QUESTIONS

1. List 4 reasons for anaesthetic premedication.
2. List 5 drug classes often employed as premedicants.
3. As with general anaesthetic drugs, premedicants need to be chosen with care. The choice of drug and the dose rate should be selected in accordance with the requirements of the individual. List aspects to be considered with regard to premedication.
4. How is it possible to maximise the effects of sedatives or tranquillisers without increasing the drug dose?
5. What is another name sometimes given to tranquillisers?
6. One of the reasons for the administration of premedicants is to decrease anxiety in the patient. What group of compounds are lowered in order to achieve this effect?
7. What is a parasympathetic antagonist, and give 3 examples that may be used in veterinary practice?
8. What are the advantageous properties of using parasympathetic antagonists as premedicant drugs?
9. List some disadvantageous properties of parasympathetic antagonists.
10. Acepromazine (ACP) is a commonly used example of the phenothiazine drug group. It is a popular drug due to its safety and does not cause coma if an overdose occurs. List 6 additional advantages of its use as a premedicant.
11. Acepromazine (ACP) has several possible adverse side-effects. These are mainly due to the effect of ACP on the nerves that release noradrenaline causing adrenergic block. This may result in hypotension, excessive vagal tone and bradycardia. For these reasons it is undesirable to administer ACP to certain patients. In which animals is it undesirable to administer ACP and why?
12. List some further disadvantages of acepromazine, which whilst controllable and not necessarily life-threatening do require attention.
13. Acepromazine has both tranquillising and sedative properties. Given in very low doses, it tranquillises without sedation; whilst moderate doses promote moderate sedation (although not in resistant animals!). Why is it undesirable to administer high doses of acepromazine?
14. In addition to acepromazine, list 3 other phenothiazines used in veterinary practice.
15. Opioids (narcotic analgesics) are often used in conjunction with other drugs such as acepromazine in order to provide a synergistic combination of analgesia and sedation. Why must the same degree of care be given to patients administered with this drug combination as for general anasethesia?
16. What legislations control the use of opioid analgesics? The Misuse of Drugs Act 1971 and the Misuse of Drugs Regulations 1985.
17. Butyrophenones are similar in behaviour to phenothiazines, but none are licensed for veterinary use. Drugs such as droperidol and fluanisone are however available in commercial neuroleptanalgesic mixtures. What advantages exist in the use of such combinations?
18. What is the name of the common commercial neuroleptanalgesic used very successfully in rabbits and guineapigs?
19. Give 2 advantages of Hypnorm as a premedicant drug.
20. In which cases would the administration of Hypnorm be contraindicated and why?
21. What is the name of the narcotic antagonist that reverses the effects of Hypnorm?
22. Give 2 examples of alpha agonists commonly used in veterinary practice.
23. What is the name of the drug used to antagonise the effects of medetomidine (Domitor), and why is its use desirable?
24. High doses of alpha agonists produce basal narcosis; describe this condition.
25. In addition to basal narcosis, list 4 other advantages of the alpha agonists.
26. List 6 disadvantages of alpha agonists.
27. The benzodiazepines which include diazepam (Valium) and midazolam are often used in premedication due to their muscle relaxant effects and tranquillising properties. Give 2 other important advantages of these drugs.
28. List 2 other uses of diazepam in addition to premedication.
29. List 4 disadvantages of diazepam. ·
30. What is the name of the most common benzodiazepine antagonist?
31. Finally, a word about the commercial neuroleptanalgesic "Immobilon". This powerful drug combination produces deep sedation, hypnosis and profound analgesia, however it also results in severe respiratory depression. What species is very susceptible to Immobilon and what precautions should be taken if it is used?