Pharm Part II Flashcards by Julie Broomell

What class of drugs are used to treat strep?

Beta lactam

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If you are treating a dog with severe, gram negative sepsis, what drug classes would you use?

-amikacin, enrofloxacin,

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You are treating a dog with a foul smelling infection with gas bubbles in the horse, what antibiotic would you choose?

-metronidazole, TMS, procaine penicllin G

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What route of administration is preferred by most clients?
What route is preferred by most patients?

oral
oral

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What route of absorption is the most variable?

-oral -> GI disease

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Intramuscular administration?

-tolerated by most patients
-less tolerated by clients
-reliable absorption
-greater risk for injection site reactions

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Subcutaneous administration?

-subcutaneous
-better tolerated by patients and clients
-absoprtion usually good (beware in dehydrated animal)
SC rarely used in horses due to volume

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Intravenous administration?

-rarely done by owners
-typically well tolerated by patients
-most technically difficult
-highest absorption -> highest risk for adverse effects

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If a drug is injectable, is it suitable for all parental routes?

Not necessarily

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What drug is administered IV in dogs?

Unasyn

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What antibiotic can be given IM in horses?

Excede, Naxcel

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Convenia is approved for which route of administration in cats?

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Enrofloxacin is approved for what route of administration in cats?

Oral

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Enrofloxacin is approved for what route of adminstration in dogs?

Oral

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Frequency of administration becomes difficult with _ dependent antibiotics

Time

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Do you overdose or underdose antibiotics?

Overdose

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Why do we round up for antibiotics?

-underdosing may lead to sub-therapeutic concentrations

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When do we use the high end of the dose range?

-Difficult site of infection (CNS, eye, prostate, abscesses that cant be drained
-Anerobes (lack of blood supply)
-Poorly perfused tissue that cant be removed

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Potassium Penicillin

-GO slow IV (over 5 min, use small needle)
-causes tachycardia (take HR before)
-often causes cow-flop 15 min after administration

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Procaine Penillicin

-Refrigerate
-shake the bottle
-change needle after drawing up
-adminster with 18 guage needle
-split dose into 2 sites on 2 sides

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What is empiric therapy based on?

-choosing an antibiotic based on experience
-which bacteria most commonly causes infection at that site
-which antibiotics will treat those bacteria

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Why do we use first line?

-cheap, safe, effective
-common, non-life threatening infections
-little impact on human medicine

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Why do we use second-line antibiotics?

-assumption of resistnace
-more severe infections
-benefit outweight impact

What do antibiograms tell you?

-They dont tell you about the specific patient
-give you reasonable options for patients that dont respond to first tier treatments
-while awaiting culture results or if culture is not possible

What are the top 6 innapropriate antibiotic usages in dogs?

-clavamox for URi and community-acquired pneumonia - urinary tract signs without confirming infection -metronidazole for treatment of acute diarrhea -enrofloxacin twice daily- split dose -routine use of prolonged antibiotic -dental prophylaxis

What are the top 5 innappropriate antibotic uses in horses?

-treatment of cough -wounds over non-vital structures -prophylactic/peri-operative antibitocs -TMS once daily -route use of prolonged antibiotic courses

When do we prescribe a systemic antibacterial?

-is the bacterial infection confirmed or probable? -will the infection cause critical illness -will the infection progress without any treatment -is the patients condition life threateneing

When do we prescribe antibiotics before our C/S results show

-high suspicion of bacterial infection (pus, CBC changes, knowledge of common pathogens) -animal showing signs of sepsis/immunosuppression

Is a systemic antibiotic necessary -> No but...

-owner requests -animal will be lost to follow up -they are really sick and you dont know why

When is a systemic antibiotic MAYBE warranted?

-bacterial infection that cna be treated topically -fever of unknown origin

When do we not prescirbe a systemic antibiotic?

-viral infection without signs of secondary bacterial infection -in a non immunosuppressed animal -fungal infections

What is the most common bacteria found in equine URI?

Strep zoo

Most common bacteria found in dog UTI?

E.coli

Broad spectrum

-greater effects on a wider range of resident flora -antibiotic resistance

Narrow spectrum

-greater chance of being wrong -therapeutic failure

Common practice is to start _ and go _

broad narrow

When do we pick a drug with a small volume of distribution?

Infection in the plasma/ISF -sepsis, pneumonia, pyoderma, UTI

When do we pick a drug with a large volume of distribution

-infection located in protected site -CNS, eye, prostate

What drugs have a large volume of distribution?

-macrolides, fluroquinolones, phenicols, lincosamides

If you have an immune compromised patient would you use cidal or static?

cidal

What do we use to treat supericial bacterial folliculitis?

-can use topical -the longer the infections go on, the more difficult to treat.

What antibiotics are practical to administer to dogs for skin and soft tissue?

-ampicillin -TMS (maybe) --Enrofloxacin -Cefovecin -treat for 4 weeks for systemic

Will the antibiotics reach the site of infection in the skin/soft tissue?

-typically the ECF/ISF

What are patient or local factors affecting efficacy of skin and soft tissue infections

-allergies (atopy, food, flea) -immunosuppresion (cancer, metabolic disease)

How can you determine if you can use a topical for skin infections?

-hairy or non hairy site -extent -> area superficial vs deep -oral exposure

Do we treat bite wounds with antibiotics? What drugs do we use to treat skin and soft tissue?

-multiple organisms from the oral cavity and normal skin flora -may abscess -need to debride necrotic tissue (think anaerobes) -clavmox, clindamycin, doxy

Do we always treat UTIs?

Not if they arent showing CS

What antibiotics do we use to treat UTIs

-amoxicillin or TMS for 3-5 days Horses- >TMS, ceftiofur, enrofloxacin

What kind of drugs are successful for treating uncomplicated UTI

-drugs with intermediate sensitivity

What are reasons for treatment failure for UTIs

-inadequate duration of treatment (3-5 days) 4-6 weeks minimum if kidney or prostate involved -Increased urine production (concurrent disease, fluids, increased drug excretion) -administer at night -prolonged corticosteroid use -sequestration of calculi -infection isnt in the urine (kidney or prostate)

What are the blood prostate barriers?

-unionized -lipophilic -low protein binding -pH in dog prostatic fluid lower in plasma (trapping of weak bases)

Respiratory tract infections barriers

-relatively few barriers to lung penetration -exceptions (non-fenestrated capillaries in the alveoli, abscesses, consolidated

Respiratory infections are often _

mixed -aerobic and anaerobic bacteria are most likely -broad spectrum coverage required initially

What drugs can we use for respiratory infections?

-B-lactam and aminoglycloside and fluroquinolones

How do we treat myocplasma

-tetracylclines, and macrolides

How do we treat bronchiseptica infections

-require antibiotics with good penetration -tetracyclines and macrolides -enrofloxacin