Chapter 6: Sedation and Analgesia

6.1Non-steroidal anti-inflammatory drugs exert their effect through inhibition of

  1. arachidonic acid
  2. cyclooxygenase
  3. lipoxygenase
  4. alpha-2 adrenergic receptors
  5. opiate receptors

6.2Which are potential complications of non-steroidal anti-inflammatory drug use?

  1. Hepatic sinusoidal necrosis
  2. Renal tubular necrosis
  3. Enterocolitis
  4. Renal papillary necrosis and right dorsal colitis
  5. Laminitis

6.3Which of the following are considered COX-1 sparing non-steroidal anti-inflammatory drugs?

  1. Phenylbutazone
  2. Firocoxib
  3. Flunixin meglumine
  4. Ketoprofen
  5. Naproxen

6.4Xylazine and detomidine are commonly used in the management of pain in horses. What is their mechanism of action?

  1. alpha-2 adrenergic receptor agonist
  2. alpha-1 adrenergic receptor agonist
  3. alpha-2 adrenergic receptor antagonist
  4. alpha-1 adrenergic receptor antagonist
  5. opiate receptor agonist-antagonist

6.5Which of the following are some effects that may be observed following administration of alpha-2 agonists?

  1. Bradycardia
  2. Antinociception
  3. Increased urine production
  4. Aggression (kicking and biting)
  5. All of the above

6.6Which of the following is correct regarding intravenous lidocaine use in postoperative colic patients?

  1. Cardiovascular effects occur at lower plasma concentrations than do CNS effects.
  2. Cardiovascular effects include increased myocardial contractility and vasoconstriction.
  3. Low concentrations are sedating and seizures can occur at higher doses.
  4. The plasma levels necessary for analgesia are much higher than those required to block normal peripheral nerve conduction.
  5. Intravenous administration of lidocaine increases MAC (minimum alveolar concentration) of inhalant anesthetic drugs.

6.7 Side effects associated with administration of hyoscine-N-butylbromide (Buscopan®) include

a. Seizure activity

b. Tachycardia and hypotension

c. Bradycardia and hypertension

d. Bradycardia and hypotension

e. Tachycardia and hypertension

6.8Which statement is correct regarding the use of hyoscine-N-butylbromide (Buscopan®) in colic patients?

  1. The effects of hyoscine-N-butylbromide on intestinal motility and visceral analgesia have been variable.
  2. Repeated short-interval administration is recommended.
  3. Buscopan® did not decreased rectal pressure and number of rectal strains compared to intra-rectal administration of 50 mL of 2% lidocaine
  4. Dipyrone has been banned by the European Union (EU) because of its cardiovascular effects in humans.
  5. Hyoscine-N-butylbromide (Buscopan®) is a derivative of the opiate alkaloids

6.9Which drug is considered the primary analgesic drug for colic patients (select the best answer)?

  1. Xylazine
  2. Detomidine
  3. Butorphanol
  4. Acepromazine
  5. Flunixin meglumine

6.10A 10 year old Thoroughbred gelding is showing moderate signs of abdominal pain. He was administered flunixin meglumine 500 mg (10 mL) intravenously (IV) 30 minutes previously and requires additional analgesia. Which drug regimen would be a good choice for this horse?

  1. Flunixin meglumine 500 mg (10 mL) IV (second dose)
  2. Xylazine 150 mg (1.5 mL) and butorphanol 5 mg (0.5 mL) IV
  3. Detomidine 15 mg (1.5 mL) IV
  4. Phenylbutazone 2 g (10 mL) IV
  5. Phenylbutazone 2 g (2 x 1 g tablets) orally