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

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