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Pharmacology I. Note Cards. Drug of choice for treatment of postoperative non-obstructive urinary retention. Bethanechol. Drug of choice for treatment of myasthenia gravis. Pyridostigmine. Drug of choice for diagnosis of Myasthenia gravis. Edrophonium.

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pharmacology i

Pharmacology I

Note Cards

drug of choice for treatment of postoperative non obstructive urinary retention
Drug of choice for treatment of postoperative non-obstructive urinary retention
  • Bethanechol
rebound tachycardia occurs with withdrawal of these drugs
Rebound tachycardia occurs with withdrawal of these drugs
  • Non-selective beta blockers
    • propranolol
    • timolol
    • sotalol
best drug to use in examination of glaucoma patients
Best drug to use in examination of glaucoma patients
  • Phenylephrine--does not cause cycloplegia
drug of choice for treatment of glaucoma in a broncho asthmatic patient
Drug of choice for treatment of glaucoma in a broncho-asthmatic patient
  • Betaxolol
direct acting parasympathomimetics
Direct-acting Parasympathomimetics
  • Carbachol
  • Bethanechol
  • Muscarine
  • Pilocarpine
reversible indirect acting parasympathomimetics
Reversible indirect-acting Parasympathomimetics
  • Physostigmine
  • Neostigmine
  • Edrophonium
  • Pyridostigmine
  • Demecarium
irreversible indirect acting parasypathomimetics
Irreversible indirect-acting Parasypathomimetics
  • Isoflurophate
  • Echothiophate
  • Dichlorvos
  • Trichlorfon
tertiary parasympatholytics
Tertiary Parasympatholytics
  • Atropine
  • Scopolamine
  • Dicyclomine
quaternary parasympatholytics
Quaternary Parasympatholytics
  • Glycopyrrolate
  • Propantheline
  • Ipratropium
mydriatic parasympatholytics
Mydriatic Parasympatholytics
  • Atropine
  • Scopolamine
  • Cyclopentolate
  • Homatropine
  • Tropicamide
competitive ganglionic blockers
Competitive ganglionic blockers
  • Hexamethonium
  • Mecamylamine
  • Propantheline
  • Trimethaphan
drug of choice for treatment of nicotine poisoning
Drug of choice for treatment of nicotine poisoning
  • Mecamylamine--competitive ganglionic blocker
alpha 1 selective agonists
Alpha -1 selective agonists
  • Phenylephrine
  • Methoxamine
beta 2 selective agonists
Beta-2 selective agonists
  • Albuterol
  • Terbutaline
  • Metaproterenol
  • Clinbuterol
indirect acting parasympathomimetics
Indirect-acting Parasympathomimetics
  • physostigmine
  • neostigmine
  • edrophonium
  • pyridostigmine
  • demecarium
ophthalmic organophosphates
Ophthalmic organophosphates
  • Isoflurophate
  • Echothiophate
t or f propantheline blocks only muscarinic receptors
T or F: Propantheline blocks only muscarinic receptors
  • F--it blocks ganglionic nicotinic receptors also (a parasympatholytic)
catecholamine sympathomimetics
Catecholamine Sympathomimetics
  • Epinephrine
  • Norepinephrine
  • Isoproterenol
  • Dopamine
  • Dobutamine
dopamine acts as agonist at what receptors
Dopamine acts as agonist at what receptors?
  • Dopaminergic
  • alpha 1
  • alpha 2
  • beta 1
dobutamine acts as agonist on what receptors
Dobutamine acts as agonist on what receptors?
  • beta 1 (mainly)
  • beta 2 & alpha (minor)
dopamine s 2 most useful effects in conditions with decreased renal perfusion
Dopamine’s 2 most useful effects in conditions with decreased renal perfusion
  • Increased GFR
  • Renal vasodilation
catecholamines given to correct hypotension due to inhalation anesthetics
Catecholamines given to correct hypotension due to inhalation anesthetics
  • Dopamine
  • Dobutamine
non catecholamines
Ephedrine

Pseudoephedrine

Phenylpropanolamine

Amphetamine

Cocaine

Monoamine oxidase inhibitors

Phenylephrine

Methoxamine

Albuterol

Terbutaline

Metaproterenol

Non Catecholamines
direct indirect acting non catecholamines
Direct & Indirect acting non catecholamines
  • Ephedrine
  • Psuedoephedrine
  • Phenylpropanolamine
indirect acting sympathomimetics
Indirect-acting Sympathomimetics
  • Amphetamine
  • Cocaine
  • Monoamine oxidase inhibitors
direct acting sympathomimetics
Alpha-1 selective agonists

Phenylephrine

Methoxamine

Beta-2 selective agonists

Albuterol

Terbutaline

Metaproterenol

Direct-acting Sympathomimetics
non catecholamines used to treat prevent acute bronchoconstriction
Non catecholamines used to treat & prevent acute bronchoconstriction
  • Beta-2 selective agonists
    • albuterol
    • terbutaline
    • metaproterenol
sympatholytics
Alpha blockers

Phenoxybenzamine

Prazosin

Beta blockers

Propranolol

Timolol

Sotalol

Atenolol

Betaxolol

Sympatholytics
non selective beta blockers
Non-selective beta blockers
  • Propranolol
  • Timolol
  • Sotalol
beta 1 selective blockers
Beta-1 selective blockers
  • Atenolol
  • Betaxolol
sympatholytics used to treat supraventricular ventricular tachyarrhythmias
Sympatholytics used to treat supraventricular & ventricular tachyarrhythmias
  • Propranolol
  • Timolol
  • Sotalol
preferred in patients w bronchial asthma or diabetes mellitus
Preferred in patients w/ bronchial asthma or diabetes mellitus
  • Beta-1 selective blockers
    • Atenolol
    • Betaxolol
3 ways indirect sympatholytics work
3 ways indirect sympatholytics work
  • inhibit synthesis of norepinephrine
  • inhibit storage of norepinephrine
  • inhibit release of norepinephrine
t or f parasympathomimetics are safe to use systemically
T or F: Parasympathomimetics are safe to use systemically
  • F--they cause cardiovascular collapse & bronchoconstriction w/ increased secretion
name 2 physiological causes of glaucoma
Name 2 physiological causes of glaucoma
  • Increased production of aqueous humor
  • Decreased drainage of aqueous humor
t or f cyclospasm is caused by relaxation of the ciliary muscles
T or F: Cyclospasm is caused by relaxation of the ciliary muscles
  • F--the ciliary muscles contract
what are the muscarinic effects
What are the “muscarinic effects”
  • Salivation
  • Lacrimation
  • Urination
  • Defecation
t or f atropine is an effective treatment of bronchial asthma
T or F:Atropine is an effective treatment of bronchial asthma
  • F--atropine only antagonizes 1 of the many causes of bronchial constriction
t or f sympathomimetics have a stimulatory effect on all alpha s
T or F: Sympathomimetics have a stimulatory effect on all alpha’s
  • False--stimulatory on all, except GI & insulin secretion
t or f sympathomimetics have an inhibitory effect on all beta s
T or F: Sympathomimetics have an inhibitory effect on all beta’s
  • F--inhibitory on all, except heart & insulin secretion
t or f epinephrine causes reflex tachycardia
T or F: Epinephrine causes reflex tachycardia
  • True--a bronchodilator & increases 4 heart parameters (contractility, heart rate, excitability, automaticity)
nondepolarizing neuromuscular blockers
Tubocurarine

Atracurium

Cisatracurium

Doxacurium

Mivacurium

Metocurine

Pancuronium

Vecuronium

Pipecuronium

Rocuronium

Gallamine

Nondepolarizing neuromuscular blockers
t or f succinylcholine s duration of action is 10 minutes in all species
T or F: Succinylcholine’s duration of action is <10 minutes in all species
  • F--it is 25+ minutes in dogs
t or f all neuromuscular blockers produce analgesia
T or F: All neuromuscular blockers produce analgesia
  • F--they are QUATs and cannot cross the BBB
nondepolarizing nm blocker w most rapid onset of action
Nondepolarizing NM blocker w/ most rapid onset of action
  • Rocuronium (1-2 minutes)
  • “rock and roll”
slide95
T or F: Drugs eliminated by the kidneyhave longer duration of action than drugs that are eliminated by the liver
  • True
which nm blocker has the shortest duration of action why
Which NM blocker has the shortest duration of action & why
  • Mivacurium (10-20 minutes)
  • b/c metabolized by plasma cholinesterase
which 2 nm blockers block muscarinic receptors in the heart cause sympathetic stimulation
Which 2 NM blockers block muscarinic receptors in the heart & cause sympathetic stimulation?
  • Gallamine
  • Pancuronium
name the steroid derivative nm blockers
Name the steroid derivative NM blockers
  • Pancuronium
  • Vecuronium
  • Pipecuronium
  • Rocuronium
which nm blockers do not cause the release of histamine
Which NM blockers do not cause the release of histamine?
  • Pancuronium
  • Vecuronium
  • Rocuronium
  • Pipecuronium
  • Cisatracurium
  • Doxacurium
  • Gallamine
t or f depolarizing nondepolarizing muscle relaxants have significant cns effects
T or F: Depolarizing & nondepolarizing muscle relaxants have significant CNS effects
  • F--they do not cross the BBB b/c they are QUATs
treatment of succinylcholine toxicity
Treatment of succinylcholine toxicity
  • Artificial respiration w/ O2
  • Hope & pray
treatment of nondepolarizing nm toxicity
Treatment of nondepolarizing NM toxicity
  • Artificial respiration w/ O2
  • Cholinesterase inhibitors (neostigmine)
  • Atropine to block M effects
  • Ca+ salts
t or f succinylcholine can be used when patient has cholinesterase inhibitor toxicity
T or F: Succinylcholine can be used when patient has cholinesterase inhibitor toxicity
  • F--the cholinesterase inhibitor inactivates succinylcholine
name 6 ways muscle relaxants act
on the brain

on the spinal cord

on the motor neuron

pre-junctional on the NMJ

post-junctional on the NMJ

on the muscle cell

Name 6 ways muscle relaxants act
means a genetic predisposition to fever w induction of inhalation anesthetics
Means a genetic predisposition to fever w/ induction of inhalation anesthetics
  • Malignant hyperthermia
t or f succinylcholine causes skeletal muscles to relax in this order
T or F: Succinylcholine causes skeletal muscles to relax in this order
  • Face, glottis, intercostals, diaphragm, others
  • True
t or f nondepolarizing nm blockers cause relaxation of muscles in this order
T or F: Nondepolarizing NM blockers cause relaxation of muscles in this order
  • Eyes, face, neck, diaphragm, limbs, chest, abdomen
  • F--diaphragm is last
t or f recovery from muscle relaxants is in the same order that they are affected
T or F: Recovery from muscle relaxants is in the same order that they are affected
  • F--it is in reverse order
t or f acetaminophen is an nsaid
T or F: Acetaminophen is an NSAID
  • F--it does not work on COX and it is not anti-inflammatory
an nsaid must have these 3 properties
An NSAID must have these 3 properties
  • Anti-inflammatory
  • Antipyretic
  • Analgesic
slide128
T or F: NSAIDs that are more selective COX-2 inhibitors than COX-1 inhibitors will have less side effects
  • True
t or f all are nsaids aspirin etodolac phenylbutazone piroxicam acetaminophen carprofen flunixin
T or F: All are NSAIDs--aspirin, etodolac, phenylbutazone, piroxicam, acetaminophen, carprofen & flunixin
  • F--acetaminophen is not an NSAID
which nsaids are more selective cox 2 inhibitors
Which NSAIDs are more selective COX-2 inhibitors?
  • Celexcoxib
  • Deracoxib
  • Carprofen
  • Etodolac
why does aspirin have such a long t 1 2 in cats
Why does aspirin have such a long T1/2 in cats?
  • Cats are deficient in glucuronic acid conjugation & cannot metabolize aspirin
name 2 anti oxidant nsaids
Name 2 anti-oxidant NSAIDs
  • Dimethylsulfoxide (DMSO)
  • Orgotein
name 2 nsaids given intra articularly as lubricants
Name 2 NSAIDs given intra-articularly as lubricants
  • Hyaluronic acid
  • Polysulfated GAG’s
what does an anti oxidant do
What does an anti-oxidant do?
  • Scavenges free O2 radicals
which nsaid has a garlic odor
Which NSAID has a garlic odor?
  • Dimethylsulfoxide (DMSO)
which of the following nsaids are not approved in horses
Which of the following NSAIDs are NOT approved in horses?
  • Aspirin, etodolac, phenylbutazone, meclofenamic acid, ketoprofen, carprofen, naproxen, flunixin, deracoxib
  • Etodolac
  • Carprofen
  • Deracoxib
cns stimulants
CNS Stimulants
  • Doxapram
  • Methylxanthine derivatives
  • Antagonists
methylxanthine derivatives
Methylxanthine derivatives
  • Caffeine
  • Theobromine
  • Theophylline
  • Aminophylline
antagonists
alpha-2 antagonists

Yobimbine

Tolazoline

Atipamezole

4-AP

Antagonists
used as a respiratory analeptic reverses resp due to inhalation barbiturate anesthesia
Used as a respiratory analeptic, reverses resp ¯ due to inhalation & barbiturate anesthesia
  • Doxapram
t or f the 1 o mechanism of action of methylxanthine derivatives is inhibition of phosphodiesterase
T or F: The 1o mechanism of action of methylxanthine derivatives is inhibition of phosphodiesterase
  • F--they antagonize presynaptic adenosine receptors to inhibit the release of NE
methylxanthine derivatives are used to treat these 3 situations
Methylxanthine derivatives are used to treat these 3 situations:
  • Bronchoconstriction
  • Bronchial asthma
  • COPD
t or f methylxanthine derivatives do not cause salivation nausea vomiting
T or F: Methylxanthine derivatives do not cause salivation, nausea, & vomiting
  • F--they do, only because they are alkaloids and irritate the GI tract
t or f the 1 cause of death from methylxanthine derivatives is respiratory failure
T or F: The #1 cause of death from methylxanthine derivatives is respiratory failure
  • True
t or f as a spinal cord stimulant strychnine acts by blocking glycine receptors
T or F: As a spinal cord stimulant, strychnine acts by blocking glycine receptors
  • True--glycine is the main inhibitor of spinal cord pre-synaptics
  • Inhibiting an inhibitor results in stimulation
drugs used for treatment of strychnine poisoning
Barbiturates:

Pentobarbital in dogs

Thiopental in cats

Diazepam

Xylazine

Methocarbamol

Guaifenesin

Drugs used for treatment of strychnine poisoning
t or f strychnine other alkaloids can be precipitated by an acid drug
T or F: Strychnine & other alkaloids can be precipitated by an acid drug
  • True--but must be given within 2 hours of the OD of alkaloid
list the 7 types of cns ors
Sedatives & hypnotics

Tranquilizers (neuroleptics)

alpha-2 agonists

Opioid agonists & antagonists

Neuroleptanalgesics

Anticonvulsants

General anesthetics

List the 7 types of CNS ¯’ors
list the 7 sedatives hypnotics
Barbiturates:

Thiopental

Thiamylal

Phenobarbital

Pentobarbital

Non barbiturates:

Chloral hydrate

Propofol

Etomidate

List the 7 sedatives & hypnotics
t or f all of these barbiturates can be used in cats
T or F: All of these barbiturates can be used in cats
  • Thiopental, phenobarbital, thiamylal, pentobarbital
  • F--only thiopental
t or f the most likely mechanism of action for barbiturates is that they stimulate gaba
T or F: The most likely mechanism of action for barbiturates is that they stimulate GABA.
  • True--by stimulating an inhibitor, they cause CNS depression
t or f s h s are anesthetics anticonvulsants analgesics
T or F: S & H’s are anesthetics, anticonvulsants, & analgesics
  • F--they are very poor analgesics (& MR’s)
what is the 1 enemy of s h s how can it be minimized
What is the #1 enemy of S&H’s & how can it be minimized?
  • Respiratory depression
  • Use other drugs as preanesthetics to ­ the safety margin
t or f cats have a very slow rate of metabolism of all barbiturates so they are seldom used
T or F: Cats have a very slow rate of metabolism of all barbiturates so they are seldom used
  • F--thiopental is used in cats b/c it has an “ultra-short” duration (10 minutes)
which barbiturates eica s during inhalation anesthesia
Which barbiturates ­ EICA’s during inhalation anesthesia?
  • Thiobarbiturates
  • b/c of vagal stimulation
list the species that are sensitive to barbiturates and explain why
List the species that are sensitive to barbiturates and explain why.
  • Cats, birds, fish
  • b/c they are deficient in the oxidative enzymes that metabolize barbiturates
give the duration of action
Pentobarbital

2-4 hours

Thiopental

<10 minutes

Phenobarbital

8-24 hours

Give the duration of action
t or f chloral hydrate is a good analgesic and muscle relaxant
T or F: Chloral hydrate is a good analgesic and muscle relaxant
  • F--MgSO4 is given w/ it to potentiate its muscle relaxant effects
name the 2 major enemies of chloral hydrate
Name the 2 major enemies of chloral hydrate
  • Respiratory depression
  • CICA (catecholamine-induced cardiac arrythmias)
t or f chloral hydrate is seldom used in all species
T or F: Chloral hydrate is seldom used in all species
  • F--hypnotic, & preanesthetic in large animals; combined with MgSO4 &/or pentobarbital as an anesthetic
  • Hypnotic & anesthetic in birds & fish
list the 7 types of cns ors1
Sedatives & hypnotics

Tranquilizers (neuroleptics)

alpha-2 agonists

Opioid agonists & antagonists

Neuroleptanalgesics

Anticonvulsants

General anesthetics

List the 7 types of CNS ¯’ors
name 3 classes of neuroleptics
Name 3 classes of neuroleptics
  • Phenothiazine derivatives
  • Butyrophenone derivatives
  • Benzodiazepine derivatives
phenothiazine derivatives
Phenothiazine derivatives
  • Acepromazine
  • Chlorpromazine
  • Prochlorperazine
  • Promethazine
  • Trimeprazine
name 3 phenothiazines used as anti emetics
Name 3 phenothiazines used as anti-emetics
  • Chlorpromazine
  • Prochlorperazine
  • Promethazine
name 3 phenothiazines used for motion sickness
Name 3 phenothiazines used for motion sickness
  • Promethazine
  • Trimeprazine
  • Acepromazine
t or f promethazine is used as an anti emetic antihistamine for motion sickness
T or F: Promethazine is used as an anti-emetic, antihistamine, & for motion sickness
  • True
m of a of phenothiazines
M of A of phenothiazines
  • Competitive antagonists on dopamine excitatory receptors in the CNS
t or f phenothiazines cause little respiratory at therapeutic doses
T or F: Phenothiazines cause little respiratory ¯ at therapeutic doses
  • True--that is why they are preferred as preanesthetics
t or f phenothiazines prevent eica s during inhalation anesthesia
T or F: Phenothiazines prevent EICA’s during inhalation anesthesia
  • True--they have a beta-1 blocking action that causes bradycardia as well as directly depressing the myocardium
t or f phenothiazines have both a and b1 blocking actions
T or F: Phenothiazines have both a- and b1- blocking actions
  • True--they cause vasodilation and bradycardia
t or f phenothiazines also act as nondepolarizing mr s weak antispasmodics antihistamines
T or F: Phenothiazines also act as nondepolarizing MR’s, weak antispasmodics, & antihistamines
  • True
name 6 common uses of phenothiazines
Preanesthetics

Tranquilizers

Chemical restraint

Antiemetics

Antihistamines

Motion sickness

Name 6 common uses of phenothiazines
name the 3 butyrophenones
Name the 3 butyrophenones
  • Haloperidol
  • Droperidol
  • Azaperone
t or f butyrophenones are antihistamines anti motion sickness drugs
T or F: Butyrophenones are antihistamines & anti motion sickness drugs
  • F--otherwise, they are very similar to the phenothiazines
t or f butyrophenones generally have less side effects than phenothiazines
T or F: Butyrophenones generally have less side effects than phenothiazines
  • T--more potent tranquilizers & antiemetics
  • also, less potent hypotensive & hypothermic
name the 7 benzodiazepines
Diazepam

Oxazepam

Clonazepam

Clorazepate

Midazolam

Zolazepam

Lorazepam

Name the 7 Benzodiazepines
m of a for benzodiazepines
M of A for Benzodiazepines
  • Enhance GABA binding & open Cl- channels to ¯ the CNS
specific antidote for benzodiazepines
Specific antidote for benzodiazepines
  • Flumazenil
  • Competitive pharmacological antagonist
slide203
T or F: Benzodiazepines have greater effects on respiration and the CV than do phenothiazines & butyrophenones
  • F--they have insignificant effects on respiration and minimal CV effects
t or f benzodiazepines should not be used long term
T or F: Benzodiazepines should not be used long-term
  • True--they are metabolized to active metabolites (enzyme inducers) and therefore produce tolerance
t or f benzodiazepines are hepatotoxic in cats
T or F: Benzodiazepines are hepatotoxic in cats
  • True--b/c the carrier, propylene glycol, is a toxin
t or f benzodiazepines are used for all of the following
T or F: Benzodiazepines are used for all of the following:
  • Behavioral modifiers, anticonvulsants, preanesthetics, neuroleptanalgesia, appetite stimulants, & chemical restraint
  • True
t or f benzodiazepines are also used for all of the following
T or F: Benzodiazepines are also used for all of the following:
  • Anti-emetic, anti-histamine, anti-motion sickness, & prolactinemia
  • F--phenothiazines are used for that
list the 7 types of cns ors2
Sedatives & hypnotics

Tranquilizers (neuroleptics)

alpha-2 agonists

Opioid agonists & antagonists

Neuroleptanalgesics

Anticonvulsants

General anesthetics

List the 7 types of CNS ¯’ors
name 3 a 2 adrenergic agonists
Name 3 a-2 adrenergic agonists
  • Xylazine
  • Detomidine
  • Medetomidine
t or f reversal agent means the same thing as specific antidote
T or F: Reversal agent means the same thing as specific antidote
  • F--reversal agent works on only one effect to bring it back to normal; while a specific antidote reverses all the effects of the drug
t or f xylazine s the cns by stimulating pre synaptic central a 2 adrenergic receptors
T or F: Xylazine ¯’s the CNS by stimulating pre-synaptic central a-2 adrenergic receptors
  • True--results in an inhibition of NE and dopamine release
list the following species in order of decreasing sensitivity to xylazine
List the following species in order of decreasing sensitivity to xylazine:
  • Swine; cattle; goats; horses, dogs, & cats
  • Goats
  • Cattle
  • Horses, dogs, cats
  • Swine
t or f xylazine should not be used in pregnant cattle or sheep
T or F: Xylazine should not be used in pregnant cattle or sheep
  • True--causes myometrial contractions
t or f xylazine is a cns
T or F: Xylazine is a CNS ­
  • True--only at high doses
t or f detomidine is approved only in dogs and medetomidine is approved only in horses
T or F: Detomidine is approved only in dogs, and medetomidine is approved only in horses
  • F--other way around
name the antagonist
Xylazine--CNS

yohimbine (tolazoline)

Detomidine--CV

atropine

Medetomidine--CV

atipamezole

Detomidine--CNS

tolazoline (yohimbine)

Medetomidine--CNS

atipamezole

Xylazine--CV

atropine

Name the antagonist
list the 7 types of cns ors3
Sedatives & hypnotics

Tranquilizers (neuroleptics)

alpha-2 agonists

Opioid agonists & antagonists

Neuroleptanalgesics

Anticonvulsants

General anesthetics

List the 7 types of CNS ¯’ors
name the 4 classes of opioid agonists antagonists
Name the 4 classes of Opioid agonists & antagonists
  • Opioid agonists
  • Mixed agonist-antagonist
  • Partial agonist
  • Pure opioid receptor antagonist
name the 6 opioid agonists
Morphine

Codeine

Meperidine

Oxymorphone

Fentanyl

Carfentanil

Name the 6 Opioid agonists
list the 9 opioids in decreasing order of analgesic potency
Carfentanil (10,000)

Fentanyl (50-100)

Buprenorphine (30-100)

Oxymorphone (10)

Butorphanol (5)

Morphine

Codeine

Meperidine Pentazocine

List the 9 Opioids in decreasing order of analgesic potency
t or f opioids cause cns in all species
T or F: Opioids cause CNS ¯ in all species
  • F--not in cats, horses, ruminants, & pigs; actually, only in dogs, humans and NHP’s
t or f morphine is an emetic and an antitussive
T or F: Morphine is an emetic and an antitussive
  • F--emetic in dogs only at small to moderate doses; large doses depress the emetic center
slide239
T or F: Morphine stimulates respiration, reflex tachycardia, ­IOP, histamine release,& death from respiratory failure
  • True
t or f all of the following are uses of opioids in general
T or F: All of the following are uses of opioids in general:
  • Analgesics, preanesthetics, antidiarrheals, neuroleptanalgesics, & antitussives
  • True
which of the following is the best antitussive
Which of the following is the best antitussive?
  • Butorphanol, codeine, dextromethorphan, loperamide, diphenoxylate, tincture of opium
  • Dextromethorphan
which of the following is the best antidiarrheal
Which of the following is the best antidiarrheal?
  • Loperamide, diphenoxylate, tincture of opium, dextromethorphan, or codeine
  • Loperamide
t or f codeine is a less potent analgesic than morphine
T or F: Codeine is a less potent analgesic than morphine
  • True--carfentanil < fentanyl < buprenorphine < oxymorphone < butorphanol < morphine < codeine < meperidine = pentazocine
t or f codeine is used as an antitussive analgesic antidiarrheal antihistamine
T or F: Codeine is used as an antitussive, analgesic, antidiarrheal, & antihistamine
  • F--it can cause histamine release
t or f meperidine is less potent than morphine as an analgesic
T or F: Meperidine is less potent than morphine as an analgesic
  • True--carfentanil < fentanyl < buprenorphine < oxymorphone < butorphanol < morphine < codeine < meperidine = pentazocine
t or f oxymorphone is a more potent analgesic than morphine
T or F: Oxymorphone is a more potent analgesic than morphine
  • True--carfentanil < fentanyl < buprenorphine < oxymorphone < butorphanol < morphine < codeine < meperidine = pentazocine
t or f fentanyl is 10 4 times more potent than morphine
T or F: Fentanyl is 104 times more potent than morphine
  • False--it is only 50-100 times more potent
t or f butorphanol has minimal cv effects at therapeutic doses
T or F: Butorphanol has minimal CV effects at therapeutic doses
  • True--makes it a useful analgesic
t or f pentazocine is used for its sedative effect usually
T or F: Pentazocine is used for its sedative effect usually
  • False--it has less sedative effects than other opioids; used as an analgesic
name 2 partial opioid agonists
Name 2 partial opioid agonists
  • Buprenorphine
  • Nalorphine
t or f buprenorphine acts as both a partial agonist and as an antagonist
T or F: Buprenorphine acts as both a partial agonist and as an antagonist
  • True--partial agonist at low doses; antagonist at high doses
drug used to treat buprenorphine toxicity
Drug used to treat buprenorphine toxicity
  • Doxapram--need to use a drug that will kick it out of the opioid receptors rather than just competing for the receptors as an opioid antagonist such as naloxone would do
name 3 opioid antagonists
Name 3 opioid antagonists
  • Naloxone
  • Naltrexone
  • Diprenorphine
t or f naloxone reverses respiratory cns of opioids hypovolemic shock emetic effect of apomorphine
T or F: Naloxone reverses respiratory & CNS ¯ of opioids, hypovolemic shock, & emetic effect of apomorphine
  • F--does not reverse the emetic effect of apomorphine (works on opioid receptors, not excitatory receptors) in dogs
list the 7 types of cns ors4
Sedatives & hypnotics

Tranquilizers (neuroleptics)

alpha-2 agonists

Opioid agonists & antagonists

Neuroleptanalgesics

Anticonvulsants

General anesthetics

List the 7 types of CNS ¯’ors
give 3 examples of neuroleptanalgesics
Give 3 examples of neuroleptanalgesics
  • Droperidol-fentanyl
  • Acepromazine-oxymorphone
  • Diazepam-oxymorphone
what is the big positive to using neuroleptanalgesics
What is the big positive to using neuroleptanalgesics?
  • They have a synergistic effect, which means that less of each drug needs to be used in the patient
t or f neuroleptanalgesics do not cause a complete loss of consciousness
T or F: Neuroleptanalgesics do not cause a complete loss of consciousness
  • True--can remedy by using a low dose of pentobarbital as preanesthetic
which breed of dogs can be resistant to the neuroleptanalgesic effect of droperidol fentanyl
Which breed of dogs can be resistant to the neuroleptanalgesic effect of droperidol-fentanyl?
  • Australian terriers--but they are sensitive to the adverse effects
what drug is given as a preanesthetic to the vagal stimulation due to fentanyl
What drug is given as a preanesthetic to ¯ the vagal stimulation due to fentanyl?
  • Atropine
name the antidote for droperidol fentanyl
Name the antidote for droperidol-fentanyl
  • The combination of 4-AP & naloxone IV
  • 4-AP reverses droperidol
  • Nalozone reverses fentanyl
list the 7 types of cns ors5
Sedatives & hypnotics

Tranquilizers (neuroleptics)

alpha-2 agonists

Opioid agonists & antagonists

Neuroleptanalgesics

Anticonvulsants

General anesthetics

List the 7 types of CNS ¯’ors
list 5 anticonvulsant drugs
Phenobarbital

Primidone

Phenytoin

Potassium bromide

Benzodiazepines:

Diazepam

Clonazepam

Clorazepate

List 5 anticonvulsant drugs
t or f phenobarbital s seizure activity by enhancing gaba binding
T or F: Phenobarbital ¯’s seizure activity by enhancing GABA binding
  • True--it depresses the motor cortex & raises the threshold for seizure activity
drug of choice for prevention of epileptic seizures1
Drug of choice for prevention of epileptic seizures
  • Phenobarbital
  • b/c of its efficacy, safety, and pharmacokinetics
another drug given iv to treat status epilepticus but develops tolerance rapidly
Another drug given IV to treat status epilepticus, but develops tolerance rapidly
  • Clonazepam
used as an adjunctive antiepileptic w phenobarbital b c its tolerance is not as rapid as diazepam
Used as an adjunctive antiepileptic w/ phenobarbital b/c its tolerance is not as rapid as diazepam
  • Clorazepate
name the 3 anticonvulsants that are not used in cats
Name the 3 anticonvulsants that are not used in cats
  • Primidone
  • Phenytoin
  • Potassium bromide
  • remember the 3 P’s--potentiate problems in ‘puddy tats’
slide281
Drugs mainly used as adjunctives in dogs that have developed toxicity or not responded to phenobarbital or primidone
  • Phenytoin
  • Potassium bromide
drugs contraindicated in epileptic animals
Cause CNS excitement & seizures:

Phenothiazines

Butyrophenones

Xylazine

Opioid analgesics

Methylxanthines

Ketamine

Cross BBB/ very lipid soluble:

Corticosteroids

Chloramphenicol

Fluoroquinolones

Dopamine antagonist:

Metoclopramide

Drugs contraindicated in epileptic animals
list the 7 types of cns ors6
Sedatives & hypnotics

Tranquilizers (neuroleptics)

alpha-2 agonists

Opioid agonists & antagonists

Neuroleptanalgesics

Anticonvulsants

General anesthetics

List the 7 types of CNS ¯’ors
name the clinical stages of anesthesia
Name the clinical stages of anesthesia
  • Stage I
  • Stage II
  • Stage III
  • Stage IV
involuntary excitement loss of consciousness voluntary control signs of cns
Involuntary excitement, loss of consciousness & voluntary control, signs of CNS ­
  • Stage II anesthesia
loss of consciousness pain sensation neuromuscular reflexes and muscle tone
Loss of consciousness, pain sensation, neuromuscular reflexes, and muscle tone
  • Stage III (aka ‘surgical anesthesia’)
plane 3 plane 4 of stage iii
Plane 3 + Plane 4 of Stage III = ?
  • Deep or surgical anesthesia
name the 4 components of balanced anesthesia
Name the 4 components of balanced anesthesia
  • Sensory blockade
  • Motor blockade
  • Mental blockade
  • Reflex blockade
means the administration of drugs shortly before administration of the general anesthetic
Means the administration of drugs shortly before administration of the general anesthetic
  • Preanesthetic
name the major reason for giving preanesthetics
Name the major reason for giving preanesthetics
  • To reduce the amount of the general anesthetic
name 4 factors affecting the concentration of the anesthetic in the brain
Name 4 factors affecting the concentration of the anesthetic in the brain
  • Concentration of the anesthetic in arterial blood
  • Cerebral blood flow
  • Movement of the anesthetic to other tissues
  • Lipid solubility of the anesthetic
t or f you want the inhalation anesthetic to be soluble in blood
T or F: You want the inhalation anesthetic to be soluble in blood
  • F--if it’s in the blood, it’s not affecting the brain
t or f the lower the blood gas partition coefficient the faster the induction recovery
T or F: The lower the blood/gas partition coefficient, the faster the induction & recovery
  • True--means less of the gas is in the blood so more is able to affect the brain at a given concentration of anesthetic
slide305
Desflurane

Nitrous oxide

Sevoflurane

Isoflurane

Enflurane

Halothane

Methoxyflurane

Doc

Never

Said,

“It’s

Easy.”

He

Managed.

List the inhalation anesthetics from fastest to slowest based on the blood/gas partition coefficient
t or f the lower the oil gas partition coefficient the faster the induction recovery
T or F: The lower the oil/gas partition coefficient, the faster the induction & recovery
  • True--means less gas in the body tissues so more is able to affect the brain at a given concentration of anesthetic
slide307
Means the minimum alveolar concentration of an anesthetic that causes immobilization in 50% of animals exposed to a standard painful stimulus
  • MAC
t or f a drug with a lower mac is more potent than one with a higher mac
T or F: A drug with a lower MAC is more potent than one with a higher MAC.
  • True--a drug with low MAC means that you can use less drug to get the desired affects=>more potent
list the inhalation anesthetics in decreasing order of potency
Methoxyflurane

Halothane

Isoflurane

Enflurane

Sevoflurane

Desflurane

Nitrous oxide

My

Heart

Is

Even

Sensing

Depression

Now

List the inhalation anesthetics in decreasing order of potency
list the inhalation anesthetics in decreasing order of biotransformation
Methoxyflurane

Halothane

Sevoflurane

Enflurane

Isoflurane

Desflurane

Nitrous oxide

Most

Hospitals

Serve

Emergencies

In

Dire

Need

List the inhalation anesthetics in decreasing order of biotransformation
a relatively potent bronchodilator is anesthetic of choice in patients w asthma
A relatively potent bronchodilator & is anesthetic of choice in patients w/ asthma
  • Halothane
t or f some of the inhalation anesthetics also cause mr hypotension respiratory
T or F: Some of the inhalation anesthetics also cause MR, hypotension, & respiratory ¯
  • True--they potentiate the effects of nondepolarizing MR’s
  • listed from most to least:
  • Enflurane Even
  • Isoflurane I
  • Methoxyflurane Miss
  • Halothane Home
list in decreasing order of ability to cause cica s
Halothane

Methoxyflurane

Enflurane

Isoflurane

Halo

May

Excite

Individuals

List in decreasing order of ability to cause CICA’s
drugs that cardiac arrythmias
alpha-2 agonists

xylazine

detomidine

medetomidine

Thiobarbiturates

thiamylal

thiopental

Exogenous beta-1 agonists

epinephrine

norepinephrine

isoproterenol

Succinylcholine

Vagal stimulation

Drugs that ­ cardiac arrythmias
drugs that cardiac arrythmias1
Drugs that ¯ cardiac arrythmias
  • beta-1 blockers
    • phenothiazines
    • butyrophenones
  • Droperidol-fentanyl
  • Lidocaine
  • Deeper anesthesia
t or f inhalation anesthetics may cause malignant hyperthermia
T or F: Inhalation anesthetics may cause malignant hyperthermia
  • True--especially halothane
hepatotoxic inhalation anesthetics
Hepatotoxic inhalation anesthetics
  • Halothane
  • Methoxyflurane
  • Sevoflurane--metabolized in liver, but not toxic
nephrotoxic inhalation anesthetics
Nephrotoxic inhalation anesthetics
  • Methoxyflurane
  • Enflurane
not a potent inhalation anesthetic often used as anesthetic adjuvant analgesic but poor mr
Not a potent inhalation anesthetic, often used as anesthetic adjuvant; analgesic, but poor MR
  • Nitrous oxide
name the injectable anesthetics
Barbiturates

thiamylal

thiopental

pentobarbital

Chloral hydrate

Propofol

Etomidate

Dissociative anesthetics

ketamine

tiletamine

Name the injectable anesthetics
slide330
Because propofol is metabolized by conjugation to glucuronic acid, what species should it not be used in?
  • Cats
t or f ketamine works by noncompetitively antagonizing nmda receptors
T or F: Ketamine works by noncompetitively antagonizing NMDA receptors
  • True--by antagonizing the receptors responsible for the development of abnormal pain, ketamine produces analgesia and anesthesia
t or f ketamine does not cause complete loss of consciousness reflexes are maintained
T or F: Ketamine does not cause complete loss of consciousness, & reflexes are maintained
  • True
t or f a muscle relaxant is generally given with tiletamine zolazepam
T or F: A muscle relaxant is generally given with tiletamine-zolazepam
  • F--the zolazepam provides the MR effect
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