Drugs SA Flashcards
1
Q
Praziquantel
A
- Droncit
- Species: Cats, Dogs
Therapeutic indication: Tapeworm Product
- Anthelmintics for dogs, Anthelmintics for cats
- ex: Paragonimus kellicotti, Taenia taeniaformis
- Praziquantel is also commonly used in combination with other antiparasitic medications
2
Q
Fenbendazole
A
Panacur
- granules or oral suspension
- Species:Cats, Dogs
- Endoparasiticides: Anthelmintics for dogs, Anthelmintics for cats
- ex: Giardia intestinalis
- Can be used for cats and dogs for the treatment of roundworms, tapeworms (not effective against Dipylidium caninum the ‘flea tapeworm’), lungworms and Giardia. Probably the most user friendly wormer for kittens and puppies
3
Q
Ronidazole
A
-
Ronidazole is most commonly used to treat a protozoal infection in cats called Tritrichomonas foetus. This protozoa is a common cause of diarrhea in cats, particularly young cats and those living in multi-cat households.
*
4
Q
Clindamycin
A
- Clindamycin is a broad-spectrum lincosamide antibiotic. It is efficacious against gram-positive aerobic bacteria (including most Staphylococcus and Streptococci spp), anaerobic bacteria, and some protozoal infections (including Toxoplasma). Clindamycin is approved by the FDA for use in dogs and cats with the following label indications: wounds, abscesses, and osteomyelitis (Staph aureus)
- cryptosporidium spp.
- Clindamycin is considered the treatment of choice for clinical Toxoplasmosis in both dogs and cats
- Clindamycin is used to treat a variety of infections in dogs and cats. Its indications in dogs include Staph pyoderma, wounds, abscesses, dental infections, osteomyelitis, susceptible hepatobiliary or respiratory infections, anaerobic infections, intra-abdominal sepsis, actinomycosis, some methicillin resistant Staph infections, and susceptible protozoal infections, including Toxoplasmosis.
5
Q
Licensed first-line antiepileptic drugs:
(3)
A
- Phenobarbitone
- Potassium bromide
- Imepitoin
6
Q
Second-Line Antiepileptic Drugs
(5)
A
- Levetiracetam
- Zonisamide
- Gabapentin/Pregabalin
- Topiramate
- Felbamate
7
Q
Difference between Maropitant and Odancetron
A
- anti-emetics –> maropitant may not assist in reducing nausea like Odancetron
8
Q
Gabapentin
A
- Gabapentin is an anticonvulsant prescribed by veterinarians predominantly to treat chronic pain in dogs, cats, and other animals.
- It also is used as a seizure-control agent, either by itself or in conjunction with other anti-seizure medications
- analgesic –> can be really good for neuro related pain! (ex: spinal surgery)
- few side effects - other than some sleepiness maybe
9
Q
Azathioprine Side effects for IMHA patients
A
- Bone marrow suppression
- Gastrointestinal upset
- Hepatotoxicity
- Acute pancreatitis
Nephrotoxicity is not a reported side effect of azathioprine
GI upset is the most common of the 4 listed, although it is still relatively infrequent. The other 3 listed side effects are uncommon, but can be life-threatening, so they must be discussed with the owner before starting treatment.
Cats are more sensitive to these side effects than dogs because of a deficiency in thiopurine methyltransferase, the enzyme used to metabolize azathioprine. Azathioprine should be used with caution, if at all, in cats.
10
Q
Enrofloxacin
A
- brand name: Baytril
- fluoroquinolone antibiotic used to treat bacterial infections.
- Its use in dogs to treat certain specific infections and its use in small mammals, birds, and reptiles is ‘off label’ or ‘extra label’.
- Enrofloxacin is a not a very good choice for oral infections since it is ineffective against anaerobic bacteria. Beta-lactam antibiotics (especially Clavamox) or clindamycin are better choices for oral infections because of their activity against anaerobes
11
Q
Allopurinol
A
- Allopurinol (brand names Lopurin®, Zyloprim®) is a drug used to prevent the recurrence of uric acid and calcium oxalate uroliths (stones) in dogs.
- This medication works by decreasing the production of uric acid in the body
12
Q
What is this image depicting?
What breed is predisposed?
A
- The image is classic for a urethral prolapse.
- This condition is almost exclusive to young English bulldogs
- The cause of urethral prolapse is not always determined but may be secondary to excessive masturbation, sexual excitement, or an infection.
- Treatment involves either urethropexy to replace the prolapse or amputation of the tip.
- The patient should be examined closely to ensure there is no evidence of concurrent neoplasia or infection.
13
Q
L-lysine
A
L-lysine is an anti-viral medication that may have some benefit for suppression of herpes virus (FHV)
however may research articles are saying the therapy may be ineffective and advise against use
14
Q
Methimazole
A
- The most common medication prescribed to treat feline hyperthyroidism is called methimazole (trade name Tapazole or Felimazole).
- This medication has virtually replaced the older medication propylthiouracil or PTU because methimazole is effective without as much tendency for side effects.
- The drug will block the production of T4 and T3. Thyroid hormones that are already in the body when medication is started are still in play, so a good 2 to 4 weeks are needed before thyroid blood tests will show the effect of treatment.
15
Q
Levothyroxine
A
- Levothyroxine is a thyroid supplement used for treating hypothyroidism
- There is no cure for hypothyroidism. Dogs must be treated for life with thyroid hormone replacement therapy. Only one drug, THYRO-TABS CANINE (levothyroxine sodium tablets), is FDA-approved for replacement therapy for diminished thyroid function in dogs.
- Approved by FDA in January 2016, THYRO-TABS CANINE is a prescription drug containing levothyroxine sodium as the active ingredient.
- The tablets are available in nine strengths
16
Q
Rutin
A
- possibly chylothorax medication
- believed to increase macrophage removal of proteins, which promotes absorption of fluid
- complete resolution of effusion appears to occur in some patients but may be unrelated to the therapy
17
Q
Somatostatin analogues
(octreotide)
A
- naturally occurring substance that can inhibit gastric, pacreatic, and biliary secretions
- also prolongs gastrointestinal transit time
- decreases jejunal secretion
- stimulates gastrointestinal water absorption
- may aid in cases of traumatic chylothorax by reduction of gastrointestinal secretions may aid in the healing of the thoracic duct by decreasing TD flows
18
Q
Aluminum Hydroxide?
Epakitin?
A
- With CKD, cats with increasing phosphorus levels should be placed on a phosphorus binder.
- If the calcium is also elevated a non-calcium based Phosphorus binder should be chosen to prevent exacerbation of the hypercalcemia. The most commonly used non-calcium-based binder is aluminum hydroxide
- Epakitin (a calcium based phosphorus binder) could be used if the patient has a normal Ca level
- Phosphorus is absorbed in the intestine and stored in bone. Kidneys excrete the excess phosphorus not needed.
- When renal function is compromised, the kidneys can no longer perform this function, thus leading to hyperphosphatemia
19
Q
Amlodipine
A
- Calcium Channel Blocker
- Often used in cats with systemic hypertension
20
Q
Calcitriol
A
- Vitamin D
- Calcitriol therapy can be considered for treatment of chronic renal failure after serum phosphorus has been decreased to less than 6.0 mg/dL in patients in whom it was initially elevated
- Calcitriol is recommended for some cats in CRF due to the inability of the kidneys to activate Vitamin D.
- Calcitriol should not be used until the phosphorus is less than 6 mg/dL and used with extreme caution in cases where calcium is already elevated.
- In such cases, the best indication for use of calcitriol is an elevated parathyroid hormone level, which could be elevated from secondary renal hyperparathyroidism.
21
Q
Which of the following is the screening test of choice for hyperthyroidism in the cat?
A
- total T4 levels
- his test is routinely available and reliable in the vast majority of hyperthyroid cats for diagnosing hyperthyroidism and monitoring therapy.
- Free T4 by equilibrium dialysis can be increased with diseases other than hyperthyroidism, so this test should always be paired with a total T4
- the total T4 should be increased or in the high end of the normal range in conjunction with a high free T4, in order to make a diagnosis of hyperthroidism.
22
Q
Paracetamol
A
- Acetaminophen
- do NOT give to cats - cats lack glutathione and the enzyme glucoronyl transferase, acetaminophen is metabolized differently.
- Cats accumulate toxins that result in methemoglobinemia and cell death. The blood becomes dark and the cats become dyspneic and develop facial edema.
- Immediate gastrointestinal decontamination is needed if the ingestion was within 2-3 hours.
- Treatment includes N-acetylcysteine, SAMe, vitamin C and supportive care
23
Q
Sulfadimethoxine (Albon)
A
- Treatment for coccidia is usually with sulfonamides such as sulfadimethoxine or trimethoprim sulfa
- Ex: Isospora seen in the picture below from a cat
- Isospora are parasitic coccidia that can cause diarrhea as this cat is showing
24
Q
Droncit
A
- Primarily used to rid of cestodes (tapeworms)
25
Q
Revolution
A
- Selamectin
- For fleas, heartworms, hookworms, roundworms, and ear mites
- Revolution kills adult fleas and prevents flea eggs from hatching for one month. It is also indicated for the prevention and control of flea infestations, prevention of heartworm disease caused by Dirofilaria immitis, and the treatment and control of ear mite infestations. Revolution is also indicated for the treatment and control of roundworm and intestinal hookworm infections in cats.
26
Q
Metronidazole
A
- antibacterial/antiprotozoal agent
- Primarily for anaerobes, also used for giardia and trichomonas
- Metronidazole is used to treat protozoal infections in dogs and cats including Giardia, Entamoeba, Trichomonas, and Balantidium. It also is used to treat anaerobic bacterial infections. Metronidazole has immune-modulating activity and may be prescribed to treat inflammatory bowel disease
27
Q
Tetracycline
A
- Oral tetracycline is used in dogs and cats to treat susceptible bacterial infections and infections due to other susceptible organisms
- The tetracycline antibiotics are bacteriostatic.
- Tetracycline antibiotics are used to treat bacterial infections due to aerobic, gram-positive and gram-negative bacteria, mycoplasma, rickettsiae, chlamydia, and some protozoa.
- Tetracycline has some immunomodulatory properties and may be used with steroids and niacinamide to treat cutaneous discoid lupus erythematosus of dogs
- Ophthalmic tetracycline is used to treat Chlamydial, Mycoplasma, and non-specific conjunctivitis in the cat. Although topical ophthalmic tetracycline is useful for improving the clinical signs associated with Chlamydia, systemic treatment with doxycycline may be necessary to eliminate the organism.
28
Q
Acyclovir
A
- Antiviral medication
- Its inhibitory action against herpes viruses is highly selective due to its affinity for the enzyme thymidine kinase encoded by the virus.
- The use of Acyclovir includes the treatment of herpes virus infections, typically in avian species (treatment of Pacheco’s disease), and in cats with corneal or conjunctival herpes infections.
29
Q
Colchicine
A
- Colchicine is used in the early stages of familial renal amyloidosis in Shar-Pei dogs.
- This inherited inflammatory disease is also called familial Shar-Pei fever (FSF). FSF was once thought to be an animal model for Familial Mediterranean Fever in humans.
30
Q
Chlorampenicol Eye Tx
A
- Chloramphenicol Veterinary Ophthalmic Ointment 1% is appropriate for use in dogs and cats for the topical treatment of bacterial conjunctivitis caused by pathogens susceptible to chloramphenicol
- CONTRAINDICATIONS: Chloramphenicol products must not be used in meat, egg or milk-producing animals.
This medication is an especially good choice for infections where:
- There is a necrotic or walled off area with inner infection (pneumonia is a good example)
- The central nervous system or eye is involved
- The prostate gland is involved
- Intracellular parasites are involved (chlamydia, mycoplasma, rickettsia).
31
Q
Tarsorrhaphy
A
- Lateral tarsorrhaphy is commonly used to protect the cornea and reduce excessive tearing and pain. With a lateral tarsorrhaphy, a surgeon attaches the lateral portion of the lower and upper lids together;
- this helps a patient partially close the eye
32
Q
Seidel Test
A
- The Seidel Test is used to assess the presence of anterior chamber leakage in the cornea.
- It is used as a screening test for many corneal disorders including corneal post-trauma, corneal perforation and corneal degeneration
- sterile fluorescein is gently applied to the suspected perforation.
- In the case of an aqueous humour leak, this is seen as a green stream of fluid coming from the eye as the dye is diluted.
- A stream of aqueous humour across the corneal surface may be also noted
33
Q
Equine Recurrent Uveitis
or
“Moon Blindness”
A
- It is one of the most common diseases of the equine eye, with an estimated prevalence of 2-25% in the United States.
- Equine recurrent uveitis is characterized by inflammation occurring inside the eye, first impacting the uveal tract (termed uveitis). The uveal tract consists of vascular tissues inside the eye essential to proper nourishment and function of the eye.
- The symptoms observed by owners are often subtle and can range from very mild tearing or swelling of the eyelids, to more obvious squinting and noticeable change in appearance (cloudiness) of the eye. One or both eyes can be affected, and though any horse can be diagnosed with ERU, at risk breeds include Appaloosas, European warm bloods, and draft breeds.
34
Q
Amlodipine
A
- Ca2+ channel blocker
- often used to treat hypertension (in feline patients most often)
- Amlodipine besylate is classified as a calcium channel blocker medication, and it is effectively used in veterinary medicine to treat hypertension in cats and dogs. The mechanism of action is through the inhibition of calcium entry into smooth muscle cells. —> vasodilation
- It can be combined with angiotensin-converting enzyme (ACE) inhibitors, and beta-blockers.
- Amlodipine is considered a very successful first-line treatment for systemic hypertension in cats. Common causes of systemic hypertension in cats include kidney disease, hyperthyroidism, cardiomyopathy, and diabetes.
- Some clinicians prefer to use amlodipine with ACE-inhibitor drugs in cats with renal disease because of the potential for glomerular damage.
- Amlodipine therapy has been shown to decrease proteinuria in the majority (69%) of cats with chronic renal disease
35
Q
Terbutaline
A
- Terbutaline sulfate can be used as a metered dose inhaler for dogs or cats who need periodic airway dilation.
- B-2 agonist
- The beta2 receptors enable the airways of the lung to dilate, allowing for a deeper breath to be taken, which is helpful if you are running from a predator.
- Airway dilation is helpful in other situations as well, such as bronchitis and asthma. The beta2 agonists are drugs that are able to stimulate beta2 receptors alone or without significant stimulation of the other receptors
36
Q
Four Main Anti-pruritic medications used in SA dermatology
A
REMEMBER: it is important to seek out the underlying cause if there is one! These drgs may only provide “band-aid” relief
- Apoquel (Oclacitinib)
- Cytopoint (lokivetmab)
- Cyclosporin (Atopica)
- Steroids (Prednisone)
others exist as well: antihistamines, other topical formulations
37
Q
What is the key biological mediator of pruritis?
A
- IL-31 is a key mediator of pruritus.
- This cytokine activates the JAK/STAT pathway, causing pruritus and release of pro-inflammatory cytokines.
- In the allergic dog the JAK/STAT pathway is activated by cytokine IL-31 and ultimately produces itch.
The major steps to this pathway are as follows:
- IL-31 activates the JAK receptor
- Activation of the JAK receptor causes JAK to form a dimer (two JAK’s) There are four Janus kinases (JAK 1, JAK 2, JAK 3, and TYR 1). Different JAK’s and their combinations produce different effects; for example, inhibition of JAK2 can suppress hematopoiesis, while inhibition of JAK1 suppresses proinflammatory cytokines and itch.
- Dimerization of JAK activates STAT. 4. STAT travels to the nucleus and causes transcription of proinflammatory cytokines and itch.
be able to recognize the key players: IL-31, JAK, and STAT
○ Both Apoquel and Cytopoint affect the same pathway, but they act at different points. Cytopoint acts higher in the pathway than Apoquel.
38
Q
Apoquel
A
- Considered a JAK inhibitor; preferentially targeting JAK1.
- Apoquel is a competitive inhibitor to the receptor for IL-31 which prevents JAK1 and STAT to be activated; thereby blocking itch.
Possible side effects:
- May increase susceptibility to Demodex, and other infections.
- Also, may exacerbate neoplasia.
- Gastrointestinal effects (vomiting, diarrhea) have been observed, but were similar to placebo in rate of occurrence.
- Do not administer in patients less than one year of age – Demodex and severe infections (pneumonia) have been observed
39
Q
Cytopoint
A
- Monoclonal antibody that binds to IL-31 which prevents IL-31 from binding and activating the JAK/STAT pathway
Side Effects:
- GI upset was similar to placebo group.
- Appears to be well-tolerated.
- Current studies have not shown hypersensitivity reactions
40
Q
Prednisone in reducing Pruritis
A
- Depending on the dose, prednisone can be either anti-inflammatory or immunosuppressive.
- Steroids have may different mechanisms of action to reduce pruritus and inflammation – in general they inhibit inflammation-associated molecules and also up-regulate anti-inflammatory mediators such as lipocortin 1 (annexin 1).
SIDE EFFECTS:
- Has many side effects including polyuria, polyphagia, polydipsia, behavioral changes, gastrointestinal ulceration, hepatopathy, diabetes, hyperlipidemia, and decreased thyroid hormone.
- why PU/PD? It is believed that excessive levels of cortisol (the primary adrenal glucocorticoid) interferes with the release of ADH; in the relative absence of ADH, fluid is lost in the urine…and enhancement of thirst mechanisms are invoked to replace this loss
- Effects on the skin include delayed wound healing, calcinosis cutis, cutaneous atrophy (thinning of skin), and comedones.
- Secondary infections such as demodicosis, toxoplasmosis, and urinary tract infections may occur.
Drug interactions: Do not use in conjunction with NSAIDS (e.g. Meloxicam) – increases the risk of gastrointestinal ulceration and renal failure.
41
Q
Cyclosporin
A
- Calcineurin inhibitor - calcineurin activates the T cells of the immune system.
- Drug suppresses cytokine IL-2 which blocks proliferation of T cells; thereby reducing inflammation and the allergic response
Side Effects:
The main side effect is gastrointestinal upset.
Other side effects of cyclosporin include increased hair growth (hirsutism), papillomas, and gingival hyperplasia, which resolve after cessation of use.
Cyclosporin is known to decrease function of pancreatic B-cells and may influence dosing of insulin in a diabetic patient, but has not been noted to cause clinical diabetes in healthy animals. Unlike other immunosuppressive drugs, myelosuppression is not observed.
46
Q
Forms of Inhaled Medications in cats (2)
A
- Corticosteroids and bronchodilators can be given by inhalation to cats with asthma through metered dose inhalers.
- A spacer (i.e. Aerokat®) is commonly used to perform these treatments as it is challenging to get cats to inhale deeply on command.
- Medications that can be administered by this route include:
- Fluticasone Propionate (Flovent®) – An inhaled steroid without known systemic side effects
- Albuterol (Proventil®) – A rapidly acting bronchodilator
- While not sufficient for all cases of feline asthma, inhaled steroids and bronchodilators are the standard of care for treatment of human asthma; they are believed by most feline respiratory specialists to be safe, practical, and useful in avoiding complications associated with oral steroid use
47
Q
Beta Lactam Antibiotics:
Penicillins?
Cephalosporins?
A
48
Q
Aminoglycoside Antibiotics:
MOA? Spetrum of Activity? Cidal or Static? Time or Concentration Dependent?
A
49
Q
Fluoroquinolones and Tetracyclines:
MOA? Spetrum of Activity? Cidal or Static? Time or Concentration Dependent?
A
50
Q
Trimethoprim/Sulfonamides:
MOA? Spetrum of Activity? Cidal or Static? Time or Concentration Dependent?
A
51
Q
Chlormaphenicol, Lincosamides, and Macrolides (AB’s):
MOA? Spetrum of Activity? Cidal or Static? Time or Concentration Dependent?
A
52
Q
Vancomycin and Rifampin AB’s:
MOA? Spetrum of Activity? Cidal or Static? Time or Concentration Dependent?
A
53
Q
Metronidazole:
MOA? Spetrum of Activity? Cidal or Static? Time or Concentration Dependent?
A
55
Q
Hepatocutaneous Syndrome
A
- Hepatocutaneous syndrome refers to a necrotizing skin disorder that is often associated with metabolic or vacuolar liver diseases.
- Diseases that potentially cause this syndrome in the dog include glucagonoma, phenobarbital-induced hepatopathy, mycotoxin hepatopathy, copper-associated hepatitis, glucagon-secreting hepatic tumors, and hepatopathies of unknown origin.
- Hepatocutaneous syndrome is most often associated with some sort of hepatopathy in the dog
- Skin biopsy and histology are required for definitive diagnosis of this condition.
- Abnormalities include marked, diffuse parakeratotic hyperkeratosis, intercellular and intracellular edema, keratinocyte degeneration, and hyperplastic basal cells.
- These changes create a characteristic red, white, and blue histologic appearance (see image).
- Biopsy samples should be taken from multiple sites, with footpad samples included. Ultrasound of the liver often shows a pathognomonic honeycomb appearance
61
Q
Maropitant
A
- Maropitant (Cerenia) is a central and peripheral acting anti-emetic approved for the use in dogs
- neurokinin-1 (NK1) receptor antagonist which was developed by Zoetis specifically for the treatment of motion sickness and vomiting in dogs. It was approved by the FDA in 2007 for use in dogs and in 2012 for cats
68
Q
Which urolith is the most likely cause with large stones (>2cm) and alkaline urine?
A
- Large bladder stones in the presence of UTI and alkaline urine are usually struvite, particularly when accompanied by struvite (magnesium ammonium phosphate) crystalluria.
- In dogs, struvite stones are almost invariably infection-associated.
- The infecting organisms are usually urease-producers (Staphylococus, Proteus, Klebsiella, some E. coli) which alkalinize the urine and favor struvite formation.
- The single most important long-term management is prevention of infection
- Treat with culture-based antibiotics, and either dietary dissolution or surgical removal of stones
83
Q
bismuth subsalicylate
A
Bismuth subsalicylate, sold as generic and under the brand name Pepto-Bismol, is an antacid elixir medication used to treat temporary discomforts of the stomach and gastrointestinal tract, such as nausea, heartburn, indigestion, upset stomach, and diarrhea.
88
Q
Milk of Magnesium
A
91
Q
Treatment for Sarcoptic Mange in Dogs
A
- Some of these oral medications include:
- milbemycin (the active ingredient of Interceptor® and Sentinel®), afoxolaner (NexGard®), fluralaner (Bravecto®), and sarolaner (Simparica®).
- These medications are used ‘off label’ for the treatment of sarcoptic mange.
