more for the anesthesia lab final

Anesthetics

Render animal or person with no sensation

General Anesthesia

Reversible loss of sensation associated with unconsciousness

Local Anesthesia

Reversible loss of sensation in a regional area of the body without loss of consciousness

Analgesia

Compounds designed to decrease the perception of pain but not necessarily cause total loss of sensation

Rimadyl/Aspirin

An example of analgesic, decreases pain associated with inflammation, but does not produce anesthesia

Atropine

Blocks stimulation of vagus nerve, reduces salivation, reduces gastrointestinal activity, pupil dilation (mydriasis), reduces tear production, promotes bronchodilation, will cross BBB and placenta. Route: IV, IM, or SC

Glycopyrrolate

Similar effects of atropine, onset of 2-3 min. after IV injection, longer duration (2-3 hours v.s. 60 minutes), less likely to cause tachycardia, suppresses salivation more effectively, does not cross placental barrier.

Acepromazine (Ace)

Phenothiazine tranquilizer that produces mentally relaxed state, used to be used for storm anxiety, found to be that the animal is paralyzed, but still has massive anxiety.

Phenothiazine

Block alpha 1 receptors relaxation of smooth muscles and vasodilatation, causing a sharp drop in blood pressure, no analgesic effects.

Benzodiazepine class

Includes Diazepam (Valium), Zolazepam (Telazol), Midazolam (Versed)

explain Benzodiazepines

Decrease risk of seizure activity, overall safe, few side effects, very effective when given intravenously.

Midazolam

pH is more basic, thus less painful when administered IM or SQ.

Flumazenil

GABA antagonist, rare that these drugs ever need reversing, used commonly in liver patients.

Alpha-2 Agonists

Includes Xylazine (Rompun), Detomidine (Dormosedan), Dexmedetomidine (Dexdomitor), ), exert their effects by stimulating alpha-2 receptors, compounds produce a calming effect.

Dexdomitor

The only alpha-2 agonist with analgesic effects.

Xylazine

Used in most species for sedation or may be combined with other drugs in a preanesthetic regimen, cattle VERY sensitive, horse, dog/cats less, swine least sensitive.

Monitoring Blood Pressure

Vital to monitor blood pressure, many patients will become cyanotic.

Systolic Blood Pressure

Systolic above 90mmHg patient is safe, continue to monitor values.

Bradycardia Concern

If bradycardia is a concern, reverse drug.

Alpha-2 Antagonist

Alpha-2 antagonist: Dexmedetomidine: ATIPAMEZOLE,

Xylazine: YOHIMBINE/TOLAZOLINE,

Detomidine: YOHIMBINE/TOLAZOLINE.

Yohimbine/Tolazoline Administration

Yohimbine/Tolazoline: IV.

Dissociative Anesthetics

Dissociative Anesthetics produce anesthesia in which the animals feel dissociated from their body.

Ketamine Effects in Cats

Cats given Ketamine, eyes remain open and unblinking; be sure to use eye lubricant on these.

Dissociative Anesthetics Analgesia

Dissociative Anesthetics produce good somatic (peripheral tissue) analgesia and are suitable for superficial surgery.

Ketamine Absorption

Ketamine is well absorbed through the mucous membranes of the mouth and nasal cavity.

Propofol

Propofol is an injectable anesthetic agent unrelated to barbiturates, marketed as an emulsion drug made from egg lecithin and soybean oil.

Propofol Administration

Injected by IV bolus, leading to rapid induction/short period of unconsciousness.

Propofol Effects

Provides sedation with no analgesic effects.

Etomidate

Selective hypnotic drug occasionally used for induction in cats and dogs; good muscle relaxation but no analgesia.

Alfaxalone

Water-soluble neuroanaesthetic, C-IV, rapidly metabolized by the liver with minimal side-effects.

Narcotics Receptors

Five classes: Mu (pain regulating areas, analgesia, euphoria, respiratory depression),

Kappa (cerebral cortex, spinal cord; analgesia, sedation),

Sigma (struggling, whining, hallucinations),

Delta and Epsilon (unknown).

Opioids Mode of Action

Bind to receptors in the brain and spinal cord, mimicking endorphins and enkephalins.

Opioids Classification

Agonist (pure agonist if bind to all 4 receptors),

Partial agonists (bind to some),

Agonist-antagonist (stimulate some, block others),

Antagonist (blocks all four receptor sites).

Butorphanol

Partial agonist with weaker opioid effects, used for cough control in small animals and reduction of colic pain in horses.

Buprenorphine

Partial agonist and antagonist with moderately strong analgesic properties; good efficacy when given transmucosally in cats.

Fentanyl

Potent opioid with an analgesic effect 250 times greater than morphine; respiratory effects of fentanyl, no vomiting.

Meperidine

Fairly weak analgesic and sedative, fairly safe when injected subcutaneously to restrain cats.

Morphine, Hydromorphone, Oxymorphone

All have effects similar to that of fentanyl.

Hydromorphone

Can cause "hydro panting" animal feels warm so pants to decrease temperature. can casue transient hyperthermia in cats

Morphine

Causes vomiting/defecation/histamine release.

Naloxone

Considered a "pure" narcotic antagonist because when it combines with u- and k-receptors.

NSAIDS

Block cyclooxygenase (COX).

Cox 1

Modulation of renal blood flow and synthesis of gastric mucosa.

Cox 2

Formation of prostaglandin.

Aspirin Actions

Analgesia, antipyrexia, anti-inflammatory, reduction of platelet aggregation, block cyclooxygenase.

Aspirin Adverse effects

Gastric irritation; cats very sensitive to aspirin.

Phenylbutazone

Mild to moderate pain, anti-inflammatory, antipyrexia.

Phenylbutazone Adverse effects

Gastrointestinal bleeding (stomach ulcers).

Flunixin Meglumine

Banamine; actions include analgesia, antipyrexia, anti-inflammatory.

Flunixin Meglumine Adverse effects

Swelling at injection site, sweating, GI ulcerations.

Dimethyl Sulfoxide

DMSO; commercial solvent, anti-inflammatory, carrier of other agents.

Acetaminophen

Limited antipyretic and anti-inflammatory action.

Acetaminophen Adverse effects

Cats: methemoglobinemia, cyanosis, anemia, liver damage; dogs: GI bleeding.

Carprofen

Rimadyl (Pfizer); actions include Cox inhibitor, analgesic, anti-inflammatory, antipyretic.

Carprofen Adverse effects

GI disorders, liver damage

Deracoxib

Coxib class; Cox 2 inhibitor for control of pain and inflammation.

Deracoxib Adverse side effects

GI upset, renal dysfunction.

Firocoxib

Coxib class; Cox 2 inhibitor that treats pain and inflammation.

Firocoxib Adverse side effects

GI upset, renal dysfunction.

Meloxicam

Cox 2 inhibitor used for pain and inflammation; labeled for cats.

Meloxicam Adverse side effects

GI upset and renal dysfunction.

Robenacoxib

Cox 2 selective; Onsior for both dogs and cats.

Galliprant

Grapiprant: NSAID specific for canine O.A.; Prostaglandin E2 (PGE2) EP4 receptor antagonist.

Solensia

Frunevetmad; specific for feline osteoarthritis; well tolerated by feline patients.

Cerenia

Maropitant; neurokinin-1 antagonist receptor used as antiemetic and motion sickness.

Tramadol

Synthetic Mu receptor; not regulated as is not an opioid; used for mild to moderate pain.

Gabapentin

Molecule of GABA; very useful for chronic pain and long term neuropathic pain control.

Local Anesthetics

Results: block depolarization of nerve fiber; sensation disappears in the following order: pain, cold, warmth, touch, joint, and deep pressure.

Epinephrine

Vasoconstriction; delays absorption, reduces toxicity and increases safety.

Mepivacaine

Amide linked local anesthetic

Bupivacaine

Amide linked local anesthetic (Maracaine).