Premeds

Question 1

What are the anticholinergics?

Answer 1

Atropine Glycopyrolate

Question 2

MoA anticholinergics

Answer 2

inhibit PSNS

antagonists on the muscarinic ach receptors

Question 3

Atropine solubility, absorbs, does it cross bbb and placenta?

Answer 3

lipid soluble
absorbs well IM SC PO
crosses bbb and placental barrier

Question 4

Glycopyrrolate solubility, absorbs, does it cross bbb and placenta?

Answer 4

water soluble
absorbs slowly im sc po (slower than atropine, even IV)
does NOT cross bbb and placental barrier

Question 5

Indications for anticholinergics?

Answer 5

Increase HR

Decrease salivation and bronchial secretion

Question 6

Contraindications for anticholinergics

Answer 6

tachycardia, hyperthyroidism, most heart dz’s (except to tx bradycardia), narrow angle glaucoma

Question 7

CV side effects for Anticholinergics

Answer 7

2nd degree AV block, bradycardia, cardiac arrest

tachycardia, hypertension

Question 8

Can rabbits get atropine?

Answer 8

No, they have a lot of atropinase enzyme so they break it down, need glycopyrrolate

Question 9

A2 agonists MoA

Answer 9

competitive agonist of a2 adrenergic receptors

Question 10

What are the CNS effects of A2 agonists?

Answer 10

sedative
analgesic (synergistic w opiods)
muscle relaxation

Question 11

CV effects of A2 agonists

Answer 11

reflex bradycardia-> low CO and tissue perfusion
respiratory effects -> mild resp depression, rr decreases but tidal volume increases, upper airway resistance increases, VQ mismatch in horses

Question 12

A2 agonists resp effects (non-ruminants)?

Answer 12

mild resp depression, rr decreases but tidal volume increases, upper airway resistance increases, VQ mismatch in horses

Question 13

A2 agonist resp effects (ruminants)?

Answer 13

bronchoconstriction, v/q mismatch, lung edema and hypoxemia

mostly with xylazine in sheep

Question 14

A2 agonists GI effects?

Answer 14

salivation decreases
lower esophageal sphincter tone decreases
GI motility decreases
vomiting (cats w/ xylazine)

Question 15

What a2 agonist may cause uterine contractions and abortion in cattle?

Answer 15

xylazine

Question 16

Indications for a2 agonists

Answer 16

sedation

prev/tx of seizures

Question 17

Contraindications for a2 agonists

Answer 17

too young/old
hemodynamic instability
severely debilitated patient

Question 18

What are the a2 agonist drugs?

Answer 18

zylazine, medetomidine, dexmetatomadine, detomidine, romifidine

Question 19

What are the a2 antagonists?

Answer 19

atipamezole, yohimbine, tolazoline

Question 20

Which a2 agonists have the highest specificity?

Answer 20

medetomidine&raquo_space;> detomidine > xylazine

Question 21

Which a2 antagonists have the highest a2 specificity?

Answer 21

atipamezole»>yohimbine»tolazoline
He suggests we always use atimpamezole
Always give IM except for emergency

Question 22

Phenothyazines what drug is in this class and MoA?

Answer 22

Acepromazine

antagonist of dopamine, serotonin, a1, histamine

Question 23

CNS effects of Phenothizines?

Answer 23

acts on dopamine and serotonin
weaker sedative compared to a2 agonists
antiemetic
mild resp depression

Question 24

Do phenothiazines provide analgesia?

Answer 24

No

Question 25

Phenothiazines CV effects

Answer 25

vasodilation and hypotension

Question 26

Phenothizine indications

Answer 26

``` mild sedation prev/tx of opiod dysphoria prev of emesis caused by morphine sedation for dogs w layrngeal paralysis enhance sedative effect of xylazine in horses ```

Question 27

Phenothiazine contraindications

Answer 27

``` hypovolemia, hemodynamic instability very young/old von willebrand dz (dobies) boxers (bradycardia) breeding stallions (penile prolapse) ```

Question 28

Butyrophenones

Answer 28

Similar drug fam to phenothiazines drugs: droperidol and azaperone more likely to cause behavior side effects sedative effect is similar to acepromazine

Question 29

Benzodiazepine MoA

Answer 29

gaba receptor agonists (depress CNS)

Question 30

Indications for benzodiazepines

Answer 30

sedative, anticonvulsant, muscle relaxant | NO ANALGESIA

Question 31

Are there cv and resp side effects w/ benzodiazepines?

Answer 31

minimal

Question 32

Benzodiazepine agonists

Answer 32

diazepam, midazolom, zolazepam

Question 33

Benzodiazepine antagonists

Answer 33

flumazenil, sarmazenil

Question 34

Do benzodiazepines have a species specific sedation effect?

Answer 34

Yaas

Question 35

T/F Benzodiazepines are better sedetives in cats that ruminants

Answer 35

FALSE | Benzos have better sedative effects in ruminants, camelids, pigs, birds, and ferrets

Question 36

Benzodiazepine indications

Answer 36

premed- combine with opiods, a2 agonist or both induction- combine w ketamine or barbituates/propofol tx of seizures (status epilepticus)

Question 37

Diazepam solubility, route

Answer 37

lipid soluble, IV (pain on IM inj)

Question 38

Midazolam solubility, route

Answer 38

water soluble, IM IV or mm

Question 39

Opiod CNS effects

Answer 39

Analgesia Decrease MAC of inhalants Sedation Excitation (cats), dysphoria

Question 40

Do opiods trigger vomiting?

Answer 40

Yep, stimulate crtz in brain morphine enters the brain slowly and causes more vomiting fentanyl enters the brain fast and doesn't cause vomiting

Question 41

Opiod CV effects

Answer 41

No direct negative inotropy or vasodilation | Suitable for at risk patients

Question 42

Opioid resp effects

Answer 42

may depress resp but not strongly | have an anti-tussive effect (suppress coughing)

Question 43

Opioid GI effects

Answer 43

nasuea, vomiting defecation obstipation spasm of the sphincter of Oddie (hepatopancreatic sphincter)

Question 44

Opioid indications

Answer 44

premed w/ benzos, benzos and ketamine, ace, a2 agonists perioperative analgesia tx of acute and chronic pain

Question 45

Opioids routs of admin

Answer 45

basically any way you can think of

Question 46

Morphine can cause ______ release, especially after high doses

Answer 46

Histamine

Question 47

Hydromorphone and oxymorphone MoA

Answer 47

full u agonists

Question 48

Methadone has similar properties to hydromorphone except it acts as a _______

Answer 48

NMDA antagonist

Question 49

Fentanyl MoA, duration

Answer 49

full u agonist | fast onset short duration (15-20 mins)

Question 50

Remifentanil what is it and how does it work, probs w/ it?

Answer 50

Works similar to fentanyl, it's very short acting and does not cumulate -> good for CRI probs: accidental disruption of administration may trigger strong pain! boluses may cause sudden bradycardia

Question 51

Buprenorphine MoA, duration, strength, onset

Answer 51

partial u agonist stronger analgesic than butorphanol long acting 6-8 hrs onset slow

Question 52

Tramadol

Answer 52

Weak analgesic metabolizes in the liver and it's metabolite is u opiod agonist tramadol itself inhibits NE and serotonin

Question 53

Naloxone duration, use?

Answer 53

30 min, used to reverse resp depression

Question 54

Naltrexone duration, use?

Answer 54

10 hours, antagonize wild animals after long acting opioids

Question 55

Premed antibiotics?

Answer 55

cefazolin and amoxi clavulic acid | give IV 20 min before sx

Question 56

H1 antagonist, why is it given?

Answer 56

diphenhydramine, given to antagonize the effects of histamine in case of an anaphylactic rxn or histamine release

Question 57

H2 antagonist, why is it given

Answer 57

Ranintidine, famotadine, cimetadine | increases the pH of the stomach

Question 58

What antihistamine is given before removing a mast cell tumor?

Answer 58

H1 AND H2 antagonists