ALL THE DRUGS Flashcards
furosemide
mi
diuretic
blocks reabsorption of chloride in the loop of Henle
CHF, pulm edema, pleural effusion, ascites, renal failure
spironolactone
mi
diuretic
aldosterone antagonist (aldosterone acts on kidney to retain water)
2nd line CHF
hydrochlorothiazide
i
weak diuretic (thiazide diuretics)
mgmt of ascites & edema, used w/ spironolactone
rank diuretics from most to least powerful
furosemide > spironolactone > thiazide diuretics
ACE inhibitors
mi
vasodilator
blocks ACE (angiotensin)
CHF, hypertension
amlodipine
i
vasodilator
hypertension
nitrogylcerin
i
vasodilator
CHF
hydralazine
indications
vasodilator
CHF, hypertension
prazosin
i
vasodilator
CHF, refractory hypertension
mech of action of class 1 antiarrhtythmics?
- inhibit fast sodium channels, inhibit rate of spontaneous depolarization
lidocaine
i
class 1 antiarrhythmic
druge of choice to treat life threatening ventricular arrhtyhmias
procainamide
i
class 1 antiarrhythmic
used IV for lidocaine-refractory ventricular arrythmias
mexiletine
oral analoge of what?
i
class 1 antiarrhythmic
lidocaine
oral drug of choice for ventricular arrhtythmias in dogs
quinidine
i
class 1 antiarrhythmic
atrial fibrillation
beta blockers (class II antiarrhythmic)
mech of action
adrenergic receptor antagonists
(decrease sinus heart rate, ^ refractory period of the AV node, decrease myocardial oxygen demand)
propanolol
i
class II antiarrhythmic
supraventricular arrhythmias
atenolol, metoprolol, esmolol
i
class II antiarrhythmic
supraventricular arrythmias
class III antiarrhythmic
mech of action
block K channels -> prolong refractory period, ^ duration of AP
solatol
i
combo class II and III antirythmic
refractory ventricular arrythmias
amiodarone
structural analoge of what
i
class III antiarrhythmic
thyroid hormone
reserved for refractory ventricular tachycardia
calcium channel blockers (class IV antiarrhythmics)
mech
slows AV conduction velocity and prolongs refractory period
diltizaem
i
Ca channel blockers (class IV antiarrhythmic)
supraventicular tachyarrhythmias (Atrial fib), HCM (cats)
verapamil
i
Ca channel blockers (class IV antiarrhythmic)
supraventricular tachyarrythmias
adrenergic agonists - what do they do?
sympathomimietic -> ^ sympathetic response
dobutamine
i
adrenergic agonist
cardiogenic shock (for short term use)
dopamine
i
adrenergic agonist
hypotension, acute renal failure
digoxin
adrenergic agonist (mild positive inotrope)
CHF (decreased contractility), supraventricular tachycardia
what do phosphodiesterase inhibitors do?
positive inotropes or vasodilators
pimobendan
i
phosphodiesterase inhibitor
CHF, DCM or valve dz
Amrinone, milrinone
i
phosphodiesterase inhibitor
CHF: DCM or valvular dz
theophylline
mi
methylxanthine
smooth muscle relaxation of bronchi and pulm vasc
bronchospasm
beta-2 adrenergic agonists (for pulm)
what do they do?
- relax bronchial smooth muscle
- stimulate mucus secretion
- enhance mucociliary clearance
terbutaline, albuterol
i
beta-2 adrenergic agonist
bronchospasm
epinephrine (pulm)
i
beta-2 adrenergic agonist
allergic reactions, bronchspasm
butorphanol
opiod cough suppressant
hydrocodone
opiod cough suppressant
fluticasone
i
inhaled glucocorticoids
allergic airway dz and feline asthma
cimentidine, ranitidine, famotidine
i
H2 blockers (block HCl secretion)
reflux esophagitis, gastric ulcers, etc
omeprazole
i
PPI
reflux esophagitis, ulcers, etc.
sucralfate
i
gastroprotectant
ulcers
misopristol
i
gastroprotectant (PGE1 analogue)
prevention and tx of NSAID-induced gastric and duodenal ulcers
metoclopramide, cisapride
i
prokinetics
gastric atony, ileus, megaesophagus
phenothiazines (chlorpromazine)
mi
antiemetics
inhibit dopaminergic, cholinergic, and histaminergic receptors to reduce input to emetic center
refractory vomiting of defined cause
ondansetorn, dolasteron
mi
antiemetic: serotonergic antagonists
blocks inpute to emetic center
vomiting and nausea
diphenhydramine (for GI…)
m
antiemetic
H1 receptor antagonist; block input to emetic center
bismuth subsalicylate (pepto-bismol), kaolin and pectin
i
antidiarrheals (adsorbents)
acute diarrhea
loperamide
mi
opiod antidiarrheals
^ segmentation contractions of gut, but decrease downstream movement
acute diarrhea in dogs
salicylate derivatives (sulfasalazine)
i
antiinflammatories
chronic inflammatory colitis in dogs
prednisone/prenisolone/dexamethasone (GI)
i
glucocorticoids (anti-inflammatories)
histo evidence of GI inflammatory infiltrates of lymphangiectasia
azathioprine (imuran) (GI)
i
anti-inflammatory
lymphangiectasia, refractory or severe IBD
cyclosporine (GI)
MI
anti-inflammatory
inhibitor of T-cell fxn
lymphangiectasia, refractory or severe IBD
lactulose
osmotic laxative
Docusate sodium
surfactants (stool softener)
cisapride
prokinetic (GI)
ursodiol
mi
hepatoprotectat
^ bile flow
inflammatory/cholestatic liver dz
S-adenosylmethionine
mi
hepatoprotectant
glutathione precursor
hepatic inflammation and necrosis
silymarin (milk thistle extract)
mi
hepatoprotectant
antioxidant
hepatic inflam and necrosis
lactulose (liver)
mi
osmostic laxative
converted to osmotically active acids in colon; traps ammonia
hepatic encephalopathy
neomycin (drugs for hepatic encephalopathy)
mi
inhibits ammonia generation in colon
metronidazole (drugs for hepatic encephalopathy)
mi
kills ammonia-producing anaerobes in colon
D-penicillamine
liver decoppering agent
zinc (liver)
does what?
decreases copper absoprtion
methimazole
m
hyperthyroidism tx
inhibits thyroid peroxidase and thyroid hormone synth
radioiodine
m
hyperthyroid tx
destroys active thyroid tissue via local beta irradiation
L-thyroxine
m
hypothyroid tx
T4 replacement
mitotane
mi
cushings tx
toxic to zona fasciculata and zona reticularis layers of the adrenal glands
pituitary dependent cushing’s treatment
trilostane
mi
cushing’s tx
inhibits adrenal enzymes
pituitary dependent cushings
deoxycorticosterone pivalate (DOCP)
i
mineralocorticoid supplement
hypoadrenocorticism
fludrocortisone
i
short acting mineralocorticoid
hypoadrenocorticism
prednisone (for metabolic dz)
i
precursor of prednisolone with cortisol-like effects
physiologic replacement of cortisol in hypoadrenocorticism
dexamethasone (metabolic)
how poweful compared to prednisone
mineralocorticoid activity?
for hypoadrenocorticism
6-10 X more powerful
no
what do mineralocorticoids do?
what is the main one?
act on kidneys to resorb Na and therefore water
aldosterone
mannitol (renal disease)
i
osmotic diuretic
non-ostructive oliguric renal failure, promote diuresis in some toxicoses
dopamine (renal disease)
i
endogenous catecholamine (fight or flight)
oliguric renal failure
ACE inhibitors (enalapril, benazepril) (renal disease)
mi
vasodilator
inhibit ACE to decrease angiotensin II
hypertension, particularly that assoc w/ renal failure
EPO - what is it?
mi
human recombinant erythropoietin
stims erythropoeisis
anemia of chronic renal failure
phenoxybenzamine
i
alpha adrenergic blocker
urethrospasm (relaxation of internal urethral sphincter)
bethanecol
mi
cholinergic agonist
increases bladder detrusor tone
urinary retention w/o obstruction
amitriptylline
i
tricyclic antidepressant
spraying in cats, interstitial cystitis in cats, separation anxiety
phenylpropanolamine (-)
mi
alpha-adrenergic agonist
incontinence from decreased internal urethral sphincter tone
DES (diethlstilbestrol)
i
synthetic estrogen
hormone-responsive (spay) incontinence in dogs
penicillins (penicillin, amoxicillin, ampicillin)
good against?
antibiotics
anaerobics, some g- and g+
cephalosporins (cephalexin, cefazolin)
mechanism?
good for?
antibacterials
inhibit bacterial cell-wall synthesis
g+, anaerobes, lesser g- (2nd and third generation get better with gram -)
fluoroquinolones (enrofloxacin, marbofloxacin)
mech?
coverage?
antibacterials
inhibit DNA gyrase -> prevent bacterial DNA synthesis
g-, staph, mycoplasma, no anaerobes
tetracyclines (tetracycline, oxytetracycline, doxycycline)
mi
antibacterials
inhibit protein synth (bind to 30S and 50S ribosomal subunits)
ricketsiall, anaplams, mycopslams, brucella, chlamydia, spirochetes (leptospira, borrelia)
potentiated sulfonamindes (trimethoprim-sulfa)
mi
anti-bacterials
false folate analogues
some g-, nocardia, pneumocystis
aminoglycosides (gentamicin, amikacin)
mi
inhibit protein synth
serious g- infections, no anaerobes
metronidazole
i
antibacterials
anaerobics (also used in IBD)
macrolides (erythromycin, azithromycin, tylosin)
coverage?
antibacterials
first two: anaerobes and g+
last one: colitis
lincosamides (clindamycin)
i
antibacterials
toxoplasma, mycoplasma, chlamydia, anaerobes and g+
chloramphenicol and florfenicol
spectrum?
antibacterials
anaerobes
rifampin
spectrrum
antibacterial
mycobacteria
Azoles (ketoconazole, itraconazole, fluconazole)
mi
antifungals
block ergosterol synth
fight most fungi
amphotericin B
mi
antibiotic antifungal
binds ergosterol
systemic mycoses (aspergillus is resistant)
griseofulvin
mi
antibiotic antifungals
binds microtubules and disrupts mitosis
active against dermatophytes (none against yeast )
glucocorticoids
- act how?
- bind intracellular glucocorticoid receptor and modify expression profile of genes containing the glucocorticoid response element
glucocorticoids
effects on metabolism?
catabolic
^ gluconeogenesis, decrease protein synth, ^lipolysis or lipogenesis depending on tissue
(glucocorticoids)
- effect on musculoskeletal system?
- on CNS?
- on GI?
- enhanced bone resportion, muscle atrophy
- change in behavior (hyperactivity or drowsiness)
- ^ acid secretion and decreased mucosal cell turnover
(glucocorticoids)
- renal effects?
- on cardiovascular?
- polyuria, ^ K and Ca excretion
- ^ vasomotor tone
(glucocorticoids)
- effect on hematopoeitc (lots ehre)
- thrombocytosis
- neutrophilia, monocytosis
- eosinopenia, lymphopenia
- decrease inflammatory mediators
- decrease leukocytes phagocytosis, chemotaxis, and antigen processing
(glucocorticoids)
1-5. indications?
- inflammatory diseases
- immune-mediated diseases
- atopy and allergic diseases
- treatment of hypoadrenocorticism
- hypercalcemia
(glucocorticoids - side fx)
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(glucocorticoids)
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(glucocorticoids)
- short acting?
- intermediate-acting?
- long-acting?
- hydrocortisone
- prednisone or prednisolone, methylprednisolone
- dexamethasone
NSAIDS
mech?
inhibition of cyclo-oxygenases 1 or 2 (COX-1, COX-2), leading to inhibition of prostaglandin synthesis from arachidonic acid
NSAIDS
four major effects?
- anti-inflammatory
- antipyretic
- analgesic
- inhibition of platelet aggregation (via COX-1 inhibition)
NSAIDs
1-3. 3 indications?
- musculoskeletal pain
- postop pain and inflammation
- fever
NSAIDs
1-5. side fx?
- vomiting, diarhea
- gastric ulceration
- impaired renal blood flow
- hemorrhage due to impaired platelet function
- idiosyncratic liver tox
NSAIDs
1-5. contraindications
- GI ulcers
- bleeding disorders
- compromised renal fxn
- dehydration
- liver dysfx
(NSAIDS)
- non-selective xamples?
- COX-2 preferential
- COX-2 selective
- aspirin, phenylbutazone, flunixine, piroxicam
- carprofen, meloxicam
- deracoxib
opioid analgesics
what are the three kinds of receptors and where are they found?
mu, kappa, delta
mu in brainstem
mu, kappa, delta in spinal cord
(opioid analgesics)
- rank receptors in order of analgesia provided
- in order of sedation
- which receptor causes most resp depression, heart rate depression, hypothermia?
- which one has lots of GI side fx (nausea, vomiting, defecation)?
- mu > delta > kappa
- mu > delta (little) > kappa (none)
- mu
- mu
morphine
mi
full opioid agonist
interacts with all receptors (but mu provides most effects)
analgesia for moderate to severe pain
oxymorphone
i
full opioid agonist (morphine derivative)
analgesia for moderate to severe pain (specifically approved for dogs and cats)
fentanyl
i
full opioid agonist (highly selective for mu)
analgesia for moderate to severe pain (duration of action around 20 minutes) - transdermal patches available for prolonged use
hydromorphone
i
full opiod agonist
sedation and analgesia
buprenorphine
i
partial opioid agonists
analgesia (mild), little to no sedation
antitussive in dogs
naloxone
i
pure opioid antagonist
reverses CNS and resp depression
tramadol
i
opioid - weak agonist on mu receptor
analgesia (minimal effect on resp, cardio, GI systems)
heparin
m
anticoagulant
binds with antithrombin to inhibit thrombin formation
aspirin (effect on blood)
anticoagulant (at low dose)
phenobarbital
i
anticonvulsant
epileptic seizures
bromide
anticonvulsant
fenbendazole
i
anthelmintic
roundworms, hookworms, whipworms, giardia, lungworms
fenbantel
i
anthelmintic
same as fenbendazole (roundworms, hookworms, whipworms, giardia, lungworms)
pyrantel
i
anhtelmintic
roundworms and hookworms
praziquantel
i
tapeworms
ivermectin (heartguard and heartguard plus)
i
yeah…
infective stage of heartworm larvae
milbemycin oxime
same as heartguard
selamectin
same as heartguard (plus hookworms and roundworms in cats)
melarsomie (immiticide)
treatment of adult heartworms and L5 larvae in dogs
pyrethrins and pyrethroids
i
ectoparasiticide
effective against flies, fleas, lice, and ticks
carbamates
i
ectoparasiticide
insecticide (fleas, lice, and flies), acaricide (mites and ticks)
amitraz
i
ectoparasiticide
topical generalized canine demodicosis
imidacloprid (advantage)
i
topical adulticide (kills fleas but not ticks)
fipronil (frontline)
i
ectoparasiticides
active against fleas and ticks for 1 month
ivermectin
i
ectoparasiticides
sarcoptic mange and demodicosis in dogs
selamectin
i
ectoparasiticides
fleas and ear mites in dogs and cats
mange and ticks in dogs