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Equine Medicine & Surgery > Equine Pharmacology > Flashcards

Equine Pharmacology Flashcards

1
Q

When would you use visceral analgesics?

A

Colic-behavior assoc. with visceral pain

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2
Q

What are causes of colic?

A

impaction, bowel displacement (but may not be a GI problem=false colic)

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3
Q

What are the 2 categories of true (GI) colic?

A

Simple and severe

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4
Q

What are causes of simple colic?

A

impactions, spasmodic colic (majority of cases); can be advanced and very painful: tympanites or flatulent colic

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5
Q

What are causes of severe colic?

A

anterior enteritis and strangulating obstructions (torsions, volvulus->sx)

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6
Q

What are difficulties of severe colic?

A

-pain relief doesn’t help much

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7
Q

Why should you use pain relief meds?

A

-humane reasons

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8
Q

How many classes of pain relievers are there and name them?

A

3: NSAIDs, alpha adrenergic agonists, and opiates

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9
Q

Name 2 common NSAIDS.

A

-flunixin meglumine (Banamine)

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10
Q

What are 3 characteristics of NSAIDs?

A

-inhibit COX and thus decrease PG production in bowel wall

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11
Q

If you refer an equine patient, what pain tx should you let the referral clinic know about?

A

Banamine tx bc it may mask behavioral and CV signs seen with endotoxemia and intestinal devitalization

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12
Q

What are the pharmacokinetics of NSAIDS?

A

-IV-rapid effect, duration: up to 12h

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13
Q

What are 3 adverse effects of NSAIDs?

A

-GI erosions and ulceration if use at high doses or chronically (due to COX-1 block) (seen less with Ketoprofen)

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14
Q

What is a newer NSAID and how is it different?

A

Carprofen (selective to inhibit COX-2)

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15
Q

Name 2 alpha-2 adrenergic agonists.

A

Xylazine (Rompun) (related to clonidine=mult. effects) and Detomidine (Dormosedan)

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16
Q

How strong of an analgesic is Xylazine?

A

Potent-its visceral analgesia is better than opiates (=good for gas colics-advanced simple colic)

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17
Q

What is an undesirable effect of Xylazine?

A

sedation-not great in colic tx

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18
Q

What does Xylazine relax?

A

muscles-centrally-mediated

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19
Q

What is an effect not seen in horses, sheep, goats, or cattle?

A

emesis

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20
Q

Should you give the same amount of Xylazine to a Rum. that you give to a horse?

A

no-give 1/10th amount

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21
Q

What effects would you see in a TPR and Chem panel after Xylazine admin.?

A

-depressed central thermoregulatory mechanisms=sweating and then shivering

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22
Q

What should you check in a PE before admin. of Xylazine?

A

check heart-examine for heart blocks

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23
Q

What are the pharmacokinetics of Xylazine-IV and IM?

A

-IV: rapid onset (1-2 min.), max effect in 3-10 min. and lasts up to 1.5h

24
Q

How can you increase the duration of IV Xylazine?

A

combine it w/ butorphanol

25
Q

Can you give repeated doses of Xylazine?

A

Yes, but should let wear off 1st to check horse and see if it’s still in pain

26
Q

What is a contraindication of Xylazine?

A

cardiac arrhythmias-heart blocks (bc of reflex bradycardia)

27
Q

What are 5 adverse effects of Xylazine?

A

-depresses GI motility (might get gas colic)

28
Q

What is an antagonist of Xylazine and what class of drug is it?

A

Yohimbine-alpha adrenergic antagonist

29
Q

What is Detomidine (Dormosedan) similar to and how is it different?

A

Xylazine-more potent and lasts longer

30
Q

In which situation should you use caution with Detomidine use?

A

visceral analgesia (could be lethal if CV compromised)->better for minor* procedures

31
Q

What could Detomidine cross-react with=bad?

A

IV trimethoprim sulfa (it enhances the CV effects)

32
Q

3rd class: opiates: Give an example.

A

Butorphanol (Torbugesic)

33
Q

What 3 effects does an opiate agonist like butorphanol have?

A

-analgesia (potency like morphine, more potent than Demerol)

34
Q

What are the pharmacokinetics of butorphanol?

A

-IV: onset in 3 min., peak effect at 15-30 min., duration up to 4h

35
Q

How can you prolong the sedative and analgesic effects of xylazine?

A

by giving butorphanol concurrently

36
Q

What are 3 adverse effects of butorphanol?

A

-potential for CNS excitement (it is related to morphine…)

37
Q

In what type of colic should you avoid using butorphanol?

A

impaction colics bc it induces segmentation and slows passage

38
Q

What could happen due to high doses of butorphanol?

A

depression of respiratory centers

39
Q

When should you use motility stimulants?

A

-ileus (amotile gut)-often get post colic sx

40
Q

What factors contribute to ileus? (5)

A

-distension with gas and fluid

41
Q

What is anterior enteritis and what should your tx goal be w/ it?

A

-severe infl. of duodenum with copious fluid secretion (like SI obstruction), maybe due to Clostrid. infection

42
Q

Name the classes of motility stimulants and describe if they should be used.

A

Dopamine antagonists, cholinergic agonists, lidocaine drip, etc.

43
Q

Name 2 dopamine antagonists.

A

-Metoclopramide (Reglan)

44
Q

What are 3 effects of metoclopramide?

A

-peripheral action: release of ACh at gastric and proximal SI myenteric plexus=incr. motility

45
Q

Name a drug which is used with anterior enteritis.

A

metoclopramide

46
Q

What does domperidone do in horses and does it work to increase motility?

A

-promote prolactin release for lactation in mares with fescue toxicity

47
Q

Name cholinergic agonists.

A

-Bethanechol (Urecholine) -synthetic cholinergic ester

48
Q

What is the use of bethanechol?

A

-give SQ to avoid rxns like colic

49
Q

What is the antidote for bethanechol?

A

atropine

50
Q

How should you administer neostigmine?

A

SQ-lasts longer than bethanechol

51
Q

What is an adverse effect of neostigmine which limits its use?

A

colic behavior

52
Q

Name another motility stimulant.

A

Motilin-experimental; give IV erythromycin to stimulate motilin receptors which increase motility

53
Q

What is the effect of a lidocaine drip (IV)?

A

-increase inhibitory effector neurons a lot, leading to ileus bc circ. sm. muscle relaxed

54
Q

When would you use a lidocaine drip?

A

during colic sx bc its analgesic effects allow you to decrease the anesthetic dose

55
Q

When is atropine used in horses? (3)

A

-antidote for overdoes of cholinergic agents or organophosphate intoxication

56
Q

What are 2 adverse effects of atropine?

A

-inhibited GI motility=colic behavior

Equine Medicine & Surgery (8 decks)

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