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
Can you give repeated doses of Xylazine?
Yes, but should let wear off 1st to check horse and see if it's still in pain
26
What is a contraindication of Xylazine?
cardiac arrhythmias-heart blocks (bc of reflex bradycardia)
27
What are 5 adverse effects of Xylazine?
-depresses GI motility (might get gas colic)
28
What is an antagonist of Xylazine and what class of drug is it?
Yohimbine-alpha adrenergic antagonist
29
What is Detomidine (Dormosedan) similar to and how is it different?
Xylazine-more potent and lasts longer
30
In which situation should you use caution with Detomidine use?
visceral analgesia (could be lethal if CV compromised)->better for minor* procedures
31
What could Detomidine cross-react with=bad?
IV trimethoprim sulfa (it enhances the CV effects)
32
3rd class: opiates: Give an example.
Butorphanol (Torbugesic)
33
What 3 effects does an opiate agonist like butorphanol have?
-analgesia (potency like morphine, more potent than Demerol)
34
What are the pharmacokinetics of butorphanol?
-IV: onset in 3 min., peak effect at 15-30 min., duration up to 4h
35
How can you prolong the sedative and analgesic effects of xylazine?
by giving butorphanol concurrently
36
What are 3 adverse effects of butorphanol?
-potential for CNS excitement (it is related to morphine...)
37
In what type of colic should you avoid using butorphanol?
impaction colics bc it induces segmentation and slows passage
38
What could happen due to high doses of butorphanol?
depression of respiratory centers
39
When should you use motility stimulants?
-ileus (amotile gut)-often get post colic sx
40
What factors contribute to ileus? (5)
-distension with gas and fluid
41
What is anterior enteritis and what should your tx goal be w/ it?
-severe infl. of duodenum with copious fluid secretion (like SI obstruction), maybe due to Clostrid. infection
42
Name the classes of motility stimulants and describe if they should be used.
Dopamine antagonists, cholinergic agonists, lidocaine drip, etc.
43
Name 2 dopamine antagonists.
-Metoclopramide (Reglan)
44
What are 3 effects of metoclopramide?
-peripheral action: release of ACh at gastric and proximal SI myenteric plexus=incr. motility
45
Name a drug which is used with anterior enteritis.
metoclopramide
46
What does domperidone do in horses and does it work to increase motility?
-promote prolactin release for lactation in mares with fescue toxicity
47
Name cholinergic agonists.
-Bethanechol (Urecholine) -synthetic cholinergic ester
48
What is the use of bethanechol?
-give SQ to avoid rxns like colic
49
What is the antidote for bethanechol?
atropine
50
How should you administer neostigmine?
SQ-lasts longer than bethanechol
51
What is an adverse effect of neostigmine which limits its use?
colic behavior
52
Name another motility stimulant.
Motilin-experimental; give IV erythromycin to stimulate motilin receptors which increase motility
53
What is the effect of a lidocaine drip (IV)?
-increase inhibitory effector neurons a lot, leading to ileus bc circ. sm. muscle relaxed
54
When would you use a lidocaine drip?
during colic sx bc its analgesic effects allow you to decrease the anesthetic dose
55
When is atropine used in horses? (3)
-antidote for overdoes of cholinergic agents or organophosphate intoxication
56
What are 2 adverse effects of atropine?
-inhibited GI motility=colic behavior