1. HORSES Flashcards

DRUGS

1
Q

most commonly used drug classes

A

-sedation
-analgesia
-antibacterial drugs
-some others

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2
Q

SID

A

1x day, Q 24h

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3
Q

BID

A

2x day, Q 12h

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4
Q

TID

A

3x day, Q 18h

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5
Q

QID

A

4x day, Q 6h

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6
Q

sedation: PHENODIAZINE

A

acepromazine

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7
Q

ACEPROMAZINE: mode of action

A

antagonizing dopamine

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8
Q

ACEPROMAZINE: sedation

A

-transportation, hoof trimming/shoeing, clipping
-nervous mare in clinic with foal
-laminitis

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9
Q

sedation: ACEPROMAZINE: anesthesia premedication

A

-less arrhythmias
-better recovery

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10
Q

ACEPROMAZINE routes

A

po, im, iv

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11
Q

ACEPROMAZINE: side effects

A

SYSTEMIC HYPOTENSION:
- can outlast sedation
- contraindicated in dehydrated, anemic and in shock horses
-contraindicated: foals, old horses
-contraindicated: stallions

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12
Q

ACEPROMAZINE: side effects > prescription drug

A

SHOULD NOT BE SOLD TO OWNERS FOR USE IN HOME
-misuse and overdosing
-increasing dose do not increase effect but side-effects

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13
Q

sedation and analgesia: A2-AGONIST> sedation ?

A

-dose-dependt
-low head-carriage
-decr. locomotor activity
-decr. response to stimulation

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14
Q

sedation and analgesia: A2-AGONIST> analgesia

A

-comparable to NSAIDS, OPIOIDS

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15
Q

sedation and analgesia: A2-AGONIST> also used as

A

premedication for general anesthesia (GA)

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16
Q

A2-AGONIST effect shows

A

-few min
-after IV administration

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17
Q

A2-AGONIST can be combined with

A

-opioids
-phenothiazine

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18
Q

A2-AGONIST: side-effects

A

-ataxia
-bradycardia and transient hypertension followed by hypotension
-decr.GI motility and decr. intestinal blood flow
-slow down esophageal motility: do not allow eating 2hours after sedation > risk of esophageal obstruction
-smooth muscle relaxation in upper airways
-hyåerglycemia, mydriasis, decr. HCT, sweating

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19
Q

sedation: A2-AGONIST : drugs

A

-xylazine: better analgesia in colic than opioids or flunixin
-detomidine: do not give 20 min before or after IV TMPS, sublingually onset of action 45min
-romifidine: produces less ataxia. less analgesia than xylazine or detomidine, analgesia lasts 1-3h

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20
Q

sedation and analgesia: OPIOIDS- mono therapy?

A

NOT as monotherapy in horses > always require alpha2-agonist or acepromazine

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21
Q

sedation and analgesia: OPIOIDS- BUTORPHANOL: 1.mechanism of action 2. description 3. side-effects

A

1.mechanism of action: partial myy-opioid receptor agonist, partial antagonist

  1. description: most used in horses: best pain relief amongst opioids, least side-effects, effect 30-90min
  2. side-effects: high doses can cause excitement, reduced GI motility, sudden head movements, ataxia
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22
Q

sedation and analgesia: OPIOIDS- MORPHINE: 1.mechanism of action 2. description 3. side-effects

A
  1. myy-opioid receptor agonist
  2. potentiates sedative and analgesic effect of other drugs
  3. anxiety (particularly in absence of strong pain), ileus , ataxia
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23
Q

opioids to use with?

A

ALWAYS use with alfa2-agonist > opioids CNS excitement otherwise!

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24
Q

analgesia: NSAID-how often used?

A

most common used drug class in horses

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25
NSAID: main control?
control of pain (esp. inflammatory) and inflammation -soft tissue -musculosceletal -colic pain
26
NSAIDS: used
-pain management -fever
27
NSAIDS: mode of action
decreases eicosanoids in inflammatory lesions over inhibition of cyclooxygenases (COX)
28
NSAIDS: side effects > mostly mediated by?
> mostly mediated by? >INHIBiTION OF COX-1 -inhibition of intestinal motility, inc. colonic motility -gastric and intestinal (right dorsal colon) ulceration> ponies more sensitive > more risk in hypovolemic horses or with prolonged treatment -renal damage > geriatric, hypovolemic, hypotensive horses or horses with renal, cardiac or liver damage > renal papillary necrosis and Aki (Acute Kidney Injury) -PLATELET DYSFUNCTION
29
NSAIDS: can combine with ?
-opioids
30
NSAIDS: FLUNIXIN MEGLUMIN
-most effective NSAID for visceral pain > caution when using -anti-endotoxic in lower dosages > prevents some hemodynamic effects of endotoxemia NEVER IM!!!! CLOSTRIDIAL MYOSITIS!!!
31
NSAIDS: PHENYLBUTAZONE
-mostly used orthopedic pain -relatively narrow therapeutic index -should be used with other drugs that bind to plasma proteins >gentamicin, sulfonamides -hay delays oral absorption
32
NSAIDS: MELOXICAM
-More COX-2 selective than COX-1 -not as effective as flunixin in colic patients -do not use in donkeys useless)
33
NSAIDS: KETOPROFEN
-very effective analgesic and anti-inflammatory agent -not as effective as PBZ (PhenylButaZone) but less than melox
34
NSAIDS: CARPROFEN
-effective analgesic but weak anti-inflammatory agent -more cox-2 selective than flunixin or PBZ but less than melox -not investigated for colic pain -better analgesic when pain is inflammatory in origin
35
NSAIDS: COXIBS > FIROCOXIB
-very strongly COX-2 selective -FIROCOXIB -if IV-solutions available > similar analgesia to flunixin in acute colic > can not be given/flushed with saline (precipitates)> flush with blood
36
SPASMOLYTICS: BUTYLSCOPOLAMINE
-spasmolytic used in colic -sometimes combined with dipyrone -analgesia lasts app.20min -concurrent ttachycardia -often used before rectal examination
37
ANALGESIA: LIDOCAINE-usage
-colic: pain management and treatment of ileus, anti-inflammatory -decreases repercussion injury
38
local anesthetics: ways of insertion (1-4)
1. subcutaneously > perineurial, around wound(infiltration) 2. intraarticularly 3. epidural anesthesia 4. volume depends on area
39
local anesthetics: LIDOCAINE 2%
-rapid onset (4min), shortest duration (less 1,5h) -causes most swelling and local irritation > unreliable in lameness examinations -max. dose 250ml to 500kg > can be used as topical anesthetic
40
local anesthetics: BUPIVACAINE 2%
-slow onset, prolonged duration more than 3h -toxic to chondrocytes = rustosolut!! (more than lidocaine) -more potent than lidocaine and mepivacaine
41
local anesthetics: MEPIVACAINE 2%
-rapid onset (similar to lidocaine) -least irritation to tissues, least toxic to chondrocytes -less vasodilation compared to lidocaine, less effective as topical anesthetic than lidocaine
42
ANTIBIOTICS
USE WITH CARE -not to use reserved ABs protect me- BEVA- protects ABs in future of equine health
43
ANTIBIOTICS: WHICH AB TO CHOOSE?
-empirical -bacterial culture > culture and sensitivity whenever possible -reserve group AB -route of administration -price -availability -side - effects -reactions with other drugs
44
AB: PENICILLINS (2)
1. PROCAINE BENZYLPENICILLIN - NOT IV 2. Na-BENZYLPENICILLIN - IV SLOWLY side effects: soft feces, head shaking, salivation, mild colics
45
AB: AMINOGLYCOSIDES (2)
1. GENTAMICIN - Irritate muscle, clostridial myositis -often as local ad. 2. AMIKACIN =concentration dependent
46
AB: AMINOGLYCOSIDES, side-effects
-nephrotoxicity : check creatinine before adm. > not dehydrated animals -ototoxicity -rarely as monotherapy
47
POTENTIATED SULFONAMIDES-added with?
-enhance effect of ABs
48
POTENTIATED SULFONAMIDES
-TRIMETOPRIM+SULFAMERAZINE -TRIMETOPRIM+SULFADIAZINE =NEVER IN SEDATED HORSES - sudden drop in BP, arrhythmia and death possible if combined with use of A2-AGONIST
49
TETRACYCLINES
-broad spectrum -DOXYCYCLINE -OXYTETRACYCLINE-nephrotoxic > very high doses treat contractures in foals 1x use (lihakset jänteet tai nivelsiteet jatkuvasti jännityksessä)
50
CEFALOSPORINES - generations (not often used in horses) (4)
1. generation: CEFALEXIN, CEFAZOLIN, CEFADROXIL 2.generation: RESERVED AB!!!!!!! 3. generation: CEFTIOFUR, CEFOTAXIM 4.generation: CEFQUINOME
51
FLUOROQUINOLONES - broad spectrum, reserved AB (2)
very good for gram- 1. ENROFLOXACIN: very good tissue penetration, not for young or growing horses (risk arhropathies) 2. MARBOFLOXACIN: considered to cause less arthropaties than 1
52
NITROIMIDAZOLES
-METRONIDAZOLE : anaerobes, protozoa side - effectL: inappetence, diarrhea -prohibited animals for slaughter > note to passport
53
GLUCOCORTICOSTEROIDS - systemic (2)
1. DEXAMETHASONE 2. PREDNISOLONE -laminitis risk! mostly in horses with EMS or PPID -CORTISOL suppression
54
GLUCOCORTICOSTEROIDS: inhaled - alternative for respiratory disease (2)
1. FLUTICASONE 2. CICLESONIDE -improve lung function -safer regarding side-effects than systemic -no cortisol suppression
55
drugs used in gastric ulcer treatment (5)
1. OMEPRAZOLE: suppress gastric acid production (proton pump inhibitor)-more effective in empty stomach. for treatment of glandular and non-glandular ulcers 2. ESOMEPRAZOLE: suppress gastric acid production (proton pump inhibitor)-cumulative effect from 5th day 3. SUCRALFATE: binds to ulcerated mucosa, stimulated mucous secretion, PGE synthesis, enhances blood flow-add every glandular ulcer treatment protocol 4. MISOPROSTOL: suppress gastric acid production: also anti-inflammatory effect > may cause abdominal pain- ONLY GLANDULAR ULCERS 5. RANITIDINE: suppress gastric acid production (H2-receptor antagonist) > less effective: sometimes to ''tail up'' omeprazole
56
using medication in foals
-foals are not small adult horses!! -always more cautions in foals reg. side-effects -OFTEN DIFFERENT DOSAGES AND DOSING INTERVALS
57
routes of administration: systemic administration
-oral PO -intramuscular IM -intravenous IV -per rectum PR -subcutaneus SC
58
routes of administration: local administration
-intra-articular IA -intravenous regional limb perfusion IVRLP -local anesthesia -into eye CORNEAL SURFACE -inhalation -nebulisation -epidural anesthesia
59
administering drugs PO
-flush syringe 50-100 ml -insert syringe from corner of mouth -rise head up -let horse swallow -feed in stomach changes absorption of many drugs
60
administering drugs IM part 1
-choose right place -insert whole needle im -aspirate -hold needle from hub and inject
61
administering drugs IM part 2
-absorption varies in different sites injection sites : neck>pectorals>gluteals>semimembranosus -possible reactions at inj.sites: accesses, cellulitis, muscle swelling, pain -not enough muscle mass Is limiting -some drugs too irritating, painful
62
administering drugs IV
-needle -single use IV catheter -IV catether > sterilely
63
administering drugs IV part 2
-use upper 3rd of neck -stasis -insert needle into vein -aspirate before and after administration -take off stasis -remove needle
64
administering drugs SC
-few systemic drugs -local anesthesia -nerve blocks -lift up skin > easier to insert needle
65
administering drugs into eye
-ointment > medial canthus > 3rd eyelid -break needle until hub -open eyelids (no pressure on eyeball) -spray from distance -eye lavage system if many drugs, long-term treatment or horse does not allow to medicate
66
administering drugs into eye
-5min between diff. drugs -when using drops only, serum is always last -ointments always last
67
drug inhalation
-equihaler or babyhaler -chake vial, insert drug into chamber>can be done away from horse -put inhaler on 1 nostril -let horse inhale 1-2min
68
NEBULIZATION
-nebulization: converts liquid to aerosol, inhalation, NaCl, gentamicin, dexamethasone and other hormones
69
IV regional limb perfusion
mostly aminoglycosides are used -torniquet, nose twitch,, sedation if needed