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    Pre-Anesthetic Medication: Drug Categories

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    Aleya Albert Rama
    This document discusses categories of pre-anesthetic medications including anticholinergics, tranquilizers, opioids, and neuroleptanalgesics. Anticholinergics like atropine and glycopyrrolate are used to prevent salivation and bronchial secretions. Tranquilizers like phenothiazines and benzodiazepines produce calming effects. Opioids provide analgesia and sedation. Neuroleptanalgesics combine tranquilizers and analgesics to induce sedation-analgesia for short procedures. Each drug category has unique effects, durations of action, side effects, and clinical applications in veterinary anesthesia.

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    Pre-Anesthetic Medication: Drug Categories

    Uploaded by

    Aleya Albert Rama
    37 views4 pages
    This document discusses categories of pre-anesthetic medications including anticholinergics, tranquilizers, opioids, and neuroleptanalgesics. Anticholinergics like atropine and glycopyrrolate are used to prevent salivation and bronchial secretions. Tranquilizers like phenothiazines and benzodiazepines produce calming effects. Opioids provide analgesia and sedation. Neuroleptanalgesics combine tranquilizers and analgesics to induce sedation-analgesia for short procedures. Each drug category has unique effects, durations of action, side effects, and clinical applications in veterinary anesthesia.

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    2.%20PRE-ANESTHETIC%20MEDICATIONS%20-%20DRUG%20CATEGORIES

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    This document discusses categories of pre-anesthetic medications including anticholinergics, tranquilizers, opioids, and neuroleptanalgesics. Anticholinergics like atropine and glycopyrrolate are used to prevent salivation and bronchial secretions. Tranquilizers like phenothiazines and benzodiazepines produce calming effects. Opioids provide analgesia and sedation. Neuroleptanalgesics combine tranquilizers and analgesics to induce sedation-analgesia for short procedures. Each drug category has unique effects, durations of action, side effects, and clinical applications in veterinary anesthesia.

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    37 views4 pages

    Pre-Anesthetic Medication: Drug Categories

    Uploaded by

    Aleya Albert Rama
    This document discusses categories of pre-anesthetic medications including anticholinergics, tranquilizers, opioids, and neuroleptanalgesics. Anticholinergics like atropine and glycopyrrolate are used to prevent salivation and bronchial secretions. Tranquilizers like phenothiazines and benzodiazepines produce calming effects. Opioids provide analgesia and sedation. Neuroleptanalgesics combine tranquilizers and analgesics to induce sedation-analgesia for short procedures. Each drug category has unique effects, durations of action, side effects, and clinical applications in veterinary anesthesia.

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    of 4

    PRE-ANESTHETIC MEDICATION: DRUG CATEGORIES

    I. ANTICHOLINERGICS
     Beneficial Effects:
    a. 1O – to prevent salivation and production of mucous in the air passages
    b. Inhibits bradycardia caused by increases in vagal tone (e.g., laryngeal or ocular
    stimulation and vasovagal reflexes – traction of visceral organs)
    c. Inhibits bradycardia from increased vagal tone associated with administration of
    opioids, general anesthetics, α-2 agonists
    d. Inhibits oculocardiac reflex
    1. Atropine
    - Induces sinus bradycardia before the establishment of sinus tachycardia
    - DOA: 60-90 minutes
    - May produce drowsiness
    - Contraindications:
    a. Ruminants – inhibits secretions making the saliva more viscid → proper
    positioning of the animal is important to prevent aspiration
    b. Very young animals - ↑ HR → arrhythmia
    c. Dogs with bronchiectasis - ↑ tenacity of secretions without eliminating them
    d. IV administration of atropine and glycopyrrolate – results in cardiac
    arrhythmias, i.e., sinus tachycardia and atrioventricular block; ventricular
    arrhythmias may also result from IV atropine
    2. Glycopyrrolate
    - Has longer duration of action (2-4 hours) but more expensive
    - Does not induce sinus bradycardia
    - Does not cross the blood-brain or placental barrier – no CNS or fetal effects
    3. Scopolamine
    - May produce drowsiness

    II. TRANQUILIZERS/NEUROLEPTICS/ATARACTICS
     produce a calming effect and lowers the amount of general anesthesia to produce
    anesthesia

    1. Phenothiazines – acepromazine, promazine


    - Effects:
    a. Mental calming effect – can be temporarily reversed with adequate stimulus
    - calms vicious or nervous animals
    b. Decrease motor activity
    c. Increase threshold for responding to external stimuli
    d. Lower seizure threshold level in animals with epilepsy
    e. Marked antiemetic effect
    f. Not much analgesic activity but improve the analgesic effects of drugs with
    analgesic activity
    g. Most have antihistaminic effect
     Cardiopulmonary effects:
    a. hypotension
    b. tachycardia
    c. direct depression of the myocardium and vascular smooth muscle
     Side effects:
    a. Akathisia – restless condition in which the patient needs to be in constant
    motion
    b. Acute dystonic reactions: hysteria, seizures, ataxia
    c. Hypotension

    VSUR 151 Pre-Anesthetic Medications – Drug Categories EP Manigbas, DVCS, CVM, UPLB 1
    d. Hypothermia
    e. Inhibited platelet function

    2. Butyrophenones
     Similar to phenothiazine derivatives…
     Do not lower seizure threshold level
     Cause excitement and extrapyramidal effects in horses at relatively low doses
    a. Droperidol
    b. Azaperone – produces calming and prevents fighting and cannibalism in pigs

    3. Benzodiazepenes – diazepam, midazolam


     Effects:
    a. Produce minimal or no calming in normal animals; calming effects observed
    in sick, depressed, or debilitated animals
    b. Muscle relaxation; reduce muscle spasm and spasticity – additive or
    synergistic effects with other drugs used to produce general anesthesia
    (i.e., barbiturates)
    c. Anticonvulsant- increases seizure threshold
    d. Increases appetite in domestic cats and ruminants
    e. Behavior modification
     Cardiopulmonary Effects:
    a. Hypotension
    b. Bradycardia – after rapid IV administration
    c. Minimal effect on the respiratory rate and tidal volume
     Side effects:
    a. Ataxia – particularly evident in large animal species
    b. Paradoxical increase in anxiety and fear response in some animals
    c. Pronounced CNS depression in neonates
     Antagonist:
    a. flumazinil

    4. α-2 adrenergic receptor agonists –xylazine, medetomidine, detomidine


     induce a sleeplike state similar to phenothiazine, only more pronounced
     produce analgesia
     effects are additive when combined with other depressant and analgesic drugs
    to produce chemical restraint or general anesthesia
     can be administered epidurally or subarachnoidally to produce regional or
    segmental anesthesia
     Cardiopulmonary effects:
    a. Slow heart rate – may initiate sinus bradycardia or first- or second-degree
    atrioventricular blockade
    b. Initially increase BP, then reduce BP to below control values
    c. Bradycardia
    d. Centrally depress respiratory centers
    e. May induce stridor and dyspnea in horses and brachycephalic dogs with
    upper airway obstruction
     Pharmacologic effects:
    a. Suppress salivation, gastric secretions and gastrointestinal motility
    b. May stimulate pica and appetite at low doses
    c. Cause vomiting in dogs and cats
    d. Depress swallowing reflex
    e. Used to treat colic
     Side effects:
    a. Severe respiratory depression (respiratory acidosis)
    b. Bradyarrhthymias

    VSUR 151 Pre-Anesthetic Medications – Drug Categories EP Manigbas, DVCS, CVM, UPLB 2
    c. Hypotension
    d. Ataxia in large animals
    e. Sweating in horses
    f. Diuresis
    g. Occasional severe inflammatory response if administered subcutaneously in
    horses or cattle
    h. Produce profound sleep in dogs, cats, foals and small ruminants – partially
    reversible with doxapram hydrochloride
    i. Highly excited or nervous animals may react adversely by becoming
    extremely ataxic, reacting violently or viciously when approached or
    touched, or showing inadequate response to the drug
    j. Oxytocin-like effect in ruminants
     Antagonists:
    a. Yohimbine
    b. Tolazoline
    c. Atipamazole

    III. OPIODS
    a. Pure agonist
    i. Fentanyl – most potent analgesic
    ii. Etorphine
    iii. Morphine
    iv. Meperidine
    v. Oxymorphone
    b. Agonist-antagonist – antagonize the effects of other opioid agonists but can
    produce mild CNS depression, euphoria and analgesia when given in therapeutic
    doses.
    i. Pentazocine – least potent analgesic
    ii. Butorphanol – excellent cough suppressant
    iii. Buprenorphine
    iv. Nalorphine
    c. Pure antagonist
    i. Naloxone

     MOA: act by reversible combination with one or more specific (opiate and
    nonopiate) receptors in the brain and spinal cord to produce a variety of effects
    including:
    a. Analgesia – produce analgesic action at doses lower than needed for sedation
    b. Sedation – produce excellent sedation in dogs but may cause excitement when
    given rapidly IV
    c. Euphoria
    d. Dysphoria
    e. Excitement – cats and horses are particularly susceptible to excitatory effects of
    opiods
    f. Miosis in dogs and pigs, mydriasis in cats and horses
     Produce additive effect when used with other depressants
     May be used in combination with tranquilizers and sedatives to produce
    neuroleptanalgesia
     Can be administered subarachnoidally or epidurally to produce regional or
    segmental anesthesia
     Cardiopulmonary effects:
    a. Bradycardia
    b. Hypotension
    c. Respiratory depression
    d. Reduced respiratory reserve capabilities

    VSUR 151 Pre-Anesthetic Medications – Drug Categories EP Manigbas, DVCS, CVM, UPLB 3
     Gastrointestinal effects:
    a. Salivation
    b. Nausea
    c. Vomiting
    d. Defecation
    e. Non-propulsive GI hypermotility, increases in sphincter tone
     Cross the placental barrier more slowly; useful for C-section because depressant
    effects can be antagonized
     Side Effects:
    a. Excitement, dysphoria
    b. Apnea
    c. Bradycardia
    d. Ataxia and incoordination
    e. Excessive vomiting
    f. Excessive sweating in horses

    IV. NEUROLEPTANALGESICS – combination of tranquilizer and analgesic drug


    a. Fentanyl and droperidol (Innovar-Vet) – dogs, cats, pigs
    b. Acepromazine with morphine/meperidine/oxymorphone - dogs
    c. Diazepam and oxymorphone – dogs and cats
    d. Xylazine and morphine - horses
    e. xylazine and butorphanol - horses
     the animal may or may not retain consciousness and is responsive to auditory
    stimuli; many animals defecate, some vomit
     Results of the combination:
    a. Sedation-analgesia, ataxia, and/or recumbency
    b. Respiratory depression
    c. Bradycardia
    d. Defecation and flatulence
    e. Analgesia
     Most animals are premedicated with an anticholinergic to prevent bradycardia and
    excessive salivation
     Useful for short operative procedures and for C-section in small animals

    Pre-anesthetic drug comparison


    Drug Duration of Analgesia Muscle Sedation
    action relaxation
    1. Phenothiazine 4-8 hrs - - -

    2. Butyrophenones 4-8 hrs - + azaperone

    3. Benzodiazepenes 1-4 hrs - + -

    4. Xylazine 20-40 mins + + +

    5. Detomidine 1 ½ -2 hrs + + +

    6. Medetomidine 45-90 mins + + +


    7. Opiods + - +
    except except
    naloxone naloxone

    VSUR 151 Pre-Anesthetic Medications – Drug Categories EP Manigbas, DVCS, CVM, UPLB 4

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