Podcast
Questions and Answers
What is the primary mechanism of action of Butorphanol?
What is the primary mechanism of action of Butorphanol?
Which of the following is an advantage of using hydromorphone?
Which of the following is an advantage of using hydromorphone?
What is a common side effect of Butorphanol in patients requiring stronger analgesics?
What is a common side effect of Butorphanol in patients requiring stronger analgesics?
What aspect of mu opioid administration does Butorphanol affect?
What aspect of mu opioid administration does Butorphanol affect?
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What is a specific disadvantage of using hydromorphone?
What is a specific disadvantage of using hydromorphone?
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In what type of patients is Butorphanol particularly beneficial?
In what type of patients is Butorphanol particularly beneficial?
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Which option is a reversal agent for hydromorphone?
Which option is a reversal agent for hydromorphone?
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Why is it important to monitor patients receiving hydromorphone?
Why is it important to monitor patients receiving hydromorphone?
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What is the main action of Acepromazine as a sedative?
What is the main action of Acepromazine as a sedative?
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Which of the following is a key disadvantage of using Acepromazine?
Which of the following is a key disadvantage of using Acepromazine?
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In comparison to Acepromazine, what is a significant benefit of using Dexmedetomidine?
In comparison to Acepromazine, what is a significant benefit of using Dexmedetomidine?
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What should be considered when using Dexmedetomidine in compromised patients?
What should be considered when using Dexmedetomidine in compromised patients?
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Which of the following best describes a unique feature of Acepromazine?
Which of the following best describes a unique feature of Acepromazine?
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What is a primary reason to avoid using Acepromazine in certain breeds like those with the MDR1 gene?
What is a primary reason to avoid using Acepromazine in certain breeds like those with the MDR1 gene?
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What is a significant side effect associated with using Dexmedetomidine?
What is a significant side effect associated with using Dexmedetomidine?
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What is a common effect of both Acepromazine and Dexmedetomidine?
What is a common effect of both Acepromazine and Dexmedetomidine?
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What is one of the clinical advantages of pre-medication in anesthesia?
What is one of the clinical advantages of pre-medication in anesthesia?
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Which route of medication administration has the longest duration of action?
Which route of medication administration has the longest duration of action?
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What is the primary goal of preemptive analgesia?
What is the primary goal of preemptive analgesia?
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Which of the following is NOT a benefit of multimodal therapy in pain management?
Which of the following is NOT a benefit of multimodal therapy in pain management?
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Which anesthetic premedication option is commonly used in large animals?
Which anesthetic premedication option is commonly used in large animals?
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What is a key function of the pre-medications during the operative period?
What is a key function of the pre-medications during the operative period?
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Which of the following statements about the onset of action for medication routes is accurate?
Which of the following statements about the onset of action for medication routes is accurate?
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What aspect of shock is improved by using pre-medications during anesthesia?
What aspect of shock is improved by using pre-medications during anesthesia?
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Flashcards
Acepromazine Use
Acepromazine Use
Acepromazine is a pre-med used for mild sedation, anxiolysis, and as an antiemetic. It also spares anesthetic use.
Acepromazine Side Effects
Acepromazine Side Effects
Acepromazine can cause hypotension, hypothermia, increased heart rate, and may lower seizure threshold. Avoid in MDRI Gene Dogs. Also less effective in cats.
Dexmedetomidine mechanism
Dexmedetomidine mechanism
Dexmedetomidine is an alpha 2 adrenergic agonist, causing profound sedation and moderate muscle relaxation.
Dexmedetomidine advantages
Dexmedetomidine advantages
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Dexmedetomidine CV effects
Dexmedetomidine CV effects
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Hydromorphone mechanism
Hydromorphone mechanism
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Acepromazine dose concern
Acepromazine dose concern
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Dexmedetomidine dose concern
Dexmedetomidine dose concern
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Hydromorphone: Potency
Hydromorphone: Potency
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Hydromorphone: Reversibility
Hydromorphone: Reversibility
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Hydromorphone: Side Effects
Hydromorphone: Side Effects
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Butorphanol: Mixed Agonist/Antagonist
Butorphanol: Mixed Agonist/Antagonist
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Butorphanol: Analgesia Plateau
Butorphanol: Analgesia Plateau
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Butorphanol: Antitussive
Butorphanol: Antitussive
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Buprenorphine: Partial Mu Agonist
Buprenorphine: Partial Mu Agonist
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Buprenorphine: Kappa Antagonist
Buprenorphine: Kappa Antagonist
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Pre-anesthesia Medications (Pre-meds)
Pre-anesthesia Medications (Pre-meds)
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Preemptive Analgesia
Preemptive Analgesia
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Pre-med Route Rankings
Pre-med Route Rankings
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Multimodal Therapy
Multimodal Therapy
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Anesthetic-Sparing Effect
Anesthetic-Sparing Effect
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Reducing Adverse Effects
Reducing Adverse Effects
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Improved Quality of Recovery
Improved Quality of Recovery
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Pain Management
Pain Management
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Study Notes
Anesthetic Agents and Adjuncts
- Anesthetic agents are drugs inducing a loss of sensation, potentially with unconsciousness.
- Adjuncts are drugs not true anesthetics, used during anesthesia to enhance desired effects like sedation, muscle relaxation, analgesia, reversal, neuromuscular blockade, or parasympathetic blockade.
Anesthesia Activity & Terminology
- Intrinsic activity is a drug's ability to produce a biological response, measuring efficacy or potency.
- Drug efficacy is the ability to initiate changes after binding to receptors, leading to certain effects.
- Potency is a comparison of different doses needed to reach the same pharmacological effect.
- Agonists bind to and stimulate target tissues; many anesthetic agents and adjuncts are agonists.
- Antagonists bind to tissues but don't stimulate; reversal agents are antagonists.
- Pharmacokinetics describe how the body affects a drug (absorption, distribution, metabolism, excretion).
- Pharmacodynamics describe a drug's effects on the body (mechanism of action, side effects).
Adjunct Classifications
- Drug administration routes (SQ, IM, IV, PO, etc.)
- Administration timing (pre-medication, induction, maintenance, recovery).
- Principle effects (local vs. general, sedatives/tranquilizers vs. analgesics, blockers, anticholinergics).
- Drug chemistry and pharmacology.
Drug Combinations
- Avoid mixing incompatible drugs in a single syringe.
- Verify compatibility before administering drug combinations.
- Most anesthetic agents and adjuncts are water-soluble, but some aren't (Diazepam).
- Check compatibility charts or use resources for safe drug combinations.
Pre-anesthesia Medications ("Pre-meds")
- Calming patients reduces excitement and improves handling.
- Reduces stress, anxiety, and catecholamine release.
- Provides analgesia and muscle relaxation.
- Allows for reduced anesthetic induction and maintenance drug use.
- Improves vital systems stability during surgery.
- Enhances recovery from anesthesia, minimizing excitement and aiding a smoother process.
- Often used as adjunctive agents for local anesthetics.
Pre-medication Routes
- Intravenous (IV) administration provides the fastest onset.
- Intramuscular (IM) administration has a faster onset than subcutaneous (SC) but slower than IV.
- Subcutaneous (SC) administration provides the slowest onset and longest duration of action.
- Oral administration commonly used for some medications with slower onset and duration.
Preemptive Analgesia
- Administering pain medication before pain occurs to prevent pain signals.
- Usually involves adding analgesic drugs during pre-medication.
- Reduces overall analgesic requirements and duration (MAC sparing).
- Prevents pain-related windup, making subsequent pain management easier.
Perioperative Pain Management
- Preemptive analgesia starts before surgery with pre-medication.
- Anesthetic pre-medication can include the administration of analgesics or pain medication.
- Transdermal fentanyl patches offer consistent analgesic release.
- Non-steroidal anti-inflammatory drugs (NSAIDs) can be used in large animals (primary use).
- Multimodal therapy uses more than one pain-control drug in combination (e.g. covering different receptors).
- Dose reduction of individual drugs, while enhancing pain management.
Pre-Med: Phenothiazines (Acepromazine)
- Advantages: Mild sedation, anxiety reduction, lessened interest in surroundings, anesthetic sparing, antiemetic effects, smoother induction, and histamine prevention.
- Disadvantages: Cardiovascular effects (vasodilation, hypotension, hypothermia, increased heart rate), non-reversible, use caution in MDRI Gene Dogs (herding breeds), potential decreased seizure threshold, no analgesic effect, less effective in cats, and can worsen respiratory depression from other drugs.
Pre-Med: Dexmedetomidine
- Advantages: Profound sedation (most profound group), reversible (atipamezole), moderate muscle relaxation, mild analgesia, reduces stress, lessens sympathetic outflow, and anesthetic sparing (50-80%).
- Disadvantages: Profound peripheral vasoconstriction, reflex bradycardia, possible arrhythmias (1st, 2nd AV block), mild bradypnea, reduced GI motility, not suitable for compromised/ill patients, Severe reduction in CO (cardiac output ) likely, and use cautiously only in normal, healthy dogs and cats.
Pre-Med: Opioids (Hydromorphone)
- Advantages: Robust analgesia (strongest), mild to moderate sedation, reversible with naloxone, minimizes direct cardiovascular effects, suitable for compromised patients, lessened nausea and histamine release comparatively to morphine, but more than that.
- Disadvantages: Cardiovascular and respiratory depression, vomiting, nausea, hypersalivation, dysphoria (excitement, especially in cats), ileus (colic in horses), reduced GI motility, histamine release, high abuse potential (Class II narcotic), and chronic pain use not advisable.
Pre-Med: Butorphanol
- Advantages: Mild-moderate analgesia, mild-moderate sedation (kappa receptor stimulation effect), partially reversible with naloxone, antitussive effects, tolerable in GI compromised patients.
- Disadvantages: Weaker analgesic effect if stronger analgesic is needed, analgesia plateau at higher doses, blocks mu receptors, abuse potential (Class IV narcotic).
Pre-Med: Buprenorphine
- Advantages: Mild to moderate analgesia (mu partial agonist), good for mild pain to severe pain (dose-dependent), reversible with naloxone, anesthetic sparing, good for GI compromised/compromised patients, use with caution only with normal healthy dogs/cats, and long-lasting analgesic effects (72-hr).
- Disadvantages: Analgesia plateau with high doses, slower onset (30mins), may not be suitable to administer a pure mu drug since it blocks mu receptor, can also have abuse potential (Class III narcotic).
Opioids Overall
- Vary in potency, duration, and side effects.
- Mu receptors are the strongest for pain control.
- Kappa receptors play a role in sedation.
- Used for pre-medication or intra/postoperative analgesia, diminishes windup pain, induces potent sedation, and/or neuroleptanalgesia.
- Reduced rate and tidal volume can lead to hypoventilation which is also dangerous.
Pre-Med: Benzodiazepines (Diazepam/Midazolam)
- Advantages: Sedative, hypnotic (species-dependent), reversible (flumazenil), muscle relaxation, anti-convulsant, minimizes direct cardiovascular effects, and minimizes respiratory effects while possibly reducing induction amount needed
- Disadvantages: Paradoxical excitation (especially in cats with midazolam.) No analgesia and cannot be administered IM (burns), Diazepam sensitive to plastics/light, potential for abuse (Class IV).
Ampule Medications
- Common ampule medications include Diazepam, Epinephrine, Atropine.
- Safe practices for handling ampules include hand hygiene, following the 5 Rs, understanding the scoring lines and using appropriate safety steps (wrap with alcohol, face away from user).
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Description
This quiz explores the roles of anesthetic agents and adjuncts in anesthesia, emphasizing their intrinsic activity, efficacy, and potency. It focuses on the mechanisms of agonists and antagonists, as well as the pharmacokinetics and pharmacodynamics of these substances. Test your knowledge on these essential components of anesthesia.
