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Veterinary Medicine > Drug therapy > Flashcards

Drug therapy Flashcards

1
Q

Hartmanns

A

Balanced, isotonic, buffered solution

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2
Q

Hypertonic saline (7%)

A

Very high osmolarity
Used for rapid fluid resuscitation
(Can use colloids - stay in vascular compartment, keep fluids in vascular)

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3
Q

Shock dose

A

90ml/kg/hour over 15 min (dogs)
60-70ml/kg/hour over 15 min (cats)

Case by case adjustment
Reassess

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4
Q

Glucocorticoid

A

Specific group of corticosteroids that act on inflammatory system and will have other metabolic effects

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5
Q

Glucocorticoid mechanism

A 
Bind to specific intracellular receptors
Alter gene expression
Alter regulation of many cellular processes
Increase their own metabolism
Decrease cortisol proudction
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6
Q

Why are glucocorticoids better at suppressing inflammation than NSAIDS?

A

Suppress T-lymphocyte functions
Inhibit monocyte - macrophage activities
Suppress fibroblast functions and collagen deposition
Reduce histamine release from mast cells
Decreased synthesis of lymphokines

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7
Q

Metabolic duration

A

Short acting 48h): flumethasone, dexamethasone, betamethasone

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8
Q

Fluticasone proprionate

A

Inhalant therapy for asthmatic inflammation

Inhaler, face-mask, deep constant flow

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9
Q

Atypicals

A 
Rickettsia
Mycoplasma
Chlamydia
Borrelia
Bartonella 
Mycobacterium
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10
Q

Minimum inhibitory concentration

A

Lowest concentration of drug that will inhibit bacterial growth
MIC90 - therapeutic dose to kill 90% of a bacteria

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11
Q

Inhibition of cell wall synthesis

A

Penicillins
Cephalosporins
Bacitracin

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12
Q

Inhibition of cell membrane function

A

Polymyxins
Amphotericin B
Imidazoles
Nystatin

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13
Q

Inhibition of protein synthesis

A 
Chloramphenicol
Macrolides
Lincosamides
Tetracyclines 
Aminoglycosides
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14
Q

Inhibition of nucleic acid synthesis

A 
Sulphonamides
Trimethoprim
Quinolones
Metronidazoles
Rifampin
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15
Q

Bacteriostatic

A 
Chloramphenicol
Lincosamides 
Macrolides
Tetracyclines
Non-potentiated sulponamides
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16
Q

Bacteriocidal

A

Time dependent vs Concentration dependent

Penicillin 
Cephalosporins
Aminoglycosides
Fluoroquinolones
Potentiated sulphonamides (TMPS)
Metronidazole
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17
Q

Time dependent

A

Time above MIC over 24h period predicts therapeutic success

Penicillins, cephalosporins, TMPS

Bacteria must be multiplying (don’t combine with bacteriostatic)

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18
Q

Concentration dependent

A

Peak concentration achieved or area under the curve predicts therapeutic success

Aminoglycosides, fluoroquinolones, metronidazole

Effective against dormant bacteria (can combine with bacteriostatic)

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19
Q

Red antibacterial

A

No useful activity against the vast majority of bacteria i a quadrant

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20
Q

Green antibacterial

A

Excellent activity against most bacteria in this quadrant

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21
Q

Blue antibacterial

A

Good activity against many bacterial species in this quadrant but some important species resistant

22
Q

Brown antibacterial

A

Moderate activity against bacterial species in a quadrant - some susceptible, some resistant

1st gen cephalosproins, cefovicin and amoxycillin (no clav) against gran negatives aerobes and obligated anaerobes

Lincosamides other than clindamycin against anaerobes

TMPS in all quadrants

Tetracyclines in all quadrants (except gram positive) - excellent activity against atypicals

23
Q

Gram-positive aerobes

A 
Penicillin G
Aminopenicillins 
Cephalosporins
Lincosamides/Macrolides
Tetracyclines
Rifampin
Fluoroquinolones
24
Q

Gram negative aerobes

A 
Fluoroquinolones
Aminoglycoside 
2nd/3rd generation cephalosporins (not cefovicin)
Ticarcillin-clavulanate
Amoxy-clav
25
Q

Obligate anaerobes

A 
Penicillin G 
Amoxy-clav
Clindamycin
Metronidazole
Chloramphenicole 
Rifampin
26
Q

Penicillinase-producing Staph

A 
Amoxy-clav
1st/2nd gen Cephalosporins (and cefovicin)
Cloxacillin 
Fluoroquinolones
Rifampin
Clindamycin
27
Q

Intracellular bacteria

A 
Bartonella
Brucella
Chlamydophila
Mycobacterium
Rickettsia
Staphlococcus
28
Q

How well do antimicrobials penetrate?

A

Poor: pencillin, cephalosporins, beta lactamase inhibitors, polymixins, aminoglycosides

Good: Suphonamides, trimethoprim, lincoasmides macrolides, tetracycline

Great: Chloramphenicol, fluoroquinolones, lipophilic tetracyclines (moxycycline, doxycycline), metronidazole, rifampin

29
Q

Environmental conditions affected anti-microbials

A

Haemoglobin - decrease pencillin efficacy
TMPS - inactivated by pus
Erythromycin, clindamycin, fluoroquinolones - low pH causes reduced activity

30
Q

Urinary infections

Which antibiotic?

A

Usually gram negative or mixed infection
If prostate involved (usually in entire) - need good penetration

TMPS good option - excreted in urine

Amoxycillin(-clav) good option in bitches

31
Q

Kennel cough with systemic signs

A

Causative agent: Bordetella - Gramnegative

Amoxy-clav, tetracyclines, TMPS

32
Q

Strangles

A

Causative agent: Streptococcus equi equi - Gram positive

Quarantine livery yard

Penicillin - good against early signs - treat all mildly affected/exposed horses

Once developed submandibular abscesses, don’t use penicillin!

  • Flush abscesses
  • Supportive care
  • No antibiotics
  • Quarantine for at least 4 weeks

Complicated form:

  • Bacteria spread through other lymph nodes
  • Long term antibiotics (penicillin or TMPS)
33
Q

Systemic inflammatory reponse

H

A

Stabilise
Septicaemia

Peritoneal tap +/- ex lap and lavage

Fluroquinolone + metronidazole to cover all four quadrants until results back from culture and sensitivity

34
Q 
Bacterial meningitis (calf)
Which antibiotic?
A

Florphenicol

  • Good penetration
  • Good against gram negatives
  • Safe to use in young production animals
35
Q

PLACE

Small Mammals

A 
Penicillin
Lincosamides
Aminoglycosamides
Cephalosporins
Erythrofloxacin
36
Q

FINE TO MEDICATE

Small Mammals

A

Fluoroquinolines (Baytil)
TMPS
Metronidazole

37
Q

Mare - salmonella

A

Aerobic gram negative - aminoglycoside

Penicillin can lead to overgrowth of clostridium

38
Q

Cat bite abscess

A

Open, flush, close with drain

Gram negative anaerobes most likely in an abscess but consider contamination from skin (gram positives)

Clindamycin, metronidazole, amoxy-clav

39
Q

Deep pyoderma

A

Can be Pseudomonas or Staphylococcus
Should take skin scrape and look for rods and send for culture and sensitivity

Topical therapy?
Amoxyclav, 1st/2nd generation cephalosporin, fluoroquinolone

40
Q

Toxic mastitis

A

E. coli - gram negative (or Strep uberis, Staph aureus)

Need systemic treatment

  • Cephalosporins 2nd/3rd - not great penetration, intramammary?
  • Amoxy-clav?

Carprofen (and flunixin) have effects against endotoxaemia

41
Q

Drugs not to use in production animals

A

Enrofloxacin in layers
Chloramphenical
Metronidazole

42
Q

Mucolytics

A

Bromhexine - alters mucus viscosity
Dembrexine - alters secretory activity of glands

Assist the removal of mucus plugs

43
Q

Expectorants

A

Said to be of limited therapeutic value

Oral e.g. ipecacuana and squill - irritate mm and caused increased clearance of mucus

Inhaled e.g. eucalyptus oil - increase secretion of watery mucus

44
Q

Nasal decongestants

A

Pseudoephedrine:

  • Indirectly acting sympathomimetic
  • Decreases blood flow to secretory glands, reducing mucus production

Use: URT conditions associated with profuse secretion e.g. allergic rhinitis in cats

45
Q

Bronchodilators

Muscarinic receptor agonists

A

Atropine, ipratopium
Inhibition of vagally-induced contraction of airway smooth muscle

Adverse effects: inhibition of mucociliary clearance, inhibition of GIT function, CNS stimulation

46
Q

Bronchodilators

Beta-adrenoreceptor agonists

A

Beta2-selective drugs (Beta2-agonists):

  • Clenbuterol (horses, cattle)
  • Terbutaline (cats and dogs)
  • Salbutamol, salmeterol (horses - inhaled)

Relaxation of airway smooth muscle by activate of beta2 receptors

Other properties:

  • Inhibition of vascular permeability and swelling
  • Inhibition of cell activation
  • Improve mucociliary clearance

Adverse effects: tachycardia, hypotension, sweating, restlessness/excitation, muscle tremors, hyperkalemia

Non-selective drugs: Epinephrine, emergency treatment, isoprenaline

47
Q

Bronchodilators

Methylxanthines

A 
Theophylline, etamiphylline
Unclear mechanism:
- Phosphodiesterase inhbition
- Adenosine antagonism
- Anti-inflammatory effects
- Direct stimulation of respiratory centres in CNS

Renal and circulatory effects may improve respiratory function in some conditions

Adverse effects: tachycardia, restlessness/excitability, vomiting

48
Q

Bronchodilators

Uses

A

Infection/inflammation of the respiratory tract
Allergic respiratory disease
Chronic obstructive pulmonary disease (COPD)

49
Q

Airway inflammation drugs

A

Anti-inflammatory:

  • Glucocorticoids
  • NSAIDs
  • Methylxanthines
  • Histamine, serotonin, leukotriene
  • (Prophylactic) sodium cromoglycate and nedocromil
50
Q

Prokinetics

A

Metoclopramide

Carbachol etc.

51
Q

Laxatives

A

Liquid paraffin: lubricate
Stimulant: senna
Bulk forming: wheat bran, methylcellulose
Osmotic: lactulose, magnesium sulphate, sodium sulphate, enema

Veterinary Medicine (15 decks)

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