Premed

Question 1

Describe the action, function and uses of Alpha 2 Agonists (give examples)

Answer 1

= Sedative and Analgesic

e. g. xylazine, medetomidine, dexmedetomidine (most selective = safest)
- Synergistic effects with opioid (reduced a2a required)
- Biphasic effect on blood pressure (increase then back to normal)
- Reduced cardiac output (reduced blood flow to the liver and therefore drug metabolism rates)
- Increased urine output = decreases vasopressin and renin production

Question 2

Describe the reversal of aplha 2 agonists

Answer 2

Atipamezole - a 2 antagonist, should be administered IM for smooth recovery

Question 3

What can alpha 2 agonists be used for

Answer 3

Standing sedation and ASA class 1, 2 and 3 
(can be used alongside, Opioid, BZD, Ketamine)

Question 4

Describe the action of Phenothiazines including examples

Answer 4

= Sedation and Anxioxylis
e.g. Acepromazine
- Requires analgesic (opioid)
- Alpha 1 adrenoreceptor agonist = peripheral vasodilation
NOT FOR USE WITH PATIENTS WITH MARKED CVS DISEASE
- Long lasting and non reversible
- Antiarrhythmic properties

Question 5

Describe the contraindications of Phenothiazines

Answer 5

Not to be used with patients with marked CVS disease

Not to be used in large dogs and breeding stallions

Question 6

Describe the action of Benzodiazepines

Answer 6

= Muscle relaxant, Anxiolxylis
GABA receptor agonist = CNS depression
- Minimum to no sedation in healthy animals
- Given in combination with another sedative (e.g. opioids)

Question 7

What is an ASA category 1 animal and how would you premed it?

Answer 7

= Healthy animal having an elective procedure

Admin: Acepromazine/Meditomidine (cats)

Question 8

What is an ASA category 2 animal and how would you premed it?

Answer 8

= Systemic disease with no clinical signs
Admin: Acepromazine and opioid (cats)
Dexmedetomidine if not CVS

Question 9

What is an ASA category 3 animal and how would you premed it?

Answer 9

= Systemic disease, minor clinical signs

Admin: Acepromazine/BZD (both with opioid) - BZD more CV friendly

Question 10

What is an ASA category 4 animal and how would you premed it?

Answer 10

= Systemic disease and clinical signs

Benzodiazepine and opioid (or ketamine with cats)

Question 11

What is an ASA category 5 animal and how would you premed it?

Answer 11

= Not expected to survive

Low dose benzodiazipine and opioid (or ketamine with cats)

Question 12

What is an ASA category 6 animal and how would you premed it?

Answer 12

= Brain dead

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