others Flashcards
Schedule 1 drugs
No current therapeutic use
Possession and supply require Home Office permission
Schedule 2 drugs
Have therapeutic use but are hgihly addictive (subject to restrictions- prescription, storage, destruction and record keeping)
e.g. Methadone, Morphine, Fentanyl, Pethidiine, Quinalbarbitone, Ketamine, Etorphine
Kept in locked cabinet
Recorded in register (quinalbarbitone is exception)
Schedule 3 drugs
Have therapeutic use but (mis)use may lead to moderate or low physical dependence or high psychological dependence (subject to restrictions- prescription and sometimes storage)
E.g. Buprenorphine, tramadol, gabapentin, pregablin, midazolam, pentobarbitone
buprenorphine, diethylpropion, flunitrazepam and temazepam must be kept in a locked cabinet
Dont need to record use
Advised to keep in locked cabinet
Schedule 4 drugs
Therapeutic but misuse may lead to limited physical dependence or psychological dependence (no additional controls)
E.g. Alprazolam, diazepam, nandrolone, clenbuterol, somatotropin
Schedule 5 drugs
Contain such small quantities of substances which may cause dependence that the potential for abuse is considered extremely low
e.g. paracetamol with codiene (pardale)
Frusemide
Diuretic
Give to horse with pulmonary oedema in recovery
Dexamethasone
Corticosteroid
Give to horse with pulmonary oedema in recovery
ciclosporin clinical use
Immune suppressant
DECREASES IL-2 and therefore T and B cell activation and clonal expansion
Alters function of eosinophils, mast cells, granulocytes, macrophages, NK cells
Decreases other cytokines such as IL-3, IL-4, Granulocyte colony-stimulating factor, Tumour necrosis factor
Steroid sparing, often given with PREDNISOLONE
Licenced for atopic dermatitis, use in IMDS increasing
Side effects of ciclosporin
Mild GI signs often self-limiting if the dose is decreased for a few days
Increased risk of infection
Increased risk of thromboembolism
Other less likely: gingival hyperplasia and lymphoproliferative disorders
Azothiazine
Steroid sparing
NEVER USE IN CATS
Cytotoxic drug- inhibits DNA and RNA synthesis
Impact on cell-mediated immunity-> decreased lymphocyte numbers and T cell-dependent antibody synthesis
low cost generally tolerated well
Onset can be delayed but variable
-> myelosuppression, acute pancreatitis, hepatotoxicity
Glucocorticoids
Rapid, cheap, good anti-inflammatory action but significant side effects with long term use
-> neutrophilia, lymphocytopenia, eosinopenia
Glucocorticoids
Rapid, cheap, good anti-inflammatory action but significant side effects with long-term use
-> neutrophilia, lymphocytopenia, eosinopenia
Low dose glucocorticoids
Anti-inflammatory
- inhibits release of pro-inflammatory cytokines
- stabilises granulocyte membranes
high dose glucocorticoids
Immune suppressive
- targets macrophage function- down-regulates Fc receptor expression, reduces phagocytosis of opsonised red blood cells (IMHA) and platelets
- Decreases antigen processing, suppresses t cell function and induces apoptosis of T cells, might inhibit B-cell antibody production in longer-term
prednisolone
most common glucocorticoid-> dogs and cats
Sometimes given to horses
ORALLY
24hr onset
Dexamethosone
IM/IV to horses
Methylprednisolone acetate
Sometimes given as injection to fractious cats but avoid where possible due to side effects
Triamcinolone acetonide
Given to horses to treat joint disease
Olacitinib
Apoquel
oral->dogs
Block JAK-1 pathway predominantly
Good antipruritic with some anti-inflammatory action- atopic dermatitis
Appears safe long term
Lokivetmab
Monoclonal antibody
Cytopoint
For atopic dermatitis
monthly injection- dogs only
Monoclonal antibody vs IL-31- very targeted therapy- good safety profile
Good antipruritic but minimal anti-inflammatory action
24hr onset
Bedinvetmab
FOR DOGS
Monoclonal antibody
Librella
Neuralises Nerve growth factor
osteoarthris pain
Solensia
Anti NGF monoclonal antibody as above
FOR CATS
only subcut injections
Systemic options for osteoarthritis
tend to have more side effects
* NSAIDs (all species) (+paracetamol- works in a different way so useful in combination)
* Bisphosphonates (equine)
Glycosaminoglycan derivatives- regenerative therapies
Intra-articular treatment for osteoarthritis
- Corticosteroids!- none licensed in small animals, could use horse ones as part of cascade, all are chrondrotoxic
- Glycosaminoglycan derivatives (hyaluronic acid)
- Synthetic hydrogels
- Biological products (stem cells (allogenic or autogenic), IRAP, PRP)
- IRAP- Interleukin-1 reactive protein, harvested and incubated from patients own blood- has immunomodulatory effects
PRP- similar effects to IRAP
- IRAP- Interleukin-1 reactive protein, harvested and incubated from patients own blood- has immunomodulatory effects
