Test 1: 7: pre med

Question 1

why use premeds

Answer 1

• reduce fear or anxiety
• sedation before IV placement
• reduce the amount of drugs needed for general
• aggressive fractious animals
• reduce pain before painful activity
• minor procedures that need sedation

Question 2

medetomidine and dexmedetomidine do what to the CV system

Answer 2

peripheral effect: ↓HR ↑BP
CNS effect: ↓HR ↓BP

do not use in dogs with heart disease because it causes CO to decrease

can cause increased respiratory work in horses, because acts as muscle relaxant

⍺2 agonist: cause sedation, analgesia, ↓SYM (↓HR ↓BP)

Question 3

during HTN caused by dexmdetomidine or medetomidine what should you not treat slow HR with

Answer 3

anticholinergics

Question 4

is medetomidine and dexmedetomidine reversible? and if yes what drug?

Answer 4

atipamezole

⍺2 antagonist

Question 5

dexmedetomidine is used to treat

Answer 5

pain
and has profound sedative effects

Question 6

acepromazine works as a — and causes — as a side effect

Answer 6

tranquilizer

hypotension

hypothermia
enlarged spleen from sequestration

NOT reversible

ace is a D2 antagonist-
do not use in old CV pt or adult horses- causes erections, no allergy testing
will ↓MAC by 30-45%, milk and meat withdrawal, works as sedative/tranqilizer/↓vomiting, takes 15 mins to work

Question 7

if acepromazine reversible? and if so with what

Answer 7

not reversible

ace: tranquilizer that causes ↓BP, ↑ spleen, ↓temp, mild anti vomiting and (erections in horses). Do not use in old CV pt, or for allergy testing. MAC ↓ by 30-45%

Question 8

onset and duration of acepromazine

Answer 8

slow onset (15 mins)
long duration (3-4 hours)

no reversal
↑MAC reduction

Question 9

how does Acepromazine effect MAC?

Answer 9

↑ mac reduction (30-45%)

also causes hypotension
hypothermia
splenic enlargment

NOT reversible

tranquilizer

Question 10

Benzodiazepine can cause — in young healthy animals

Answer 10

excitement

if used in healthy animals alone or used in combo with opioids

Question 11

benzodiazepine is used for — by increasing —

Answer 11

anti-anxiety, sedation, antiseizure, muscle relaxant, amnesia

increases affinity for GABA at GABA receptor

muscle relaxation
* prevent muscle rigidity associated with ketamine
* contrast tremors alfaxalone

can cause excitement in young, healthy animals and cats

CV sparing
increased duration with pt with liver issues (portal systemic shunt)

Question 12

opioids are used for —

Answer 12

pain relief
sedation- drowsiness

can cause vomiting- morphine and hydromorphone
can cause dysporia in horses without pain and huskies post op- yelling, paddling
respiratory depression, ↓cough
↑temp in cats and ruminants
↓temp in dogs
minimal effect on CV system: merperidine and morphine can cause histamine release → vasodilation and ↓BP

Question 13

opioids will do what to CV system

Answer 13

CV sparing

but can cause brady arrhythmias (AV block, SSS, atrial standstill)

treat ↓HR with atropine/glycopyrrolate

Question 14

side effects of opioids

Answer 14

pain relief, sedation

cause vomiting (morphine and hydromorphone)
dysphoria (in huskys and labs and non painful horses) → if you reverse will also reverse the pain relief

can cause brady-arrhythmias

Question 15

— should never be used alone because it causes muscle rigidity and tremors

Answer 15

ketamine

used in combo with: midazolam, ace, dex

Question 16

ketamine effect on CV system

Answer 16

stimulant

↑HR and BP (short lasting)

do NOT use in cats with HCM

Question 17

is ketamine reversible? what is used

Answer 17

Not reversible

Question 18

ketamine can cause what side effects

Answer 18

muscle rigidity and tremors

can increase secretions

careful (seizures, ↑ intracranial pressure, interocular pressure)

NOT reversible

Question 19

alfaxalone is used if you dont want to use —

Answer 19

dex, ketamine or ace

preserves laryngeal function
fast acting/short duration
no alalgesic effect

can be given IM
sedation
use with opioids- do not use alone

used in cats and small dogs

Question 20

Trazadone when mixed with prozac or tramadol can cause

Answer 20

serotonin syndrome- tremors and hypotension

Question 21

trazadone works as a

Answer 21

anti anxiety

mild sedative

(oral med to reduce stress)

Question 22

— are pure agonists used for pain

Answer 22

morphine, hydro/oxymorphone, methadone

Question 23

— are partial agonist/ agonist antagnoist opiods

Answer 23

buprenorphine
butorphanol

Question 24

most pure agonist opiods last

Answer 24

3-4 hrs ( morphine, hydro/oxymorphone, methadone)

except fentanyl (< 1 hr)

Question 25

for premed what do you start with

Answer 25

opioid

Question 26

after using opioid for premed what should you add if needed to sedate more

Answer 26

tranquilizer- ace or dex- not in older or heart disease pt

or

benzodiazepine- NOT in young healthy animals with opioids- excitability

Question 27

if you give opioid, tranquilizer or benzo and still need more premed what can you give

Answer 27

ketamine- careful with renal cats, usually works well with midazolam or dex

Telazol- similar to ketamine, longer lasting

alfaxalone- cats or small dogs only for IM dose, can cause tremors (use with midazolam or a tranquilizer (ace or dex))