Pre-medicants

Question 1

Objectives of pre-mendicant use

Answer 1

Relaxation & anxiety reduction
Provision of sedation & analgesia
Aid smooth induction & recovery
Drug sparing
Reduction of side effects

Question 2

Effective sedation requires…

Answer 2

Quiet environment

Adequate time for full effect

Question 3

ROA affects…

Answer 3

Duration of action
Time to peak effect
Incidence of side effects

Question 4

Effects of a sedative

Answer 4

CNS depression
Drowsiness/lethargy
Loss of consciousness

Question 5

Effects of a tranquilliser

Answer 5

Calms & reduces anxiety

No loss of consciousness

Question 6

Effects of a neurolept

Answer 6

State of apathy & mental detachment
Major tranquilliser
No loss of consciousness

Question 7

Effect of a narcotic

Answer 7

Drug induced stupor

Insensibility & paralysis

Question 8

Classification of acetylpromazine & general properties

Answer 8

Phenothiazine
Sedation at appropriate dose
Increasing does does not increase degree of sedation; increases duration & side effects
Addition of opioid potentiates sedation (neutroleptanalgesia)

Question 9

Advantages of aceytlpromazine

Answer 9

Anti-arrhythmic
Anti-emetic
Wide safety margin (no coma w/OD)
Can be combined w/opioid to improve sedation

Question 10

Disadvantages of acetlypromazine

Answer 10

Slow onset; long acting
No analgesia
Poor muscle relaxation
Unpredictable effect
May cause syncope
Causes vasodilation (hypotension & hypothermia)

Question 11

3 examples of alpha-2 agonists

Answer 11

Medetomidine
Dexmeditomidine
Xylazine

Question 12

Alpha-2 agonist properties

Answer 12

Provide sedation; anaesthesia if combined w/ketamine
Bind to a-2 receptors in brain & spinal cord: block pain impulse transmission
Generally reserved for young & healthy animals
Avoid in CNS & hepatic disease

Question 13

Alpha-2 advantages

Answer 13

DD sedation
DD duration of action
Reasonably predictable
Drug sparing 
Visceral analgesia 
Muscle relaxation
Reversible

Question 14

Alpha-2 disadvantages

Answer 14

CVS & resp. Depression
Impaired thermoregulation
Reduced hepatic blood flow
Apnoea & grey mms

Question 15

Full agonist opioid examples & indication for use

Answer 15

For mod-severe pain
Can to topped up to increase effect
Morphine
Methadone
Butorphanol
Pethidine
Fentanyl

Question 16

Partial agonist opioid example & indication for use

Answer 16

For mike-mod pain
Cannot be topped up
Buprenorphine

Question 17

Properties of opioids & how they work

Answer 17

Relief of pre-op pain & anxiety
Contribute to sedation when combined with another agent
Combine w/specific receptors in brain & spinal cord

Question 18

Opioid advantages

Answer 18

DD analgesia
Drug sparing
causes sedation in non-painful animals
Reversible (naloxone)

Question 19

Opioid disadvantages

Answer 19

High dose may cause profound resp. Depression
Full agonists may cause bradycardia
Exciting on OD, leading to dysphoria (esp. cats)
Anti-tussive - accumulation of bronchial secretions impairing resp.

Question 20

Define neutroleptanalgesia

Answer 20

Combination of neurolept & analgesic
Operate synergistically
Drug sparing

Question 21

Neutroleptanalgesia advantages

Answer 21

Increased sedation quality
Increased predictability
Reduced side effects
Stable CP performance

Question 22

Neutroleptanalgesia disadvantages

Answer 22

Increased sensitivity to stimuli
Can only reverse opioid
Behavioural changes in dogs

Question 23

Examples of benzodiazepines & their ROA

Answer 23

Diazepam IV

Midazolam IM

Question 24

Characteristics of benzodiazepines

Answer 24

Often combined w/opioids
Only used alone in critically ill -
Provide safe sedation

Question 25

Benzodiazepines advantages

Answer 25

Wide safety margin Minimal CP effects Muscle relaxation Anti-epileptic

Question 26

Benzodiazepines disadvantages

Answer 26

Unpredictable - may cause excitation in healthy animals | Water insoluble diazepam may be painful if given IM

Question 27

Define anti-cholinergics & examples

Answer 27

Parasympathetic agonists Atropine Glycopyrrolate

Question 28

Atropine advantages

Answer 28

Reduces salivation & bronchial secretions | Controls intro-op bradycardia

Question 29

Atropine disadvantages

Answer 29

Increases HR & MBR Thickens bronchial secretions Increases myocardial o2 consumption

Question 30

Indications for use of anti-cholinergics

Answer 30

``` When a vagal activity is a concern Bradycardia Hypotension Brachycephalics Ocular & laryngeal sx ```

Question 31

Glycopyrrolate advantages

Answer 31

Decreases salivation | Reduces incidence of tachyarrythmias

Question 32

Glycopyrrolate disadvantages

Answer 32

Mild mydriasis (dilation) Xerostoma (dry mouth) Tachycardia