Test 1: 7: pre med Flashcards
why use premeds
- 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
medetomidine and dexmedetomidine do what to the CV system
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)
during HTN caused by dexmdetomidine or medetomidine what should you not treat slow HR with
anticholinergics
is medetomidine and dexmedetomidine reversible? and if yes what drug?
atipamezole
⍺2 antagonist
dexmedetomidine is used to treat
pain
and has profound sedative effects
acepromazine works as a — and causes — as a side effect
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
if acepromazine reversible? and if so with what
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%
onset and duration of acepromazine
slow onset (15 mins)
long duration (3-4 hours)
no reversal
↑MAC reduction
how does Acepromazine effect MAC?
↑ mac reduction (30-45%)
also causes hypotension
hypothermia
splenic enlargment
NOT reversible
tranquilizer
Benzodiazepine can cause — in young healthy animals
excitement
if used in healthy animals alone or used in combo with opioids
benzodiazepine is used for — by increasing —
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)
opioids are used for —
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
opioids will do what to CV system
CV sparing
but can cause brady arrhythmias (AV block, SSS, atrial standstill)
treat ↓HR with atropine/glycopyrrolate
side effects of opioids
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
— should never be used alone because it causes muscle rigidity and tremors
ketamine
used in combo with: midazolam, ace, dex
ketamine effect on CV system
stimulant
↑HR and BP (short lasting)
do NOT use in cats with HCM
is ketamine reversible? what is used
Not reversible
ketamine can cause what side effects
muscle rigidity and tremors
can increase secretions
careful (seizures, ↑ intracranial pressure, interocular pressure)
NOT reversible
alfaxalone is used if you dont want to use —
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
Trazadone when mixed with prozac or tramadol can cause
serotonin syndrome- tremors and hypotension
trazadone works as a
anti anxiety
mild sedative
(oral med to reduce stress)
— are pure agonists used for pain
morphine, hydro/oxymorphone, methadone
— are partial agonist/ agonist antagnoist opiods
buprenorphine
butorphanol
most pure agonist opiods last
3-4 hrs ( morphine, hydro/oxymorphone, methadone)
except fentanyl (< 1 hr)
for premed what do you start with
opioid
after using opioid for premed what should you add if needed to sedate more
tranquilizer- ace or dex- not in older or heart disease pt
or
benzodiazepine- NOT in young healthy animals with opioids- excitability
if you give opioid, tranquilizer or benzo and still need more premed what can you give
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))
