Drugs ch.3 & 8
46 Questions
21 Views

Drugs ch.3 & 8

Created by
@MomentousMorganite

Podcast Beta

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

    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