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CVM 741B > Exam 5 > Flashcards

Exam 5 Flashcards

1
Q

Hormone Drugs Lecture

A
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2
Q

Progesterones

A
  1. Function in reproduction

-Pro gestational
-Predominant hormone during diestrus

  1. Affects on the reproductive cycle

-Suppresses estrus behavior
-Female will not be receptive to natural mating
-Closes cervix
-Decreases myometrial contractions
-Lowers immune function locally within the uterus
-Prolonged use can contribute to pyometra

  1. Indications and modifications on the reproductive cycle

-Synchronization protocols (CIDR, melengestrol acetate)
-Maintenance of pregnancy: oral or injectable
-Estrus suppression

  1. Scenarios of positive/negative feedback loops

-Negative feedback on LH

  1. Generic and trade names for common drugs

Progesterone (P4): Altrenogest (Regumate, Altresyn, Matrix), MGA: melengestrol acetate (oral), Progesterone in oil (injectable), CIDR: controlled internal release drug (intravaginal)

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3
Q

Estrogens

A
  1. Function in reproduction

-Enhances estrus behavior
-Primes uterus for contractility
-Predominant in estrus

  1. Affects on the reproductive cycle

-Opens cervix
-Heightens immune function locally within uterus

  1. Indications and modifications on the reproductive cycle

-Synchronization protocols
-Enhances effects of being in estrus
-Thickens vaginal wall in bitches
-Induces behavior of estrus
-Interferes with unwanted breeding in dogs
-Treatment for urinary incontinence
-Can induce bone marrow suppression

  1. Scenarios of positive/negative feedback loops

-Negative feedback to FSH

  1. Generic and trade names for common drugs

-Estradiol 17B: naturally occurring, unconjugated.
-Estriol (Incurin): urinary incontinence in dogs
-Esterified estrogens (injectable): estradiol cypionate, estradiol benzonate.
-Estradiol valerate: longest acting
-Estrogen sulfate (Premarin): from fetus to placenta, good indicator of fetal vialibility

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4
Q

Testosterone

A
  1. Function in reproduction

-Muscle building
-Appetite stimulant
-Stops cyclicity

  1. Affects on the reproductive cycle

-Stops cyclicity

  1. Indications and modifications on the reproductive cycle
  2. Scenarios of positive/negative feedback loops

-Negative feedback on LH
-Stops cyclicity

  1. Generic and trade names for common drugs

-Mibolerone (Cheque Drops, Matenon)
-Stanozolol (Winstrol V)

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5
Q

Gonadotropins

A
  1. Function in reproduction

-Regulate FSH and LH release from the pituitary
-Secreted by hypothalamus
-Pulsative relase

  1. Affects on the reproductive cycle

-Initiate cyclicity
-Initiate ovulation
-Treat cystic ovarian syndrome

  1. Indications and modifications on the reproductive cycle

-Long term use can down regulate LH/FSH

  1. Scenarios of positive/negative feedback loops

-Causes release of LH

  1. Generic and trade names for common drugs

-Synthetic: Gonadorelin (Crystorelin, Factrel, Fetagyl)
Deslorelin equine (SucroMate, Ovuplant)
Bruserelin, xxxrelin (ferrets)
-Primarily causes release of LH

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6
Q

Prostaglandins

Side effects due to Arachidonic Acid Cascade

-Vomiting
-Sweating
-Colic
-Inappetence

A
  1. Function in reproduction

Prostaglandin F2-alpha
-Lyse luteal phase: short cycle the estrous cycle
-Stimulate uterine contractions: ecbolic

  1. Affects on the reproductive cycle

-Short cycle the estrous cycle (PGF2a)
-Smooth muscle relaxant (PGE1,2)

  1. Indications and modifications on the reproductive cycle

-Cervical relaxation
-Oviductal relaxation

  1. Scenarios of positive/negative feedback loops
  2. Generic and trade names for common drugs

Prostaglandin F2alpha
-Dinoprost tromethamine (Lutalyse)
-Cloprostenol sodium (Estrumate)

Prostaglandin E1, E2.
-Dinoprostone Gel (Primigyn or Prepidil) PGE2
-Misoprostol (Cytotec) PGE1

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7
Q

Dopamine antagonists

A
  1. Function in reproduction

-Stimulating lactogenesis

  1. Affects on the reproductive cycle

-Decreases dopamine
-Increases prolactin

  1. Indications and modifications on the reproductive cycle

-Stimulation of lactogenesis primarily fescue toxicosis

  1. Scenarios of positive/negative feedback loops
  2. Generic and trade names for common drugs

Equidone Gel trade name

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8
Q

Dopaminergic agents (Agonist)

A
  1. Function in reproduction
  2. Affects on the reproductive cycle
  3. Indications and modifications on the reproductive cycle

-May decrease milk production
-Induce abortion
-Treatment for Equine PPID

  1. Scenarios of positive/negative feedback loops
  2. Generic and trade names for common drugs

Pergolide (Prascend)
-Equine PPID treatment

Bromocryptine and Cabergoline (Dostinex)
-Induce abortion in dogs

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9
Q

Glucocorticoids

A
  1. Function in reproduction
  2. Affects on the reproductive cycle
  3. Indications and modifications on the reproductive cycle
  4. Scenarios of positive/negative feedback loops
  5. Generic and trade names for common drugs
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10
Q

Others

A

Follicle Stimulating Hormone

-Secreted by pituitary
-Target granulosa cells or sertoli cells
-Increase estrogen production
-Stimulated follicular growth
Used to superovulate

-Folltropin trade name
-reFSH: recombinant equine FSH (EquiPure)

Luteinizing Hormone

-Target the ceca cells or leydig cells
-Increase testosterone production
-Primarily used to stimulate ovulation
-reLH equine: Equine pure LH

Pg 600

-Combination of eCG and hCG
-Induces estrus in pigs
-induces superovulation in small ruminants

Human chorionic gonadotropin (hCG)

-LH-like activity

Equine chorionic gonadotropin (eCG)

-FSH and LH like
-Primarily FSH

Oxytocin

Ecbolic
-Initiates parturition
-Milk let down
-Uterine contraction
-Down regulates oxytocin receptors: used to prolong corpus luteum lifespan in horse

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11
Q

Tocolytics

A

Clenbuterol/Terbutaline

-Smooth muscle relaxation
-Bronchodilator
-Uterine relaxation
-Illegal in food producing animals

Buscopan

-N-butylscopolamonium bromide
-Indicated for control of abdominal pain (colic) associated with spasmodic colic, flatulent colic, and simple impactions in horses

-Antispasmodic and anticholinergic drug
-Suppresses spasms of the digestive system

-Decreases peristalsis for palpation per rectum
-May relax cervix with topical application

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12
Q

Reasons for manipulation of the reproductive tract

A
  1. Induce luteolysis
    -PGF2A
  2. Induce ovulation of a mature follicle
    -LH
  3. Suppress estrus
    -Progesterone
  4. Induce cyclicity in anestrus animals
    -Gonadotropin release hormone
    -FSH and LH release
  5. Terminate pregnancy
    -Estrogen
    -Dopamine agonist: abortion
  6. Manage dystocias
    -Oxytocin
  7. Treat uterine disease
    -PGE1
  8. Increase milk production
    -Oxytocin
    -Domperidone: dopamine agonist
    -Increases lactin (fescue toxicosis)
  9. Super ovulate cyclic animals
    -FSH
  10. Growth promotant

-Estradiol
-Testosterone
-Progesterone
-Zeranol (Ralgio)
-MGA
-Stanozolol
-Boldenone undecyclenate

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13
Q

When to Use intrauterine treatment

A

-First time infections
-No history of chronic infetility
-Good biopsy score
-Antibiotic is not irritating to endometrium
-Do not require long term treatment
-Owner compliance, budget
Culture, cytology, history

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14
Q

Urinary pharmacology Lecture

A
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15
Q

Chronic kidney disease

A
  1. Diet

Phosphorous restriction
-Low Pi diet

Phosphorous binders
-Aluminum hydroxide
-Calcium carbonate
-Sevelamer
-Lanthanum

Goal: 4.5 mg/dl

  1. Hypertension

-RAAS inhibitors
-ACE inhibitors: Enalaprin, Benazepril. Decrease transglomerular pressure.
-ARB: Telmisartan, Losartan, Irbesartan
-Ca channel blockers: Amlodipine

  1. RAAS inhibition

-ACE Inhibitors
-ARB
-Spironolactone

  1. Proteinuria

-ACE-I & ARB

  1. Renal 2nd HPTH

-Decreased calcitriol = increase PTH release
-Calcitriol: PTH suppression. Anti-proliferative (anti-tumor), intestinal calcium and phosphorus absorption
-When phosphorus <6mg/dl, stop if >6mg/dl

  1. Anemia

-Epoetin
-Darbepoetin

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16
Q

Acute Kidney Injury

A

-Furosemide: thick ascending loop of Henle. Inhibits cotransport of Na along luminal surface
-Dopamine: increases RBF, GFR. Vasoconstriction, adrenergic receptors.
-Mannitol: Osmotic diuretic. Increases GFR and tubular flow. Free radical scavenger. Contraindicated in volume overload. Pulls intracellular fluid into intravascular space
-Diltiazem: reversal of renal vasoconstriction. Pre glomerular vasodilation, natriuresis independent of GFR. Prevents intracellular calcium accumulation

17
Q

Urinary Stones

A
18
Q

Urinary pathogens

A

-Amoxixillin
-TMS (pro prostate)
-Fluoroquinolones (pro prostate)

19
Q

Stress induced urinary problems

A

-Acepromazine: inhibits dopaminergic (D2) receptors to cause sedation and tranquilization. Blocks norepinephrine at peripheral adrenergic receptors (Alpha adrenergic blocking/antagonist)
-Buprenorphine: partial mu receptor agonist
-MEMO!!

20
Q

Urine obstruction/leakage

Sympathetic: storage phase
Parasympathetic: emptying phase

A

Cholinergic

B-adrenergic

Alpha adrenergic
-Phenylpropanolamine: stimulate urethral alpha receptors and cause norepinephrine release, increase urethral closure function. Hypertension side effect possible

PSMI Treatment

-PPA
-Estrogen: maintains urethral submucosal blood flow, maturation and periurethral Incurin (Estradiol) or Premarin collagen synthesis. Bone marrow suppression if overused. Combination with alpha-agonist synergistic
-Gonadotropin releasing hormone: effective as estrogen, Leuprolide acetate
-Testosterone: Methyltestorterone prostatic enlargement, should not be used with prostatic carcinoma.

Imipramine hydrochloride

-Both anticholinergic and beta agonist
-Encourages detrusor muscle relaxation and inhibiting detrusor contraction

Detrusor instability & Urge Incontinence

Treatment

-Anticholinergic medications
-Decrease detrusor contractions

Oxybutynin

-Direct muscarinic effects on bladder smooth muscle without affecting vasculature
-Antispasmodic and reduces maximum bladder pressures
-Side effects: diarrhea, constipation, hypersalivation.

Propantheline

-Direct antimuscarinic agent with effects on bladder smooth muscle
-Side effects: dry mouth, tachycardia, ielus, constipation

Detrusor-urethral dyssynergy

Alpha adrenergic blockage

-Phenoxybenzamine
-Prazosin: internal and external urethral sphincter
-Tamsulosin: internal urethral sphincter, q24 hrs

Striated muscle involvement

-Benzodiazepines: diazepam
-Acepromazine
-Methocarbamol
-Dantrolene and baclofen: potential side effects

Bladder or Detrusor Atony

-Bethanechol: parasympathomimetic
-Cisapride or Metoclopramide: dopaminergics

Urethrospasm - functional obstruction

-Alpha adrenergic blockage
-Skeletal muscle relaxation

21
Q

Protein loss nephropathy

A

RAAS blockage

ACE-I
-Enalapril
-Benazapril

ARB

-Losartan
-Telmisartan

Calcium channel blocker

-Amlodipine

Anti-thrombotic treatment

-Aspirin
-Clopidogrel

Edema Control

-Furosemide
-Spironolactone

22
Q

Integrative Medicine Lecture

A
23
Q

Common terminology to describe health care options

A

Conventional Western Medicine
-Healing at the organ level
-Diagnosis

Integrative Health
-Conventional and complementary approaches

Complementary Health
-Non-mainstream
-Together

Alternative medicine
-In place of conventional

Functional medicine
-Personalized, integrative
-Prevention, management
-Root causes
-Naturopahty/naturopathic

24
Q

The four bases or pillars of integrative medicine therapy

A
  1. Pharmaceuticals

-NSAIDs
-Gabapentin or pregabalin
-NMDA antagonists
-Monoclonal antibodies targeting NGF
-Tricyclic antidepressants

  1. Physical Medicine

-Acupuncture
-PEM
-Low level laser
-Massage
-Underwater treadmill

  1. Integrative nutrition/food therapy & supplements/nutraceuticals

-Omega 3 fatty acids
-Polysulfated glycoaminoglycans: injectable approved by FDA dogs and horses. Osteoarthritis. Adequan
-Yunnan Baiyao: stops bleeding.
-Curcuminoids

  1. Regenerative medicine

-Shock wave therapy: high energy wave sounds. OA, non-union fractures, wound healing. 1-3 treatments.
-PRF, PRFG and stem cell therapy
-Spryng veterinary medical device: Intra articular injection.
-Radio-isotope (tin-117n) therapy: Synovitis, OA.

25
Q

MOA and clinical use of pharmaceuticals

A

NSAIDs

Gabapentin or pregabalin

-Gaba analog, bind to alpha2.. subunit of presympathetic voltage Calcium ion channels. Block release of excitatory neurotransmitters.
-Anxiolytic, anticonvulsant, neuropathic pain, MAC reduction. After OVH in cats

NMDA antagonists

Ketamine
-Prevent wind up
-Blockage of glutamate effects at the NMDA receptor
-Sub anesthetic dose in conjunction with analgesic
-Potentially lower dose of opioid

Amantadine
-Help allodynia and opioid tolerance in chronic pain cases
-NMDA antagonist
-Osteoarthritis, neuropathic pain

Monoclonal antibodies targeting NGF

-Bind to target molecules and blocks the activity of the target
-Nerve growth factor for OA
-Ex: Bedinvetmab, Frunevetmab

Tricyclic antidepressants

Amitriptyline

-Tricyclic antidepressant
-Blocks catecholamine uptake which enhances inhibitory systems
-Also has NMDA receptor antagonism activity
-Chronic pain with a neuropathic component

Tramadol

-Weakly binds to u opioid receptor
-Analgesic
-Chronic pain in cats

26
Q

Good candidates for regenerative medicine options

A

Dorsi-flex Assist

-Sciatic nerve injury
-Tarsal hyperextension
-Wobblers, ataxia

27
Q

Camelid Pharmacology Lecture

A
28
Q

Be familiar with the drugs that are used more commonly

A

-No drugs are approved in US
-Extra label use necessary

Oral

-Dewormers
-Meloxicam
-Prednisone

SQ

-Lateral thoracic wall, behind the elbow
-Low in the neck cervical epaxial muscle
-Needle 20-18g x 1 inch, Crias 22g x 1 inch

IM

-Oxytocin
-Sedation
-Low in the neck, semimembranosus/semitendinosus

IV

-Flunixin
-Jugular vein
-Lateral saphenous
-Cephalic

Tissue damage

-Sodium iodide
-Phenylbutazone

Anesthesia - short term

-Xylazine (Yohimbine reversal)
-Butorphanol
-Ketamine

Induction

-Ketamine
-Diazepam

Caudal epidural

-Lidocaine: toxic dose 5mg/kg

Antimicrobials

-Ceftiofur
-Penicillin
-Aminoglycosides: Gentamicin, Amikacin

Endoparasite Tx

-Macrocyclin lactones
-Benzimidazoles
-Imidazothiazole
-Quinolone

Coccidia Tx

-Amprolium hydrochloride
-Sulfadimethoxine
-Ponazuril

Pain management

-Flunixin
-Meloxicam
-Phenylbutazone
-Ketoprofen
-Lidocaine

GI ulcer

-Omeprazole: oral not useful, need IV
-Pantoprazole
-Sucralfate: limited efficacy

29
Q

Recognize drugs that should be used with caution or should not be used

A

Contraindicated

-Ionophores
-Tilmicosin
-Tolazoline
-Dinoprost

Tissue damage

-Sodium iodide
-Phenylbutazone

Adverse reactions and death

-Tolazoline

Florfenicol: avoid in crias

Oxytetracycline: avoid IM

Tulathromycin: save for aggressive infections, can cause acute death

Trimethoprim sulfamethoxazole: Not clinically effective oral

30
Q

Understand limitations/risks when extrapolating from other species

A

Pain management

-Flunixin: transdermal not affective in camelids
-Meloxicam
-Phenylbutazone: longer 1/2 life
-Ketoprofen
-Lidocaine

Opioids

-Butorphanol
-Fentanyl: llamas 4 patches
-Morphine
-Lidocaine

Steroids

-Pregnancy loss in last trimester
-Anemia
-Hyperglycemia

31
Q

Meningeal Worm Treatment

A

-Fenbendazole
-Moxidectin or ivermectin
-NSAIDs: flunixin meglumine, meloxicam
-Dexamethasone instead of NSAIDs

32
Q

Other

A

Postpartum

-Oxytocin
-NSAID
-Antimicrobial

Agalactia

-Domperidone

Neonatal Sepsis

-Penicillin
-Ceftiofur
-Amikacin
-Gentamicin
-Flunixin
-Omeprazole
-Crystalloids, colloids
-Diazepam for seizures

Neonates

-Vitamin D
-Caffeine for dummy cria
-Enemas
-Selenium: Vit E
-Iron Dextran
-Vitamin B12
-Vitamin B complex
-Thiamine
-Capstar
-Propylene glycol

33
Q

Endocrine - Hormone Pharmacology Lecture

A
34
Q

Adrenals

A
  1. Hyperadrenocorticism

Trilostane

-MOA: competitive inhibition 3beta-hydroxysteroid dehydrogenase enzyme
-Blocks production of aldosterone and cortisol

Mitotane

-AKA o,p’DDD
-Potent adrenocorticolytic drug

Ketoconazole

-Reversibly inhibits adrenal steroid genesis with minimal effect on mineralocorticoids

L-Deprenyl

-Irreversible inhibitor of the enzyme monoamine oxidase type B
-Dopamine levels balanced

Others
-Melatonin
-HMR lignans
-SDG lignans

  1. Hyoadronocorticism
  2. Phenochromocytoma

-Tumor of chromaffin cells adrenal medulla
-Manage hypertension, arrhythmias before surgery
Alpha and beta blockage

  1. Hyperaldosteronism

Primary or idiopathic, AKA Addison’s disease

ACTH elevated

Mitotane or Trilostance induced

Tx

Acute

-Dexamethasone
-NaCl 0.9%
-Bicarbonate
-50% Dextrose

Maintenance

-Desoxycorticosterone pivalate DOCP: once per month injection

-Fludrocortisone acetate: daily oral

-Glucocorticoid: Prednisolone or Prednisone

Hyperaldosteronism

-K gluconate
-Spironolactone
-Amlodipine: hypertension tx

35
Q

Thyroid

A
  1. Hyperthyroidism (cats)

-Diet
-Medication
-Surgery
-Radioactive iodine

Methimazole (Felimazole)

-Inhibits synthesis of thyroid hormone
-No anti tumor effect

Thiamazole
Carbimazole

  1. Hypothyroidism (dogs)

Levothyroxine
-T4 supplementation

36
Q

Pancreas

Acromegaly = diabetes mellitus
-Somatostatin analogs

A

Diabetes Mellitus

Insulin

-Vetsulin: porcine lente
-ProZinc: human lente
-NPH: Human neural protamine hagedorn intermediate to Long 24 hrs DOGS
-Glargine: Human analog, Lantus 9-24 hrs CATS
-PZI-Vet: porcine, bovine 6-24hrs
-Determir: 12-24 hrs
-Lente: 24 hrs

Diet
Exercise

SGLT2 receptor inhibitors

-Bexacat
-Lowers blood sugar by increasing urine excretion of glucose

37
Q

Hypothalamus/Petuitary gland

A

Diabetes insipidus - Central

ADH Vasopressin

-Oral or conjunctival

Nephrogenic

-Thiazide diuretics
-Low sodium
-No treatment

38
Q

Parathyroid

A
  1. Hypoparathyroidism

-Slow IV calcium
-Vitamin D supplementation and oral calcium

  1. Hyperparathyroidism

Calcitriol

-Induces formation of its own receptor in parathyroid VDR

Calcium Carbonate

39
Q
A

CVM 741B (5 decks)

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