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Nervous system

Neurologic Drugs

QuestionAnswer
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