Routes of Administration
Which route of administration has the fastest onset?
Midazolam is known to cause what after administration, especially if administered alone?
Therefore, it is recommended to administer midazolam with an opioid or as a co-induction agent.
Paradoxical excitement
Lidocaine is contraindicated to use for associated ______?
Lidocaine blocks sodium channels which can result in lowering patient heart rates. It is useful to administer in dogs with ventricular tachycardia, ventricular fibrillation, and AIVR.
(Hint, can answer with specific names or a broad classification)
1. Bradyarrhythmias: conduction issues - slow/blocked signals (SA node)
AV blocks, Sick Sinus Syndrome
2. Supraventricular arrhythmias: electrical signal affects above the ventricles (AV node)
Atrial fibrillation, Atrial flutter
Name at least 2 local anesthetic agents.
1. Lidocaine
2. Bupivacaine
(BONUS - 100 points): Lidocaine is also what type of drug?
Vasoconstriction occurs after administration of this alpha-2 adrenergic agonist.
Normal to higher blood pressure values with a reflex bradycardia can be observed.
Dexmedetomidine
Propofol can be administered via which route?
Only via intravenously (IV)
Name two common side effects of opioids.
1. nausea/vomiting
2. hyperthermia
3. increased salivation
4. reduces the lower esophageal sphincter (increases reflux)
5. defecation
6. excitation/dysphoria
Which drug (s) should be used in caution with known MDR1 patients?
1. Butorphanol
2. Acepromazine
Butorphanol can be classified as what kind of drug?
Opioid
(BONUS - 100 points): Name the full drug classification.
Atropine and glycopyrrolate are considered anticholinergics. Which vital parameter is greatly affected after administration?
Heart Rate
Anticholinergics are used to treat bradycardia with associated hypotension and vagal reflex responses. This increases the heart rate to help improve cardiac output.
Which two common routes can buprenorpine be administered?
IV or PO
Which opioid (s) can cause histamine release?
(Use of during MCT removal is cautionary)
1. Morphine
2. Hydromorphone - minimal to possibly none
True or False:
Ketamine is contraindicated to administered with HCM patients.
TRUE
Ketamine stimulates the sympathetic nervous system. This will increase the heart rate and workload of the cardiac muscles, thus shortening the resting (filling) time of the ventricles.
Name three ("true") induction agents.
1. Propofol
2. Alfaxalone
3. Etomidate
Yes, you can induce with midazolam and ketamine combination. (Good for Greyhound induction)
Two Parts:
Name two drugs that can cause vasodilation.
Which vital parameter is greatly affected with vasodilation?
(BONUS - 100 points): Name another “drug” that primarily causes vasodilation? (Hint - think anesthesia)
Two drugs that can cause vasodilation:
1. Acepromazine
2. Propofol
Which vital parameter is greatly affected with vasodilation?
1. Blood pressure values
(BONUS answer): inhalant anesthetics (sevoflurane/isoflurane)
Two parts:
Midazolam can be administered via which route (s)?
Diazepam can be administered via which route (s)?
Midazolam can be administered via IV, IM, & IN.
Diazepam can be administered IV, IN, PO, and rectally.
(BONUS - 200 points): Other than route of administration, what is a major difference between midazolam and diazepam? (Hint - it is the reason diazepam should not be administered IM!)
Propofol can cause this adverse effect in patients resulting in stiffness, rigidity, and “jerky“ movements. What is it called?
Myoclonus
Which drug is contraindicated with patients of known cardiac disease?
Dexmedetomidine
Zenalpha
(BONUS - 100 points): Dexmedetomidine can useful with which cardiac disease?
Name at least 3 sympathomimetics.
Sympathomimetics stimulates the sympathetic nervous system leading to increased heart rates, high blood pressure values, and bronchodilation.
1. Dopamine
2. Dobutamine
3. Norepinephrine
4. Ephedrine
5. Phenylephrine
6. Epinephrine
What vital parameter is greatly affected after administration of ketamine?
Heart Rate
Ketamine causes an increased heart rate by stimulating the body to release more norepinephrine. Typically, an increase in heart rate and could cause an increase in blood pressure values, thus overall improving cardiac output.
Name all the routes of administration for fentanyl. (Hint, there are 4!)
1. IV
2. IM
3. SQ
4. transdermal (patches)
Dexmedetomidine causes vasoconstriction resulting in normal to higher blood pressure values. As an indirect response, a reflex bradycadia occurs. What other side effects can occur after dexmedetomidine administration?
1. Arrhythmias
2. Transient hyperglycemia - be aware when administering to DM patients
3. Pale mucous membrane colors
4. Biphasic response - hypotension after initial hypertension
(BONUS - 100 points): Can you name at least two arrhythmias?
Etomidate should be avoided in patients that have what kind of disease?
Adrenal insufficencies
Hypoadrenocorticism
(BONUS - 100 points): Name that disease.
Name two drugs that can be classified as an NMDA antagonist.
N-methyl-D-aspartate (NMDA) antagonists are used to help manage acute and chronic pain by preventing "wind-up" phenomenon.
1. Ketamine
2. Methadone
(BONUS - 100 points): "Wind-up" phenomenon can lead to what?
Name at least 3 drugs that can cause bronchodilation. *Injectable Only*
1. Butorphanol
2. Ketamine
3. Terbutaline
4. Glycopyrrolate
5. Atropine
6. Propofol