Quick Medication Reference Flashcards
Acepromazine pros are?
Adding acepromazine to drugs like morphine (which can also cause sedation) will reduce the needed dose of morphine and therefore decrease side effects associated with this drug (decrease in respiratory rate and heart rate). Acepromazine has some anti-emetic effects (will help block vomiting).
Acepromazine cons are?
Acepromazine can cause hypotension.
Acepromazine should be used cautiously (or not at all) in brachycephalic breeds, as the relaxation of the throat area can increase breathing difficulty associated with the elongated soft palate these breeds usually have.
Large and giant breeds are exceptionally sensitive to acepromazine. Doses should be cut in half for dogs over 30kg, and we NEVER give more than 2 mg ace to any dog, no matter what.
Basic Acepromazine info?
Phenothiazine sedative
What’s important to remember about NSAIDs and anaesthesia?
NSAIDs can damage the kidneys. Low blood pressure under GA can also damage the kidneys. NSAIDs plus hypotension = super high potential for renal damage. NSAIDs should only be given after the patient has completed general anaesthesia and has normal and stable blood pressure. If, for any reason, the patient is already on NSAIDs prior to anaesthesia (as might be seen with a cruciate repair), you need to ensure that the blood pressure is monitored and kept at renal safe levels for the entire peri-anaesthetic period.
Diazepam pros are?
cause sedation and muscle relaxation, and decrease anxiety (anxiolytic). They have minimal effect on the cardiovascular or respiratory systems, so are considered quite safe to use in patients that are older or have heart disease.
Diazepam cons are?
Diazepam should be given IV or PO, as it is absorbed very slowly when given IM. The injectable form can be given rectally for control of ongoing seizures when venous access is not available.
Basic Diazepam info?
is in the group of Benzodiazepines.
Basic Atropine info?
So, elevating heart rate is beneficial if needed, but can be harmful if it is excessive. For this reason, it is best to use atropine if and only if it is actually needed - for example, if the heart rate has dropped enough to be worrisome. Also remember that atropine will cause the pupils to dilate and may interfere with your interpretation of pupil size during monitoring.
Basic Medetomidine info?
it is often used for short procedures such as xrays and ear flushes. It is really classified more as a sedative, but does see some mixed use in anaesthesia.
Basic Alfaxalone info?
Neuroactive steroid that produces loss of consciousness with minimal analgesic properties.
Alfaxalone pros are?
Expected recovery (extubation and head lift) after 15 minutes for a single dose of alfaxalone; when used as a CRI for TIVA (total intravenous anaesthesia) can increase slightly. Give slowly to avoid drops in RR, HR, BP. Typically HR, RR, and BP are quite stable with this drug.
Alfaxalone cons are?
Stings if given outside a vein. Alfaxalone will cause hypotension, but only at high doses. Alfaxalone does accumulate in tissues, so as a CRI we expect a longer recovery from a prolonged anaesthetic with this as a sole agent.
Basic Propofol info?
Hypnotic agent that causes loss of consciousness with little to no analgesic properties.
Propofol pros are?
Expected recovery after 2-5 minutes for a single dose, and does not increase when used as a CRI for TIVA. Propofol does not build up in tissues, and is not redistributed to fat, so is safe for use in lean animals such as sighthounds.
Propofol cons are?
However, sight hounds might have a slower recovery if maintained for a long (hours) surgery with propofol TIVA. Preserved version can be toxic for cats at high doses. Damage to feline RBCs can occur (Heinz bodies) with CRIs. Often results in apnea post-induction, so always pre-oxygenate. Causes significant hypotension and can cause bradycardia.
Ketamine cons are?
Can cause breath holding (apneustic breathing), muscle spasms (give with a benzodiazepine), and will keep eyes open and forward (lubricate). Stings if given outside a vein. Excreted in urine so use cautiously in renal patients. Recovery to extubation approximately 15 minutes, but will take a few hours for full (send them home) recovery.
Basic Ketamine info?
Dissociative anaesthetics and NMDA receptor antagonists with excellent analgesic properties (however, for invasive procedures we need an opioid on board as well). Ketamine is typically used for induction and maintenance of anaesthesia for short procedures (sole agent), or induction for longer procedures when used with isoflurane.
Ketamine pros are?
Increases HR and BP, so very useful for patients that are hypotensive prior to anaesthesia. As a personal note, I used ketamine a lot in the emergency clinic for this reason. At a much lower dose in a CRI, ketamine is a potent analgesic.
Basic Isoflurane info?
They do have some analgesic properties, but require additional analgesics to avoid super high delivery settings.
Isoflurane cons are?
Induction using these agents (except for sevoflurane) is prolonged and typically involves patient struggling, so is not ideal. Most commonly used inhalant in practice currently, Causes bradypnea, bradycardia and hypotension. These agents are not analgesics! They work by creating an unconscious patient, who is not aware of pain. However, lots of pain will make this patient respond and require higher levels of the inhalant. Long-term exposure of staff to these agents can lead to health problems including miscarriages, liver issues, cancer, and other problems.
Isoflurane pros are?
These agents are popular (especially Isoflurane) because they are relatively inexpensive to use for anaesthetic maintenance and are easy to titrate (adjust to desired depth). Fast adjustment of depth. The newer inhalants (isoflurane, sevoflurane) are very quickly absorbed and eliminated, so depth is really easy to adjust quickly. Ability to induce anaesthesia using a mask. Can be used in patients for whom IV access is impossible or very difficult. Fast recovery. Since these agents are eliminated mostly just by respiration rather than needing to be broken down or filtered out of the body, the recovery from them is faster.
Basic Medetomidine info?
they stimulate (agonize) specific nerve receptors in the adrenergic (flight/fight) nervous system. Unfortunately, this isn’t very enlightening in their use for sedation, anaesthesia, and analgesia - so knowing this is pretty academic.
