Opioids and Alpha 2 Agonists

Question 1

how do opioids cause analgesia?

Answer 1

central and peripheral actions

Question 2

which opioids are more effective analgesics?

Answer 2

agonists> agonist/antagonists or partial agonists

Question 3

where do alpha 2 agonists enact analgesia?

Answer 3

central and peripheral actions

Question 4

what is opioid-alpha 2 agonist analgesia synergy?

Answer 4

can use lower doses of each together and get more sedation and analgesia than either drug alone at higher doses

Question 5

which opioid is used more often for sedation that for analgesia in small animal patients?

Answer 5

butorphanol

Question 6

which opioid agonists are used in veterinary medicine?

Answer 6

hydromorphone
morphine
fentanyl
methadone

Question 7

which opioid is a partial agonist?

Answer 7

buprenorphine

Question 8

what are the most important side effects of opioids?

Answer 8

cardiovascular (bradycardia)
respiratory depression (hypoventilation)
gastrointestinal (nausea, vomiting, constipation)

Question 9

how do opioids impact cardiac output and MAP?

Answer 9

minimal direct effects

Question 10

what are thee respiratory effects of opioids?

Answer 10

decreases responsiveness to CO2: hypoventilation

Question 11

what are the immediate gastrointestinal effects of opioids?

Answer 11

agonists: nausea, vomiting, defecation

Question 12

what are the long-lasting gastrointestinal effects of opioids?

Answer 12

decrease propulsive motility

Question 13

what are opioids used for in small animal?

Answer 13

premedication
induction of anesthesia
epidural analgesia

Question 14

do opioids decrease minimum alveolar concentration (anesthesia) in horses?

Answer 14

not consistently

Question 15

which opioid is most commonly used in horses?

Answer 15

butorphanol

Question 16

what happens in camelids and ruminants with opioids?

Answer 16

locomotion: hyperthermia, self injury
gastrointestinal stasis

Question 17

what is sensitivity to alpha 2 agonists like between species?

Answer 17

huge variations in sensitivity to drug between species

Question 18

how should you choose an alpha 2 agonist?

Answer 18

intended species on label
duration of effect
route of administration

Question 19

which systems do alpha 2 agonists have adverse effects in?

Answer 19

cardiovascular
respiratory
gastrointestinal
endocrine

Question 20

what is hypertension with alpha 2 agonists mediated by?

Answer 20

alpha2B AR

Question 21

what is the impact of alpha 2 agonists on cardiac output?

Answer 21

dose dependent decrease in cardiac output
overall reduction in organ blood flow

Question 22

what does using an anticholinergic and alpha 2 agonist cause?

Answer 22

worse hypertension and increases myocardial work

Question 23

which opioid is a partial agonist?

Answer 23

buprenorphine

Question 24

what can an IV morphine bolus cause?

Answer 24

histamine release

Question 25

how do opioids induce bradycardia?

Answer 25

vagally

Question 26

how do opioids cause hypoventilation?

Answer 26

decrease responsiveness to CO2

Question 27

do agonist/antagonists or partial agonist opioids cause vomiting?

Answer 27

no

Question 28

what can be used with opioids in patients with cardio, liver, and renal disease?

Answer 28

benzodiazepine

Question 29

which patients should you not use opioids in?

Answer 29

head trauma: increases intracranial pressure through hypoventilation increased risk of aspiration pneumonia/difficulty sustaining normal oxygenation cats hyperthermic, dogs hypothermic

Question 30

what opioid is most commonly used in horses?

Answer 30

butorphanol

Question 31

which opioid is avoided in horses?

Answer 31

buprenorphine: hard to reverse

Question 32

what is a significant problem with opioids in camelids?

Answer 32

gastrointestinal stasis

Question 33

what is the peripheral hypertension with alpha 2 agonists from?

Answer 33

vasoconstriction

Question 34

how does hypotension occur with alpha 2 agonists?

Answer 34

central effect alpha2A AR

Question 35

what is the blood flow reduction from alpha 2 agonists like?

Answer 35

more reduced to skin than vital organs continues after reversal of drug

Question 36

do alpha 2 agonists or opioids cause more severe bradycardia?

Answer 36

alpha 2 agonists

Question 37

what arrhythmias are associated with alpha 2 agonists?

Answer 37

heart block paroxysmal V tach

Question 38

what are the respiratory effects of alpha 2 agonists?

Answer 38

decreased no significant change blood gas pulmonary edema: ruminants

Question 39

how do alpha 2 agonists impact mucous membrane color?

Answer 39

similar to dead patient helps to supplement oxygen

Question 40

what is kitty magic?

Answer 40

ketamine butorphanol or buprenorphine dexmedetomidine

Question 41

which alpha 2s are used in horses?

Answer 41

xylazine detomidine romifidine

Question 42

how effective are alpha 2 agonists with colic pain in horses?

Answer 42

more effective than opioids or NSAIDs

Question 43

which ruminants are the most sensitive to alpha 2 agonists?

Answer 43

goats

Question 44

how sensitive are pigs to alpha 2 agonists?

Answer 44

very resistant to sedative effects

Question 45

what is important to monitor with alpha 2 agonists?

Answer 45

SPO2 heart rate blood pressure blood loss