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Intro to Pharmacology > Week 8 - Muscle Relaxants > Flashcards

Week 8 - Muscle Relaxants Flashcards

1
Q
  • An Anesthetic is a drug used to induce a loss of sensation with or without unconsciousness
  • Adjunct or Pre-Anesthetic is a drug that is not a true anesthetic, but that is used during anesthesia
    to produce other desired effects such as sedation, muscle relaxation, analgesia, reversal,
    neuromuscular blockade, or parasympathetic blockade
    Used prior to the administration of an anesthetic agent to make anesthesia safe and
    more agreeable to the patient.
    Used:
  • For sedation, to reduce anxiety and apprehension
  • To obtain an additive or synergistic effect so that induction could be smooth and rapid
  • To counteract certain adverse effects of anesthetic drug
  • To relieve from pain
A

^^ already have these definitions I think?

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2
Q

 Opioids provide analgesia
 Tranquilizers provide pre-operative sedation and amnesia
and help to prevent or counteract the CNS
stimulation caused by some anesthetics
 Central muscle relaxants provide muscle relaxation during anesthesia
 Anticholinergic agents prevent profuse salivation and bradycardia

A

^ already have these definitions I think

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3
Q

The opioids _____ and ______ provide analgesia.

A

Morphine
Butorphanol

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4
Q

The tranquilizers ___________ (_________) and __________ (_________) provide pre-operative sedation and amnesia
and help to prevent or counteract the CNS stimulation caused by some anesthetics.

A

Phenothiazine: Acepromazine (D2)
Benzodiazepines: Diazepam (GABA)

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5
Q

Pre- and post-anesthetic (peri-anesthetic) medications are essential to safe anesthetic management

A
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6
Q

When used appropriately, pre-anesthetic medications can minimize _____, __________ depression, and the ______ effects produced by anesthetic administration

A

stress, cardiopulmonary, adverse

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7
Q

Pre-anesthetic medications generally include combinations of drugs from multiple categories including:

A
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8
Q

Pre-Anesthetic α2 – Adrenergic Agonists produce ?

A

sedation, stupor, analgesia, and muscle relaxation without producing general anesthesia

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9
Q

Examples of Pre-Anesthetic α2 – Adrenergic Agonists include?

A
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10
Q

Pre-Anesthetic α2 – Adrenergic Agonists are
* __________ agents
* Produce?
* _____ and _____ animals (particularly?)
* Administration: ___ or ___
* Administered _____ to _____ procedures
* Readily reversed with ___-_____

A

Non-controlled, Sedation, analgesia, and muscle relaxation, Large, small, dogs, cats, horses, IM, IV, prior, minor, α2-antagonists

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11
Q

alpha2 - Agonists
Pharmacological Effects on the CNS

A

CNS: dose-dependent sedation
Analgesia: short-acting (30 min)

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12
Q

alpha2 - Agonists
Pharmacological Effects on the Cardiovascular system (Early phase)

A

Early phase: dose-dependent vasoconstriction & hypertension –>
Bradycardia, Cardiac arrhythmias

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13
Q

alpha2 - Agonists
Pharmacological Effects on the Cardiovascular system (Late phase)

A

Late phase: decrease cardiac output –> Hypotension and further bradycardia

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14
Q

alpha2 - Agonists
Pharmacological Effects on the GI system

A

bloat ( dogs, cattle, horses)

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15
Q

alpha2 - Agonists
Pharmacological Effects on the Respiratory system

A

Respiratory system: Dose-dependent depression

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16
Q

List some other effects of alpha2 Agonists
1. Muscle ______
2. ______ effect of other Anesthetics
3. ______, immediate response in dogs and cats
4. _______ transient
5. ______
6. ________ labor(last semester)
7. _______ (horses)
9. Absorbed via ___
10.Avoid in ? patients
11. Administer ______ 10-20 min prior

A

relaxation, Potentiate, Vomiting, Vomiting, Hypothermia, Premature, Sweating, skin, geriatric, diabetic, pregnant, pediatric, or ill , anticholinergics

Don’t necessarily have to remember this; just know that alpha 2 acts on many tissues and can lead to adverse effects

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17
Q

alpha2 - Agonists
Adverse Effects on the CNS

A

CNS : change in behavior (varies with species)

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18
Q

alpha2 - Agonists
Adverse Effects on the Cardiovascular System

A

Cardiovascular:
bradycardia
hypotension

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19
Q

alpha2 - Agonists
Adverse Effects on the Respiratory System

A

Respiratory system:
Depression: variable in different animals
More severe if given with other drugs

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20
Q

α2 - Agonists
* Xylazine
* Medetomidine hydrochloride (Domitor R )
* Detomidine (for sedation of large animals)
* Romifidine
* Dexmedetomidine (DexdomitorR )

A
21
Q

Xylazine: is a sedative that provides ____ relief as well as muscle _____ in ____. It stimulates ___ receptors of the ______ NS, decrease release of ___ aka no “?” response.

  1. Administration results in ?
  2. Metabolized in ____, excreted in ___
  3. ___ sedation; __-__ ___ duration
A

pain, relaxation, dogs, α2, sympathetic, NE, fight-or-flight

sedation, analgesia, bradycardia, hypotension, and hypothermia, liver, urine, Rapid, 1-2 hr

22
Q

Xylazine is a ______ with ______ and muscle _____
properties in animals. ______ are more sensitive to the effects
than are most other species. ____ are more sensitive than are other ruminants.

Note: ( ____ concentrations small-animal formulations should be used). The dose of 0.12 mg/kg IV is effective for most ruminants

A

sedative, analgesic, relaxant, Ruminants, Goats, low

23
Q

Domitor (_______)
* More potent & selective & commonly used in Vet Med
* ___-______ with sedative and analgesic properties
* Similar but more ____ and ____ than Xylazine
* Registered for use in animals only, prescription drug
* Used as ____ and _____ in cats and dogs
* After IV: effects are seen in __ ___
* After IM: effects are seen in ___-___ min
* Despite appearing completely sedated, animals can still ___, even ___, ___ or ____,
in response to ____ stimulation

A

Medetomidine, α2- Agonist, potent, safer, sedative, analgesic, 5 min, 10-15, move, kick, bite, scratch, sharp

More potent because are more specific to receptors? than Xylazine

24
Q

Adverse effects of Domitor (Medetomidine)
* _____ heart rate
* ___ body temperature
* ____ breathing rate
* ______

A

Slowed, Low, Slowed, Vomiting

25
Q

Caution - Domitor (Medetomidine)
* Not to be used in animals < ____ weeks of age
* Not to be used in the ___ trimester of pregnancy
* When used in animals with heart disease, low blood pressure, shock, breathing problems,
severe liver or kidney disease, a known seizure disorder.

A

12, last

26
Q

Alpha2-Agonists
Reversal of:
Effects of α2 Agonists causing analgesia and sedation
no effect on the respiratory system (beneficial effects)
bradycardia (detrimental effects)
* High margin of safety however, you can overdose as well; always need to be careful.

A
27
Q

Effects of α2 Antagonist overdose
1. Neurological: ______ and muscle _____
2. Cardiovascular: ______ and ______
3. GI: _____ and _____

A

excitement, tremors, hypotension, tachycardia, salivation, diarrhea

28
Q

Yohimbine is an alpha 2 - ______:
* Used in ? species
* Reverses ______ and ______ effects of ______.
* Dose ratio is species dependent
dogs and horses: ___ to ___
cats: __ to ___

A

antagonist, dogs, cats, horses, and exotic, cardiovascular, sedative, Xylazine, 10 to 1, 2 to 1

29
Q

Atipamezole:
* Specific antagonist for _______
* Administration: ___ or ___ in emergencies
* Use ½ the dose in ___ compared to dogs
* Reversal: __-___ min after IM injection

A

Medetomidine, IM, IV, cats, 5-10

30
Q

Pre-Anesthetic Anticholinergics Prevent, limit _____ secretions and ______ and
limit or prevent _______

A

salivary, emesis, bradycardia

31
Q

Parasympatholytic drugs: block the action of ______ (?) via __ receptors
 Prevent and treat _______
 Decrease _____ secretions

A

acetylcholine, (Ach), M, bradycardia, salivary

32
Q

Atropine and Glycopyrrolate (dogs and cats) (not _____ and _____)
They are classified as ______ agents.
 Administration?
 Atropine: ____ onset, ____ peak, _____ duration EMERGENCY
 Glycopyrrolate: _____ onset, ____ peak, longer _____

A

horses, rabbits, anticholinergic, IV, IM, SC, or IT, faster, shorter, shorter, slower, longer, duration

33
Q

Anticholinergics Effects
*_____: limited effects
* Cardiovascular: prevent ______
* Secretions: _____
* Eye: ______ (?) and corneal ____
* ________ (increase airflow to the lungs)

A

CNS, bradycardia, decrease, mydriasis, dilated pupils, dryness, Bronchodilation

34
Q

Anticholinergics Adverse Effects

Adverse effects:
* Cardiac ______ (in animals with _____ heart rates or cardiac _____)
* Temporary ______
* _____ respiratory and salivary secretions (may lead to airway _____)
* Intestinal _____ inhibition (may lead to ____ (horses) or _____ (ruminants)

A

arrhythmia, elevated, diseases, bradycardia, Thickened, blockage, peristalsis, colic, bloat

35
Q

Anticholinergic agents
* Atropine (plant-derived, atropa belladonna ) (crosses BBB)
* Glycopyrrolate (synthetic, 5-6 times more potent, prolonged duration) (does not cross BBB)
Effects:
* Increase heart rate (prevent bradycardia)
* Inhibit secretions (nasal, oral, and bronchial)
* Decrease gastric secretions, smooth muscle tone and peristalsis
* Used in small animals, horses, pigs
Adverse effects:
* Atropine may slow heart rate transiently after IV administration
* Cardiac arrhythmias
* Can cause heart failure in animals with preexisting cardiovascular disease
* CNS depression in dogs and cats
* Restlessness, delirium, and disorientation in ruminants and elephant
* Colic in horses

A
36
Q

Pre-Anesthetic Muscle Relaxants (Spasmolytics)
Spasticity is an increased muscle _____ (Spasm) in a variety of _____ conditions
* Aim of spasmolytics: ?

A

tone, neurological, reduction of excessive skeletal muscle tone
without reduction of muscle strength

37
Q

Centrally acting muscle relaxants
Drugs that act in the CNS to mitigate _____ and ____ of skeletal muscles
* Structurally ________ and act at a variety of receptors in the CNS
* Act as CNS _____
* Have _____ and _______ relaxant properties

A

tension, spasm, heterogeneous, depressants, sedative, musculoskeletal

38
Q

Peripheral acting muscle relaxants
[Neuromuscular Blocking Agents (NMBAs)]

A
39
Q

Site of spasmolytic action: ?

A

spinal cord

40
Q

Benzodiazepines
 Diazepam (GABAA)
 Chlordiazepoxide
 Clonazepam
 Nitrazepam

A
41
Q

GABA agonists
 Baclofen (GABAB)

A
42
Q

α2 - Agonists
Tizanidine (α2-receptor)

A
43
Q

Centrally Acting Spasmolytics

Side Effects:
Diazepam : significant ___________ but ____ than that produced by other
sedative-hypnotic drugs at doses that induce equivalent muscle relaxation
Baclofen: less sedation than _____, but provides muscle _______.
Tizanidine: ?

A

sedation, milder, diazepam, relaxation, asthenia, drowsiness, dry mouth, and hypotension

44
Q

Guaifenesin
Used: IV with ______ and _______ for induction of anesthesia
In ____, ____, and ____
Effects: Mild _____ accompanies the muscle ______
Mild _____
________ blood pressure in horses, but minimal effect on _____ ___
Minimal ______ effects

A

thiobarbiturates, ketamine, horses, cattle, swine, sedation, relaxation, analgesia, Decreases, heart rate, respiratory

45
Q

Guaifenesin (5%) solution is combined with additional ____ ____ and _____ to create so called “Triple Drip”, which prolongs anesthesia up to an ____

A

α2 agonist, ketamine, hour

Triple Drip is important - remember that we are talking about Guafinesins which has a good degree of muscle relaxation.

46
Q

Guaifenesin
Adverse effects:
* ______ reaction in horses
* Overdose can cause ?
* _______ injection causes inflammation, necrosis, and sloughing at the injection site

A

Allergic, bradycardia, hypotension, extensor rigidity,
apnea, and cardiac arrest, Perivascular

47
Q

Mathocarbamol
(Guaifenesin analog)
Used: To treat _____ ____ in dogs and cat

A

muscle spasms

48
Q

Baclofen - a Dangerous Muscle Relaxant in ____ and ____
MOA: mimics ____ (agonist, GABAB) within the spinal cord and works by depressing _____ reflex activity at the spinal cord level, thereby reducing skeletal muscle spasm

A

Dogs, cats

GABA, afferent

It is used but can be toxic.

49
Q

Baclofen - a Dangerous Muscle
Used: To treat urinary ____ by reducing urethral ______
and gastroesophageal ___

Adverse effects:
* _____ margin of safety
* Clinical use is ____
* Causes loss of the ___ reflex putting dogs at high risk for _____
* Dogs ____ excessively and can _____ their own saliva
* Severe ?

Intoxication?

A

retention, resistance, reflux, Narrow, infrequent, gag, aspiration, drool, aspirate, vomiting, seizures and cardiac arrest

Intro to Pharmacology (31 decks)

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