A neurotransmitter that allows a nerve impulse to cross the synaptic junction (gap) between two nerve fibers or between a nerve fiber and an organ (e.g., muscle, gland).
Define
Acetylcholinesterase
An enzyme that brings about the breakdown of acetylcholine in the synaptic gap.
Define
Adrenergic
A term used to describe an action or a receptor that is activated by epinephrine or norepinephrine.
Define
Analgesia
The absence of the sensation of pain.
Define
Anesthesia
The loss of all sensation. May be described as local (affecting a small area), regional, or surgical (accompanied by unconsciousness).
Define
Autonomic Nervous System
That portion of the nervous system that controls involuntary activities.
Define
Catalepsy
A state of involuntary muscle rigidity that is accompanied by immobility, amnesia, and variable amounts of analgesia. Some reflexes may be preserved.
Define
Catecholamine
The class of neurotransmitters that includes dopamine, epinephrine, and norepinephrine. When given therapeutically, catecholamines mimic the effects of stimulating the sympathetic nervous system.
Define
Cholinergic
Activated by or transmitted through acetylcholine; also called parasympathomimetic. Cholinergic drugs increase activity in the gastrointestinal tract.
Define
Effector
A gland, organ, or tissue that responds to nerve stimulation with a specific action.
Define
Ganglionic synapse
The site of the synapse between neuron one and neuron two of the autonomic nervous system.
Define
Muscarinic receptors
Receptors activated by acetylcholine and muscarine that are found in glands, the heart, and smooth muscle. An acronym for remembering muscarinic effects is SLUD: S, salivation; L, lacrimation; U, urination; D, defecation.
Define
Nicotinic receptors
Receptors activated by acetylcholine and nicotine found at the neuromuscular junction of the skeletal muscle and at the ganglionic synapses.
Define
Parasympathetic nervous system
That portion of the autonomic nervous system that arises from the craniosacral portion of the spinal cord, is mediated by the neurotransmitter acetylcholine, and is concerned primarily with conserving and restoring a steady state in the body.
Define
Parasympathomimetic
A drug that mimics the effects of stimulating the parasympathetic nervous system.
Define
Sympathetic nervous system
That portion of the autonomic nervous system that arises from the thoracolumbar spinal cord, is mediated by catecholamines, and is concerned with the fight-or-flight response.
Define
Sympathomimetic
A drug that mimics the effects of stimulating the sympathetic nervous system.
The nervous system exerts control over the endocrine system through the influence of the ______________ on the _____________
The nervous system exerts control over the endocrine system through the influence of the hypothalamus (brain) on the pituitary gland
The CNS is composed of
the brain
spinal cord
The peripheral nervous system is divided into
efferent
afferent
Afferent is composed of
nervous cells that carry impulses from the CNS to muscles and glands
The afferent system is composed of
nerve cells that carry information from the receptors in the periphery of the body to the CNS
somatic nervous system consists of
efferent nerves that carry impulses from the CNS to skeletal muscle tissue
The fundamental unit of all branches and divisions of the nervous system is the
neuron
Neurons have a nucleus surrounded by
cytoplasm
Axons
carry electric-like messages away from the nerve cell
Dendrites
carry electric-like messages away toward the nerve cell
Depolarization is also known as
charge reversal
"positive in, negative out" occurs in
depolarization or charge reversal
Polarized or "resting" fibers have _____ charges outside of their membrane and ____ charges inside of their membrane
Polarized or "resting" fibers have positive charges outside of their membrane and negative charges inside of their membrane
what is telodendra
the terminal branches of an axon; make contact with other neurons at synapses.
Define
Neurotransmitter
Neurotransmitters are chemical messengers that your body can't function without. Their job is to carry chemical signals (“messages”) from one neuron (nerve cell) to the next target cell. The next target cell can be another nerve cell, a muscle cell or a gland.
A fibers
a large-diameter nerve fiber
conducts nerve impulses faster than those with small diameters
generally myelinated
B fibers
a medium diameter nerve fiber
generally mylenated
C fibers
a small diameter nerve fiber
Define
myelin
a mixture of proteins and phospholipids forming a whitish insulating sheath around many nerve fibers, increasing the speed at which impulses are conducted.
A reflex arc is composed of
• A receptor
• A sensory neuron
• A center in the CNS for a synapse
• A motor neuron
• An effector
define
spinal reflex
Spinal reflexes are those in which the sensory stimuli arise from receptors in muscles, joints, and skin, and in which the neural circuitry responsible for the motor response is entirely contained within the spinal cord.
An impulse that travels around the arc without going to the brain for analysis.
Spinal reflexes can occur if spinal cord is completely severed
The cerebrum is responsible for higher functions of the brain, such as
learning
memory
interpretation of sensory input (vision, pain recognition, etc)
The thalamus serves as
a relay center for sensory impulses from the spinal cord, brainstem and cerebellum to the cerebrum
may also be involved in pain interpretation
The hypothalamus serves as
the primary mediator between the nervous system and the endocrine system through its control of the pituitary gland.
controls and regulates the ANS
The medulla carries
both sensory and motor impulses between the spinal cord and brain.
is a network of neurons located in the brain stem that project anteriorly to the hypothalamus to mediate behavior, as well as both posteriorly to the thalamus and directly to the cortex for activation of awake, desynchronized cortical EEG patterns.
is responsible for our wakefulness, our ability to focus, our fight-flight response, and how we ultimately perceive the world
Neurotransmitter substances include
acetylcholine
norepinephrine
dopamine
serotonin
GABA - gamma-aminobutyricc acid
ANS fibers innervate what structures
smooth muscle
heart muscle
salivary glands
other viscera
the ANS portion of the nervous system controls
unconscious body activities
the ANS system operates automatically and involuntarily to control visceral functions such as
GI motility
rate and force of the heartbeat
secretion by glands
sizes of the pupils
various other involuntary functions and characteristics
the two subdivisions of the ANS
parasympathetic aka cholinergic
sympathetic aka adrenergic
sympathetic division regulates
energey-expending activities - fight or flight
the parasympathetic nervous system regulates
energy-conserving activities
Stimulation of the sympathetic nervous system causes
increase in HR
increase in RR
decrease in GI activity
dilation of pupils
constriction of blood vessels, smooth muscle
dilation of blood vessels in skeletal muscle
dilation of bronchioles
increase in BG levels
Stimulation of the parasympathetic nervous system causes
decrease in HR
decrease in RR
increase in GI activity
constriction of pupils
constriction of bronchioles
Receptors of the sympathetic (adrenergic) system are
•Alpha-1
•Alpha-2
•Beta-1
•Beta-2
•Dopaminergic
Alpha receptors are generally
A) simulatory
B) inhibitory
A) simulatory
beta receptors are generally
A) inhibitory
B) simulatory
A) inhibitory
The parasympathetic nervous system has what to receptors
nicotinic
muscarinic
Effector organs have what kind of receptors
Either one or a combination of nicotinic and muscarinic receptors
The primary neurotransmitters for adrenergic sites are
norepinephrine, epinephrine, and dopamine
Epinephrine stimulates which receptors
alpha and beta receptors equally
The target organ for Alpha-1 receptors are
Arterioles
Urethra
Eyes
Response to Alpha-1 receptors being stimulated
Constriction of arterioles
Increased tone of the urethra
Dilation of the pupils of the eye
The target organ for Alpha-2 receptors are
skeletal muscle
The response of stimulation of Alpha-2 receptors are
constriction of the skeletal muscle
The target organs of Beta-1 receptors are
Heart
Muscle
The response when Beta-1 receptors are stimulated are
Increase HR, conduction and contractility of the heart
renin release in the kidneys
The response when Beta-2 receptors are stimulated are
Dilation of the skeletal blood vessels
Dilation of the bronchioles
What is the target organ of the Beta-2 receptors
Skeletal blood vessels
Bronchioles
What is the target organ for Dopaminergic receptors?
Kidneys
Heart
Mesenteric blood vessels
The response when Dopaminergic receptors are stimulated are
Dilation of blood vessels in the kidneys
Dilation of coronary vessels of the heart
Dilation of the mesenteric blood vessels
Acetylcholine combines with what two receptors
nicotinic and muscarinic
Cholinergic sites are found in both
sympathetic and parasympathetic nervous system
Nicotinic receptors are found in
all autonomic ganglia
adrenal medulla
neuromuscular junction of the somatic nervous system
Muscarinic receptors are found at
synapse of postganglionic fibers of the parasympathetic nervous system
at a few of the sympathetic postganglionic fibers
Autonomic drugs bring about their effects by influencing the sequence of events that involve neurotransmitters. Most autonomic drugs bring about this alteration of events by
• Mimicking neurotransmitters
• Interfering with neurotransmitter release
• Blocking the attachment of neurotransmitters to receptors
• Interfering with the breakdown or reuptake of neurotransmitters at the synapse
How do Cholinergic Agents work
stimulate receptor sites mediated by acetylcholine
Mimic the action of acetylcholine (direct-acting) or by inhibiting its breakdown (indirect acting)
Cholinergic agents are also called
parasympathomimetic
Clinical uses of cholinergic agents
• Aid in the diagnosis of myasthenia gravis
• Reduce the intraocular pressure of glaucoma
• Stimulate GI motility
• Treat urinary retention
• Control vomiting
• Act as an antidote for neuromuscular blockers
Define
Myasthenia gravis
a chronic autoimmune disorder in which antibodies destroy the communication between nerves and muscle, resulting in weakness of the skeletal muscles. Myasthenia gravis affects the voluntary muscles of the body, especially those that control the eyes, mouth, throat and limbs.
Define
glaucoma
Glaucoma is an eye disease where by the pressure within the eye becomes elevated. It can cause significant pain and lead to blindness.
Dogs and cats with primary glaucoma are believed to have an anatomic or biochemical problem that affects how fluid drains from the eye, so the onset can be spontaneous.
Secondary glaucoma results from another disease process within the eye. Glaucoma usually requires lifelong treatment unless the underlying cause can be reversed or treated successfully.
Name Direct-Acting Cholinergics
Acetylcholine
Carbamylcholine
Bethanechol (Urecholine)
Pilocarpine (Isopto Carpine, Akarpine, Pilocar)
Metoclopramide (Reglan)
What does a direct-acting cholinergic do
mimics the action of acetylcholine
What do indirect-acting cholinergic agents (Anticholinesterase) do
Inhibits the breakdown of acetylcholine
Name Indirect-Acting Cholinergic Agents
Edrophonium (Tensilon)
Neostigmine (Prostigmine, Stiglyn)
Physostigmine (Antilrium, Eserine)
Organophosphate compounds
Demecarium (Humorsol)
Pyridostigmine (Mestinon)
What is another name for indirect-acting cholinergic agents
Anticholinesterase agents
What are the adverse side effects of cholinergic agents
How do Cholinergic blocking agents work?
AKA Anticholinergic agents
block the action of acetylcholine at muscarinic receptors of the parasympathetic nervous system.
What are the clinical uses of anticholinergics AKA Cholinergic blocking agents
• Treatment of diarrhea and vomiting via a decrease in GI motility
• Drying of secretions and prevention of bradycardia before anesthesia
• Dilation of the pupils for ophthalmic examination
• Relief of ciliary spasm of the eye
• Treatment of sinus bradycardia
What is the prototype for anticholinergic agents AKA cholinergic blocking agents
the belladonna plant, which is from the nightshade family
What are the dosage forms of Anticholinergic agents?
AKA Cholinergic Blocking Agents
• Atropine
• Methscopolamine
• Glycopyrrolate (Robinul-V)
• Aminopentaminde (Centrine)
• Propantheline (Pro-Banthine)
• Pralidoxime (Protopam, 2-PAM)
What class of medication is Atropine?
Anticholinergic AKA Cholinergic Blocking Agent
What class of medication is Methscopolamine?
Anticholinergic AKA Cholinergic Blocking Agent
What class of medication is Glycopyrrolate?
Anticholinergic AKA Cholinergic Blocking Agent
What class of medication is Aminopentamide?
Anticholinergic AKA Cholinergic Blocking Agent
What class of medication is Propantheline?
Anticholinergic AKA Cholinergic Blocking Agent
What class of medication is Pralidoxime?
Anticholinergic AKA Cholinergic Blocking Agent
What class of medication is Edrophonium (Tensilon)
Anticholinesterase Agent
AKA Indirect-Acting Cholinergic Agent
What class of medication is Neostigmine (Prostigmine, Stiglyn)
Anticholinesterase Agent
AKA Indirect-Acting Cholinergic Agent
What class of medication is Physostigmine (Antilirium, Eserine)
Anticholinesterase Agent
AKA Indirect-Acting Cholinergic Agent
What class of medication is Organophosphate compounds
Anticholinesterase Agent
AKA Indirect-Acting Cholinergic Agent
What class of medication is Demecarium (Humorsol)
Anticholinesterase Agent
AKA Indirect-Acting Cholinergic Agent
What class of medication is Pyridostigmine (Mestinon)
Anticholinesterase Agent
AKA Indirect-Acting Cholinergic Agent
Numerous generic and trade name products available for parenteral or ophthalmic administration.
Uses include:
• preanesthetic to dry secretions and prevent bradycardia
• counteract organophosphate poisoning
• dilate the pupils for ophthalmic examination
• control ciliary spasms of the eye; to treat sinus bradycardia
• slow a hypermotile gut.
Anticholinergic AKA Cholinergic Blocking Agent
used to control diarrhea
Methscopolamine, an ingredient of Biosol-M
Anticholinergic AKA Cholinergic Blocking Agent
quaternary ammonium compound with actions similar to atropine. It provides a longer duration of action than atropine and is used primarily as a pre-anesthetic.
Adverse side effects of Anticholinergic Agents AKA Cholinergic Blocking Agents
SE are dose-related.
OD can cause drowsiness, disorientation, tachycardia, photophobia, constipation, anxiety, burning at the injection site
What are adrenergic agents also known as?
Sympathomimetic Agents
what are sympathomimetic agents also known as?
adrenergic agents
How do adrenergic agents work?
works on receptors mediated by epinephrine or norepineprhine
What can adrenergic agents be further classified as?
catecholamines or noncatchecolamines
alpha 1 and alpha 2 receptor activity, in most cases, causes what kind of response
excitatory response except in the GI tract
beta-1 and beta-2 receptor activity generally causes what kind of response
an inhibitory response, except in the gut
Name clinical uses for adrenergic agents
• Stimulate the heart to beat during cardiac arrest
• Reverse the hypotension and bronchoconstriction of anaphylactic shock
• Strengthen the heart during congestive heart failure
• Correct hypotension through vasoconstriction
• Reduce capillary bleeding through vasoconstriction
• Treat urinary incontinence
• Reduce mucous membrane congestion (vasoconstriction) in allergic conditions
• Prolong the effects of local anesthetic agents by causing vasoconstriction of blood vessels at the injection site, thereby prolonging their absorption
• Treat glaucoma (alpha stimulation increases the outflow of and beta stimulation decreases the production of aqueous humor)
Trade name of Epinephrine
Adrenalin
What class of drug is Epinephrine
Adrenergic Agent
What does epinephrine do
• Stimulates all receptors
• Increase HR and Cardiac Output
• Constriction of blood vessels in the skin
• Dilation of blood vessels in muscle
• Dilation of bronchioles
• Increase in metabolic rate
Generic name of Levophed
Norepinephrine
What does Norepineprhine do
• alpha stimulator /w some beta stimulation
• vasopressor (raises BP)
Generic name of Isuprel
Isoproterenol
What does Isoproterenol do
• beta stimulator
• bronchodilation
What class of drug is Epinephrine
Adrenergic agent
What class of drug is Norepinephrine
Adrenergic agent
What is the generic name of Neo-synephrine
Phenylephrine
What class of drug is Phenyleprhine
Adrenergic agent
What is Phenylephrine used for
• alpha stimulator
• nasal vasoconstrictor
What is the generic name of Inotropin
Dopamine
What class of drugs is dopamine
Adrenergic agent
What does Dopamine do
• dose-dependent
• tx shock & CHF
• increase renal perfusion
What is the generic name of Proin
Phenylpropanolamine
What class of drugs is Phenylpropanolamine
Adrenergic agent
What does phenylpropanolamine do
• tx urinary incontinence in dogs
What is the generic name of Dobutrex
Dobutamine
What class of drug is Dobutamine
adrenergic agent
What does Dobutamine do
• beta-1 agonist
• short-term tx of heart failure
What is the generic name for Proventil
Albuterol
What class of drugs is Albuterol
Adrenergic agent
What does Albuterol do
• Beta agonist
• Bronchodilation
What are the adverse side effects of adrenergic agents
• tachycardia
• hypertension
• nervousness
• cardiac arrhythmias
• pulmonary edema with OD
How are adrenergic-blocking agents classified
• alpha blocker
• beta blocker
• ganglionic blocker
What do adrenergic blocking agents generally do
block the activity of the sympathetic nervous system
General use for alpha blockers
• limited use in vet med
What are some dosage forms of alpha-blockers
• Phenoxybenzamine (Dibenyline)
• Acepromazine
• Prazosin (Minipress)
• Yohimbine (Yobine)
• Atipamezole (Antisedan)
What class is Phenoxybenzamine
alpha-blocker
What does Phenoxybenazmine do
• blocks alpha receptors
• tx of laminitis in horses
• tx of urethral obstruction in cats
• vasodilator
What is the generic name of Dibenyline
Phenoxybenzamine
What does Acepromazine do
• tranquilizer
• alpha blocker
• vasodilation
What class of drugs is Acepromazine
• Alpha blocker
•What does Prazosin do
• vasodilator
• alpha blocker
What is the generic name of Minipress
Prazosin
What class of drugs is Prazosin
alpha blocker
What is the generic name of Yobine
Yohimbine
What class of drugs is Yohimbine
alpha blocker
What does Yohimbine do
• antidote for xylazine toxicity
What is the generic name for Antisedan
Atipamezole
What class of drugs is Atipamezole
Alpha blocker
What does Atipamezole do
reversal agent for dexmedetomidine
Adverse side effects of phenoxybenzamine
• hypotension
• tachycardia
Adverse side effects of tranquilizers
• hypotension
Adverse side effects of prazosin
• hypotension
Adverse side effect of yohimbine
muscle tremors
Adverse side effect of acepromazine
• seizures
What are beta blockers used for
tx of
•glaucoma
• arrhythmias
• hypertrophic cardiomyopathy
What is hypertrophic cardiomyopathy
(HCM) is a type of heart disease that affects cats and dogs. It is characterized by the thickening of the heart muscle, particularly the left ventricle, which can make it difficult for the heart to pump blood effectively.
What are the dosage forms of Beta Blockers
• Propranolol (Inderal)
• Timolol (Timoptic)
• Atenolol (Tenormin)
• Carteolol (Ocupress)
• Levobunolol (Betagan)
• Metipranolol (OptiPranolol)
What are the side effects of beta blockers
• hypotension
• bradycardia
• worsening of heart failure
• bronchoconstriction
• heart block
• syncope
What is syncope
occurs when there is a sudden decrease in blood flow to the brain, leading to a brief loss of consciousness. This can be caused by a number of factors, including low blood pressure, heart disease, or a problem with the nervous system. In some cases, syncope may be triggered by external factors such as excitement, stress, or exercise.
Animals may also experience seizures or convulsions during a syncopal episode. It is important to note that syncope is not the same as a seizure, as syncope is caused by a loss of blood flow to the brain, while seizures are caused by abnormal electrical activity in the brain.
What class of drug is Propranolol
Beta blocker
What is the generic name for Inderal
Propranolol
What does Propranolol do?
• tx of cardiac arrhythmias
• tx of hypertrophic cardiomyopathy
What class of drugs is Timolol
beta blocker
What is the generic name of Timoptic
Timolol
What is Timolol used for
• ophthalmic medication for tx of glaucoma
What is the generic name of Tenormin
Atenolol
What is Atenolol used for
• tx of cardiac arrhythmia
• tx of hypertrophic cardiomyopathy
What class of drug is Carteolol
Beta blocker
What is the generic name of Ocupress
Carteolol
What is Carteolol used for
• human labeled antiglaucoma med
What class of drug is Levobunolol
Beta blocker
What is the generic name for Betagan
Levobunolol
What is Levobunolol used for
• human labeled anti-glaucoma med
What class of drug is Metipranolol
beta blocker
What is the generic name of OptiPranolol
Metipranolol
What is metipranolol used for
human labeled antiglaucoma med
How often are ganglionic blockers used in vet med?
Rarely.
The use of ganglionic blockers has declined due to the development of newer and more targeted drugs that are safer and more effective in managing these conditions.
There are some situations where ganglionic blockers may still be used in veterinary medicine, such as in the treatment of certain types of poisoning or in certain types of surgical procedures.
What are depressant drugs used for
• tranquilize/sedate animals to facilitate restraint or anesthetic procedures
• control pain
• induce anesthesia
• prevent or control seizures
What are the effects of drugs that affect the CNS?
Drugs that affect the CNS can cause depression or stimulation by altering nerve impulse transmissions within the brain or between the spinal cord and brain. Interfering with impulses in the thalamus can prevent messages of painful stimuli from being interpreted in the cerebrum, while altering impulses in the reticular activating system can change levels of consciousness or wakefulness. These changes are likely due to altered neurotransmitter activity.
CNS drug classes include:
• Tranquilizers
• Barbiturates
• Dissociatives
• Opioid/antagonists
• Neuroleptanalgesics/antagonists
• Drugs to prevent or control seizures
• Inhalants
• Miscellaneous CNS drugs
• CNS stimulants
• Euthanasia agents
Phenothiazine derivatives are a type of
tranquilizer
CNS medication
considered dopamine blockers
What is the proposed mechanism of action for phenothiazine derivatives on the CNS and what is their effect on the cardiovascular system?
The mechanism of action of phenothiazine derivatives on the CNS is not well understood, but they are believed to be dopamine blockers.
The drugs have an effect on the cardiovascular system through alpha-adrenergic blockade.
What are some effects of phenothiazine derivative tranquilizers on animals?
• Sedation, reduce fear and anxiety, and have mild antipruritic effects, but do not produce significant analgesia.
• Sudden painful stimuli can still arouse the animal.
• Antiemetic effect works by depressing the chemoreceptor trigger zone in the brain
• reduce the tendency of epinephrine to induce cardiac arrhythmias.
What are the clinical uses of phenothiazine derivatives
• prevention or tx of vomiting
• relief of mild pruritis
• sedation/tranquilization
What are the dosage forms of phenothiazine derivatives
What class of drugs is Chlorpromazine hydrochloride
Phenothiazine derivative
Tranquilizer
What class of drugs is Sparine
Phenothiazine derivative
Tranquilizer
What class of drug is Prochlorperazine
Phenothiazine derivative
Tranquilizer
What are the adverse side effects of Phenothiazine derivatives
• hypotension
• hypothermia via vasodilator effects (alpha blockade)
• induce seizures (lowering seizure threshold)
What are some cautions with phenothiazine derivatives
• caution with other CNS depressants, may have an additive effect
• do not use within 1 mo. of organophosphate anthelmintic
• tranquilizing effect may be reduced in excited patient
Most phenothiazine derivatives are metabolized via the _____ and excreted by _____
metabolized by liver
excreted by kidneys
Benzodiazepine derivatives act as what kind of depressant
CND depressant
Benzodiazepine derivatives are primarily used for what purposes
• anxiolytic
• sedative
• hypnotic effects
• appetite stimulation
How do Benzodiazepine derivatives work
• enhances activity of GABA which reduces activity of certain neurons in the brain and results in calming and sedative effects
All benzodiazepines are what label products
human-label
What are the veterinary dosage forms of benzodiazepines
• Diazepam (Valium, Diastat)
• Midazolam (Versed)
• Alprazolam (Xanax)
What is the generic name for Valium and Diastat
• Diazepam
What is the generic name for Versed
Midazolam
What is the generic name for Xanax
Alprazolam
What are the adverse side effects of Benzodiazepines
• sedation
• ataxia
• respiratory depression
• excitement in some patients
What considerations are there for diazepam
• store in room temperature
• protect from light
• do not store in plastic syringes or soln. bags
• do not mix with other meds or soln.
Diazepam is metabolized by ____ and excreted by ____
metabolized by liver
excreted by kidneys
What is Alprazolam used for
appetite stimulant
What is Diazepam used for
• injectable anesthetic
• combined with ketamine, induces short-term anesthesia
• tx of seizures in progress
What kind of medication is xylazine
alpha-2 agonist
CNS depressant
What properties does Xylazine Hydrochloride have
• sedative
• analgesic
• muscle relaxant
What animals is Xylazine Hydrochloride approved for use in
• dogs
• cats
• horses
• deer
• elk
What is a common SE of xylazine hydrochloride in cats and some dogs
vomiting
What is the reversal agent of xylazine hydrochloride
yohimbine
What is xylazine hydrochloride used for
• analgesia in horses (colic, sedation for minor procedures)
• mx with ketamine for short-term procedures in horses (castration, suturing of wounds) (15-20 min of recumbency)
• induction of vomiting
What is a cow-related extra-label use of xylazine hydrochloride
c-sections in cattle and other sx procedures
What are the dosage forms of xylazine hydrochloride
• Rompun
• AnaSed
• Gemini
• Sedazine
• Cervizine (labeled for deer and elk)
What are adverse side effects of Xylazine Hydrochloride
• bradycardia
• hypotension
• respiratory depression
• increased sensitivity to epinephrine -> cardiac arrhythmias
What is the generic name of Rompun
Xylazine Hydrochloride
alpha-2 agonist
What is the generic name of AnaSed
Xylazine Hydrochloride
alpha-2 agonist
What is the generic name of Gemini
Xylazine Hydrochloride
alpha-2 agonist
What is the generic name of Sedazine
Xylazine Hydrochloride
alpha-2 agonist
What is the generic name of Cervizine
Xylazine Hydrochloride
alpha-2 agonist
What drug should be used as a premedicant to prevent xylazine-induced bradycardia or heart block in dogs?
Atropine
What is the dosage of xylazine in cattle?
one-tenth of the quine dose
What is a precaution around horses when using xylazine hydrochloride
horses may still be able to kick, despite appearing heavily sedated
What is heart block?
Heart block is a condition in which there is a delay or interruption in the electrical impulses that regulate the heartbeat. This can lead to an abnormal heart rhythm or arrhythmia, which can cause symptoms such as weakness, lethargy, collapse, or sudden death. Heart block can be congenital (present at birth) or acquired later in life due to various factors such as age, disease, or medication.
What class of drugs is Detomidine Hydrochloride
Alpha-2 agonist
What is detomidine generally used for?
Sedation and analgesia in horses
What are dosage forms of Detomidine hydrochloride?
• Dormosedan inj
• Dormosedan Gel (for sublingual use)
What are the adverse SE of Detomidine
• sweating
• muscle tremors
• penile prolapse
• bradycardia
• heart block
The manufacturer of detomidine warns that it should not be mixed with what kind of meds?
Potentiated sulfa drugs such as trimethoprim/sulfamethoxazole
What class of drugs is Medetomidine
alpha-2 adrenergic agonist
What is medetomidine labled for use for and in?
sedative and analgesia in dogs older than 12 wks
What is the reversal agent for medetomidine
Atipamezole (Antisedan)
What are clinical uses of Medetomidine
• facilitating clinical examination
• minor surgical procedures
• minor dental procedures that do not require intubation
What is the dosage form of Medetomidine
• Domitor *not available in US market
What are the adverse SE of Medetomidine
• bradycardia
• atrioventricular heart block
• decreased respirations
• hypothermia
• urination
• vomiting
• hyperglycemia
• pain at the injection site
What class of drugs is dexmedetomidine
alpha-2 adrenergic agonist
What are the uses of dexmedetomidine
• sedative
• pre-anesthetic
• analgesic
• combine with opioid (ketamine) to produce surgical anesthetic levels
Which is more potent: medetomidine or dexmedetomidine
dexmedetomidine
What is the dosage form of Dexmedetomidine
Dexdomitor
What are the adverse side effects of dexmedetomidine
• bradycardia
• hypertension
• vomiting
• AV block
• muscle tremors
What types of patients should not receive dexmedetomidine
• CV issues
• resp issues
• kidney issues
• liver disease
• patients in shock
• patients with debilitation or stress due to heat, cold, fatigue
What is the reversal for dexmedetomidine
Atipamezole
What class of drugs is Romifidine
alpha-2 adrenergic agonist
What species is Romifidine labeled for use in
horses
What are the clinical uses for Romifidine
• sedative to facilitate handling
• premedication before general anesthetsia
What is the generic name for Sedivet
Romifidine
Barbiturates are used in veterinary medicine for:
• sedatives
• anticonvulsants
• general anesthetics
• euthanasia agents
The oldest categories of CNS depressants are
Barbiturates
What is the duration of action of Phenobarbital
4 - 8 hours
What is the duration of action of Pentobarbital
1/2 - 2 hours
What is the duration of action of Thiopental
10 to 30 minutes
What is the generic name for Luminal
Phenobarbital
What is the generic name for Nembutal
Pentobarbital
What is the generic name for Pentothal
Thiopental
What is the classification and drug class of Phenobarbital
Drug class: barbiturate
Classification: Long-acting oxybarbiturate
What is the classification and drug class of Pentobarbital
Drug class: Barbiturate
Classification: Short-acting oxybarbiturate
What is the classification and drug class of Thiopental
Drug class: barbiturate
Classification: ultrashort-acting thiobarbiturate
Barbiturates are metabolized where
by the liver
Barbiturates are contraindicated in the following patients
• poor liver function
• little body fat
• preexisting illnesses that cause acidosis
Barbiturates have depressing effects on which systems mainly
• cardiac
• pulmonary
• respiratory
Barbiturates are reversible
False
Ultrashort-acting barbiturates can cause what if administered in SQ space?
necrosis of tissue due to its alkalinity
How are barbiturates classified?
Based on duration of action
OR
by the chemical side chain (oxybarbiturate vs thiobarbiturate)
Which barbiturate class is highly soluble in fat?
Thiobarbiturates
Which barbiturate class is connected by sulfur side chains?
thiobarbiturates
Which barbiturate class is connected by oxygen side chains?
oxybarbiturates
Which barbiturate is a Class IV controlled substance?
Phenobarbital
Phenobarbital is primarily used as what?
anticonvulsant to prevent epileptic seizures
Phenobarbital is primarily administered via what route?
PO
Pentobarbital is primarily administered via what route?
IV injection
may be given IP
What is the current primary use of Pentobarbital
• controlling seizures in progress
• euthanasia agent
Which barbiturate is a Class II controlled substance
Pentobarbital
Pentobarbital, combined with glucose or given with chloramphenicol may cause what?
a prolonged recovery period
Thibarbiturates can cause what if given rapidly IV?
apnea
Barbiturates can cause a period of what when given IV too slowly?
CNS excitement
What are the adverse side effects of Barbiturates?
• CNS depression
• paradoxical CNS excitement
• severe respiratory depression
• CV depressoin
• irritation if given perivascularly
Dissociative agents belong to which family?
Cyclohexylamine family
What drugs are included in the cyclohexylamine family
• phencyclidine
• ketamine
• tiletamine
What drugs are dissociative agents
• phencyclidine
• ketamine
• tiletamine
What symptoms characterize dissociative anesthesia?
• involuntary muscle rigidity (catalepsy)
• amnesia
• analgesia
What reflexes are retained during dissociative anesthesia?
• pharyngeal & laryngeal
Is muscle tone increased or decreased with dissociative use?
increased
What type of pain is not controlled by dissociative agents?
deep abdominal pain is not controlled
this means surgical stage II usually can not be reached with dissociative agents alone
DIssociative agents do what to the thalamus and cerebral cortex
cause depression
What system do dissociative agents activate?
limbic system
What is the limbic system comprosed of?
• amygdala
• hippocampus
• hypothalamus
• thalamus
• other structures
What is the limbic system regulated by?
various neurotransmitters including:
• dopamine
• serotonin
• norepinephrine
What is the limbic system involved in?
• regulation of emotional behavior
• memory
• motivation
• appetite
• sexual behavior
• stress response
What are some symptoms you may see during induction and recovery with dissociative agents
• ataxia
• hyperresponsiveness
• tremors
• spasticity
• convulsions
• hallucinations suspected in cats
Ketamine is what class of drugs?
Dissociative agent
Ketaset, Vetalar, and Ketalar are all name brands of what drug?
Ketamine HCl
Ketamine is approved for use in what species
• humans
• primates
• cats
Ketamine has extra-label use in what species
• dogs
• horses
• birds
• small ruminants
• reptiles
What drugs are often used concurrently with etamine to enhance muscle relaxation and to deepen the level of anesthesia?
tranquillizers such as
• diazepam
• dexmedetomidine
• xylazine
• diazepam
What reflexes are maintaned with ketamine use, except at high doses?
• oral
• ocular
• laryngeal
What effect will you normally see with cats on ketamine?
• occasional spastic jerking
Ketamine produces analgesic effects by acting on what receptor as an antagonist?
NMDA (N-Methyl-D-asparate)
What can Ketamine HCl cause that can be controlled or prevented with atropine or glycopyrrolate?
increased salivation
Why would we need to use an ophthalmic lubricant in patients that receive ketamine or tiletamine?
eyes will remain open, especially in cats
What dissociatives are a class III controlled substance?
• Ketamine HCl
• Tiletamine HCl (Telazol)
What are the active ingredients in Telazol?
• Tiletamine (related to ketamine)
• Zolazepam HC (a benzodiazepine)
What species is Telazol approved in?
cats and dogs
What drug was originally an immobilizing agent for nonhuman primates, is no longer available, and is now known as "PCP" or "angel dust"
Phencyclidine (Sernylan)
What are the adverse SE of dissociative agents?
• spastic, jerking movement
• convulsions
• respiratory depression
• burning at the IM injection site
• drying of the cornea
How are dissociative agents excreted?
via the kidneys
What patient conditions can make dissociative agents contraindicated?
• kidney issues
• some cardiac conditions
Opioids are derived originally from what plant?
opium poppy
What are the four classes of opioid receptors?
• Mu
• Kappa
• sigma
• Delta
Where is the Mu receptor found
• found in pain regulation areas of the brain
Where is the kappa receptor found
• cerebral cortex
• spinal cord
What does the Mu receptor contribute to
• analgesia
• euphoria
• respiratory depression
• physical dependence
• hypothermic actions
What does the Kappa receptor contribute to
• analgesia
• sedation
• miosis
What is the Sigma receptor responsible for?
• struggling
• whining
• hallucinations
• mydriatic effects
What does the Delta receptor do?
• modify mu receptor activity
Opioid agonists have what properties at low doses?
• antitussive
• antidiarrheal
Adverse effects of opioid agonists include
• respiratory depression
• panting
• flatulence
• vomiting
• sound sensitivity
• diarrhea
• convulsions
What effect may occur in dogs if opioid agonists are given rapidly IV?
excitatory effects
What effect may be seen with opioid agonist use in cats and horses at high doses?
excitatory effects
Opioid agonists can be used during c-sections because:
• cross the placenta slowly
• effects can be antagonized
Opioid agonists are metabolized by the ____ and are eliminated in the ____
metabolized by liver
eliminated in urine
Many opioid agonists are what schedule-controlled drug?
Class II controlled substance
What are some clinical uses of opioid agonists?
• analgesia
• sedation
• restraint
• anesthesia
• tx of coughing
• tx of diarrhea
Name two naturally occurring narcotics
• Opium
• Morphine sulfate
Laudanum 10% (Opium) is used primarily for what in veterinary medicine
tx of diarrhea in calves and foals
What class of drugs is Opium (Laudanum 10%)
opioid agonist
naturally occurring narcotic
What class of drugs is Morphine sulfate?
Opioid agonist
Naturally occurring narcotic
Duramorph generic is
Morphine sulfate
Morphine sulfate can be used for
• severe pain management
• pre-anesthetic or anesthetic agent
• relieve anxiety associated /w acute CHF
Morphine primarily acts on what receptors
• Mu receptors
What schedule drug is Morphone sulfate?
Class II controlled subtance
Name some synthetic narcotics
• Meperidine (Demerol)
• Oxymorphone (Numorphan, Opana)
• Butorphanol tartrate (Torbutrol, Torbugesic)
• Fentanyl (Recuvrya, Sublimaze, Duragesic)
•Hydrocodone bitratrate (Hycodan Tussigon)
• Etorphine (M-99)
• Pentazocine (Talwin)
• Diphenoxylate (Lomotil)
• Apomorphine (Apokyn)
• Methadone (Dolophine)
• Codeine
• Carfentanil (Wildnil)
• Buprenorphine (Buprenex)
• Tramadol
Opioid antagonists
block
The generic name for Demerol is
Meperidine
Meperidine acts on what receptor
Mu agonist
How potent is Meperidine compared to morphine?
Meperidine is 1/8th as potent as morphine
What is Meperidine used for
• acute pain *i.e. after orthopedic sx
• anesthetic agent when combined with tranquilizer
What is the antagonist of opioid agonists?
Naloxone
Meperidine has a veterinary label.
False
It is used extra-label in veterinary medicine
The generic for Numorphan and Opana is
Oxymorphone
What receptor does Oxymorphone work on?
mu agonist
What is the potency of Oxymorphone when compared with Morphine?
10x more potent than morphine
What is the primary use of oxymorphone
• restraint
• dx procedures
• minor sx procedures
• combined with tranquilizers to produceneuroleptanalgesia
The generic for Torbutrol and Torbugesic is
Butorphanol tartrate
What receptors does Butorphanol tartrate work on?
• agonist activity on kappa and sigma receptors
• antagonist activity on mu receptor
What schedule drug is Butorphanol tartrate?
Class IV controlled substance
What is the potency of Butorphanol tartrate when compared with morphine?
• butorphanol is 7x more analgesic than morphine and has increased antitussive effects
What is Torbutrol approved for?
• antitussive agent in dogs
• analgesic & preanesthetic in dogs and cats
What is Torbugesic approved for?
• tx of pain associated /w colic in horses
• used /w sedatives & tranquilizers in horses, dogs & cats
• pre-anesthetic
• minor surgical procedures
Butorphanol should be used as the only anesthetic agent
False
What is the generic drug for the following drugs: Recuvrya, Sublimaze, Duragesic)
Fentanyl
What schedule is Fentanyl
Class II controlled substance
What is the potency of Fentanyl compared to morphine?
Fentanyl is 100x more potent in analgesic properties than morphine
What is the common form of fentanyl in veterinary medicine?
transdermal patches for control of chronic pain
What is the generic drug of Hycodan and Tussigon
Hydrocodone bitartrate
Hydrocodone is used primarily as
• antitussive agent in dogs
What schedule drug is Hydrocodone bitartrate?
Class III controlled substance
The generic name drug in M-99 is
Etorphine
What is the potency of Etorphine compared to morphine?
Etorphine is 1,000x more potent than morphine in analgesic effects
Etorphine is restricted for use in
• zoo animal or exotic animal practice
What are some safety things to know about etorphine?
• can be absorbed through intact skin
• lethal to people who accidentally inject themselves ** inject the antagonist immediately**
What is the antagonist for Etorphine?
Diprenorphine
What schedule drug is Etorphine?
Class II controlled subtance
The generic drug in Talwin is
Pentazocine
What type of agonist is Pentazocine?
partial opioid agonist
What is Pentazocine approved for use in?
pain relief in
• horses
• dogs
What schedule is Pentazocine
Class IV controlled subtance
What is the generic drug in Lomotil?
Diphenoxylate
What is Diphenoxylate combined with for use as an antidiarrheal agent?
Atropine
What class of drug is Diphenoxylate
Opioid agonist
What class of drug is Etorphine
Opioid agonist
What class of drug is Pentazocine
opioid agonist
What class of drug is Hydrocodone bitartrate?
opioid agonist
What schedule is Diphenoxylate?
Class V controlled substance
What is the generic drug found in Apokyn?
Apomorphine
What kind of agonist is Apomorphine?
Dopamine
What is the principal effect of apomorphine?
induction of vomiting via stimulation of chemoreceptor trigger zone in brain
How is apomorphine typically administered?
via tablet placed in conjunctival sac of eye
What is the generic drug found in Dolophine?
Methadone
What is methadone used for in vet med?
tx of colic pain in horses
What schedule is methadone?
Class II controlled substance
What class of drug is Codeine?
Opioid agonist
What class of drug is Methadone?
Opioid agonist
What is the primary use of codeine in veterinary medicine
• antitussive in dogs
What schedule drug is codeine?
• Class II when alone
• Class III or V when in combination with other products
What is the generic drug in Wildnil
Carfentanil
What is the primary use of Carfentanil?
• induction of wildlife anesthesia
What is the potency of Carfentanil compared to morphine?
• 10,000x more potent than morphine
What schedule is Carfentanil?
Class II agent
*avoid accidental exposure to humans*
What receptors does Buprenorphine act on?
partial mu agonist/antagonist
The generic form of Buprenex is what
Buprenorphine
What schedule is Buprenorphine?
Class III
What class of drugs is Buprenorphine
Opioid agonist
What class of drugs is Tramadol
• Opioid Agonist
What receptors does Tramadol act on?
mu-receptor
How does tramadol work?
• inhibits reuptake of norepinephrine and serotonin (acts like an alpha-2 agonist)
• mu-receptor agonist
What are the clinical uses of tramadol?
• alternative analgesic agent
• adjunct postoperative
• chronic pain in dogs and horses
What are the adverse SE of tramadol?
• anxiety
• tremors
• vomiting
• diarrhea
• sedation
Author
MissAriel
ID
361404
Card Set
Drugs used in nervous system disorders
Description
Applied Pharmacology for Veterinary Technicians 5th Edition Boyce Wanamaker, Kathy Massey.
Chapter 4 Drugs used in nervous system disorders
