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What are preanesthetic agents?
Drugs given before the general anesthetic drugs are given.9
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List 4 reasons to use preanesthetic drugs
- Tranquilize
- Reduce side effects
- Balanced anesthesia
- Analgesia
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Do all patients need to be tranquilized before they are anestheized?
No
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What are the 2 main advantages to tranquilizing a veterinary patient before anesthesia?
Reduces the amount of drug needed for general anesthesia & makes the patient easier to work with
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List 4 side effects of general anesthetic drugs that may be reduced by administration of preanesthetic drugs
- Salvation
- Bradycardia
- Arrhythmia
- Vomiting
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What is "balanced anesthesia"?
Using a combination of preanesthetic & anesthetic drugs in order to decrease the doses of each, decrease side effects, & increase patient safety
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Are all preanesthetic drugs analgesic?
No
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List 2 advantages of using an analgesic drug as a preanesthetic drug.
Pain relief can help with procedures such as a catheterization. Also the pain control may last long enough to provide post op relief for short procedures
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Name the 2 main classes of preanesthetic drugs
- Anticholinergics
- Tranquilizers and sedatives
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Name another class of drug that can be used as a preanesthetic
Analgesics
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Do all tranquilizers and sedatives have analgesic effects
No (example - acepromazine is a tranquilizer but not analgesic)
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Do some tranquilizers and sedatives have analgesic effects?
Yes (example - xylazine)
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Do all analgesic drugs also act as tranquilizers or sedatives l?
No (examples - aspirin is analgesic but not a tranquilizer)
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Do some analgesic drugs also act as tranquilizers or sedatives?
Yes (example - butorphanol)
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What does "anticholinergic" mean?
"anti" - against, "choline" - acetylcholine. Against acetylcholine - a drug that blocks some of the effects of acetylcholine
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What does parasympathetic mean?
"parasympatho" - parasympathetic. "lytic" - lyse, burst, destroy. A drug that blocks parasympathetic effects. Since acetylcholine is the main parasympathetic neurotransmitter, this means the same thing as "anticholinergic"
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If a drug blocks parasympathetic effects in the patient, what kind of effects is that patient going to show?
Sympathetic effects
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Name the 2 main examples of anticholinergic drugs.
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The nervous system has both "incoming" and "outgoing" impulses. What type of impulse is Afferent?
Sensory - touch, sight, hearing, taste, smell
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What type of pulse is efferent?
Motor - causes contraction of muscles, secretion of glands
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What are 2 types of motor impulses?
- Voluntary - skeletal muscle
- Autonomic - smooth muscle, cardiac muscle, and glands
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What general type of body functions is the autonomic nervous system concerned with? Give examples
Involuntary control. Functions that the individual cannot consciously control. Examples - blood pressure & heart rate
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What are 2 parts of the autonomic nervous system?
Sympathetic nervous system and parasympathetic nervous system
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The sympathetic nervous system operates under what general condition?
Fight or flight
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What body functions does sympathetic stimulation tend to increase?
- Heart rate
- Respiratory rate
- Blood pressure
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What body function does sympathetic stimulation tend to decrease?
Gastrointestinal function
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Name the 2 main neurotransmitters of the sympathetic nervous system
- Epinephrine
- Norepinephrine
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The parasympathetic nervous system operates under what general conditions?
Rest and restore
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What body functions does parasympathetic stimulation tend to decrease?
- Heart rate
- Respiratory rate
- Blood pressure
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What body function does parasympathetic stimulation tend to increase?
Gastrointestinal function
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Name the main neurotransmitters of the parasymapthetix nervous system
Acetylcholine
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Name the 2 main types of parasympathetic receptors.
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Are nicotinic receptors located close to the CNS or on organs?
Close to the CNS
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Are muscarinic receptors located close to the CNS or on organs?
On organs
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Which type of receptor is found at the neuromuscular junction of skeletal muscle cells - nicotinic or muscarinic?
Nicotinic
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Do anticholinergic drugs block nicotinic or muscarinic receptors?
Muscarinic
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Name the 2 main examples of anticholinergic drugs
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Are anticholinergic drugs commonly given SQ or IM?
SQ
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Are anticholinergic drugs commonly given IV?
No - is possible, just not common
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Can anticholinergics be mixed in the same syringe with ace, ketamine, and butorphanol?
Yes
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Can anticholinergics be mixed with diazepam?
No
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What is the advantage of mixing drugs into one syringe?
Less pain and stress for the patient
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What plant is atropine originally derived from?
European deadly nightshade - belladonna atropa
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Is atropine analgesic?
No
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Is atropine a tranquilizer?
No
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Name the main nerve supplying parasympathetic stimulation to the organs of the thorax and most of the abdomen l?
Vagus nerve
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What nerve carries sensory information from the thorax and most of the abdomen to the brain?
Vagus
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What nerve (left and right branches) lies on each side of the trachea?
Vagus nerve
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What happens to the patients heart rate when the trachea or abdominal viscera are handled?
Heart rate slows down
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Do atropine and glycopyrrolate stimulate or block stimulation of the vagus nerve?
Block stimulation
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Does administration of atropine and glycopyrrolate cause or block bradycardia?
Blocks bradycardia
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Is salvation considered to be a gastrointestinal function?
Yea
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Does administration of atropine and glycopyrrolate cause or block salvation?
Blocks salvation
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What problems can excess salvation cause during anesthesia?
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Does administration of atropine and glycopyrrolate cause or block GI activity?
Blocks GI activity
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Does atropine tend to cause or prevent vomiting?
Prevent vomiting
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What is miosis? What is mydriasis?
- Miosis - constriction of pupil
- Mydriasis - dilation of pupil
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Does atropine cause miosis or mydriasis?
Mydriasis
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Does atropine increase or decrease tear secretions?
Decrease
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What should you do about decreased tear secretions in your anesthetic patient?
Place artificial tears or ophthalmic ointment in his eyes
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Is it possible for atropine administration to cause problems in a patient with dyspnea? How?
Yes - can dry up respiratory secretions causing blockage of airways, & can cause bronchodilation, which means that the patient has to pull in more air ( or more anesthetic gases) in order to get air to his alveoli
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What is a contradiction?
A reason not to use a drug
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List 4 contraindications to use of atropine
- Tachycardia
- Congestive heart failure
- Constipation
- Respiratory distress
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What is an indication?
A reason to use a drug
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List 4 indications for use of atropine
- Preanesthetic
- Antidotal for organophosphate toxicity
- Antispasmodic for vomiting and diarrhea
- Topical mydriatic
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The effects of which drug last longer - atropine or glycopyrrolate?
Glycopyrrolate
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Which drug has les tendency to cause tachycardia and cardiac arrhythmia - atropine or glycopyrrolate?
Glycopyrrolate
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Which drug suppresses salivation better - atropine or glycopyrrolate?
Glycopyrrolate
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Which drug cost more - atropine or glycopyrrolate?
Glycopyrrolate
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Is glycopyrrolate analgesic?
No
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Is glycopyrrolate a tranquilizer?
No
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List the 3 main classes of tranquilizers and sedatives
Phenothiazines, benzodiazepine, Thorazine derivatives
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List 3 specific phenothiazine drugs. Which one is most commonly used in small animal medicine?
- Acepromazine, chlorpromazine, triflupromazine
- Acepromazine is most commonly used in small animal medi ine
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What is the long form of the word acepromazine? What is the short form?
- Acetylpromazine maleate
- Ace
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What color is an acepromazine solution?
Yellow
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Is acepromazine an emetic or an antiemetic?
Antiemetic - prevents vomiting
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What effect does act administration have on the third eyelids?
Causes them to prolapse
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Does ace cause or prevent cardiac arrhythmias?
Prevent - antiarrhythmic
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Should we use ace as a preanesthetic on an animal about to undergo allergic skin testing? Why or why not?
No - is antihistaminic, prevents skin reaction to allergens
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Is ace more likely to cause hypotension or hypertension? Why?
Hypotension - low blood pressure, because it causes peripheral vasodilation
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Should ace be given to an animal who dehydrated or in shock?
No
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Should ace be given to a patient who is prone to seizures?
No - lowers the seizure threshold
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Which drug would be the most appropriate tranquilizer to use in an apileptoc animal - acepromazine or diazepam?
Diazepam
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What is photosensitivity? Can ace cause photosensitivity?
more likely to sunburn. Yes
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Is ace a relatively safe drug?
Yes
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List 3 other drugs that ace can be mixed with
- Atropine
- Ketamine
- Butorphanol
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List 1 non-anesthetic, non-tranquilizer use for acepromazine
Antiemetic, prevent motion sickness
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List the 3 most commonly used benzodiazepine tranquilizers/sedatives in veterinary medicine
Diazepam - Valium, zolazepam - telazol, midazolam
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Are the benzodiazepines controlled drugs?
Yes
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What is the common trade name of diazepam?
Valium
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The commercial combination Telazol is composed of what 2 drugs?
Zolazepam and tiletamine
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What are the main advantages of midazolam over diazepam?
More water soluble, can mix with more drugs, more effective IM administration
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What effect do the benzodiazepine have on the patients frame of mind?
Anti-anxiety, calming
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Which is a more effective tranquilizer for a healthy patient - diazepam or acepromazine?
Acepromazine
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For our purpose in this class, is diazepam an analgesic?
No
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What effect do the benzodiazepine have on skeletal muscle?
Relaxation - skeletal muscle relaxation
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Which drug is the most appropriate pre-anesthetic for an epileptic patient - acepromazine or diazepam? Why?
diazepam - it is used to treat seizures in progress. Ace can cause seizure - lowers the seizure threshold
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What does anticonvulsant mean?
Drug that treats or prevents seizures
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Which drug is more appropriate for risky patients - ace or diazepam?
Diazepam
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How is diazepam most commonly administered, for either preanesthetic or anticonvulsant purposes - IM, IV, or SQ?
IV
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Should diazepam be injected IV fast or slow? Why?
Slowly - bc it's carrier - the liquid it is dissolved in - is propylene glycol, which is a cardiovascular depressant
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Is diazepam an oil or water based compound?
Oil based
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Can diazepam be mixed with water - soluble drugs?
No
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What drug can diazepam be mixed with?
Ketamine
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What drug can be used as a reverser for diazepam?
Flumazenil - anexate
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List the 4 main uses for diazepam
Preanesthetic, treat seizure in progress, appetite stimulant in cats, behavior modification in dogs, cats and people
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What kind of drug is zolazepam?
Benzodiazepine tranquilizer
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What kind of drug is glycopyrrolate?
Anticholinergic
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What kind of drug is diazepam
Benzodiazepine tranquilizer
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What kind of drug is atropine
Anticholinergic
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What kind of drug is acepromazine
Phenothiazine tranquilizer
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What kind of drug is midazolam
Benzodiazepine tranquilizer
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