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Nervous system
Neurologic Drugs
| Question | Answer |
|---|---|
| Two types of drugs in the ANS | sympathetic (adrenergic) & Parasympathetic (Cholinergic) |
| What does Sympathetic nervous system do | "fight or flight"- increases HR, RR, & blood flow to muscles, decreases GI function, causes pupillary dilation |
| What does parasympathetic N.S. do | "homeostatic"- brings HR, RR, and blood flow to muscles back to normal levels; returns GI function to normal; constricts pupils to normal size |
| ANS drugs work by: | 1. acting like neurotransmitters 2. interfering with neurotransmitter release .blocking attachment of neurotransmitters to receptors 4. interfering with the breakdown/re-uptake of neurotransmitters at the synapse |
| Cholinergic agents clinical uses: | 1. decrease IOP of glaucoma 2. help control vomiting 3. stimulate GI motility 4, treat urinary retention 5. act as antidote for neuromuscular blockers |
| Pilocarpine | (direct-parasympathomimetic)- decrease glaucoma associated IOP, treats neurogenic keratoconjunctivitis sicca (dry eyes) |
| metoclopramide (Reglan) | (direct-parasympathomimetic)- antiemetic; promotes gastric emptying |
| bethanechol | (direct-parasympathomimetic)- treat GI and urinary atony (muscle weakness) |
| organophosphate compounds | (indirect-parasympathomimetic) commonly used as insecticide dips; may result in toxicity if used inappropriately; clinical signs= SLUDD |
| what is SLUDD | salivation, Lacrimation, Urination, Digestion, Defecation |
| What are the adverse side effects of Cholinergic agents? | bradycardia, hypotension, heart block, lacrimation, V/D, increased intestinal activity, increased bronchial secretions |
| What are the clinical uses for anticholinergic drugs? | pre-anesthetic, treatment of V/D via a decrease in GI motility, dilation of pupils of examination, treatment of sinus bradycardia |
| what is a pre-anesthetic? | drying of secretions and prevention of bradycardia before anesthesia |
| atropine | preanesthetic to dry respiratory secretions and prevent bradycardia, dilate pupils for examination, emergency drug (fastest onset, less duration than glycopyrrolate), |
| glycopyrrolate | preanesthetic to dry respiratory secretions and prevent bradycardia, emergency drug (slower onset and longer duration of action than atropine) |
| pralidoxime | treat OP intoxication |
| What are the side effects of anticholinergic agents? | (dose related) drowsiness, disorientation, tachycardia, photophobia, constipation, anxiety, burning at injection site |
| what do adrenergic drugs do? | simulate the action of sympathetic N.S; bring about action at receptors mediated by epi & norepi; classified according to specific receptor types activated (alpha and beta) |
| What are the clinical uses of adrenergic drugs? | stimulate the heart to beat during cardiac arrest, reverse hypotension and bronchoconstriction of anaphylactic shock, strengthen the heart during CHF, correct hypotension through vasoconstriction, treat urinary incontinence, treat glaucoma |
| how do adrenergic drugs treat glaucoma? | increase outflow of and decrease production of aqueous humor |
| epinephrine | (sympathomimetic)- stimulates all receptors to cause increase in HR and CO; dilation of blood vessels in muscle; dilation of bronchioles; increase metabolic rate |
| norepinephrine | (sympathomimetic)- increase blood pressure |
| dopamine | (sympathomimetic)- precursor of epi and norepi; treat shock and CHF; increases renal perfusion |
| phenylpropanolamine | (sympathomimetic)- treat urinary incontinence in DOGS |
| dobutamine | (sympathomimetic)- short term treatment of heart failure |
| What are the adverse side effects of adrenergic drugs? | tachycardia, hypertension, nervousness, arrhythmias |
| What do adrenergic blocking agents (antiadrenergics/sympatholytics) do? | block the efforts of the adrenergic neurotransmitters (disrupt the activity of SNS); classified according to the site of their action (alpha/beta blockers) |
| acepromazine | (alpha blocker)-tranquillizer; causes vasodilation |
| yohimbine | (alpha blocker)- antidote for xylazine (tranquilizer) toxicity |
| atipamezole (Antisedan) | reversal agent for dexmedetomidine (Dexdomitor) |
| Side effects of alpha blockers | hypotension, tachycardia, muscle tremors |
| propranolol | beta blocker; used to treat cardiac arrhythmias an hypertrophic cardiomyopathy |
| atenolol | beta blocker; similar to propranolol |
| timolol | beta blocker; ophthalmic preparation used to treat glaucoma |
| adverse side effects of beta blockers | bradycardia, hypotension, worsening heart failure, bronchoconstriction, heart block, syncope |
| CNS drugs do: | alter nerve impulses to tranquilize or sedate animals, control pain, induce anesthesia, prevent/control seizures, antagonize/reverse effects of some depressant drugs, stimulate the CNS to treat cardiac/ respiratory depression/arrest, perform euthanasia |
| anesthesia | means without sensation |
| general anesthetics | affect the CNS, produce loss of sensation with partial or complete loss of consciousness |
| local anesthetics | block nerve transmission in the area of application with no loss of consciousness; uses: nerve blocks, aid in endotracheal tube placement, ease skin irritation |
| inhalant anesthetics | used to produce general anesthesia, liquid agents are vaporized in oxygen; distributed via concentration gradient in blood stream, vaporizer specific to anesthetic agent |
| effects of inhalant anesthetics | reversible depression of the CNS, muscle relaxation, slight analgesia, respiratory depression, slight cardiac depression, decreased blood pressure, potentiate cardiac arrhythmias |
| adverse affects of inhalant anesthetics | dose-related hypotension can cause decrease in renal perfusion; GI effects including nausea, vomiting, ileus |
| vapor pressure | measurement of the tendency of a liquid to evaporate |
| blood-gas solubility coefficient | measurement of the tendency of an agent to dissolve in blood; associated with the speed of induction, recovery, and change in anesthetic depth; lower coefficient= faster action |
| minimum alveolar concentration | measurement of the potency of an agent; how much agent is needed to attain surgical anesthesia; high MAC=less potent |
| Administration of local anesthetics | topically to mucous membranes and the cornea, infiltration of a wound or joint, IV with continuous drip, injection around nervous tissue |
| tranquilizers | calming agent used to calm animals; reduce anxiety and aggression |
| sedatives | calming agents used to quiet excited animals; decrease irritability and excitement |
| anti anxiety drugs | calming agent to lessen anxiousness, but do not make animals drowsy |
| Purpose of phenothiazine tranquilizers | dopamine blockers(alpha-adrenergic blockers)- actions: sedation, allay fear and anxiety, antiemetic- depress chemoreceptor trigger zone in brain, no analgesia |
| what is a precursor of epinephrine and norepinephrine | dopamine |
| phenothiazine tranquilizers | acepromazine, chlorpromazine, prochlorperazine |
| side effects of phenothiazine tranquilizers | profound hypotension (vasodilation), possible hypothermia, lower seizure threshold, protrusion of nictitating membrane, paraphimosis (horses only), bradycardia |
| What do benzodiazepine derivatives do | depress thalamic and hypothalamic regions of brain; limbic system; actions= sedation, muscle relaxation, anticonvulsant activity, reduction of anxiety, appetite stimulant, no analgesia |
| benzodiazepine derivatives | diazepam (Valium), midazolam (Versed), alprazolam (Xanax); Schedule IV controlled drugs |
| diazepam (Valium) | often used with ketamine for anesthesia, used for treatment of in process seizures |
| side effects of benzodiazepine derivatives | CNS excitement in dogs; overdose may cause excessive CNS depression |
| purpose of Alpha-2 agonists | bind to alpha-2 receptors on neurons, reduces production of norepinephrine, absence of norepinephrine causes sedation; used of sedation, preanesthetic, analgesia, emetic in cats |
| side effects of alpha-2 agonists | analgesia, muscle relaxation, decreased response to stimuli |
| dexmedetomidine (Dexdomitor) | alpha-2 agonists; sedative and analgesic; can be combined with other drugs to produce surgical anesthetic levels; side effects: bradycardia/heart block, biphasic BP response, decreased RR, vomiting; reversal agent= atipamezole (antisedan) |
| biphasic BP response | short period of hypertension followed by hypotension |
| poor peripheral perfusion | poor mm color and unreliable peripheral BP measurements |
| xylazine (Rompun, AnaSed) | alpha-2 agonist; sedation, some analgesia, muscle relaxant, emesis (cats); side effects= profound bradycardia, hypotension, hypoventilation, cardiac arrhythmias, increase sensitivity to epinephrine; ruminants are more sensitive; reversal agent= yohimbine |
| detomidine | alpha-2 agonist; used as sedative in horses, produces better analgesia than xylazine |
| romifidine | alpha-2 agonist; used as a sedative and preanesthetic in horses, facilitates handling. |
| barbituates | one of the oldest categories of CNS depressants, sedatives, anticonvulsants, general anesthetics, euthanasia agents, non-reversible, must be metabolized by liver prior to elimination, must be administered via IV due to tissue sloughing |
| pentobarbital | barbituate; short acting 1-2 hours; given IV or IP; uses: anticonvulsant and euthanasia; schedule II controlled drug |
| phenobarbital | barbituate; long acting 8-12 hours; primary use= anticonvulsant; oral and injectable, plasma drug levels must be monitored frequently; schedule IV controlled drug |
| thiopental | barbituate; ultra short acting 5-30 mins anesthetic induction agent; not currently in USA; IV only, causes tissue necrosis & tissue sloughing if perivascular injection, rapidly redistributed to fat; can cause apnea or CNS excitment; class III drug |
| Euthanasia solutions | barbituates; used to humanely end an animals life, should produce rapid unconsciousness followed by cessation of respiratory and cardiac functions, minimal struggling, vocalizations, or excessive voluntary movements, usually pentobarbital |
| Purpose of Dissociative agents | alter neurotrans activity causing depression of thalamus & cerebral cortex; sedation, restraint, analgesia, anesthesia; produce muscle rigidity, respiratory depression, minor cardiac stimulation; ataxic & hyper responsive anesthesia induction & recovery |
| ketamine (Ketaset) | dissociative; immobilizes patient but mild analgesic effect; primary sedative used in nonhuman primates; side effects: increased salivation, eyes remain open (need ocular lubricant), may cause burning sensation at injection site; schedule III drug |
| tiletamine (Telazol= tiletamine with zolazepam) | dissociative; provides better analgesia than ketamine; addition of zolazepam eliminates need for combination with other agents for muscle relaxation; schedule III drug |
| purpose of opiods | produce analgesia, sedation, and relieve anxiety, does not produce anesthesia; side effects= respiratory depression, excitement if given too rapidly; low doses= antitussive properties; produce effects by action on opiod receptors |
| opiods: Mu | found in pain regulating brain areas |
| opiods: Kappa/Delta | found in the cerebral cortex and spinal cord; areas associated with pain modulation |
| Opiods: Sigma | found in the brain |
| Full Opiod agonists | morphine, oxymorphone, fentanyl |
| partial opiod agonists | buprenorphine (Buprenex), butorphanol (Torbugesic), tramadol |
| buprenorphine (Buprenex) | Mu- partial agonist, Kappa- antagonist; Delta- antagonist (weak) |
| butorphanol (Torbugesic) | Mu- antagonist; Kappa- partial agonist |
| tramadol | Mu-agonist, serotonin-norepinephrine reuptake inhibitor |
| opiod antagonists | block the binding of opiods to their receptors, used to treat respiratory and CNS depression of opiod use, naloxone (Narcan) |
| neuroleptanalgesia | opiod + tranquilizer or sedative |
| neuroleptanalgesics | can cause a state of CNS depression and analgesia and may/may not produce unconsciousness, combination products may be prepared by vet; ex: acepromazine + morphine, xylazine + butorphanol |
Created by:
Katiepatch96
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