Pre-anesthetic Medications Flashcards
(85 cards)
1
Q
Muscle Relaxants
A
- Part of balanced anesthesia
- Used for skeletal muscle relaxation
- Must provide mechanical respiration and analgesia
2
Q
Hydromorphone Effects
A
- Dose-related respiration depression
- Vomiting / BM
3
Q
Hydromorphone Use
A
- Used with cats and dogs
- Pre/Post anesthetic sedation and analgesia
- Used for c-sections
4
Q
Sedative Effects
Diazepam & Midazolam
A
- Unreliable when used alone
- Minimal to no analgesia
- No anti-emetic properties
5
Q
Torb and Dex Effects
A
- Moderate-severe respiratory depression (dose-related)
- Hyper-reactivity to auditory stimuli (opiod related)
6
Q
Torb Effects
A
- Use with cats and dogs
- Antitussive in dogs
- Slight cardiovascular and respirtatory depression
7
Q
Guaifenesin
A
- Gecolate
- Muscle relaxant
- Minimal cardiovascular effect
8
Q
Dex and Rompun
A
- Alpha-2 adrenergic agonists
- Non-phenothiazine, non-narcotic
- Derived from thiazine
- Chemically similar
9
Q
Torb
A
- Narcotic
- Not good used alone*
- Analgesic
*use with Ace or Rompun
10
Q
Torb-Dex Uses
A
- Use for short procedures
- Use with greyhounds
- Not reversed if longer analgesia required
11
Q
Ace-Torb
A
- Neuroletanalgesic
- Sedation + Pain relief
- Use prior to anesthesia
12
Q
Anticholinergics
A
- Don’t provide analgesia
- Don’t cause CNS or respiratory depression
- Dilates pupils
- Treats organophosphate poisonings
13
Q
Ace and Anesthesia
A
- Most widely used pre-anesthetic tranquilizer
- Predictable sedation with a wide margin of safety
- Lessens excitement phase during induction
14
Q
Effects on Heart
Dex and Rompun
A
- Causes bradycardia
- Depresion of heart muscles
- Second degree heart block*
*no QRS sometimes after P
15
Q
Morphine Routes
A
SQ or IM
* no IV due to hyper-excitation
16
Q
Tranquilizers
A
Diazepam and Midazolam
* benzodiazepine
* not phenothaizine or narcotic
* controlled drugs
* given IV or IM
17
Q
ACE and Sympathetic Nervous System
A
- Activity suppressed
- Blocks nerve receptors and neurotransmitter activity*
*Alpha and Dopamine
18
Q
Hydromorphone
A
- Synthetic opioid
- Like oxymorphone but less $$
- Can combine with ACE
19
Q
Reverse Hydromorphone
A
Reverse with Naloxone
20
Q
Dopamine Receptors
A
- In brain
- Neuotransmitters
- Naturally produced in the body
- Lack of contributes to sedation
21
Q
Atropine
A
- Anticholinergics
- Injectable
- IV given in emergencies
22
Q
ACE Patients
A
- Use with calm animals; excitable may be resistant to effects
- Avoid in prediatric and geriatric due to prolonged effects
23
Q
ACE and Eyelid Effects
A
Cause prolapse of the third eyelid
24
Q
FDA Approval
Rompun and Dex
in dogs and cats
A
- Dog: pre-anesthetic
- Cat: sedative and anesthetic
25
Alpha Receptors
When blocked, protect the heart against epinephrine induced arrhythmias
26
Fentanyl
Systemic Effects
* Respiration / Cardiovascular Depression
* May cause bradycardia*
| * have Atropine ready
27
Ace & Skin Tests
Avoid use in skin testing
* anti-histamine activity
28
Diazepam & Midazolam
| Patients
Good for patients with epilepsy or cardiovascular disease
* Less depressant on heart and vessels
* Minimal cardiopulmonary depression
29
Hydromorphone
| Forms & Routes
* Injectable
* No oral use
* SQ or IM
* IV with dogs if needing immediate action
30
Buprenorphine
* Narcotic
* Acts longer than torb
* Can cause respiratory depression*
| *monitor for 2 hours after given
31
Diazepam
* Not water soluble
* Poorly absorbed when given IM or SQ
* Should not be mixed with other water solubles*
| *Ketamine is exception
32
Torb Routes
* IV
* IM
* SQ
33
Diazepam & Midazolam
| As anticonvulsants
* Given IV
* Given in dogs combined with Ketamine
* Reduces possibilty of seizures
34
Ace
| with horses
* Can cause penile paralysis
* Leads to prolapse of penis from sheath
35
Diazepam & Midazolam
| Metabolism & Excretion
Metabolized by liver
Excreted in urine
36
Morphine
| General Effects
* Miosis
* Vagal Stimulation
* Bradycardia
* Vomitting / BM
* Decreased Body Temp
37
Ace
| Metabolization
Liver
38
Fentanyl
| Forms
No oral
Transdermal
* administerd via patch
* don't use with heating pads due to increased absorption
39
Opioid
| SIde Effects
* Respiratory Depression
* Bradycardia
* GI Stimulation
* Excitement
40
Opioid
| Excitement Causes
Dogs: high dose
Cats: given too fast via IV
41
Morphine
| Analgesia & Anesthesia
Analgesia = low dose
* minimal effect on myocardium
Anesthesia = high dose
* BP and respiratory depression
42
Ace
| Effects on Heart
* Reduces strength of contraction
* Don't use in cases of shock, hypotension, or cardiac disease
43
Ace
| As a Travel Pill
* Sedation
* Anti-emetic Properties*
| *suppresses chemoreceptor trigger zone
44
Atropine
| with Rompun and Dex
Atropine used to prevent bradycardia
* must be given 10 minutes before Alpha-2
* bad arrhythmias if given after Alpha-2
45
Diazepam & Midazolam
| in cats
* May be used to stimulate appetite
* May also cause vomiting
46
Anticholinergics
| Undesirable Side Effects
* Excessive, thick mucus in respiratory system
* Increased anotomical dead space*
* Increased HR = Increased O2 consumption
* Intestinal paralysis
| *Bronchi dilation
47
Glycopyrrolate
* Anticholinergics
* Lasts two times longer than atropine
* Less effects on the heart
* Doesn't cross placental barrier
48
Diazepam Given out of Vein
May cause perivascular irritation
49
Morphine
* Narcotics
* Schedule II
* From opium plant
* Inexpensive
50
Morphine
| Reversal
Reversed with Nalline
* nalorphine
51
Narcotic Antagonists
Only reverses effects of narcotics
* works within 1-2 minutes
Causes CNS arousal
52
Ace with other drugs
* Reduces barbiturate dose by half
* When combined with ketamine in cats, produces muscle relaxation
53
Phenothiazine Derivatives Tranquilizers
* Acepromazine
* Chlorpromazine*
* Promazine
| *used an anti-emetic
54
Midazolam
* Water soluble
* Readily absorbed given SQ or IM
* Can be mixed with other agents
55
Alpha-2 Agonist Agents
* Causes vasoconstriction
* Depresses CNS
56
Alpha-2 Agonist Agents
| Effects
* Sedation
* Hypnotic Effects
* Analgesia
* Muscle Relaxation
57
Alpha-2 Agonist Agents
| Routes
* SQ
* IM
* IV
58
Opioid Reversal
Specific narcotic reversal agents
* Nalline & Narcan
59
Opioid Reversal
| and Atropine
Give Atropine prior to counteract vagal effects
60
Narcotics
* Opioids
* Controlled - mostly II
61
Narcotics
| Pre-anesthetic Use
* Provide sedation and analgesia
* Reduce induction med dose by half
62
Rompun & Dex Reversals
Rompun (Xylazine)
* yohimbine
Dex
* antisedan
63
Dex Dose Determination
Dogs
* based on body surface area; not weight
Cats
* based on weight
64
Buprenorphine Administration
* Most often given in cats
* For mild-moderate pain
* Give on MM
65
Anticholinergics
| In Horses
Not routinely used
* causes paralytic effects in intestinal tracts
* leads to colic
66
Ace
| and Placental Barrier
Crosses barrier
* sedates newborn if used during c-sections
67
Anticholinergics and Eyes
* Pupil dilation
* Reduced tear secretion - leads to drying of cornea*
| *use ointment
68
Gallamine
* Muscle relaxant
* Blocks motor nerve impulse
* No muscle twitching
69
Neuroleptanalgesia
Combination of narcotic and a tranquilizer
70
Nalorphine HCI
* Nalline
* Narcotic antagonist
* Synthetically derived from morphine
71
Nalorphine HCI
| Narcotic Antagonist
Use for morphine and fentanyl
72
Ace and Hypotension
| Cause
Produced due to site of action of epinephrine on the arterioles being blocked
* give IV fluids
73
Acepromazine
* Phenothiazine derivative tranquilizer
* Desired action is tranquilization
74
Naloxone
* Narcan
* Narcotic antagonist
* Derived from oxymorphone
75
Naloxone
| Narcotic Antagonist Use
Use for:
* hydromorphone
* fentanyl
* morphine
76
Narcotic Antagonists
| Routes
* Fastest = IV
* IM or SQ via umbilical vein
* Drop under the tongue
77
Morphine Effects
| Cats and Dogs
Both hyperactive to sound
Dogs
* unpredicatable excitement
Cats
* use with caution
* give tranquilizer
78
Glycopyrrolate
| Routes
* SQ
* IM
* IV
79
Fentanyl
* Similar to morphine
* Great analgesia with low dose
80
Fentanyl
| Reversal
Reversed with an antagonist
* nalline
81
Ace-Hydromorphone
| or Ace-Oxymorphone
* Neuroleptanalgesic
* Used for C-sections
82
Ace Routes
* Fastest: SQ (used most often)
* IM
* IV*
| * caution of severe hypotension
83
Ace
| Reticular Activating System
* Reduces activity of
* System responsible for awake state
* Reduced response to stimuli
* Sedation
84
Torb
| As A Reversal
Can be used as narcotic reversing agent for morphine and oxymorphone
85
Anticholinergics
| Desired Effects
* Take "brakes off heart"
* Counteract vagal tone
* Prevent bradycardia
* Prevent salivary gland and upper airway secretion
* Reduce laryngospasm during intubation
