO
Adverse effects: dry secretions, initial bradycardia then tachycardia, slowing of gut and urinary tract, mydriasis

25
Q

Hydromorphone MOA

A

Opiate sedative/analgesic

Receptors in lambic system, spinal cord, thalamus, hypothalamus, midbrain, GI, Urinary, smooth muscle tissues

26
Q

Hydromorphone Uses

A

Sedative, restraining agent, analgesic, preanesthetic
Less sedating than morphine
Minimal histamine release
Rarely causes vasodilation or hypotension

27
Q

Hydromorphone Disadvantages

A

Dogs: nausea, vomiting, defecation, panting, focalization, sedation. CNS depression, resp depression, bradycardia, decreased GI motility

Cats: nausea common, ataxia, hyperesthesia, hyperthermia, behavioral changes

28
Q

Methadone MOA

A

Opioid/Narcotic agonist

Mu opioid receptor agonist, also non-competitive inhibitor of NMDA receptors

29
Q

Methadone Uses

A

Preanesthetic or analgesic in dogs or cats

Alternative to morphine, causes less histamine release, sedation, and vomiting than morphine

30
Q

Methadone Disadvantages

A

Caution with hypothyroidism, renal insufficiency, Addison’s, geriatric, severely debilitated patients
Extreme caution with head injuries, increased ICP, colic
Resp depression, vomiting, panting, whining, sedation, constipation

31
Q

Midazolam MOA

A

Parenteral benzodiazepine (injectable)
Depresses subcortical levels of CNS
Antagonist of serotonin, increased release of gaba, decrease turnover of ACh in CNS

32
Q

Midazolam Uses

A

Anxiolytic, sedative, skeletal muscle relaxant, anticonvulsant effects
Pre-op med
Can be given IM for sz
Best when used with other drugs, not a good premed alone

33
Q

Midazolam Disadvantages

A

Contraindications: acute narrow-angle glaucoma, hepatic or renal dz, geriatric/debilitated, coma, shock, resp depression
Adverse effects: resp depression, cats may get excited

34
Q

Morphine MOA

A

Classic opioid analgesic

Mu receptor agonist

35
Q

Morphine Uses

A

Analgesia, for acute pain and preanesthetic, sedation

Can be reversed with Naloxone

35
Q

Morphine Disadvantages

A

Caution: hypothyroidism, renal azotemia, adrenocortical insufficiency, geriatric/debilitated, head injuries, increased intracranial pressure, acute abdominal conditions(colic)
Adverse effects: histamine release, vasodilation, resp depression, bronchoconstriction, CNS depression, hyperthermia in cats, hypothermia in dogs, GI effects(nausea/vomiting)

36
Q

Romifidine MOA

A

Alpha-2 adrenergic agonist
A2receptors found in CNS and several tissues peripherally
Feedback inhibition of norepi release

37
Q

Romifidine Uses

A

Sedative, muscle relaxant, analgesic effects, preanesthetic

Horses as sedative and analgesic

38
Q

Romifidine Disadvantages

A

Horses: bradycardia, 1 and 2 degree heart block, sinus arrhythmias, initial hypertension followed by hypotension, ataxia, sweating, salivation, muscle tremors, urination, swelling of face, decreased GI motility
Dogs/cats: bradycardia, cardiac arrhythmias, hypotension, hyperglycemia, thermoreg problems, pant, salivate, vomit

40
Q

Xylazine

A

Alpha-2 adrenergic agonist
Less selective for a2 than detomidine, dex, or romifidine
Can have a1 activity

41
Q

Xylazine Uses

A

Sedative and analgesic
Emetic in cats

Reversed by yohimbine, atipamezole

42
Q

Xylazine Disadvantages

A

Caution with hypotension, shock, cardiac problems, resp dysfunction, seizure disorders
Adverse effects: muscle tremors, bradycardia with partial av block, reduced resp rate, movement in response to stimuli