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VTT Pharmacology 4

Opioids, Inhalents, NSAIDS?

QuestionAnswer
Opioids synthetic or semi-synthetically produced from opiates
examples of semi-synthetic opioids Buprenorphine, Hydromorphone, Hydrocodone
examples of fully synthetic opioids fentanyl, tramadol
Opiates alkaloids in the resin of the opium poppy
examples of opiates morphine, codeine
Narcotics Substances that can cause addiction
MOA of opioids the result of the drugs action on receptors in the CNS
Which opioids are strong agonists? morphine, Fentanyl, Hydromorphone, Merperidine
What opioids are partial agonists? Butorphanol (partial agonist/agonist) Buprenorphine (partial agonist/antagonist
What opioids are strong antagonists? naloxone
What opioids are partial antagonists? Nalorphine (partial antagonist/agonist)
Neurleptanalgesia Higher doses of an opioid and a tranquilizer are given in combo to produce profound sedation and analgesia *Used when significant analgesia and CNS depression are necessary but general anesthesia is not
Opioids as antitussives Opioids used at low doses for cough suppression
What happens when morphine is given too fast IV? When in combo w/ Merperidine, may cause facial swelling and hypotension after rapid IV dosing
What is the difference between oxymorphone and Hydromorphone oxy is synthetic hydro is semi-synthetic, and slightly less potent w/ similar duration of effect, cheaper
What is the duration of analgesia for Butorphanol? Short duration w/ IM&SQ 45-90 minutes
What opioid is commonly used as an antitussive for dogs w/ kennel cough? Butorphanol
What is the duration of analgesia for Buprenorphine? 6-12hrs IM & SQ up to 6+ hrs. OTM
What is an ampoule a sealed glass capsule containing a liquid measured out to a specific quantity ready for injection
What does OTM stand for? Oral Trans Mucosal.
Why is it important that OTM buprenorphine not be swallowed? due to the first pass effect
What is the bioavailability of OTM buprenorphine in cats? Dogs? 100%, 30%
Which Fentanyl patch cannot be cut to size? Why? Duragesic, because the drug is in a gel layer
What is the company that made the generic fentanyl patch that CAN be cut to size? Why can it be cut? Mylan Pharmaceuticals, because the drug is actually in the adhesive of the patch
Why must fentanyl be administered as a CRI or transdermal patch? Due to the short duration of analgesia when given IV 30 mi ns
When can propofol cause apnea? When given to rapidly or at a high dose
Can propofol cause histamine release? yes
What is the shelf life for the original propofol? 6 hrs. at room temperature or 24 hours refrigerated
What is the shelf life of propofol-28? 28 days
What is the difference between the original propofol and propofol-28? The original contains egg lecithin requiring the drug to be refrigerated, Propoflo-28 does NOT contain egg lecithin and therefore does not require refrigeration
What is guaifenesin used for? primarily used in horses as a muscle relaxant, usually used in combo with ketamine, diazepam and/or xylazine
What are the effect of guaifenesin? laryngeal and pharyngeal muscle relaxation, makes intubation easier, mild analgesic and sedative, excitement free induction
TIVA Total IntraVenous Anesthesia
Malignant Hyperthermia causes a fast rise in body temperature and severe muscle contractions when the patient undergoes general anesthesia
What is the nickname for malignant hyperthermia? porcine stress syndrome
distribution/ elimination The way inhalants move from the lungs to the blood can be explained by a concentration gradient.in which chemicals move from an area of high concentration (initially the lungs) to an area of low concentration (initially the blood) and back again
What are the 3 physical properties of inhalants vapor pressure, solubility coefficient, MAC
Vapor Pressure The measure of how readily a liquid turns into a gas (temperature dependent)
Why are agents with a high vapor pressure considered volatile? because the evaporate so readily that they can reach 30% of total gas & oxygen mixture reaching the patient (this is fatal)
agents with a high vapor pressure ___________ easily therefore they require ____________ vaporizers evaporate, precision
Solubility coefficient an agents susceptibility to being dissolved/absorbed into something such as blood/tissue
What information can the solubility coefficient tell us about an agent? speed of induction/ recovery
the _______-the solubility coefficient, the faster the induction and recovery lower, faster
Blood: gas coefficient is what? A measure of the agents distribution between the blood phase and the gas phase
the _______ the solubility the slower the induction and recovery higher
When a patient is on isoflurane or sevoflurane how quickly will they respond to a change in the vaporizer setting? 1 minute
How long will a patient on methoxyflurane take to wake up after anesthesia? 30-60 minutes
MAC Minimum Alveolar Concentration
Define MAC- The lowest concentration of an anesthetic that produces NO responses in 50% of patients exposed to painful stimuli
Is an agent with a low MAC more or less potent? Why? More because it take less of the agent to produce the anesthetic effect, therefore the agent is more potent
Which inhalant has the fewest adverse effects on the heart? Isoflurane
What is the maintenance vaporizer setting for Isoflurane? 1.5%-2.5%
What is the maximum vaporizer setting for Isoflurane? 55
Is the vapor pressure of Sevoflurane higher or lower than Isoflurane? Lower
What is the maintenance vaporizer setting for Sevoflurane? 2.5%-4%
What is the maximum vaporizer setting for Sevoflurane? 8%
Sevoflurane can react with the Baralyme scavenger and produce what? Compound A
What is compound A? a vinyl ether
What is the most common undesirable side effect of Sevoflurane? Hypotension
What is the maintenance vaporizer setting for desflurane? 8-12%
What is the maximum vaporizer setting for desflurane? 18%
Why do they say desflurane is the single breath induction in humans? Due to its extremely low solubility coefficient of 0.42
Why was N2O used with methoxyflurane and halothane to speed induction/recovery, additional analgesic, lowers MAC by 20%-30% thus decreasing adverse effects
Can N20 reach a surgical plane of anesthesia by itself? No
What is the ratio of N2O to O2?? No more than 2:1
personality, fears and emotions are the result of what? a complex integrated balance of a wide variety of chemical neurotransmitters
Give 4 examples of behaviors that may benefit from behavior- modifying drugs fears and phobias, separation anxiety, compulsive disorders, age-related disorders
can drug therapy be used alone? no
Why or why not? Drugs are just the support system, behavior modification is still necessary in the form of training and work with the animal, the drug will make the animal more tractable and teachable but it will not teach them desired behavior
Since most behavior modifying drugs are labeled for human use, what document should a client sign prior to prescribing/dispensing these drugs? informed consent
For what reason must we obtain informed consent from the client/ in case of adverse effects
name 3 major groups of behavior modifying drugs anti-psychotic, anxiolytics, anti-depressants
behavior modifying drugs work by what mechanism? changing the concentration of selected neurotransmitters in the brain with intent to decrease or enhance specific mental (neuronal) activities
Why is acepromazine not the best choice in an aggressive dog? some aggressive animals may have learned adaptive behaviors that have reduced their natural displayed aggression. when a phenothiazine is given the learned responses are lessened possibly allowing instinctual aggressive behavior to re-emerge
Name 3 indications for the use of clomipramine in veterinary medicine obsessive compulsive disorders (chewing, licking, grooming) Male dominance aggression, fearful/fear aggression, noise phobia, separation anxiety
Why do some people think ssris are safer than TCAs because SSRIs have less of a depressant effect on the heart than TCAs
What behavior disorder is selegiline used for? canine cognitive disorder (old dog senility
How does selegiline work? increases the effects of dopamine by blocking the mechanism by which dopamine is taken up again by the mitochondria in neurons
What is buspirone used for in cats? low grade anxieties/ fears, spraying, over-grooming
How do synthetic progestin's work? by inhibiting pituitary secretion of gonadotropins(FSH, LH) thus affecting hormone levels
What are 4 serious side effects of progestin use? Adrenocortical suppression, adrenal atrophy, diabetes mellitus/personality change, mammary enlargement/neoplasia, endometeritis, pyometra
Created by: Adeprey4311