Anesthetic Agents and Adjuncts: Preanesthetics Flashcards by Marli Verbanes

Not a true anesthetic but used for other desirable effects such as sedation, tranquilization, analgesia, and anticholinergics

Anesthetic adjunct

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Bind to and stimulates receptors

Pure agonist

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Bind to receptors but do not stimulate them (reversal agents)
Blockers

Pure antagonists

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Bind to and partially stimulate receptors

Partial agonists

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Bind to more than one receptor type and simultaneously stimulate at least one, and block at least one

Agonists/Antagonists

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These must be administered as adjuncts

analgesics

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These type of drugs can’t be administered in the same syringe

Incompatible drugs

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Drugs that are safely mixed together in the same syringe

Combination drugs

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Often combined with ketamine in a 50:50 mixture

Valium (diazepam)

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A term that describes the period immediately preceding the induction of anesthesia

Preanesthesia

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The process by which an animal leaves the normal conscious state and enters an unconscious state

Induction

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“Heart protectants”

Anticholinergics

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Cause calming and sleep effects

Tranquilizers and Sedatives

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AKA narcotics

Cause analgesic effects

Opioids

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When should preanesthesia drugs be given?

15-20 minutes prior to induction

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Controversial as pre-meds but help combat adverse side effects

Anticholinergics

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AKA parasympatholytics
Block the binding of acetylcholine to prevent bradycardia, salivation, peristalsis, and pupil constriction
Works on the vagus nerve
Can be reversed with physotimine or pilocarpine
Causes bronchodilation

Anticholinergics

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2 anticholinergics used in preanesthesia

Atropine and glycopyrrolate

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An older drug derived from the nightshade plant
Short duration of action, but fast onset (used for emergencies)
Treats organophosphate toxicity
Increases the firing of the SA node
Can cross the placental barrier, but carrier of other substances

Atropine

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A newer synthetic drug approved for dogs and cats
Slow onset, long duration
Minimally crosses the placental barrier
Less tendency to cause tachycardia

Glycopyrrolate

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These drugs can cause ataxia, prolapse of the third eyelid, respiratory distress, and unusual behaviors

Tranquilizers and Sedatives

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3 classes of sedatives/tranquilizers

Phenothiazines
Benzodiazepines
Alpha 2 agonists

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These sedatives are NON CONTROLLED substances that suppress the sympathetic nervous system
May cause hypothermia
SHOULD NOT BE GIVEN TO SEIZURE PTS

EX: Acepromazine

Phenothiazines

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Bright yellow in color

Shouldn’t be used in stallions, epileptics, boxers, liver failure pts, and hypotensive pts

Acepromazine

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These are minor tranquilizers with a wide safety margin, mostly used as muscle relaxers (not reliable sedatives) Cardiovascularly friendly drugs

Benzodiazepines

Drug used to reverse benzodiazepines

flumazenil

4 benzodiazepines

1. diazepam 2. zolazepam 3. midazolam 4. lorazepam

Diazepam is AKA

valium

only licensed benzodiazepine licensed for animals

zolazepam

This drug is the drug of choice for seizure and cardiovascular pts, is cardiovascularly friendly, compatible with ketamine Controlled and given IV

Diazepam

This drug is used as an appetite stimulant in ruminants and cats Can be given in multiple routes

Midazolam

These drugs are highly reversible and should be given in young, healthy pts ONLY Act as sedatives/tranquilizers and has slight analgesic effects

Alpha 2 agonists

First widely used alpha 2 agonist Can be combined with other pain meds as a better sedative/analgesic Can be reversed with Yohimbine

Xylazine

Xylazine is AKA

Rompun, Anased

Dosing is based on body surface area Most commonly used A2A in dogs and cats Mostly used in horses Reversed with atipamazole

Dexmedetomidine

Dexmedetomidine is AKA

metetomedine

Analgesic used in horses for colic pain

Detomidine

Romfidine is AKA

Sedivet

4 A2A's

1. Xylazine 2. Dexmedetomidine 3. Detomidine 4. Romfidine

3 Reversal agents

1. . Tolazoline 2. Yohimbine 3. Atipamazole

Reversal agents are AKA

Alpha 2 Antagonists

Used to reverse Xylazine in ruminants

tolazoline

Used to reverse xylazine (rompun) in dogs, cats, horses and exotics

Yohimbine

Used to reverse dexmedetomidine

atipamazole

Atipamazole is AKA

Antisedan

Derivatives of opium | Excellent analgesic effects

Opiates

4 opioid receptors

1. mu 2. kappa 3. sigma 4. delta

Narcotics' duration of action is dependent on the

route

Pure agonists =

excellent pain relief, more side effects

Partial agonists =

good pain relief, few side effects

Agonist/antagonist =

mild pain relief, very few side effects

Narcotics that stimulate all receptors Given to pts with severe burns, amputations, deglovings, horrible orthopedic injuries Ex: morphine, hydromorphone, oxymorphone, fentanyl, meperidine

Pure agonists

First narcotic used | Use with caution in horses and cats

Morphine

Similar to morphine in effects Safer to use in cats Not as potent as oxymorphone, but less expensive

hyrdromorphone

Weak analgesia | AKA pethidine

Meperidine

Greater potency than morphine with fewer side effects and longer duration Great for sick or cardiovascular impaired pts Expensive

Oxymorphone

One of the most potent analgesias | Most common route is transdermal patch

Fentanyl

Only partially stimulate the opioid receptors Ex: buprenorphine

Partial agonist

Given PO to cats Longest duration of any analgesia (6-12 hrs) Come in ampules Used for pts with spay, cryptorchid castration, or lacerations

Buprenorphine

These provide pain relief but do not depress the respiratory and cardio systems as much as narcotics Don't stimulate the mu receptors, but instead stimulate kappa receptors Ex: Butorphanol and Nalbuphine

Agonist-antagonist

Most effective on mild to moderate visceral pain Does not depress respiration at higher doses (ceiling effect) Low doses = antitussive

Butorphanol

Butorphanol is AKA

Torbugesic/Torbutrol

Only injectable opiod that is not a controlled substance in the US Weak analgesia/sedative Strong antagonist properties

Nalbuphine

Nalbuphine is AKA

Nubian

These type of drugs bind to receptors without stimulating them No clinical effect on their own Reverse pure agonists, partial agonists, and agonist/antagonists AKA Reversal agents Ex: Naloxone

Pure Antagonists

Blocking agents for opioids (reversal agents)

Narcotic antagonists

Effective in reversing narcotics in emergency situations

Naloxone

Naloxone is AKA

Narcan

A hyponotic state produced in which the patient appears sedate, yet can be aroused with stimulation

Narcosis

Display odd behavior patterns on opioids

Cats

Most effective for severe pain

Pure agonist

Derived from the nightshade plant and acts to prevent bradycardia Avoid in horses due to potential colic

Atropine

Anticholinergic with long duration, better for sick patients | Avoid in horses due to potential colic

Glycopyrrolate

A phenothiazine that should be avoided in epilleptics and stallions Supresses the sympathetic nervous system to help with nausea and cause vasodilation Good in geriatric pts

Acepromazine

A benzodiazepine used often in heart pts Stimulates appetites in felines Muscle relaxer and good for cardio pts AKA valium

diazepam

A component of telazol

Zolazepam

Analgesic and sedative | AKA Rompun

Xylazine

A2A approved for use in horses but can be used in other species VERY POTENT

Detomidine

Most potent sedative

Detomidine

3 pure agonists

Morphine, hydromorphone, oxymorphone

Dexmedetomidine antagonist

Antisedan

Can be given PO in cats | Longest duration of action for narcotics

Buprenorphine

AKA Torbugesic

Butorphanol

VERY WEAK NARCOTIC

Nalbuphine

Xylazine antagonist

Yohimbine

Reverses all narcotics

Naloxone

Transdermal narcotic

Fentanyl

These type of drugs prevent bradycardia and decrease salivation Not controlled Reversed with physostigmine or pilocarpine

Anticholinergics

These type of drugs are used for sedation and hypotension | Not controlled and not reversible

Phenothiazines

These type of drugs are used for muscle relaxation CONTROLLED Reversed with flumazenil

Benzodiazepines

These type of drugs are used for sedation with analgesia Not controlled Reversed with yohimbine or atipamazole

Alpha 2 Agonists

These type of drugs are used to reverse Alpha 2 Agonists to wake patients Not controlled

Alpha 2 Antagonists

These type of drugs are used for pain relief | Some are controlled and reversible

Narcotics

These type of drugs reverse the effects of narcotics to make the patient more alert Not controlled

Narcotic Antagonists

Anesthetic Agents and Adjuncts: Preanesthetics Flashcards

(94 cards)