Dare to do Drugs

Question 1

Butorphenol

Answer 1

kappa agonist/ mu antagonist

mild sedation: 1-2 hours

analgesia: ~90 min.

Question 2

Compared to mu agonist butorphenol has less:

Answer 2

respiratory depression
panting
bradycardia
less analgesia, MAC sparing
Nausea, no vomiting

Question 3

How do we use butorphenol for dogs/cats?

Answer 3

alone or with a sedative/tranquilizer

non/mild painful procedures

pre-med to avoid comiting

Question 4

How do we use butorphenol for horses?

Answer 4

with an alpha- 2 agonist

Question 5

How do we use butorphenol for RMTS?

Answer 5

Large- during/after induction

small- as premed w/ benzodiazepine

Question 6

Buprenorphine is a ____ agonist… it provides what in terms of sedation/analgesia?

Answer 6

Partial mu agonist

little sedation, mild-moderate analgesia

Question 7

Buprenorphrine has a fast/slow onset?

Answer 7

slow onset: 30-45 minutes

Question 8

How long does Buprenorphrine last in dogs/cats?

Answer 8

Dogs- 4-10 hours

Cats 6-12 hours

has a ceiling effect

Question 9

When is Buprenorphrine contraindicated and why?

Answer 9

Strong affinity for Mu receptor,

will antagonize other opioiods

do not use as pre-med in painful procedures, difficult to reverse

Question 10

Compared to mu agonists Buprenorphrine exerts:

Answer 10

Less
respiratory depression, panting, bradycardia analgesia MAC sparing
Nausea, no vomiting

Question 11

What is simbadol?

Answer 11

long acting Buprenorphrine in cats

Question 12

When comparing mixed, partial and full mu agonists what is the order to remember?

Answer 12

MU provides the most:
respiratory depression/panting
bradycardia
analgesia, MAC sparing
nausea and vomiting

Then partial MU

Then mixed

Question 13

What drugs are the full MU agonists? (4)

Answer 13

hydromorphone
morphine
oxymorphone
methadone
Fentanyl

Question 14

What are the side effects of full mu agonists?

Answer 14

moderate- severe analgesia

no ceiling effect/ dose dependent MAC sparing

minimal CV effects- bardycardia

nausea/vomiting (except methadone)

Question 15

What is special about Fentanyl?

Answer 15

full mu agonist

used for moderate-severe pain

short acting 15-30 min

requires IV catheter; CRI- constant rate of infusion

same side effects as others but has greater respiratory depression, no vomiting

Question 16

How do we use Fentanyl?

Answer 16

Induction agent in critically ill SA patients

intra/post op CRI

available as patch or transdermal formualtion

Question 17

What drugs are available as sedatives/tranquilizers?

Answer 17

Acepromazine
Alpha-2 agonists
Benzodiazepans
Dissociatives

Question 18

What are the Alpha-2s available?

Answer 18

SA- dexmedetomidine

LA- Xylazine, detomidine, romifidine

Question 19

What are the 2 commonly used benzodiazepines?

Answer 19

Midazolam/diazepam

Question 20

What are the common dissociatives?

Answer 20

Ketamine

Telazol

Question 21

Acepromazine

Answer 21

Phenothiazine, alpha-1

mild-moderate sedation

slow onset 20-30min

LONG duration

NO reversal

Question 22

Does acepromazine have analgesic effects?

Answer 22

NO, but has a synergistic effect w/ opioids

significant decrease in induction dose/ MAC of inhalant

Question 23

T/F

Acepromazine causes seizures?

Answer 23

FALSE

Question 24

What is dexmedetomidine?

Answer 24

alpha 2 agonist

potent sedative + analgesia

**DOSE dependent

rapid onset / short duration

Question 25

What effects does dexemedetomidine have on patients?

Answer 25

decrease CO, reflex bradycardia due to vasoconstriction RESERVE for healthy/very painful/fearful/aggressive patients

Question 26

What do you use to reverse dexmedetomidine?

Answer 26

Atiamazole

Question 27

What are the hemodynamic effects of dexemedtomidine?

Answer 27

initial hypertension response due to alpha 2 b stimualtion w/ vasoconstriction central alpha 2 a stimulation leads to decreased NE causing hypotension due to bradycardia and peripheral vasodialtion

Question 28

T/F Diazepam and midazolam are not good sedatives in young, healthy dogs and cats

Answer 28

TRUE

Question 29

T/F diazepam/midazolam can cause paradoxical excitement and hyporresponsiveness

Answer 29

FALSE paradoxical excitement and hyperresponsiveness

Question 30

Do diazepam/medazolam provide analgesia?

Answer 30

NO

Question 31

What species are indicated in diazepam/medazolam use?

Answer 31

small ruminants / neonatal foals

Question 32

What is the difference between diazepam/medazolam?

Answer 32

diazepam contains propylene glycol painful on injection, not well absorbed, toxic at high doses used to be cheaper

Question 33

What are the effects of anti- cholinergic drugs?

Answer 33

decrease vagal effects, salivary secretions modern drugs not as irritating to resp tract still used to counter vagal effects of other anesthetic drugs

Question 34

What is atropine?

Answer 34

used to save animals with organophosphate poisoning crosses BBB/placenta side effects- sinus tachycardia, secondary A-V block DOA: 60-90 min

Question 35

Glycopyrrolate

Answer 35

does NOT cross BBB/placenta inset of action 3-5 minutes DOA- 2-4 hours

Question 36

What are the side effects of glycopyrrolate?

Answer 36

sinus tachycardia, 2 AV block, increases w/ IV administration so give alittle, wait give second dose tachycardia is slef limiting, but be careful on old dogs Not indicated for LA

Question 37

What is Guaifenesin?

Answer 37

GG central muscle relaxant, similar to NZ, not available in US part of triple drip

Question 38

What are the disadvantages of GG?

Answer 38

cant use above 5%, causes hemolysis in cattle, thrombophlebitis in horses

Question 39

What is propofol used for, and what is its mech of action?

Answer 39

induction of SA, sedation, CRI to maintain anesthesia NOT analgesic works via GABA-a receptors

Question 40

Advantages of using propofol?

Answer 40

rapid onset, metabolism, destruction non-cumulative, extra hepatic metabolism anticonvulsant, neuroprotective

Question 41

What is Ketamine?

Answer 41

NMDA receptor agaonist dissociative anesthetic

Question 42

What are the advantages of ketamine?

Answer 42

indirect sypathomimetic CV stimualtion (increase HR, CO, BP good analgesia metabolized in the liver

Question 43

What are the uses of ketamine?

Answer 43

IM pre med- need to use in combo w/ sedative/muscle relaxant IV- induction

Question 44

What premedication combo would you give to cats?

Answer 44

Dexmedetomidine + opioid

Question 45

What premedication combo would you give to a horse?

Answer 45

Butorphanol + alpha-2 agonist

Question 46

What two classes of drugs should you avoid when premedicating a horse?

Answer 46

Benzodiazepines and mu agonist opioids

Question 47

What can you give cattle for premedication?

Answer 47

Xylazine (1/10 of equine dose) and butorphanol

Question 48

What is a drug you would only give a healthy goat?

Answer 48

Xylazine; can possibly cause hypoxia

Question 49

What are advantages of using Etomidate?

Answer 49

Minimal myocardial depression and hypotension

Question 50

What is the mechanism of action for Alfaxalone? What are advantages of this drug?

Answer 50

Interacts with GABA-A receptors Rapid induction and recovery

Question 51

What are disadvantages of using Alfaxalone?

Answer 51

Hypotension, apnea, and vasodilation in high doses

Question 52

A dog presents with a GDV; what combo would you use to induce him?

Answer 52

Opioid and benzodiazepine

Question 53

Does Etomidate have analgesic effects?

Answer 53

NO