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104 Cards in this Set
- Front
- Back
Preanesthestics
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Preanesthetics
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Why are preanesthetics used?
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calm/sedate (smooth induction & recovery), reduce/eliminate adverse effects of general anesthetics, dec amt of general anesthetic required, decrease pain during & after sugery
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What are anticholinergics used for?
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decrease parasypathetic responses produced by anesthetic drugs
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What is the autonomic nervous system?
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Part of nervous system that controls involuntary bodily functions
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What are the two division of the autonomic nervous system?
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sympathetic and parasympathetic
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Define synapse
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space between nerve ending and receptor
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Define receptor
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site stimulated to respond when it recs neurotransmitter from nerve ending
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Define neurotransmitter
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chemical that is released from nerve ending & travels across synapse, stimulating receptor
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Define parasympathetic nervous system
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stimulation produces response for "all OK - relax" situations
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Define sympathetic nervous system
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stimulation produces responses for "fight or flight" situations
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What is the neurotransmitter that stimulates parasympathetic responses?
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Acetylcholine
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What is the neurotransmitter that stimulates sympathetic responses?
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Norepineprhine
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What are some parasympathetic responses?
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increased saliva & tear production, HR slows, pupils contract, blood pressure dec, bronchi constrict, incr GI motility & secretions
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What are some sympathetic responses?
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inc saliva & tear production, pupils dilate, inc HR, inc blood pressure, bronchi dilate, dec GI motility & secretions
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What does suffix ergic mean?
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does the work of, stimulates
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What does the suffix mimetic mean?
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mimics, has similar effect
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What does the suffix lytic mean?
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prevents, tears down the effects of
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What are anticholineric drugs used for?
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prevent hypersalivation, prevent bradycardia
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What are two examples of anticholinergics?
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Atropine and Glycopyrrolate
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Atropine and Glycopyrrolate are what kind of drugs
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anticholinergics
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Do anticholinergics have sedative effects?
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Not at therapeutic doses
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Atropine is derived from what deadly plant?
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Nightshade
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Is Atropine expensive?
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No, cheap
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What is the onset of Atropine SC? IM?
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SC - 20 min, IM - 10-15 min
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What is the duration of Atropine?
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60 min after SC admin
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What are some precautions w/ Atropine
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Markedly reduces tear secretion (use artificial tears), avoid in pts w/ pre-ex rapid HR, produces thick mucous airway secretions, reduces GI activity, crosses placental barrier
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What are some signs of Atropine overdose?
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tachycardia, peripheral vasodilation, dry MM, thirst, hyperthermia, excitment, dilated pupils
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Glycopyrrolate has effects similar to ___ but costs __, has ___ duration, milder effects, and does not cross the placental barrier
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similar to Atropine but costs more, has longer duration (2-3 hrs), milder effects, and does not cross placental barrier
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Why are sedatives/tranquilizers used?
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calming effect, smooth induction & recovery, dec amt of general anesthetic reqd, prev excitatory of some anesthetics in some species
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Define sedative
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drug that causes reduced mental activity and sleepiness
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Define tranquilizer
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drug that reduces anxiety but does not necessarily decrease awareness & wakefulness
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What effects do phenothiazines have?
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sedation, antiemetic, antiarrhythmic, antihistamine, peripheral vasodilation, personality effects, penile prolapse, LACK OF ANALGESIA
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What is an example of a phenothiazine drug?
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Acepromazine
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Acepromazine is what kind of drug?
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phenothiazine
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Is Ace a controlled drug?
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No
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How long is the sedation provided by Acepromazine given IM?
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2-8 hours
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What are some benefits of Acepromazine?
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not controlled, long sedation effect, antiemetic, antiarrhythmic
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Do phenothiazines (Acepromazine) provide analgesia?
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NO!!
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What are some precautions w/ Acepromazine?
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no analgesia, prolapse of third eyelid, vasodilation(avoid in hypotensive pts), lower seizure threshold
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What is the onset of Acepromazine given IM?
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15 mins
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How can Ace be given?
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IM, SC, Oral, IV - with caution
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Acepromazine, Diazepam, Midazolam, Zolazepam, Xylazine, and Medetomidine are all what?
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sedatives/tranquilizers
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Diazepam, Midazolam, and Zolazepam are what kind of drug?
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Benzodiazepines
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What are the advantages of Benzodiazepines?
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antianxiety/calming effect, excellent muscle relaxation, anticonvulsant, minimal cardiac and respiratory depression
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Name three Benzodiazepines
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Diazepam, Midazolam, Zolazepam
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Are Benzodiazepines controlled?
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YES!
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What is a precaution of Benzodiazepines?
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may cause excitement when used alone
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What is the most commonly used preanesthetic sedative in veterinary medicine?
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Acepromazine
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What is the "big feature" of Diazepam?
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prevents seizures
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Diazepam is ___ sensitive
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light
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Diazepam is painful if given IM so it is usually given __ or ___
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IV or orally
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The only anesthetic agent that is physically compatible w/ Diazepam is ___
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Ketamine
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When drawing up Diazepam and Ketamine in the same syringe ___ is drawn up first. Why?
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Diazepam - do not want to get Ketamine into anything!
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Midazolam is expensive but is watersoluable so it can be administered ___.
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IM
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Zolazepam is most commonly seen as part of Telazol® - what is the other component?
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tiletamine
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Alpha 2 Agonists are also called what?
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Thiazine derivatives
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Thiazine derivatives are also called what?
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Alpha 2 Agonists
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What are 2 examples of Alpha 2 Agonists?
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Xylazine & Medetomidine
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Xylazine and Medetomidine are examples of what kind of drug?
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Alpha 2 Agonists/thiazine derivatives
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What are some advantages of Alpha 2 Agonists?
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Potent sedation, good muscle relaxation, effective analgesia, reversible, and not controlled
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Are Alpha 2 Agonists (xylazine & medetomidine) controlled?
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No
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Why are Alpha 2 Agonists only used in young, healthy patients?
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Can have potent cardiovasular effects
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Why is Atropine used w/ Alpha 2 Agonists?
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prevent bradycardia
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What are some other precautions of Alpha 2 Agonists (Xylazine & Medetomidine)?
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can be absorbed through skin and MM, analgesia wears off before sedation, emesis in 50% of dogs and 90% of cats, poss bloat - avoid in GDV risk pt
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What kind of drug causes emesis in 50% of dogs and 90% of cats?
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Alpha 2 Agonists (Xylazine & Medetomidine)
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What is the reversing agent for Xylazine? How is it administered?
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Yohimbine, given IV
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What are some contraindications for Alpha 2 Agonists?
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pediatric, geriatric, pregnant, sick, diabetic, cardiovasular or resp dz, GI obstruction
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How is Xylazine administered?
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IM or IV
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How long is the period of analgesia provided by Xylazine? The sedation?
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20 minutes for anagesia, up to several hours for sedation
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With Medetomidine there is a longer period of duration, but sudden ___ has been reported
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arousal
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What is the reversing agent for Medetomidine? How is is given?
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Atipamezole, given IM
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Reversing Alpha 2 Agonists do/do not reverse other drug that were given simultaneously
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do not
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When reversing an Alpha 2 Agonist, addtl pain med may be needed - why?
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It is the Alpha 2 Agonist that is providing the analgesia in many cases - if reversed you need to administer something to take over that function
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What are opioids derived from?
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opium poppy
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Opioids are a common component of preanesthetic protocols - why?
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safe for high risk pts and provide excellent analgesia for painful surgeries
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What are the most effective analgesics known?
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Opioids
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An opioid mixed w/ a tranquilizer for arousable but profound sedation/analgesia is an example of what?
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Neuroleptanalgesia
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What are three common uses for opioids
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preanesthetic, postoperative pain, and neuroleptanalgesia
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What are some advantages of opioids?
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most eff analgesia known, potent sedation, reversible, wide margin of safety
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What are some disadvantages of opioids?
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resp depression @ high doses, some are exitatory in cats & horses, can cause histamine release if given IV (facial swelling), GI clearing effects
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With opioids, they are given IV w/ caution in dogs, but you should avoid IV route in ___
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cats
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What are the four types of opioid receptors?
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Kappa, Mu, Sigma, Delta
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What effects does the opioid receptor Kappa control?
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Analgesia & cardiovascular stimulation
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What effects does the opioid receptor Mu control?
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Analgesia, euphoria, and CV depression
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What effects does the opioid receptor Sigma control?
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Analgesia & dysphoria
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What effects does the opioid receptor Delta control
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Analgesia & motor dysfunction
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What do pure agonists do? Examples of?
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Stimulate all 4 types of receptors - morphine, oxymorphone, fentanyl
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What do mixed agonists do? Examples of?
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Stimulate some types or receptors, block others - Butorphanol
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What do pure antagonists do? Examples of?
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Block all types of receptors - Nalaxone
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What are some signs of opioid overdose?
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Profound resp depression, bradycardia, extreme sedation or excitement, pinpoint pupils in dogs, dilated pupils in cats, facial swelling &/or hypotension due to histamine release excessive salivation
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Are opioids controlled?
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Yes
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How is morphine administered?
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SC, PO, slow IV (dogs only), IM
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What is the duration of morphine?
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about 2 hours
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___ is the standard by which other opioids are compared
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Morphine
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Is morphine expensive?
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No
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How is Oxymorphone administered?
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IV, IM, SC(cats), epidural
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Hydromorphone is more or less expensive than Morphine? Than Oxymorphone?
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More expensive than Morphine but less expensive than Oxymorphone
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What are some benefits of Oxymorphone over Morphine? Disadvantage?
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Adv - longer duration (~4 hrs), more potent sedation & analgesia, fewer side effects
Disadv - more expensive |
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Hydromorphone is more/less potent than oxymorphone, more/less expensive, and has duration and side effects similar to morphine
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slightly less potent, less expensive
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Butorphanol provides minimal sedation, analgesia for ____ hours, has a __ safety index, but is ___
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analgesia for 1-2 hours, high safety index, is expensive
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How are opioid reversants administered?
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IV, sublingual for neonates
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The reversant Nalorphine is __% antagonistic
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90%
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The reversant Naloxone is __% antagonistic
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100%
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The opioid Fentanyl is administered how? For what?
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By transdermal patch for postoperative pain
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