Drugs ch.3 & 8
94 Questions
44 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which of the following opioids would be the best choice for moderate to severe pain

  • Butorphanol
  • Propoflo
  • Hydromorphone (correct)
  • Codeine

    • Which of the following is incorrect when using propoflo

  • Administer within 1-2 mins
  • Administer full dose IV (correct)
  • Titrate the drug in several boluses
  • Administer calculated dose as a bolus

    • Which of the following drugs is useful in suppressing nausea and vomiting

  • Maropitant (correct)
  • Carprofen
  • Morphine
  • Hydromorphone

    • Young animals have limited glucose reserves and are at greater risks of ___________ because of fasting

    <p>Hypoglycemia</p> Signup and view all the answers

    Normal respiratory rate for a dog or cat under anesthesia is

    <p>8-12</p> Signup and view all the answers

    Which of the following is a direct effect of epinephrine

    <p>Vasoconstriction</p> Signup and view all the answers

    Which of the following is a neuroactive steroid anesthetic

    <p>Alfaxolone</p> Signup and view all the answers

    Which of the following statements regarding multimodal analgesic therapy is NOT true

    <p>Side effects are generally increased when using several analgesics concurrently</p> Signup and view all the answers

    Which of the following drug combinations is an example of multimodal analgesic therapy

    <p>Dexmedotomidine, morphine, ketamine</p> Signup and view all the answers

    Which one of the following analgesic plans targets all four steps of nociception by using three different classes of analgesic agents

    <p>Morphine IM, ketamine CRI, lidocaine nerve block</p> Signup and view all the answers

    Which of the following is NOT a potential side effect of opioid administration in cats and dogs

    <p>Renal failure</p> Signup and view all the answers

    Which of the following is the mechanism of action of non steroidal antiinflammatory drugs

    <p>They inhibit prostaglandin synthesis or action</p> Signup and view all the answers

    Which of the following is not a potential side effect of NSAID administration

    <p>Respiratory depression</p> Signup and view all the answers

    A neurolept analgesic is a combination of

    <p>An opioid and a tranquilizer</p> Signup and view all the answers

    Dogs with an MDRI(ABCB1-1delta) gene mutation have increased sensitivity to which of the following drugs

    <p>Butorphanol and acepromazine</p> Signup and view all the answers

    Which of the following is not a characteristic of dissociative anesthesia

    <p>Prolapsed third eyelid</p> Signup and view all the answers

    Etomidate is particularly well suited for induction of dogs with which of the following conditions

    <p>Severe cardiac disease</p> Signup and view all the answers

    One of the disadvantages of the drug alfaxalone is that animals that are anesthetized with it may demonstrate excitement during recovery

    <p>True</p> Signup and view all the answers

    May cause excitement or dysphoria in cats and horses and restlessness in dogs and horses

    <p>Morphine</p> Signup and view all the answers

    Adverse effects are respiratory depression, vomiting, bradycardia, heart block, hypotension

    <p>Alpha2-adrenoreceptor agonists</p> Signup and view all the answers

    Horses may remain standing but become ataxic

    <p>Xylazine, detomidine, romifidine</p> Signup and view all the answers

    Adverse effects are stomach ulcers, vomiting, gastrointestinal bleeding, lack of appetite

    <p>NSAIDs</p> Signup and view all the answers

    Adverse effects are renal toxicity and impaired platelet aggregation leading to prolonged bleeding time

    <p>NSAIDs</p> Signup and view all the answers

    Adverse effects are ulcerogenic, immunosuppressive with prolonged use, and hyperadrenocorticism

    <p>Corticosteroids</p> Signup and view all the answers

    Few adverse effects except drowsiness

    <p>Gabapentin</p> Signup and view all the answers

    Liquid form contains xylitol which is toxic to dogs and cats

    <p>Gabapentin</p> Signup and view all the answers

    Blocks NMDA at the spinal cord to prevent windup

    <p>Ketamine</p> Signup and view all the answers

    Provides intraoperative analgesia

    <p>Morphine, lidocaine, ketamine</p> Signup and view all the answers

    Used as an adjunct to more potent analgesics like opioids, local anesthetics and alpha2-agonists but does not produce analgesia by itself

    <p>Ketamine</p> Signup and view all the answers

    Examples of multimodal therapy

    <p>Acetaminophen and codeine = Oral tx for moderate to severe pain in dogs Fentanyl and meloxicam = Administered at th esame time to cats to provide analgesia until the patch takes effect Morphine and injectable NSAID (meloxicam or carprofen) = Administered at the end of surgery followed by oral NSAID for 3 days Morphine, lidocaine, ketamine = Administered in IV fluids during surgery, decreases amount of inhalant anesthetic needed</p> Signup and view all the answers

    Home analgesia

    <p>Fentanyl patches = Used sequentially for up to several months for chronic pain in dogs and cats NSAIDs = Long-term therapy of chronic painful conditions Oral morphine = Sustained-release tablet administered BID to effect Tylenol with codeine (dogs) and butorphanol = Tablet for mild-to-moderate pain</p> Signup and view all the answers

    Adverse effects are gastrointestinal stimulation in dogs and cats and ileus and colic development in horses

    <p>Morphine</p> Signup and view all the answers

    Morphine causes ____ in dogs and ____ in cats

    <p>Miosis, mydriasis</p> Signup and view all the answers

    Opioid agent that is least likely to cause vomiting in dogs and cats

    <p>Methadone</p> Signup and view all the answers

    Used in combination with midazolam or diazepam drawn into separate syringes

    <p>Fentanyl</p> Signup and view all the answers

    Can be used to reverse effects of fentanyl and morphine

    <p>Buprenorphine</p> Signup and view all the answers

    Used as a preanesthetic, sedative, and post operative visceral analgesic

    <p>Butorphanol</p> Signup and view all the answers

    Used as a reversal agent for opioid agonists (hydromorphone, morphine)

    <p>Nalbuphine</p> Signup and view all the answers

    Administered via IM or SQ route before animal regains consciousness

    <p>Post operative analgesics</p> Signup and view all the answers

    NSAIDs that inhibit the COX-1 enzyme produce the least adverse effects

    <p>True</p> Signup and view all the answers

    Can act as an antagonist to several drugs prescribed for cardiac disease and hypertension

    <p>NSAIDs</p> Signup and view all the answers

    Side effects are agitation and GI upset

    <p>Amantadine</p> Signup and view all the answers

    Useful for neuropathic pain and central hypersensitivity as well as chronic pain and musculoskeletal disease

    <p>Amantadine</p> Signup and view all the answers

    Treats neuropathic pain and hypersensitivity, useful in dogs and cats for chronic pain unresponsive to NSAIDs

    <p>Gabapentin</p> Signup and view all the answers

    Do not use concurrently with other norepinephrine or serotonin reuptake inhibitors (e.g., amytriptyline)

    <p>Tramadol</p> Signup and view all the answers

    May potentiate effects of opioids in anxious patients and may be useful in calming the excitement sometimes seen in cats and horses following opioid administration

    <p>Tranquilizers</p> Signup and view all the answers

    Any drug used to induce a loss of sensation with or without consciousness

    <p>Anesthetic agents</p> Signup and view all the answers

    A drug that is not a true anesthetic, but that is used during anesthesia to produce other desired effects such as anxiolysis, sedation, muscle relaxation, analgesia, reversal, neuromuscular blockade, or parasympathetic blockage

    <p>Adjunct</p> Signup and view all the answers

    Match

    <p>Bind to and stimulate target tissue and include most anesthetic agents and adjucts = Agonists Opioids = Partial agonists and mixed agonist antagonist Bind to target tissue but dont stimulate, are used as reversal agents = Antagonists</p> <ul> <li>= -</li> </ul> Signup and view all the answers

    Which of the following is a non-water soluble drug that will precipitate when mixed with other drugs

    <p>Diazepam</p> Signup and view all the answers

    Most general anesthetics are analgesics

    <p>False</p> Signup and view all the answers

    Controlled drug inventory must be taken yearly

    <p>False</p> Signup and view all the answers

    Which of the following requires a special DEA form 222

    <p>Schedule II</p> Signup and view all the answers

    How long can you wait to report significant loss or suspected theft of schedule II drugs to the DEA or local police

    <p>1 business day</p> Signup and view all the answers

    Used to immobilize wild animals

    <p>Thiafentanil</p> Signup and view all the answers

    Potent opioid antagonist opioid antagonist used to reverse the effects of thiafentanil and etorphine hydrochloride

    <p>Diprenorphine</p> Signup and view all the answers

    Which of the following is a tranquilizer or sedative

    <p>Phenothiazines</p> Signup and view all the answers

    Principal reasons for giving commonly used preanesthetic medications

    <p>Minimize adverse drug effects</p> Signup and view all the answers

    Anxiolytics used to minimize stress, anxiety and fear

    <p>Gabapentin</p> Signup and view all the answers

    Which of the following block acetylcholine

    <p>Parasympatholytic drugs</p> Signup and view all the answers

    Opioids

    <p>Agonists = Morphine, hydromorphone, methadone, oxymorphone, fentanyl, meperidine Partial agonists = Buprenorphine Agonist-antagonists = Butorphanol, nalbuphine Antagonists = Naloxone</p> Signup and view all the answers

    Use intramuscular in cats for deep sedation/ light anesthesia

    <p>Alfaxalone</p> Signup and view all the answers

    How long does propofol last after opening

    <p>6 hours</p> Signup and view all the answers

    Which of the following is correct of anticholinergics

    <p>Decrease in respiratory and salivary secretions</p> Signup and view all the answers

    Reduces anxiety but not awareness or wakefulness

    <p>Tranquilizer</p> Signup and view all the answers

    Reduces mental activity and causes sleepiness

    <p>Sedative</p> Signup and view all the answers

    Animals are completely docile when sedated

    <p>False</p> Signup and view all the answers

    Anticholinergics are contraindicated in animals with elevated heart rates or cardiac diseases

    <p>True</p> Signup and view all the answers

    Can cause penile prolapse in large animals

    <p>Phenothiazines</p> Signup and view all the answers

    Use of acepromazine

    <p>Use low dose = Australian shepherds and collies Increased sensitivity = Giant breeds, boxers, greyhounds Resistance = Terriers and cats</p> <ul> <li>= -</li> </ul> Signup and view all the answers

    Minor tranquilizer that may produce the opposite effect in young healthy animals

    <p>Benzodiazepines</p> Signup and view all the answers

    Can cause dysphoria/aggression in cats and ataxia or recumbency in large animals

    <p>Benzodiazepines</p> Signup and view all the answers

    A patient needs to be sedated for a minor procedure like radiography, wound tx, or bandaging, which of the following drug classes will you use

    <p>Alpha2 agonists</p> Signup and view all the answers

    Adverse effects include muscle tremors in horses and cattle may lie down

    <p>Alpha2 agonists</p> Signup and view all the answers

    The early phase cardiovascular effects of alpha2 agonists are more pronounced if the drug is given IV

    <p>True</p> Signup and view all the answers

    Alpha2 agonists can cause premature parturition in cattle and sweating in horses

    <p>True</p> Signup and view all the answers

    Opioids

    <p>Agonists = Bind to and stimulate mu and kappa receptors and are best for moderate to severe pain Partial agonists = Bind to and partially stimulate receptors Agonist-antagonists = Bind to mu and kappa receptors, but stimulate only kappa receptors Antagonists = Bind but dont stimulate mu and kappa receptors</p> Signup and view all the answers

    Opioids cause

    <p>Hypothermia in dogs and hyperthermia in cats</p> Signup and view all the answers

    Hypnosis is a sleeplike state induced by high doses of an opioid

    <p>False</p> Signup and view all the answers

    Neuroleptanalgesia is a profound state of sedation induced by simultaneous administration of

    <p>Opiates and tranquilizers</p> Signup and view all the answers

    When using opioids, sudden analgesia loss cab cause excitement, anxiety, and sympathetic nervous system stimulation. Prevent this by

    <p>Using an agonist-antagonist</p> Signup and view all the answers

    Injectable anesthetics do not provide analgesia or muscle relaxation, therefore they must be used with other agents to produce complete effects of general anesthesia. Which of the following is an example of this

    <p>Propofol</p> Signup and view all the answers

    Propofol decreases intracranial and intraocular pressure

    <p>True</p> Signup and view all the answers

    Indicates the speed of induction and recovery for an inhalation anesthetic

    <p>Blood-gas partition coefficient</p> Signup and view all the answers

    Has a low blood gas partition coefficient so it is characterized by very rapid induction and recovery rates

    <p>Sevoflurane</p> Signup and view all the answers

    A high gas partition coefficient means the agent will enter and leave the body quickly

    <p>False</p> Signup and view all the answers

    The lower the MAC, the more potent the anesthetic agent and the lower the vaporizer setting

    <p>True</p> Signup and view all the answers

    MAC is measured at the highest concentration at which 50% of patients show no response to painful stimulus

    <p>False</p> Signup and view all the answers

    A low rubber solubility means that little anesthetic agent will be lost by absorption into the rubber components of the anesthetic machine and breathing circuit

    <p>True</p> Signup and view all the answers

    Of the volatile anesthetics commonly used in vet anesthesia, sevoflurane is considered to have the fewest adverse cardiovascular effects and is therefore considered to be the inhalation agent of choice for patients with cardiac disease

    <p>False</p> Signup and view all the answers

    Isoflurane is used in patients with head traumas or brain tumors because it maintains cerebral blood flow

    <p>True</p> Signup and view all the answers

    Halogenated organic compounds

    <p>1.30-1.63% MAC, good for induction with mask or chamber = Isoflurane 2.34-2.58% MAC, good for induction with mask or chamber = Sevoflurane 7.2%-9.8% MAC, least potent inhalant agent but lowest blood gas partition coefficient (very rapid induction and recovery) = Desflurane</p> <ul> <li>= -</li> </ul> Signup and view all the answers

    Least potent inhalant agent

    <p>Desflurane</p> Signup and view all the answers

    Used to stimulate respiration in neonates

    <p>Doxapram</p> Signup and view all the answers

    Study Notes

    Opioids for Moderate to Severe Pain

    • Morphine is one of the most commonly used opioids in veterinary medicine and produces analgesia, sedation, and respiratory depression.

    • Hydromorphone is a potent opioid analgesic.

    • Fentanyl is a very potent opioid analgesic with a rapid onset and short duration of action.

    • Methadone is a long-acting opioid analgesic with a relatively long duration of action.

    • Oxymorphone is a potent opioid analgesic with rapid onset of action.

    Propofol

    • Propofol is an intravenous anesthetic that is commonly used in veterinary medicine.

    • Propofol is a powerful sedative that is injected intravenously.

    • Propofol's effects onset quickly and wear off quickly.

    • Contraindications: Do not use in patients with an egg allergy.

    • Adverse effects: It can cause apnea, hypotension, decreased heart rate, and bradycardia.

    Antiemetics

    • Metoclopramide, ondansetron, and maropitant are useful in suppressing nausea and vomiting.

    Young Animals Glucose Reserves

    • Young animals have limited glucose reserves and are at greater risks of hypoglycemia because of fasting.

    Anesthesia Respiratory Rate

    • Normal respiratory rate for a dog or cat under anesthesia is 8-12 breaths per minute.

    Epinephrine's Effects

    • Epinephrine can cause tachycardia and vasoconstriction.

    Neuroactive Steroid Anesthetics

    • Alfaxalone is an example of a neuroactive steroid anesthetic.

    Multimodal Analgesic Therapy

    • Multimodal analgesic therapy uses multiple drugs classes for improved analgesia and reduced adverse effects.

    • Multimodal therapies can include various combinations of opioids, NSAIDs, alpha-2 agonists, and local anesthetics.

    • Multimodal therapy reduces the dosage of each analgesic, reducing potential side effects.

    • Opioids work on the spinal cord to block the nerve impulses that transmit pain signals.

    • NSAIDs work at the site of injury to reduce inflammation by inhibiting cyclooxygenase enzymes.

    • Alpha-2 agonists work by stimulating alpha-2 adrenergic receptors in the central nervous system.

    • Local anesthetics are used to block pain signals by preventing nerve conduction.

    Combination Examples

    • Opioid + NSAID, Opioid + Alpha-2 agonist, or NSAID + Alpha-2 agonist are examples of multimodal analgesic therapy.

    Analgesic Plans Targeting Nociception

    • Analgesic plans using opioids, NSAIDs, and alpha-2 agonists target all four steps of nociception.

    • Step 1: Transduction involves converting painful stimuli into electrical signals.

    • Step 2: Transmission involves the conduction of electrical signals along the nerve fibers to the central nervous system.

    • Step 3: Modulation involves the processing and amplification of pain signals in the spinal cord.

    • Step 4: Perception involves becoming aware and experiencing pain.

    Opioid Side Effects

    • Opioid administration in cats and dogs can cause respiratory depression, vomiting, constipation, gastrointestinal ileus, physical dependence, urinary retention, and pruritus.

    NSAIDs Mechanism of Action

    • NSAIDs work by inhibiting cyclooxygenase (COX) enzymes, which are involved in the production of prostaglandins.

    • COX-1 enzymes are involved in normal bodily functions, while COX-2 enzymes are involved in inflammation.

    NSAID Side Effects

    • NSAID side effects include gastrointestinal ulcers, vomiting, gastrointestinal bleeding, lack of appetite, renal toxicity, hepatic toxicity, and impaired platelet aggregation.

    Neurolept Analgesia

    • Neurolept analgesia is a combination of an opioid and a tranquilizer, such as a phenothiazine or a benzodiazepine.

    • Neurolept analgesia provides profound sedation and analgesia.

    MDRI-1 Gene Mutation

    • Dogs with an MDRI(ABCB1-1delta) gene mutation have increased sensitivity to loperamide and ivermectin.

    Dissociative Anesthesia

    • Dissociative anesthesia produces catatonia, analgesia, and amnesia.

    • Ketamine is a dissociative anesthetic that has been used in veterinary medicine.

    • Ketamine can cause increased salivation, tachycardia, and respiratory depression:

    Etomidate Benefits

    • Etomidate is particularly well suited for induction of dogs with hypovolaemia and hypotension.

    Alfaxalone Issues

    • Alfaxalone can cause excitement during recovery.

    Adverse Effects of Other Anesthetics

    • Xylazine can cause excitement or dysphoria in cats and horses and restlessness in dogs and horses.

    • Tiletamine/zolazepam can cause respiratory depression, vomiting, bradycardia, heart block, hypotension, and hypothermia.

    • Guaifenesin may cause horses to remain standing but become ataxic.

    • Butorphanol can cause stomach ulcers, vomiting, gastrointestinal bleeding, and lack of appetite.

    • Acepromazine can cause renal toxicity and impaired platelet aggregation leading to prolonged bleeding time.

    • Dexmedetomidine can cause ulcerogenic effects, immunosuppression with prolonged use, and hyperadrenocorticism.

    Opioid Side Effects

    • Morphine causes constipation in dogs and urinary retention in cats.

    Morphine vs. Methadone

    • Methadone is the opioid agent that is least likely to cause vomiting in dogs and cats

    Midazolam/Diazepam

    • Midazolam or diazepam used in combination with ketamine is an example of a neurolept analgesic combination.

    Narcan (Naloxone)

    • Naloxone can be used to reverse the effects of fentanyl and morphine.

    Buprenorphine

    • Buprenorphine is used as a preanesthetic, sedative, and post operative visceral analgesic.

    Naltrexone

    • Naltrexone is used as a reversal agent for opioid agonists (hydromorphone, morphine).

    • Naltrexone is administered via IM or SQ route before the animal regains consciousness.

    COX-1 Enzymes

    • NSAIDs that inhibit the COX-1 enzyme produce the least adverse effects.

    Tramadol

    • Tramadol can act as an antagonist to several drugs prescribed for cardiac disease and hypertension.

    Amitriptyline

    • Amitriptyline's side effects are agitation and GI upset.

    • Amitriptyline is useful for neuropathic pain and central hypersensitivity as well as chronic pain and musculoskeletal disease.

    Gabapentin

    • Gabapentin treats neuropathic pain and hypersensitivity.

    • Gabapentin is useful in dogs and cats for chronic pain unresponsive to NSAIDs.

    Trazodone

    • Trazodone should not be used concurrently with other norepinephrine or serotonin reuptake inhibitors (e.g., amitriptyline).

    • Trazodone may potentiate effects of opioids in anxious patients.

    • Trazodone may be useful in calming the excitement sometimes seen in cats and horses following opioid administration.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser