clinical procedures

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clinical procedures
2012-02-27 16:41:25
preanesthetic pharmacology

Show Answers:

  1. What are some reasons to use preanesthetic?
    • Calm patient
    • Reduce subsequent doses of anesthtics and increase safety margin
    • To produce smoother anesthetic and regurgitation
    • Reduce salivary and upper airway secretions
    • Block vagal reflex (parasympathetic)can cause bradycardia, hypotension, and bronchospasm
    • Reduce pain and struggling on recovery
    • Adjunct to regional/local anesthesia
  2. Are anticholinergics a sedative?
  3. What family are atropine and glycopyrrolate in?
  4. What is the major job of Atropine?
    Blocks stimulation of the vagus nerve
  5. What are the contraindications of Atropine?
    • Pre-existing tachycardia(fear,heart disease, hyperthyroid)
    • congestive heart failure (increase heart rate may cause decrease stroke volume and a reduction in cardiac output)
    • Constipation ir ileus (even at normal dose in horse and cow)
    • Crosses the placenta (consider if doing a c-section) will effect the fetus
    • can cause arrhythmias (arrhtyhmogenic)
  6. Glycopyrrolate
    • longer duration of action up to twice as long as Atropine
    • Less effect on heart rate and rhythm
    • Possible less suppression of GI motility
    • Minimally crosses placenta
    • licensed for use in dog and cat
    • more expensive than atropine
  7. What are major tranquilizers known for?
  8. What is the family name of major tranquilizers?
    Phenothiazine derivatives
  9. What drugs are under phenothiazine derivatives>
    • Acepromazine
    • Chlorpromazine
  10. What are the neuroleptics (acepromozine) uses?
    • Decrease anxiety, produce a "tranquil" state. This effect is reduced in an already excited animal
    • Antimetic effect
    • Antiarrythmic effect
    • No analgesic effect
  11. What are the actions for phenothizine derivatives (acepromazine)?
    Action is on CNS
  12. What are the clinical effect of acepromazine?
    • Peripheral vasodilation-predisposes to hypothermia, Hypotension
    • Reduces seizure threshold: avoid use in patient w/known seizures
    • Rarely, may see excitement rather than sedation. May last up to 49 hrs
    • 1oarea of drug detoxfication is liver may still see effects 24-48hrs after a single dose
  13. What are the contraindication of acepromazine?
    • Contraindicated in shocky, hypotension, or anemic patients
    • Use with caution in animals with cardiovascular disease, toxemia, hepatic disease, geriatric and pediatric patients use cautiously in brachycephalic breeds due to pharyngeal relaxation leading to partial or complete airway obstruction
    • Boxers,greyhounds, giant breed dogs, collies, and Aust. shepherds may be more sensitive?
    • Relatively long lasting (several hours duration)
  14. What is the family name for minor tranquilizers?
  15. What drugs are in the benzodiazepines family?
    • diazepam (Valium)
    • zolazepam(telazol)
    • midazolam (versed)
  16. Is diazepam licensed in U.S or Canada for use in animals?
    NO but commonly used
  17. True or False Benzodiazepines are antianxiety and calming effect, but no analgesic effect
  18. What reaction does Benzodiazepines have when combine with ketamine?
    • Muscle rigidity
    • without ketamine is an excellent skeletal muscle relaxant
  19. Benzodiazepines
    • Excellent anticonvulsant activity
    • Minimal adverse effects on cardiovascular and respiratory systems
    • Also used as appetite stimulant in cats
    • Diazepam insoluble in water, so not compatible with most other preanesthetic agents. It is also irritating to other tissues and absorbed erratically after IM injection. Midazolam is water soluble. Not recommended in cats (orally)
    • Controlled substance-proper records are essentials
    • use in caution in neonates and animals with known liver dysfunction
    • May see excitement or aggression when used alone (diazepam)
    • Duration of effect of diazepam 1-4hrs (anticonvulsant effect shorter)
    • Most commonly used in combination with drugs that induce anesthesia
    • Reversal agent flumazenil, not commonly used due to expense and lack of severe adverse effects generally seen with these agents
  20. In what family are Pentobarbital and phenobarbital in?

    A. Benzodiazepines

    B. Anticholinergics

    C. Barbiturates

    D. Phenothiazine
    C. Barbiturates
  21. What families are sedatives/hypnotics?
    • Barbiturates
    • Thiazine Derivatives
  22. What drugs are in the Thiazine derivatives in?
    • Xylazine (rompun, Anased)
    • Medetomidine (Domitor-no longer manufactured)
    • Dexmedetomidine(Dexdomitor)
    • Detomidinde (Dormosedan)
    • Romifidine (sedivet)
  23. Where are the receptors found of the thiazine derivatives?
    on the symphathetic nerves within the brain and spinal cord
  24. How does sedation happen within the thiazine and barbiturates?
    It decreases of norepinephrine released in brain resulting in sedation (last several hours), muscle relaxation, and analgesia
  25. Why should Thiazine derivatives use with caution in young healthy patients?
    Alpha -2 adrenoreceptors in heart and blood vessels also affected significant potential for adverse effects.
  26. Where is thiazine derivatives metabolized?
    Metabolized in liver and then excreted in urine