Premedication- Anticholinergics And Benzos

Question 1

What are the parts of the anesthetic procedure?

Answer 1

Premedication
Induction
Maintenance
Recovery

Question 2

What are the purposes of premedication?

Answer 2

Sedation, analgesia
Anesthetic sparing effect 
Reduction of stress and catecholarmine release 
Reduction of O2 demand 
Increased safety for animals 
Decreasing parasympathetic tone

Question 3

What are the drugs of premedication?

Answer 3

Anticholinergics 
A2 agonists 
Phenothiazines and butyrophone 
Benzodiazepines 
Opioids 
Muscle relaxants 
Antihistamines and antibiotics

Question 4

What is the MOA of anticholinergics?

Answer 4

Antagonist on muscarinic receptors

Question 5

What are the anticholinergic drugs?

Answer 5

Atropine and glycopyrrolate

Question 6

T/F: atropine crosses the BBB but glycopyrrolate does not

Answer 6

True

Question 7

Which is lipid soluble, atropine or glycopyrrolate?

Answer 7

Atropine -> absorbers well IM, SC, and PO

Glycopyrrolate is water soluble and absorbs slowly and has slower onset of action

Question 8

When is the use of atropine indicated?

Answer 8

Treatment of opioid induced bradycardia

Prevention/treatment of reflex bradycardia

Young animals and brachycephalic breeds - these animals have higher PSNS tone

Question 9

What are the contraindications to atropine?

Answer 9

Tachycardia
Hyperthyroid
Most heart disease
Narrow angle glaucoma

Question 10

What are the cardiovascular effects of anticholinergics?

Answer 10

2degree AV block, bradycardia, cardiac arrest

Tachycardia and hypertension

Question 11

What is a 2degree AV block?

Answer 11

Depolarization of the Pwave without conduction of a QRS complex
Prolonged PR interval

Question 12

T/F: medetomidine and atropine used together often cause vasoconstriction, tachycardia and hypertension

Answer 12

True

-we dont routinely combine these drugs

Co-administration of an a2 agonist and an anticholinergic is contraindicated

Question 13

What is the preferred anticholinergic in rabbits?

Answer 13

Glycopyrrolate

Rabbits have atropinase enzymes that quickly breakdown atropine

Question 14

What is the MOA of benzodiazepines ?

Answer 14

GABA receptor agonist

Question 15

What effects do benzodiazepines have?

Answer 15

Sedative, anticonvulsant, and muscle relaxant

Minimal CV and respiratory effects

Question 16

T/F: benzodiazepines have an analgesic effect

Answer 16

False

Question 17

What is the site of most anesthetics, Eg barbiturates and propofol?

Answer 17

GABA receptors

Question 18

Diazepam and midazolam are what type of drug?

Answer 18

Benzodiazepines

Question 19

What is the reversal agent of diazepam and midazolam?

Answer 19

Flumazenil

Question 20

In what species can benzodiazepines cause disorientation, or excitation when used alone?

Answer 20

Dog, cat, and horse

Question 21

For premedication benzodiazepines are usually combined with???

Answer 21

Opioids/ a2 agonists (or both)

Question 22

For induction benzodiazepines can be combined with??

Answer 22

Dissociative anesthetic (ketamine)

Barbiturate or propofol

Question 23

How should diazepam be administered?

Answer 23

IV slowly

DO NOT give IM, causes pain and has poor absorption

Question 24

T/F: oral diazepam in contraindicated in cats

Answer 24

True

Causes hepatotoxicity

Question 25

T/F: diazepam and midazolam have good chemical compatibility

Answer 25

False

Diazepam doesn NOT have good chemical compatibility

Midazolam DOES

Question 26

How can midazolam be administered?

Answer 26

IM or IV, or mucus membranes