Drugs SA Flashcards

Question

Revolution

Answer 1

* **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.

Answer 2

* **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

Answer 3

* 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.

Answer 4

* **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_**.

Answer 5

* 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.

Answer 6

* 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).

Answer 7

* 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**

Answer 8

* 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

Answer 9

* 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.

Answer 10

* 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

Answer 11

* 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

Answer 12

**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

Answer 13

* **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:_** 1. IL-31 activates the JAK receptor 2. 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. 3. 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*.

Answer 14

* 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**

Answer 15

* 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

Answer 16

* 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.

Answer 17

* **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.

Answer 18

● **Apoquel**: Oral. Given twice daily for two weeks and then once daily. ● **Cytopoint**: Subcutaneous. Give one injection every **4-8 weeks**. ● **Prednisone**: Oral. Dose and taper schedule depends on severity of disease. ● **Cyclosporin**: Oral. Given twice daily. Can be tapered for maintenance **_Onset of Action:_** \* Prednisone, Cytopoint, and Apoquel have a quick onset of activity usually within 24 hours. ● Cyclosporin takes about 4 weeks to reduce pruritus in dogs and 2-3 weeks in cats. **_Cost:_** * cheapest: prednisone * moderate: apoquel and cytopoint * expensive: cyclosporin, especially in large dogs

Answer 19

* Cyclosporin may inhibit **P-glycoprotein** coded by ABCB1 (MDR1) gene. * P-glycoprotein is expressed at the blood-brain barrier (also found in intestines, testes) and is **responsible for pumping drugs out of cells**. Medications that are substrates for P-glycoprotein (ivermectin) should not be given in conjunction with cyclosporin. * Cyclosporin is a substrate of cytochrome P450. Inhibition of P450 with medications such as ketoconazole can be used in conjunction with cyclosporin to lower the dose of cyclosporin in order to save money. * Cytochrome P450: Family of isoenzymes located mainly in the liver responsible for metabolism of many drug

Answer 20

* **Apoquel**: Not labeled for cats, but has been administered to cats for pruritus with variable success. Safe and effective doses for cats are not established, **so use at this time is not recommended**. * **_Cytopoint: Do not use in cats since this antibody is “caninized”_**. Monoclonal antibodies are derived from mice and can be modified to work in various species. For cytopoint the antibody was caninized – **modified to work in dogs.** * **Cyclosporin: Used routinely in cats**. Dosing is different between cats and dogs. * **Prednisone**: Cats may have decreased gastrointestinal absorption and/or decreased hepatic conversion; therefore, **_PredniSOLONE_** not prednisone is recommended in cats.

Answer 21

* Albuterol sulfate, also known as salbutamol * is a bronchodilator medication that relaxes the muscles of the airways and improves breathing. * It also relieves the cough associated with asthma. It is most often used in cats, as dogs are rarely affected by true airway constriction. * Its use in cats and dogs to treat asthma and cough caused by bronchoconstriction is 'off label' or 'extra label'

Answer 22

* 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

Answer 23

* **Famotidine** (brand name: Pepcid®, Apo-Famotidine®) is an H2-receptor antagonist that is used to reduce stomach acid production for conditions such as gastrointestinal ulcers, inflammation of the stomach due to kidney disease or stress, inflammation of the esophagus, or for acid reflux

Answer 24

* **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**

Answer 25

* **Grippotyphosa, pomona, bratislava** * Icterhemorrhagiae and canicola were the most common serovars isolated in the past. * The leptospires penetrate mucous membranes or abraded skin and multiply in the blood stream and spread to organs. * The antibody response usually limits the response to the renal tubular epithelial cells. * Clinical signs include **anorexia, pyrexia, vomiting, dehydration, PU/PD, anuria or oliguria (small urine output)**. * The standard diagnostic test is the microscopic agglutination test (MAT); be careful when interpreting titers. * Remember, leptospirosis **is zoonotic.**

Answer 26

* **It causes decreased colonic pH, preventing ammonia absorption.** * Lactulose is an easily fermented carbohydrate that is metabolized to an acid in the gut. * This lowers colonic pH, which keeps ammonia in its ionized form, NH4+, rather than as NH3. * The ionized form is not absorbed and is excreted. Lactulose also acts through a number of other mechanisms. * It is a cathartic and causes decreased intestinal transit time, leading to decreased absorption of ammonia. * It also prevents ammonia formation through a process known as catabolite repression. * Finally, it is a carbohydrate source which can be used by colonic flora as an alternative to protein, preventing ammonia formation

Answer 27

* Euthanize immediately or quarantine for 6 months and vaccinate 1 month before release * Since the dog is unvaccinated, it should either be euthanized and tissue submitted for rabies testing OR immediately vaccinated for rabies and quarantined for 4 months. * The Direct Fluorescent Antibody Test detects viral antigens and should be tested on two locations from the brain (brainstem and cerebellum) and is the test of choice for rabies diagnosis. * If the dog was current on rabies vaccination, the guidelines direct to booster the rabies vaccination immediately and have the owners observe closely for 45 days. * If owners are able to provide proof the dog had been previously vaccinated for rabies but is overdue: guidelines direct to booster rabies vaccination immediately and keep the dog under owner observation for 45 days.

Answer 28

* NSAID * Canine osteoarthritis results in chronic pain and decreased physical activity. * Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely recognized as the standard of care for chronic pain, including OA * Carprofen is a non-narcotic NSAID with both analgesic and antipyretic properties. * As with most NSAIDs, carprofen works by inhibiting cyclooxygenase (COX) enzymes (selectively inhibiting COX-2 over COX-1

Answer 29

* an osmotic diuretic * Mannitol is filtered at the glomerulus and osmotically pulls water into the tubules * CAN be used for head trauma cases, but has recently been contraindicated as the primary form of tx

Answer 30

* 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**

Answer 31

* **Doxycycline** is in a class of medications called **tetracycline antibiotics**. * **It works to treat infections by preventing the growth and spread of bacteria**. * Doxycycline is an antibiotic used in treating infections in cats such as Hemobartonella and Mycoplasma.

Answer 32

* Fluconazole is an anti-fungal medication used in treating **Cryptococcus neoformans, Coccidioides immitis,** and other **fungal diseases**

Answer 33

* **SPINOSAD (capstar)** * also use with caution in neurological patients!

Answer 34

**PERMETHRIN** **in some flea collars!**

Answer 35

* **Phentolamine** is a long-acting, adrenergic, alpha-receptor blocking agent * may need in Sx for Pheochromocytomas removal due to tumor effect on the body with manipulation

Answer 36

* medication used to lower BP * releases NO once metabolized * Nitric oxide is produced by nearly every type of cell in the human body and one of the most important molecules for blood vessel health. * It's a vasodilator, meaning it relaxes the inner muscles of your blood vessels, causing the vessels to widen. * In this way, nitric oxide increases blood flow and lowers blood pressure

Answer 37

* 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**

Answer 38

* cephalosporin AB * is a third-generation cephalosporin antibiotic used to treat skin infections in dogs. The bacteria that are susceptible to cefpodoxime include certain Staphylococcus and Pasteurella species, Streptococcus canis, E. coli, and certain bacteria causing urinary tract infections

Answer 39

* **Trimethoprim-sulfa** is a broad spectrum antibiotic with excellent activity against most gram negative organisms and against Staphylococci in the skin. This makes trimethoprim-sulfa a good choice for skin infections or as a general antibiotic when the identity of the infecting organism is not known * **Can result in KCS as side effect!**

Answer 40

* **Keratoconjunctivitis sicca (dry eye)** results from destruction of the lacrimal gland. If the owner notices the patient rubbing the eyes or developing discharge, the medication should be stopped immediately. * Sulfa drugs can cause **hypersensitivity reactions**, resulting in diverse drug eruptions including erythema multiforme and toxic epidermal necrolysis. * Sulfa drugs can also cause **type 1 hypersensitivities (immediate type) resulting in urticaria and anaphylaxis.** * This drug can also cause a **type 2 hypersensitivity**, resulting in immune complex reactions and causing hematologic abnormalities that are similar to patients with lupus, such as thrombocytopenia, hemolytic anemia, leukocytopenia, and arthritis. * **Doberman Pinschers and Rottweilers** are particularly prone to these hypersensitivity effects, and sulfa drugs should be used with extreme caution in these animals. * **Hypothyroidism**, particularly in extended therapy, can also occur from sulfa drugs. * (103-105°F) or unusual tiredness in your dog or cat, you should contact your veterinarian. sulfa drugs. * Some **horses** will get a **very bad (sometimes fatal) diarrhea** from paste forms of this drug given orally

Answer 41

1. **Milbemycin** is the active ingredient in the otic solution Milbemite. This otic solution is applied directly into the ears and is usually effective in a single treatment although it is sometimes repeated once. 2. **Ivermectin** is available as an otic solution (Acarexx). Similar to Milbemite, it is applied directly into the ears and is usually effective in a single treatment although it is sometimes repeated once. Injectable ivermectin is not FDA approved for treatment of ear mites. 3. **Selamectin (Revolution)** and **moxidectin (Advantage Multi)** are approved for control of otodectes but may be more effective as a preventative for ear mites than for immediate treatment of a significant infestation. These formulations are applied topically to the skin between the shoulders. 4. **Thiabendazole**, an ingredient in Tresaderm, is effective against yeast and ear mites if used for \>10 days.

Answer 42

* weak alpha agonist * This medication **increases urethral sphincter tone** and **helps prevent incontinence.** * **note:** Diethylstilbesterol and testosterone have been used for incontinence, but both are hormones

Answer 43

* Fluoxetine (Prozac) is an anti-depressant and SSRI (serotonin re-uptake inhibitor) that can be used to treat cats for anxiety related disorders at a dose of 0.5 mg/kg orally once daily * ex: cats experiencing **pica** (urge to eat inedible materials)

Answer 44

* is similar to tricyclic anti-depressants. It is used most commonly by veterinarians to treat nausea, vomiting, and appetite loss, mainly in cats. * Rarely, it may be used to treat behavioral problems

Answer 45

* **Naloxone** * **Butorphanol**

Answer 46

* **oral antifungal** used to treat fungal infections in the mouth or gastrointestinal tract, most commonly **Candida.** * can be used topically in birds exhibiting Candidiasis * Its use in cats, dogs, reptiles, and birds to treat fungal infections is 'off label' or 'extra label' * can also use fluconazole for treatment of Candida, however, **some strains of Candida are resistant to ketoconazole**. It is sometimes advocated to administer the drug in an acidic liquid such as orange juice to aid absorption and acidify the microenvironment to make it less hospitable to Candida

Answer 47

* **HALOTHANE** * About 2/3 of halothane is exhaled unchanged. The other 1/3 or so is metabolized by the P-450 enzymes of the liver. * By way of comparison, isoflurane is less than 0.2% metabolized

Answer 48

* Doxorubicin, sold under the brand name Adriamycin among others, is a chemotherapy medication used to treat cancer * **VESICANT!** * Also cardiotoxic (due to the free radicals involved in drug administration) * In addition to the usual side effects of chemotherapeutic drugs such as myelosuppression and GI side effects, a **major concern with adriamycin administration is dose dependent cardiotoxicity.**

Answer 49

* **Dobutamine** is a medication used in the treatment of cardiogenic shock and severe heart failure. * It may also be used in certain types of cardiac stress tests. It is given by injection into a vein or intraosseous as a continuous infusion. * The amount of medication needs to be adjusted to the desired effect * can help raise BP in a procedure if crystalloids/colloids aren't working nor turning down anaesthetic gas

Answer 50

* **Melarsomine** is an antiparasitic medication derived from an organic arsenic compound that is used in a veterinary hospital setting to treat dogs that are suffering from **heartworm disease** * the treatment of choice for adult worms is melarsomine IM

Answer 51

* **Sulfadimethoxine** (brand name: Albon®) is a sulfonamide antimicrobial usually used to **treat coccidiosis** but can also be used to treat other types of infections in dogs and cats

Answer 52

**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.

Answer 53

* The **ONCEPT vaccine,** also commonly referred to as the **"melanoma vaccine"** was given a conditional product license in 2007 and was USDA approved in 2010 as a therapeutic vaccine for cancer treatment.

Answer 54

* **Isoproterenol** is a beta-1 and beta-2 adrenergic receptor agonist resulting in the following: Increased heart rate. Increased heart contractility. Relaxation of bronchial, gastrointestinal, and uterine smooth muscle * causes **vasodilation**

Answer 55

* **Sucralfate,** sold under various brand names, is a medication used to treat stomach ulcers, gastroesophageal reflux disease, radiation proctitis, and stomach inflammation and to prevent stress ulcers * Sucralfate is a **sucrose aluminum hydroxide compound** that **forms a gel-like webbing over ulcerated or eroded tissues** * **most important and specific _medical therapy for esophagitis_** * Sucralfate is best administered as an oral suspension, which can coat and protect erosions in the esophagus in cases of esophagitis.

Answer 56

* Administration of desmopressin results in **release of von Willebrand factor** * Also, Desmopressin acetate is the **treatment of choice for central diabetes insipidus in both dogs and cats.** * It is also used diagnostically to differentiate between central and nephrogenic diabetes insipidus. * As a diagnostic test, desmopressin acetate may be used instead of a water deprivation test. * may take a bit to see results as medullary washout has liekly occured in the nephrons due to CDI (need to return to normal concentration gradient after PU/PD)

Answer 57

* The **maximum safe rate of potassium infusion** is **_0.5 mEq/kg/hr_**. * Administering potassium more rapidly than this can result in **fatal arrhythmias.**

Answer 58

* **Digoxin** is a cardiac glycoside that **increases the force of myocardial contraction** and **reduces conductivity within the atrioventricular (AV) node** * Digoxin traditionally has been used to treat congestive heart failure in both dogs and cats. It usually is used in conjunction with other medications including diuretics and angiotensin-converting enzyme (ACE) inhibitors.

Answer 59

* 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.

Answer 60

* **Phenoxybenzamine** is used in dogs and cats to reduce internal urethral sphincter tone. * Although it is somewhat more effective in dogs than in cats, it is used in both species **after a mechanical obstruction of the urethra has been relieved.** * It may also be used for urethral spasm secondary to bacterial urethritis.

Answer 61

* **Metronidazole** may be recommended along with dietary modification as the first medical therapy. * Metronidazole has **antibiotic, anti-inflammatory, and antiprotozoal** properties, and is usually fairly well tolerated, although some cats may lose their appetite when given this drug

Answer 62

* succinylcholine * pancuronium * d-tubocurarine * atracurium **Edrophonium** is a cholinesterase inhibitor which can be used to reverse neuromuscular blockers

Answer 63

* **Pentoxifylline** (brand names: Trental®, PTX) is an **immunomodulatory agent used to treat certain immune-mediated skin conditions** and inflammation of the blood vessels, leading to poor blood flow. * This includes, but is not limited to, ear margin dermatitis and cutaneous lupus in dogs, and navicular disease in horses.

Answer 64

* **Succinylcholine** is a skeletal muscle relaxant for intravenous (IV) administration indicated as an adjunct to general anesthesia, to facilitate tracheal intubation, and to provide **skeletal muscle relaxation during surgery or mechanical ventilation.** **can also use:** nondepolarizing neuromuscular blocking agents such as **pancuronium, d-tubocurarine, and atracurium**. **Edrophonium** is a cholinesterase inhibitor which can be used to reverse neuromuscular blockers

Answer 65

Acetazolamide is a **carbonic anhydrase inhibitor**

Answer 66

* This is a hormone, and like many other hormones, can result in **bone marrow suppression.** * This is one of the reasons veterinarians choose to use **phenylpropanolamine** for urinary incontinence. * This drug is a weak alpha agonist and works on the muscles of the urethra to increase sphincter tone.

Answer 67

**trimethoprim-sulfa, clindamycin**, and **cephalosporins**

Answer 68

* venodilator

Answer 69

* **Diltiazem** is a **calcium channel-blocker**, which is used in veterinary medicine to treat hypertension and certain cardiac arrhythmias. * This drug is approved in human medicine under the trade names Cardizem, Dilacor, or Tiazac. * Diltiazem causes vasodilatation, decreases peripheral resistance, blood pressure, and cardiac afterload.

Answer 70

**Cyproheptadine** is used as an **appetite stimulant for sick cats**, including those undergoing chemotherapy. When used for this purpose it should be noted that it may take two to three days for the drug to reach full effect

Answer 71

In animals with detrusor hyporeflexia or bladder atony, **bethanechol chloride** may be of some benefit. This cholinergic agonist stimulates the initiation of detrusor muscle contraction