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Drug therapy Flashcards

(51 cards)

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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

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A

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

22
Q

Brown antibacterial

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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

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

Gram negative aerobes

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A 
Fluoroquinolones
Aminoglycoside 
2nd/3rd generation cephalosporins (not cefovicin)
Ticarcillin-clavulanate
Amoxy-clav
25
Obligate anaerobes
``` Penicillin G Amoxy-clav Clindamycin Metronidazole Chloramphenicole Rifampin ```
26
Penicillinase-producing Staph
``` Amoxy-clav 1st/2nd gen Cephalosporins (and cefovicin) Cloxacillin Fluoroquinolones Rifampin Clindamycin ```
27
Intracellular bacteria
``` Bartonella Brucella Chlamydophila Mycobacterium Rickettsia Staphlococcus ```
28
How well do antimicrobials penetrate?
Poor: pencillin, cephalosporins, beta lactamase inhibitors, polymixins, aminoglycosides Good: Suphonamides, trimethoprim, lincoasmides macrolides, tetracycline Great: Chloramphenicol, fluoroquinolones, lipophilic tetracyclines (moxycycline, doxycycline), metronidazole, rifampin
29
Environmental conditions affected anti-microbials
Haemoglobin - decrease pencillin efficacy TMPS - inactivated by pus Erythromycin, clindamycin, fluoroquinolones - low pH causes reduced activity
30
Urinary infections | Which antibiotic?
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
Kennel cough with systemic signs
Causative agent: Bordetella - Gramnegative Amoxy-clav, tetracyclines, TMPS
32
Strangles
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
Systemic inflammatory reponse | H
Stabilise Septicaemia Peritoneal tap +/- ex lap and lavage Fluroquinolone + metronidazole to cover all four quadrants until results back from culture and sensitivity
34
``` Bacterial meningitis (calf) Which antibiotic? ```
Florphenicol - Good penetration - Good against gram negatives - Safe to use in young production animals
35
PLACE | Small Mammals
``` Penicillin Lincosamides Aminoglycosamides Cephalosporins Erythrofloxacin ```
36
FINE TO MEDICATE | Small Mammals
Fluoroquinolines (Baytil) TMPS Metronidazole
37
Mare - salmonella
Aerobic gram negative - aminoglycoside Penicillin can lead to overgrowth of clostridium
38
Cat bite abscess
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
Deep pyoderma
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
Toxic mastitis
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
Drugs not to use in production animals
Enrofloxacin in layers Chloramphenical Metronidazole
42
Mucolytics
Bromhexine - alters mucus viscosity Dembrexine - alters secretory activity of glands Assist the removal of mucus plugs
43
Expectorants
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
Nasal decongestants
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
Bronchodilators | Muscarinic receptor agonists
Atropine, ipratopium Inhibition of vagally-induced contraction of airway smooth muscle Adverse effects: inhibition of mucociliary clearance, inhibition of GIT function, CNS stimulation
46
Bronchodilators | Beta-adrenoreceptor agonists
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
Bronchodilators | Methylxanthines
``` 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
Bronchodilators | Uses
Infection/inflammation of the respiratory tract Allergic respiratory disease Chronic obstructive pulmonary disease (COPD)
49
Airway inflammation drugs
Anti-inflammatory: - Glucocorticoids - NSAIDs - Methylxanthines - Histamine, serotonin, leukotriene - (Prophylactic) sodium cromoglycate and nedocromil
50
Prokinetics
Metoclopramide | Carbachol etc.
51
Laxatives
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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