Test 1 Flashcards by Kerry Kohler

4 Phases

PA, Induction, Maintenance, Recovery

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Why do we use PA drugs?

Sedative/tranquilize, pre-emptive analgesia, Prevent bradycardia, decrease amount of gases

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When do you give PA’s?

15-30 minutes prior to induction

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5 PA classifications

Anticholinergics, tranquilizers, alpha-2 agonists (sedatives), Opioids (narcotics), Neuroleptanalgesia

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Anticholinergic Drugs

Atropine, Glycopyrrolate

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Autonomic Nervous System branches

Sympathetic and Parasympathetic

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Epinephrine
(fight or flight) Increases HR, BP, RR
Bronchial dilation, decreases GI motility, Mydriasis, Increases blood glucose

Sympathetic NS

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Vagus nerve

Runs to eyes, pharynx, larynx, trachea, lungs, heart, GI tract

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Parasympathetic NS

Acetylcholine

Routine body functions: decrease HR, BP, RR. Bronchial constriction, Increases GI motility, Miosis

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Anticholinergics block:

Acetylcholine and the vagal nerve

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SLURED <3

Decrease salivery
Decrease Lacrimal
Contracts the urinary bladder
Causes bronchodilation
Causes mydriasis
Decreases digestion
Blocks bradycardia

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Main reason for using an anticholinergic

Prevent Bradycardia, +/- dry secretion

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Tx of bradycardia and AV blocks

Atropine

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Antidote for organophosphate (insecticide) poisoning

Atropine

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Atropine duration

60-90 minutes

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Glycopyrrolate duration

4 hours

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Tranquilizer groups

Phenothiazines, Benzodiazepines

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Why we use a Tranquilizer as a PA

Relaxation and calming

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Do Tranq. have analgesia?

NO, but can improve analgesic effects

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Phenothiazines

Acepromazine/Acetylpromazine (Promace®)

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Benzodiazepines

Diazepam (Valium®), Midazolam (Versed®), Zolezapam (in Telazol®)

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Acepromazine (Promace®)

Water soluble, YELLOW

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Ace duration

4-8-24hr up to 48hrs in geriatric, neonates or liver dz

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Phenothiazines and Cats

Less pronounced effect

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Effects on Phenothiazines

Calming, Antiemetic, Antiarrhythmic, Antihistamine, Vasodilation, no significant respiratory or cardiac depression, Prolapse of the 3rd eyelid, penile prolapse, MAY lower seizure threshold

Main effect for Phenothiazine

Vasodilation

Max dose of Acepromazine

3mg (IM, SQ), NO reversal

Benzodiazepine Group

Diazapam (Valium®), Midazolam (Versed®), Zolazepam (In Telazol®)

Reversal agent for Benzodiazepine tranq.

Flumazenil (a specific antagonist for benzo)

Effects of Benzodiazepines

Antianxiety and calming- can have excitment

Alpha-2 agonists (Sedatives)

Xylazine (Rompun®), Medetomidine (Demitor®), Dexmedetomidine (Dexdomitor®)

Reversal for Xylazine

Yohimbine

Reversal for Medetomidine and Dexmedetomidine

Atipamezole

Alpha-2 receptors produce

Analgesia, sedation, muscle relaxation

Alpha-2 agonists Bind to

alpha-2 adrenoreceptors on sympathetic nerves within brain and spinal cord

Effects of Alpha-2 agonists (sedatives)

sleepiness, muscle relaxation, short periods of analgesia, emetic

Side effects of Alpha-2 agonists

Brady and arrhythmias, decreased CO, Hypotension, Respiratory depression

Biggest side effect for Alpha-2 agonists

Peripheral vasoconstriction

Xylazine (Rompun®) Solution

Small animals- 2% Large- 10% Avoid using in old and sick animals

Medetomidine dosing

mcg per square meter of body surface

Medetomidine and Dexmedetomidine reversal

Atipamezole

Dexmedetomidine (Dexdomitor®)

Given before alpha-2 sedatives

Opioids reversable?

Yes

Opioids controlled?

Yes, all

Opioids duration

12-24hrs

3 types of opioid receptors in brain

Mu, Kappa, Sigma

Agonists

Stimulate receptors

Pure agonist

Full mu agonist

Antagonists

Block receptors

Pure agonist opioids

Morphine, hydromorphone, oxymorphone, methadone, fentanyl | Most effective for tx of severe pain

Butorphanol opioid

Mixed agonist/antagonist

Buprenorphine

Partial agonist

Opioid reversal

Naloxone

Opioid Respiratory Effects

Respiratory depression- Most common. 'Using safe dosages, respiratory doesn't have to be a problem'

Opioid Thermo effect

Panting in some animals- brain mistakenly thinks animal is hot

Dog/Cat opioid effects

Dog- Hypothermia | Cat- Hyperthermia

Morphine (Duramorph®)

Pure agonist produces analgesia with sedation Emetic

Morphine duration

4hrs in dogs

Epidural morphine duration

12-24hrs

Hydromorphone (Dilaudid®)

Pure agonist | 5 times more analgesic potency than morphine

Hydromorphone duration

4hrs

Oxymorphone (Numorphan®)

Pure agonist | 10 times more analgesic than morphine

Fentanyl (Sublimaze®)

Pure agonist 100-150 times more analgesic potency Most commonly used as CRI or Transdermal

Fentanyl patch duration

takes 4-12hr in cats and 12-24 hrs in dogs to reach therapeutic blood levels -Provides continuous steady analgesia for 3-5 days

Butorphanol (Torbugesic®, Torbutrol®)

Mixed agonist/antagonist | Kappa agonist/Mu antagonist

Butorphanol duration

1hr in dogs, 4hrs in cats

Bupernorphine (Buprenex®)

Partial agonist, Partial Mu agonist | Mild to moderate pain

Bupernorphine duration

6-8-12 hrs

OTM

Oral transmucosal | Bupernophine cheek pouch in cats

Opioid antagonist

Naloxane hydrocholride (Narcan®)

Naloxane

blocks all 3 receptors | Also helpful in neonates after C-section, 1 drop under the tongue

Elephant opioid

Etorphine (M99®) 3000-8000 times more potent

Neuroleptanalgesia

Tranq/Sedative: Ace/Butorphanol Diazepam/Hydromorphone Versed®/Fentanyl

Test 1 Flashcards

(73 cards)