Exam 2 Drugs Flashcards
Carprofen
MOI: COX inhibitor; COX2 inhibition slightly greater
Uses: analgesic, anti-inflammatory, anti-pyretic in dogs and other small animals
Adverse effects: adverse GI or renal effects
Ketoprofen
MOI: COX inhibitor
Uses: analgesic, anti-inflammatory, anti-pyretic (horses)
Adverse effects: adverse GI or renal effects
Deracoxib
MOI: COX2 inhibitor
Uses: analgesic, anti-inflammatory, anti-pyretic (small animals)
Adverse effects: adverse GI or renal effects
Flunixin
MOI: COX inhibitor
Uses: analgesic, anti-inflammatory, anti-pyretic (large animals)
Adverse effects: adverse GI or renal effects
Phenylbutazone
MOI: COX inhibitor
Uses: analgesic, anti-inflammatory, anti-pyretic (horses)
Adverse effects: adverse GI or renal effects
Xylazine
MOI: alpha2-adrenergic agonist
Uses: sedative and analgesic, emetic in dogs & cats
Adverse effects: species specific, bradycardia
Detomidine
MOI: alpha2-adrenergic agonist
Uses: sedative and analgesic (only FDA-approved to use in horses)
Adverse effects: bradycardia
Clonidine
MOI: partial alpha2-adrenergic agonist
Uses: limited, but can be used for fear in dogs
Adverse effects: bradycardia
Yohimbine
MOI: alpha2-adrenergic antgonist
Uses: reversal of xylazine
Adverse effects: transient CNS excitation, increased respiration, muscle tremors
Tolazoline
MOI: alpha1/2 adrenergic antagonist
Uses: FDA-approved reversal of xylazine in horses
Adverse effects: tachycardia
Diazepam
MOI: GABA receptor agonist
Uses: anxiolytic, muscle relaxant, seizures
Adverse effects: sedation, altered behavior, respiratory depression
T1/2: 80 min
Functional tolerance after 1wk of PO TID (CN)
Bioavailability: 40%
- Cats get idiosyncratic hepatic necrosis
- DEA Schedule IV
Midazolam
MOI: GABA receptor agonist (higher affinity than diazepam)
Uses: anxiolytic, muscle relaxant, seizures
Adverse effects: sedation, altered behavior, respiratory depression
Bioavailability: 50% (IM)
- good emergency option, water soluble
- Erratic rectal absorption
- Intranasal very effective
Lorazepam
MOI: GABA receptor agonist
Uses: anxiolytic, muscle relaxant, seizures
Adverse effects: sedation, altered behavior, respiratory depression
Acepromazine
MOI: dopamine receptor antagonist centrally, alpha1 receptor antagonist peripherally
Uses: preanesthetic, anti-motion sickness
Adverse effects: hypotension
Chlorpromazine
MOI: dopamine receptor antagonist (less potent than acepromazine, but longer lasting)
Uses: pre-anesthetic, anti-motion sickness
Adverse effects: hypotension
***NOT RECOMMENDED in horses (experience agitation, excitement, aggression)
Morphine
MOI: primarily mu, some activity at kappa & delta opioid receptor agonist
Uses: analgesic, anti-tussive
Adverse effects: dose-related CNS, CVS & respiratory depression; GI stasis, vomiting
Naloxone
MOI: kappa, mu, delta opioid receptor antagonist
Uses: reversal agent for opioid toxicity
Adverse effects: in opioid-dependent patients induces an acute opioid withdrawal response
Butorphanol
MOI: kappa agonist; mu opioid receptor agonist/antagonist
Uses: anti-tussive, analgesic
Adverse effects: CNS excitement/sedation; GI stasis, vomiting
Fentanyl
MOI: mu opioid receptor agonist
Uses: analgesic
Adverse effects: dose-related CNS, CVS, and respiratory depression; GI stasis, vomiting
Phenobarbital
- long acting barbiturate with excellent anti-seizure properties
- mechanism involves GABA
- acidic drug w/ very long half-life (24-40hrs)
- DEA controlled drug (Class IV)
-
Adverse effects:
-
chronic administration can produce:
- physical dependence > WITHDRAWAL
- marked induction of liver enzymes (decr T1/2, tolerance)
- hepatotoxicity
- decrease thryoid values
-
chronic administration can produce:
Potassium bromide
MOA: unknown
Use: anticonvulsant
- NOT a controlled drug/approved by FDA
-
actions diminished by hyperchloremia
- incr CL intake will incr renal excretion!
- used in dogs, TOXIC to cats!
- Given IV as NaBr, not KBr!
Zonisamide
MOA: involves GABAergic system
Uses: anticonvulsant
- metabolized by liver
- related to sulfonamide abx
Levetiracetam
MOA: inhibits synaptic vesicle protein SV2A, blocks Ca channels to prevent NT release
- As primary or adjunct tx
- Safe in cats and rabbits
Gabapentin
MOA: Presumeably works via GABAergic system
-
NOT an effective AED in dogs
- Drug choice in rabbits
- Used for neuro pain, AED
Hydrocortisone
- natural adrenal hormone that exhibits BOTH gluco- and mineralocorticoid activities
- administered via all routes depending on salt form
- used in most small and large animal species
- Adverse Effects: HPA axis suppression, muscle wasting, delayed wound healing, bone loss, thinning of skin, diabetes, hypothyroidism
Dexamethasone
- most widely used across species
- long acting agent (SID/BID)
- Synthetic agent that is 30X more potent that cortisol with little to no mineralocorticoid activity
- excellent anti-inflammatory profile with rapid onset
- Adverse Effects: usual concerns + colonic perforation and laminitis (horses)
Triamcinolone
- Synthetic agent that is 4-5 times more potent than cortisol and little to no mineralocorticoid activity
- intermediate duration of action
- Adverse Effects: acute laminitis in horses, HPA axis suppression, muscle wasting, delayed wound healing, bone loss, thinning of skin, diabetes, hypothyroidism
Prednisone/Prednisolone
- Classical synthetic agent used in many spp
- 4-5X more potent anti-inflammatory actions vs. hydrocortisol
- More mineralocorticoid activity than other synthetic agents
-
Prednisone is converted to prednisolone in the liver
- Not well absorbed PO in horses
- May not be well absorbed or well converted in cats
***RECOMMENDED to use prednisolone in cats/horses
- Don’t use for animals w/ severe bacterial/fungal infxn, corneal ulceration
Methyl-Prednisolone
- Synthetic agent similar to prednisone except devoid of mineralocorticoid activity
- Duration of action is very formulation-dependent
- Sodium succinate- water-soluble form w/ rapid effect, neuroprotective (tx acute spinal injury)
- Acetate - insoluble suspension > VERY LONG ACTING - Shake before use
Adverse Effects: HPA axis suppression, muscle wasting, delayed wound healing, bone loss, thinning of skin, diabetes, hypothyroidism
Penicillins
- Oldest group of antimicrobials
- Bacteriocidal (time-dependent killing)
- toxicity is relatively minor in most species
- drug interactions are limited (diminished renal tubular secretion)
Natural penicillins: Penicillin G
Agent: penicillin G (IM)
- degraded by beta-lactamases
- Effective against: Q1/2/4
- procaine salt is long acting (residues in food animals) and can cause CNS signs (horses, birds, snakes, turtles, guinea pigs, chinchillas)
- mainly used in LA (horses, food animals intra mammary)
Aminopenicillins: Amoxicillin
Agents: amoxicillin (oral), ampicillin (IV, IM)
- first line of drugs for empirical treatment in SA (non-CNS)
- Adverse effects: disrupt GI flora (nausea, vomiting)
Extended-Spectrum penicillins: Ticarcillin
Agents: ticarcillin
- improved Q3 (gram + anaerobes) activity esp. Pseudomonas (IV-reserved use)
- susceptible to beta-lactamase
Describe cephalosporins
- second major group of beta-lactam antibiotics
- MOA - cell wall inhibitors via PBP
- Bacteriocidal (time-dependent kill)
- Strong cross resistance in pen-sensitive animals
Augmented penicillins/Beta-Lactamase Inhibitors: Clavulanic Acid
Agents: amoxicillin/clavulanate (oral), ampicillin/sulbactam (IV)
- combo of broad spectrum agent + beta-lactamase inhibitor
- Adverse effects: dangerous GI toxicity in horses, rabbits, hamsters, guinea pigs
