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[[Opioids]] (''e.g.''''' butorphanol, buprenorphine''') are classified either as (full) agonists, agonist-antagonists (partial agonists) or antagonists based on differing affinities and efficacy at μ-, κ- and δ-opioid receptors, which results in activation of descending inhibitory pathways and reduction in the transmission of nociceptive signals to higher centres in the brain. Opioid
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receptors are widespread, resulting in a '''wide range of side effects''' including <u>respiratory depression, increased  intracranial pressure, hypotension and inhibition of peristalsis,</u> which vary depending on the agent used.
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'''Butorphanol''' (a κ-agonist-μ-antagonist), one of the most commonly used opioids in equines, produces '''ataxia, decreased gastrointestinal motility and decreased defecation''' and '''short-lasting, mild increases in heart rate and blood pressure''' in equines. The combination of an opioid with a sedative, such as [[Phenothiazines#Acepromazine|ACP]] or an [[Alpha-2 Agonists|α2 agonist]], provides very good quality standing restraint whilst reducing some of the CNS side effects, ''e.g.'' excitation and  increased locomotion.
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'''The neuroleptanalgesic combination of the potent opioid etorphine with the phenothiazine ACP should NOT be used in donkeys.'''
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==References==
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* Horspool, L. (2008) Clinical pharmacology In Svendsen, E.D., Duncan, J. and Hadrill, D. (2008) ''The Professional Handbook of the Donkey'', 4th edition, Whittet Books, Chapter 12
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