Pre-Medications Flashcards Preview

Veterinary Nursing Anaesthesia and Analgesia > Pre-Medications > Flashcards

Flashcards in Pre-Medications Deck (66)
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1

Why give pre-meds?

-Provide sedation and analgesia
- Calm the patient for smooth induction
- Reduce dose of induction and maintenance agents required
- May help reduce some adverse effects of the anaesthetic or surgical procedure

2

What is balanced anaesthesia?

- Using multiple drugs in combo to achieve anaesthesia
- Provide better quality of anaesthesia
- Minimise total doses of agents used whereby reducing potential side affects
- All tailored to the individual patient
- Balance out side effects with other drugs

3

What are the golden rules to using Pre-meds

- correct does tailored to the individual animal!
- Should be given and left in a quiet environment
- Give enough time for the drug to take effect
- note the route of admin (may impact time to reach effect and duration of effect)

4

How long do most pre-meds take to cause an effect?

30 minutes

5

What are Alpha-2-Agonists ?

Drugs that bind to alpha-2 receptors in the brain and spinal cord

6

How do Alpha-2-agonists work ?

Block transmission of nociceptive impulses
Exact mechanisms not fully understood

7

What do Alpha-2-Agonists provide?

Sedation and Analgesia

8

Name 2 Alpha-2-Agonists

Medetomidine
Dexmedetomidine

9

What are Alpha-2-Agonists used for?

- Sedation
- Pre-medication
- Anaesthesia

10

What other drug to Alpha-2-Agonists work with for sedation?

Opioids (usually buprenorphine)

11

What is a major benefit when using Alpha-2-Agonists as pre-medication

Can achieve a profound sparing effect which lowers the doses of other agents required for induction and maintenance

12

What other drug is commonly used with Alpha-2-Agonists for anaesthesia

Ketamine - especially in cats

13

What analgesic approach can Alpha-2 Agonists be used as a part of

multi-modal analgesic approach

14

Name 4 potential side effects with Alpha-2-Agonists

- Causes vasoconstriction
- Can cause profound bradycardia
- Causes respiratory depression
- Reduces liver blood flow
- May cause vomiting

15

What patients should you not use Alpha-2-Agonists on or have extreme caution in using on

- Patients with cardiovascular disease
- Patients with liver disease
- Patients where vomiting would be risky

16

Name 4 advantages of Alpha-2-Agonists

- There is a reversal drug (Atipamezole)
- Profound drug sparing effect
- Provides muscle relaxation
- Provides Analgesia
- Duration and level of sedation are dose dependent

17

What are opioids?

Analgesics
Light sedative effects

18

How do opioids work?

Act by combining with specific receptors in the brain and spinal cord (OP3 most commonly) and decrease the transmission of noxious stimuli

19

What are the three kinds of Opioids?

Full agonists
Partial Agonists
Antagonists

20

How do full agonist opioids work and when would you use it?

Produce maximal effect and bind all receptors
Used for moderate to severe pain e.g. bitch spay

21

Give an example of a full agonist opioid

Morphine, methadone, pethidine, fentanyl

22

What other drugs are used in combo with partial agonist opioids

Alpha-2's or phenothiazine

23

What form of pain is a partial agonist opioid use in and give an example of a partial agonist

Mild to moderate pain

Example: Buprenorphine

24

What is the function of an antagonist opioid?

Work against the analgesic effects of the agonist - can be used as an antidote

25

Give an example of an antagonist and where it is commonly found

Naloxone ('Narcan')

Often found in emergency crash kits

26

What kind of Pre-meds are opioids usually combined with

sedatives

27

Name 2 schedule 2 opioids

Morphine, fentanyl

28

Name 2 schedule 3 opioids

Buprenorphine, tramadol

29

Benefits of using an opioid?

- provide analgesia and euphoria, sedation
- Little effect on respiration at correct dose
- Drug sparing effect
- Little effect on CVS but can cause bradycardia
- Pain relief provided may improve ventilation in cases of thoracic wall injury

30

What negatives are associated with the use of opioids?

- High doses lead to profound respiratory depression
- Contraindicated in animals with increased ICP
- Vomiting may occur due to morphine
- Constipation
- Antitussive effect (suppress coughing)
- Urinary retention if given spinally