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Pre Meds Flashcards

1
Q

What are the reasons for pre-medicating a patient?

A

Calms patient, Analgesia and muscle relaxation, Anesthetic/MAC sparing, Improved vital system stability, Improved recovery

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2
Q

What are the routes of administration for pre-medication?

A

SQ, IM, IV, PO

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3
Q

Name some sedatives and tranquilizers used for pre-medication.

A
  • Alpha 2 agonists
  • Phenothiazines
  • Benzodiazepines
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4
Q

What types of analgesics are commonly used in pre-medication?

A
  • Opioids
  • NSAIDs
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5
Q

What are the muscle relaxants mentioned for pre-medication?

A
  • Benzodiazepines
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6
Q

What are the two main anticholinergics used?

A
  • Atropine
  • Glycopyrrolate
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7
Q

What is the mechanism of action for anticholinergics?

A

Inhibit the parasympathetic nervous system by being competitive antagonists to acetylcholine at postganglionic muscarinic receptors in the PNS

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8
Q

What are the indications for using anticholinergics during anesthesia?

A
  • Increasing heart rate
  • Treat or prevent anesthetic or preanesthetic bradycardia
  • Reduction of salivary/airway secretions
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9
Q

What are the contraindications for using anticholinergics?

A
  • Tachycardia
  • Congestive heart failure
  • Glaucoma
  • Constipation/Ileus
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10
Q

What are the general effects of benzodiazepines?

A
  • Sedation/hypnosis
  • Muscle Relaxation
  • Anti-convulsant
  • Reduction of induction drug dose
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11
Q

What neurotransmitter do benzodiazepines enhance the effects of?

A

GABA (Gamma aminobutyric acid)

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12
Q

What is the duration of sedation for Xylazine?

A

20-40 minutes

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13
Q

What are the effects of opioids on the body?

A
  • Strong analgesia
  • Sedation
  • Respiratory and cardiovascular depression
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14
Q

What are the classifications of opioids?

A
  • Pure agonists
  • Partial agonists
  • Mixed action
  • Pure antagonists
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15
Q

What is the primary action of mu receptors?

A

Strong analgesia and sedation

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16
Q

Fill in the blank: Opioids are the strongest available _______.

A

systemic analgesics

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17
Q

Which opioid has a longer duration and slower onset compared to others?

A

Buprenorphine

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18
Q

What are the adverse effects of opioids?

A
  • Respiratory Depression
  • Excitement or Dysphoria
  • GI disturbances
  • Histamine release
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19
Q

What is the duration of action for Naloxone?

A

Approximately 30 minutes

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20
Q

True or False: Acepromazine has a specific reversal agent available.

A

False

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21
Q

Name two adverse effects of Acepromazine.

A
  • Hypotension
  • Hypothermia
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22
Q

What is the effect of alpha 2 agonists on the respiratory system?

A

Increased upper airway resistance and lung edema

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23
Q

What is the effect of opioids on the induction drug requirements?

A

Decreases other anesthetic drug requirements

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24
Q

What is a significant contraindication for the use of alpha 2 agonists?

A

Cardiovascular compromised patients

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25
Fill in the blank: Benzodiazepines are used as muscle relaxants to counter _______ muscle rigidity.
ketamine
26
What is the difference between atropine and glycol?
Atropine is lipid, soluble, easily absorbed and crosses the blood brain barrier and placenta barrier
27
What does SLUDD stand for?
Salvation, lacrimation, urination, defecation, and digestion
28
What are other indications of anticholinergics
Bronchodilation, my dresses, decrease GII motility, relaxation of lower esophageal, sphincter, organic phosphate toxicity
29
What should you not use in rabbits
Atropine
30
What are the benzodiazepines?
Diazepam, midazam, zolazepam
31
What are the effects of benzodiazepines?
GABA–ergic effects (GABA receptor agonist)
32
What are the main effects of benzodiazepine?
Sedation/hypnosis, muscle relaxation, anti-compulsion, reduction of induction drug dose
33
What are the benefits to benzodiazepine?
Minimal cardiovascular and respiratory effects, paradoxical excitement
34
What are the cons of benzodiazepine?
No analgesic effect
35
What does GABA stand for?
Gamma aminoButyric acid
36
What is a GABA receptor?
Main inhibitory neurotransmitter in the CNC
37
What is the clinical application for benzodiazepine as a pre-med
Like analgesic and strong sedative effects; must be combined, normally used in compromise. Animals were alpha two agonist or ace are contraindicated.
38
What are the clinical applications for benzodiazepine immediately prior to induction?
Combine with potent opioids for ASAIV or higher animals, as muscle relaxants to counter ketamine muscle rigidity
39
What is the difference between diazepam and midazolam
Midazolam is compatible with other drugs, more potent, longer acting
40
What are the phenothiazine’s?
Ace promazine, promazine, propiopromazine, chlorpromazine, methotrimeprazine
41
What are indications of phenothiazines
Mild sedation, can reduce opioid induced emesis, treatment of opioid induced/wind up pain associated dysphoria, analytic prior to alpha two Agnes sedation and the horse
42
What are the general effects of ace promazine
Dose dependent CNS depression with ceiling effect, much weaker sedative, compared to Alpha two adrenergic receptor agonist, X as antagonist and multiple receptors, some muscle reaction, anti-emetic, anti-Mo, 4 to 8 hour duration of effect
43
Is there a reversal agent for ace promazine?
No
44
What are adverse effects of as promazine?
Hypertension, massive, peripheral, vasodilation, mainly to death in hypo fully animals, hypothermia, penile prolapse in stallions and bulls
45
What are contraindications of ace promazine?
Hypovolemic, von Willebrand, disease, hypothermia, neonatal, or geriatrics, boxers, brachycephalic breeds, breeding ceilings
46
What are alpha two adrenergic receptor agonist
Xylazine, medetomidine, dex medetomidine, detomidine, romifidine
47
What are general effects of alpha two energetic receptor agonist
Frequently used in both large and small and well, profound dose, dependent sedation, hypnosis, and anesthesia, can reduce GA requirements by 50 to 80%, analgesia, muscle relaxation
48
What are other effects of alpha two allergenic receptor agonist?
Respiratory system, increase upper airway resistance, along edema, G.I. system, alters, motility, diuresis , thermal regulatory center, depression, hypoinsulinemia, abortions in second trimester
49
What is the method of action for alpha two adrenergic receptors
Stimulate the sympathetic nerves found throughout the body, sedation, analgesia, reduction of sympathetic outflow from the brain
50
What are key things about xylazine?
Used most in horses and cattle, cattle are more sensitive, needing 10 times less than the horse dosing
51
What is the reversal for dexmedetomidine
Antiseden
52
Doe’s dexmedetomidine have a ceiling
No
53
What are key things about dexmedetomidine
Mostly used in small animals, degree of sedation is highly dosed dependent, higher the dose, more sedation, but more risk of adverse effects, dose can be reduced by combining with other drugs, such as opioids, adverse effects are greatly reduced, if administered to CRI, tend to avoid an CV compromise patients, decreases tear product production
54
What is an example of a schedule one drug
Heroin
55
What are examples of schedule two drugs
Hydrocodone, methadone, hydromorphone, meperidine, oxycodone, fentanyl
56
What are examples of schedule three drugs?
BuperMorphine, ketamine
57
What are examples of schedule four drugs?
Tramadol, butorphanol
58
What are the math mechanisms of action for opioids?
Opioid receptors are the side of action, strongest available, systemic analgesic, best for acute pain, greatly reduced doses of concurrently used in aesthetics, minimum CV effects, suitable for SAIII – IV patient
59
What are the effects of receptor types for opioids?
MU – strong analgesia and sedation Respiratory NCV, depression, nausea, vomiting, euphoria Kappa – weak analgesia sedation or dysphoria
60
What is a pure agonist opioid?
Maximum stimulation of MU receptors
61
What are examples of pure agonist?
Morphine, hydromorphone, methadone, fentanyl, oxymorphone, heroin, codeine
62
What is a partial agonist?
Partially stimulates MU receptors
63
What is a example of a partial agonist?
Buprenorphine
64
What is a mixed action opioid?
Agonist at Capa, antagonist at MU
65
What is an example of a mixed action opioid?
Butorphanol
66
What is a pure antagonist opioid?
Fully antagonize MU receptors
67
What are example examples of pure antagonist opioids
Naloxone, naltrexone
68
True or false opioids will compete for receptors when administered together
True
69
What is potency?
Compare effect versus dose required to achieve the effect among drugs
70
What is efficacy?
Compares the strength or severity of the fact, attainable amongst drugs
71
What are things to know about buprenorphine and butorphanol?
Complex pharmacological affects, analgesia plateaus at higher doses, limited to treating mild to moderate pain
72
What are general effects of partial agonist/antagonist opioids
Analgesia, excellent for acute pain, not ideal for chronic, sedation, decreases other anesthetic drug requirements, antitussive effect
73
What are adverse effects of partial agonist/antagonist opioids
Respiratory depression, excitement, or dysphoria, hyper anesthesia, G.I. disturbances, histamine release
74
What are opioid indications?
Premedicate, preoperative analgesia
75
What are things to know about morphine?
Widely used analgesic, effective form to severe pain, half life around 60 minutes
76
What are adverse effects of morphine?
Vomiting, constipation, and decreased urine output
77
What is hydromorphone?
Similar to morphine, more potent, but similar duration of action, no histamine release, vomiting, postop hyperthermia
78
What is fentanyl?
For a new agonist, more potent analgesia than morphine, short, duration of action, popular for induction combine with benzos in compromise, canines, no nausea/G.I. signs or histamine release
79
What is the duration of action for fentanyl?
20 to 30 minutes
80
What is buprenorphine?
Partial MU agonist, weaker Algea, ceiling effect, MU opioid receptors have higher affinity for bupe than other pure MU agonist
81
What is buprenorphine onset and duration?
20 to 40 minutes onset, 68 hours duration
82
What is butorphanol?
MU antagonist, Kepa, agonist, weak energy, ceiling effects, stronger, sedation effect
83
Should butorphanol be mixed with pure amuse
No
84
True or false, good sedation for respiratory distress patients to calm them down to allow examination/radiographs you would use butorphanol
True
85
What is naloxone
Pure MU antagonist, commonly used for emergency reversal of opioid effects in case of emergencies, apnea, severe Brady cardio, hypertension
86
What is the duration of action for naloxone
30 minutes

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