Capstone 2 drugs Flashcards by Cassie Seebart

What therapeutic index number is considered safe?

> 10

larger TI = safer drug

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First pass effect

drugs given orally –> absorbed in stomach/SI –> blood from gut goes to liver where metabolized or secreted –> remaining drug is what becomes bioavailable

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2 main routes of drug elimination

Metabolized in liver

Excretion by kidney

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Decreased clearance of a drug will result in _______

longer duration of effect

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Most drugs are eliminated based on 1st order kinetics, which means the more drug you have, the _______ it is eliminated

faster

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drug elimination by zero order kinetics

same amount of drug eliminated/time regardless of concentration

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two ways to increase steady state concentration

increase dose (give more) or
shorten dose interval (give original dose more often)

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Giving a concentration-dependent antibiotic (want brief periods of high drug levels)

higher doses with longer dose interval

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Giving a time-dependent antibiotic (longer periods of use at minimal levels)

lower dose with shorter dose interval

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Why should you give drugs based on surface area?

Metabolic rate changes more similarly to SA (vs. weight)

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Potency

conc of drug needed to get max effect

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Efficacy

measure of max effect

more important than potency

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beta 1 receptor

sympathetic

increase HR, increase contractility

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M2 receptor

parasympathetic
decrease HR at SA node, decreased conduction velocity; AV blocks at AV node
bronchoconstriction, bronchial gland secretion

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alpha 1 receptor

sympathetic
vasoconstriction
mydriasis in eye

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beta 2 receptor

sympathetic
vasodilation
bronchodilation in bronchial smooth m.
increase aqueous humor in eye

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M3 receptor

Parasympathetic
increase NO in arterial endothelium –> dilation
bronchoconstriction, bronchial gland secretion

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alpha 2 receptor

vasoconstriction, CNS depression, bradycardia

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how do you counter bradycardia

treat problem causing it and/pr anticholinergics (atropine, glyco)

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how do you counter tachycardia

treat problem causing it

give beta-blockers as a last resort (esmolol)

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how do you counter vasodilation

give vasopressors (constrictors) - Dopamine, phenylephrine

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how do you counter vasoconstriction

give vasodilators - Acepromazine, amlodipine, etc

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when can you extubate a horse

standing

b/c obligate nasal breathers

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drugs commonly used to sedate a horse? induce? maintenance?

sedate - alpha 2’s (xylaine, detomadine etc)
induce - ketamine + diaz/midaz
maint - ket, xy, Guaifen or midaz

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what does ketamine not reduce in EQ

palpebral reflex

Who do you not use Xylazine with

sheep - pulmonary intravascular hemorrhage

Ket-stun

used for standing sedation | Butorphanol, xylazine, ketamine IM

what wierd exception do rum have under anesthesia?

high arterial BP

Drugs commonly used to sedate rum/SAC

benzo's (midaz), or alpha 2's for adult cow

concern of a ruptured bladder

hyperkalemia causing arrhythmias | Must address before anesthetize

What drugs do you avoid with a head trauma patient?

ketamine | alpha-2 agonists (Xy, dex) b/c they increase ICP

Key pre-op management for anesthetizing an Addison doggo

glucocorticoid supp

What drug has potential to increase blood glu?

Dexmedetomidine

What is the one drug that doesn't decrease CMR (cerebral metabolic rate) and CBF (cerebral blood flow)?

Ketamine | increases CMR, slightly decreases CBF

Additional concerns for animals w/ renal dz

anemia hypertension electrolyte abnormalities stage of renal dz

Anesthesia drugs to avoid for a renal patient

- avoid Ace, alpha 2's b/c decrease CO - maybe avoid ketamine - metabolized in kidneys in cats - maybe avoid sevo - make nephrotoxic compound - maybe avoid NSAID's for post-op pain - alter PG synth which alters renal blood flow

what's a good pre-med choice for liver dz patients?

Opioids - minimally metabolized, reversible, little CV effects Avoid alpha 2's, ace b/c CV effects and metabolized by liver

What IA is contraindicated for liver dz?

Halothane

what drug class are emetics for dogs? for cats?

dogs - opiods | cats - alpha 2's

how do you assess pain/nociception in an anesthetized patient? (x4)

- patient conscious response or reflex (anesthetic plane) - increased RR - increased BP (usually early response) - increased HR

most common sedative/analgesic for emergencies, drug of choice for EQ

alpha 2's

how do local anesthetic doses differ between dogs and cats?

cats more sensitive, need 1/2 to 1/3 of the dose

why is lidocaine used in bier block

b/c if ineffective tourniquet and anesthetic goes systemic, lidocaine is least cardiotoxic vs. other local anesthetics

pre-med drugs to avoid for a MVD dog

Acepromazine or alpha 2's | do benzos or opioids instead

Induction commonly used for HCM cats

Etomidate b/c minimal CV effects

What is fludrocortizone used for

cortisol AND aldosterone replacement for Addison's dz

Drugs to use to stabilize/stop seziures

Diazepam Phenobarbital Bromide

Drugs used for seizure maintenance

Primary: Phenobarbital, Bromide | Secondary/add on: Gabapentin, Levetiracetam

Single most broadly used chemotherapeutic active agent used in veterinary oncology

Doxorubicin. very efficaious!! | inhibits RNA, DNA polymerase, topoisomaerase II

Cisplatin

contraindicated in cats - fatal fulminant pulmonary edema renal toxicity, BAGS, neurotox, ototox, Don't use 5-fluoricil either (can't metabolize)

What is Amoxicllin best choice to use for

best penicllin to treat UTI's | drug of choice to treat Lepto

Contraindications of tetracyclines

. irritants - see vomiting, local tissue damage at injection site 2. GI flora imbalance --> enterocolitis 3. Doxy tablets = esophageal stricture in cats 4. acute heart toxicity, renal toxicosis, yellow teeth

Uses for tetracyclines

bov/porcine resp dz complexes plague, tulaermia, listeriosis Top choice for rickettsia (SA), Chlamidophila felis in cats

What anthelminitics cause resistance

Macrocyclic lactones Benzimidazoles Tetrahydropyrimidines d/t repeated anthelminitic use eliminated susceptible worms

Drug of choice for campy diarrhea or abortion

erythromycin | alternate for penicllin sensitivity, treating lepto, rickettsia

Low dose vs. high dose epinephrine affects with adrenergic receptors

low dose - beta 2 - decreases BP, bronchodilation | high dose - alpha 1 - increases BP, CO

how does epi differ from NE?

NE doesn't cause bronchodilation - little activity w/ beta 2 NE - think mas vasoconstriction

Low dose vs. high dose dopamine affects with adrenergic receptors

low dose - vasodilation, contractility (good for CHF, renal dz) high dose - vasoconstriction

dobutamine

increases contractility but minimally changes HR/BP | good for heart failure

different classes of antiarrhythmics to slow conduction

I - sodium channel blockers (eg. lidocaine) II - beta blockers III - AP prolonging by blocking K channels IV - Ca channel blockers