analgesics

Question 1

what analgesics to use for premed

Answer 1

full µ agonist opioids - e.g. morphine and methadone

Question 2

morphine

Answer 2

very commonly used - gold standard analgesic
emetic - only use in healthy patients
good to use with acepromazine
histamine release with IV

Question 3

methadone

Answer 3

analgesia comparable with morphine
does not cause vomiting - can be used for sick animals instead of morphine
less potential to cause histamine release when given IV

Question 4

fentanyl

Answer 4

full µ agonist opioid
excellent analgesic but short DOA
can be applied as a cutaneous patch

Question 5

pethidine

Answer 5

full µ agonist opioid
histamine release - never give IV!
spasmolytic
much less potent than morphine

Question 6

butorphanol

Answer 6

K-agonist and µ-antagonist
very weak analgesia, could argue use if you were doing a really quick and non-painful surgery but generally not a good choice

Question 7

buprenorphine

Answer 7

partial µ-agonist
can be used for premed, but prolonged onset of action (~45 mins)
hyperthermia in cats

Question 8

name an opioid antagonist

Answer 8

naloxone

Question 9

NSAID - COX1+2 inhibitors

Answer 9

flunixin, ketoprofen, phenylbutazone
mostly for use in horses not small animals

Question 10

NSAID - COX2 inhibitors

Answer 10

meloxicam and carprofen

Question 11

meloxicam

Answer 11

most common NSAID used in SA
licensed for long term use
good for post-operative analgesia as it treats inflammation

Question 12

carprofen

Answer 12

good for post-op analgesia as it treats inflammation
can only give SC injection once in cats - not long term
can be given long term for dogs though

Question 13

general side effects / contraindications of NSAIDs

Answer 13

GIT ulcers
dont use with steroids

Question 14

mavacoxib

Answer 14

not commonly used
can be used when owner is unable to give tablets

Question 15

paracetamol

Answer 15

NEVER IN CATS - liver failure after one dose
not anti-inflammatory
can be combined with steroids
symptomatic pain relief post-op

Question 16

gabapentin

Answer 16

chronic and neuropathic pain
long-term treatment
multimodal analgesia

Question 17

amantidine

Answer 17

chronic and neuropathic pain
acts on NMDA receptors

Question 18

tramadol

Answer 18

at home rescue analgesic plan
dogs and cats for chronic pain
must use pain scoring as not always effective

Question 19

most common adverse effects of opioids

Answer 19

bradycardia, hypoventilation

Question 20

which opioids are mu receptor antagonists

Answer 20

butorphanol, naloxone