Pressors, NSAIDs, muscle relaxants Flashcards
1
Q
Epinephrine
A
- adrenergic receptor agonist
- IV or intratracheal
- Cardiovascular - inc CO, dec BP and SVR at low doses, inc SVR at high doses
- rapid metabolism
- arrhythmogenic
- used for CPR
2
Q
Norepinephrine
A
- adrenergic agonist at alpha-1, alpha-2, and beta-1
- manage hypotension
- low doses = beta-1 effects- inc HR and CO, dec SVR
- Higher doses - inc BP, CO, SVR, and polmonary VR
- arrhythmogenic
3
Q
Dopamine
A
Effect is DOSE DEPENDENT
- Low dose (0.5 - 2mcg/kg/min) = DA-1 and DA-2 effects - vasodilation, used during oliguric renal faluire to promote diuresis (not recommended anymore)
- Mid dose (5-10) = beta1 and beta2 receptor agonist - inc contractility, HR, CO, and coronary blood flow
- High dose (>10) = alpha1 effects - inc SVR and PulmVR, inc HR (vasoconstriction)
- short half-life = CRI
- extravasation can cause tissue necrosis
4
Q
Dobutamine
A
- synthetic catecholamine
- primarily beta1 effects but also beta2 and alpha 1 at higher doses
- Inc BP, CO but not contractility - limited effects on BP
- inc SVR and HR at higher doses
5
Q
Phenylephrine
A
- alpha1 adrenergic agonist, no beta
- Inc SVR, MAP
6
Q
Vasopressin
A
- ADH
- used to treat hypotension
- potent vasocontrictor
- alternative to epi for CPR
7
Q
NSAIDs (general)
A
- COX inhibitors, redice PGE2 production
- dec renal perfusion via dec medulary vasodilation (via inhibition of renal PGE2 production)
- Can cause GI ulceration - COX-1 PGs dec hydrochloric acid secretion, inc bicarb and mucoud production, and inc epithelial cell prolipheration and mucosal blood flow. Also, direct irritation of the drug.
- impair platelet activity via impaired PG synthesis (COX-1)
- can cause liver injury as undergo extensive heptatic metabilism - effects can be dose dependent or idiosyncratic
- Not recommended for use in liver dz as dec clearance
- More COX-2 supposed to dec side effects
8
Q
Carprofen
A
- propionic acid-derived NSAID
- COX2 selective (COX1:COX2 of 17)
- licensed for dogs
- minimal side effects
- antiinflam, antipyretic, analgesic
- poss positive effects on OA
9
Q
Deracoxib
A
- Deramaxx
- Coxib class - COX1 sparing
- licensed for dogs
- bioavail better when giving with food
- liver metabolism
- excreted in feces»urine
- sulfonamide so may case KCS
- 4mo+
10
Q
Etodolac
A
- Indole acetic acid derivative that inhibits COX1 and COX2 (primarily COX1)
- antiinflam mostly due to COX1 inhibition but also macrophage chemotaxis
- licensed for dogs
- removed through biliary exretion but also undergoes enterohepatic recirc (poss inc risk of GI side effects)
- use with caution in p with hepatic, renal, or hematologic dysfunction
- can cause KCS
- 12mo+
11
Q
Firocoxib
A
- Previcox
- pyridylsulfone
- COX2 specific (COX1:COX2 342-430)
- rapid clearance
- 6mo+
12
Q
Ketoprofen
A
- propionic acid subclass or carboxylic acid derivatives
- COX1 selective
- only labeled for 30days of use in OA
- antiinflam, antipyretic, analgesic
- renal side effects - nephritis
- CNS side effects - headaches and dizziness
13
Q
Mavacoxib
A
- COX2 inhibitor (COX1:COX2 of 21)
- very sow clearance - therapeutic concentrations last for 1mo
- bioavail better when given with food
- Elimination via biliary tract - excreted unchanged
- treatment cycle should be limited to 6.5 months with 2 mo off to allow plasma levels to drop (in case of p with slow clearance)
14
Q
Meloxicam
A
- oxicam group
- COX2 specific (COX1:COX2 of 3)
- not licensed for use in cats in US
- low GI and renal toxicity
- Black box warning for renal dx in cats
15
Q
Phenylbutasone
A
- COX2 selective (COX1:COX2 of 2.64)
- licensed in dogs
- metabolized in the liver
- chondrodestructive effects
- toxicity manifests as hemorrhage, biliary stasis, hepatitis, and renal failure
