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VTT Pharmacology 4
Opioids, Inhalents, NSAIDS?
| Question | Answer |
|---|---|
| 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 |
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Adeprey4311
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