Pharmacology Flashcards
acetylcholine
A neurotransmitter that allows a nerve impulse to cross the synaptic junction (gap) between two nerve fibers or between a nerve fiber and an organ (e.g., muscle, gland).
acetylcholinesterase
An enzyme that brings about the breakdown of acetylcholine in the synaptic gap.
Active Immunity
Immunity that occurs by an animal’s own immune response after exposure to foreign antigen
Addison’s disease
A disease or syndrome characterized by inadequate amounts of corticosteroid hormones.
adjuvant
A substance given with an antigen to enhance the immune response to the antigen. Adjuvants may form a localized granuloma at the injection site or may produce systemic hypersensitivity. Adjuvants have received much attention as a result of a possible (but not proven) link with the increased incidence of fibrosarcomas in vaccinated cats. Examples of adjuvants are aluminum hydroxide, aluminum phosphate, aluminum potassium sulfate, water in oil, saponin, and diethylaminoethyl (DEAE) dextran.
adrenergic
A term used to describe an action or a receptor that is activated by epinephrine or norepinephrine.
adsorbent
A drug that inhibits gastrointestinal absorption of drugs, toxins, or chemicals by attracting and holding them to its surface.
adverse drug event
Harm to a patient caused by a therapeutic or preventive intervention. It could be due to a medication error or adverse drug reaction.
adverse drug reaction
An undesirable response to a drug by a patient. It may vary in severity from mild to fatal.
aerobe
Organism that is able to grow in the presence of oxygen.
aerosolization
The conversion of a liquid into a fine mist or colloidal suspension in air.
Afterload
The resistance (pressure) in arteries that must be overcome to empty blood from the ventricle.
Agonist
A drug that brings about a specific action by binding with the appropriate receptor.
Alkylation
Formation of a linkage between a substance and DNA that causes irreversible inhibition of the DNA molecule. Alkylating drugs are used in chemotherapy treatment of cancer.
Anabolism
The constructive phase of metabolism in which body cells repair and replace tissue.
Anaerobe
Organism that is not able to grow in the presence of oxygen.
analgesia
The absence of the sensation of pain.
analogue
A chemical compound having a structure similar to another but differing from it in some way.
anaphylaxis
A systemic, severe allergic reaction.
Anesthesia
The loss of all sensation. May be described as local (affecting a small area), regional, or surgical (accompanied by unconsciousness).
angiogenesis
The development of blood vessels.
antagonist
A drug that inhibits a specific action by binding with a particular receptor.
anthelmintic
Drug used to eliminate helminth parasites (e.g., roundworms) from a host.
antibacterial
An agent that inhibits bacterial growth, impedes replication of bacteria, or kills bacteria.
antibiotic
An agent produced by a microorganism or semisynthetically that has the ability to inhibit the growth of or kill microorganisms.
antibody
An immunoglobulin molecule that combines with the specific antigen that induced its formation.
anticholinergic
Blocking nerve impulse transmission through the parasympathetic nervous system; also called parasympatholytic. Anticholinergic drugs may be used for the treatment of diarrhea or vomiting.
antigen
Any substance that can induce a specific immune response, such as toxins, foreign proteins, bacteria, and viruses.
antihistamine
A drug that counteracts the action of histamine in the body; are used for treating allergic reactions.
antimicrobial
An agent that kills microorganisms or suppresses their multiplication or growth.
antimicrobial residues
Presence of an antimicrobial (antibiotic) or its metabolites in food products or animal tissue.
antimicrobial resistance
Develops when microorganisms, such as bacteria and fungi, no longer respond to a drug that previously were effective.
antiseptic
A substance used on the skin to prevent the growth of bacteria or to provide preoperative cleansing of the skin.
antitussive
A drug that inhibits or suppresses the cough reflex.
arrhythmia
( or dysrhythmia) A variation from the normal rhythm.
astringent
An agent that causes contraction after application to tissue.
atony
The absence or lack of normal tone or strength.
autologous
Belonging to the same organism.
automaticity
The ability of cardiac muscle to generate impulses.
autonomic nervous system
That portion of the nervous system that controls involuntary activities.
average cost of inventory on hand
Average cost of inventory on hand is determined by adding the year’s beginning inventory to the year’s ending inventory and dividing by two.
avirulent
avirulent The inability of an infectious agent to produce pathologic effects.
bacteria
Single-celled microorganisms that usually have a rigid cell wall and a round, rod-like, or spiral shape.
bactericidal
An agent with the capability to kill bacteria.
bacterin
A killed bacterial vaccine.
bacteriostatic
An agent that inhibits the growth or reproduction of bacteria.
beta-lactamase
Enzymes that reduce the effectiveness of certain antibiotics; beta-lactamase I is penicillinase; beta-lactamase II is cephalosporinase.
bioavailability
Measure of the degree to which a drug is absorbed and reaches systemic circulation
blepharospasm
Squinting of the eye.
bots
Larvae of several fly species (e.g., Gasterophilus [horse bot]).
bradyarrhythmia
Bradycardia associated with an irregularity of heart rhythm.
bradycardia
A slower-than-normal heart rate.
bronchoconstriction
Narrowing of the bronchi and bronchioles, which results in increased airway resistance and decreased airflow.
bronchodilation
Widening lumen of bronchi and bronchioles, which results from relaxation of smooth muscle in the walls of the bronchi and bronchioles. Airway resistance is decreased, and airflow is increased.
buffer
A substance that decreases the change in pH when an acid or base is added.
callus
Hypertrophy of the horny layer of the epidermis in a localized area as a result of pressure or friction.
cardiac output
Amount of blood pumped by the heart per minute.
cardiac remodeling
Change in the size, shape, structure, and physiology of the heart due to damage to the myocardium.
catalepsy
A state of involuntary muscle rigidity that is accompanied by immobility, amnesia, and variable amounts of analgesia. Some reflexes may be preserved.
catecholamine
The class of neurotransmitters that includes dopamine, epinephrine, and norepinephrine. When given therapeutically, catecholamines mimic the effects of stimulating the sympathetic nervous system.
caval syndrome
A life-threatening condition caused by a large number of heartworms lodged in the vena cava, right atrium, and right ventricle.
ceiling effect
The highest level of a specific drug has been reached; increasing the dose does not provide any additional pain relief but may increase the side effects.
cell cycle–nonspecific
Capable of acting in several or all cell cycle phases.
cell cycle–specific
Capable of acting during a particular cell cycle phase only.
cerumen
A waxy secretion of the glands of the external ear canal.
cestode
A tapeworm.
chelating agent
An agent used in chemotherapy for metal poisoning.
chemoreceptor trigger zone
(CRTZ) An area in the brain that activates the vomiting center when stimulated by toxic substances in the blood.
cholinergic
activated by or transmitted through acetylcholine; also called parasympathomimetic. Cholinergic drugs increase activity in the gastrointestinal tract.
chondroprotectives
Substances that are able to decrease the progression of osteoarthritis by providing support to cartilage and promoting its repair; they are available as oral or injectable medications.
chronotropic
Affecting the heart rate.
closed-angle glaucoma
A type of primary glaucoma of the eye that is characterized by a shallow anterior chamber and a narrow angle that compromises filtration because the iris is blocking the angle and is causing an increase in intraocular pressure.
Collagen
A fibrous substance found in skin, tendon, bone, cartilage, and all other connective tissues.
colloid
A chemical system composed of a continuous medium throughout which small particles are distributed and do not settle out under the influence of gravity. Colloids increase intravascular volume. IV administration only. (Voluven, Hetastrach)
colony forming unit (CFI)
An estimate of viable bacterial or fungal numbers.
comedo
(pl. comedones) A plug of keratin and sebum within a hair follicle of the skin.
compounding
Any manipulation (e.g., diluting, combining) performed to produce a dosage-form drug, other than the manipulations described in the directions for use on the labeling of an approved drug product.
concentration of a drug
The amount of a drug in a given volume of blood plasma.
conjunctivitis
Inflammation of the conjunctiva.
controlled drug
(or scheduled drug) A drug that is tightly controlled due to its abuse potential or risk. Schedule I = most controlled; Schedule V = less controlled.
core vaccines
Recommended vaccines for most animals to protect them from highly contagious diseases that are widespread in the environment.
Counterirritant
An agent that produces superficial irritation that is intended to relieve some other irritation.
crash cart
crash cart A stationary or mobile cart stocked with supplies, equipment, and drugs for use during an emergency.
cream
A semisolid preparation of oil, water, and a medicinal agent.
Cushing’s disease or syndrome
Hyperadrenocorticism; a disease or syndrome characterized by an overabundance of corticosteroid hormones.
cycloplegia
Paralysis of the ciliary muscle.
cytotoxic
Capable of destroying cells.
DEA form
An official federal government DEA changed to non-carbon-copy form in 2020. form from the Drug Enforcement Administration used for ordering controlled substances.
decongestant
A substance that reduces the swelling of mucous membranes.
deep pain
Pain arising from deep receptors in the periosteum, tendons, and joint structures.
delayed billing
A benefit that some companies offer to the buyer who is purchasing increased amounts of merchandise. The date the statement must be paid is usually longer than 30–60 days away.
dentifrice
A preparation for cleansing teeth that is available in a powder, paste, or liquid.
depolarization
Neutralizing of the polarity of a cardiac cell by an inflow of sodium ions. Depolarization results in contraction of the cardiac cell and renders it incapable of further contraction until repolarization occurs.
dermatitis
dermatitis Inflammation of the skin.
dermatophyte
Fungi parasitic on the skin.
dermatophytosis
A fungal skin infection.
detergent
An agent that cleanses.
detrusor
The smooth muscle of the urinary bladder that is mainly responsible for emptying the bladder during urination.
detrusor areflexia
The absence of detrusor contractions.
diabetes mellitus
A condition that occurs due to insulin deficiency.
diastole
Relaxation phase when the chambers of the heart are filling with blood.
dilution
A process of reducing the concentration of a substance in a solution.
disinfect
To make free of pathogens or make them inactive.
disinfectant
A chemical agent applied to inanimate objects to destroy or inhibit growth of microorganisms.
disseminated intravascular coagulation (DIC)
Widespread formation of clots (thrombi) in the microscopic blood vessels of the circulatory system. DIC occurs as a complication of a wide variety of disorders and consumes clotting factors, with resultant bleeding.
dissociation
The act of separating into ionic components (NaCl → Na and Cl).
distichia
(distichiasis) Eyelashes emerge through the meibomian gland opening at the eyelid margin in a misdirected way, causing the eyelashes to touch and irritate the corneal surface
diuretic
A drug used to promote urine excretion.
dosage
The amount of a drug dose and the frequency at which the medication must be administered to a patient.
dosage
dosage form A drug’s physical appearance; the form in which they are marketed for use.
dosage range
dosage range A drug’s dosage formula expressed as a set of two numbers; a minimum and a maximum safe dose.
dose
The amount of drug to be administered to a patient (e.g., 100 mg).
downregulation
A decrease in the number of cellular receptors to a molecule resulting in reduced sensitivity to the molecule.
drug
A substance used to diagnose, prevent, or treat disease.
dystocia
Difficult birth.
ectoparasite
A parasite that lives on the outside body surface of its host.
ectropion
A rolling outward (i.e., away from the eye) or sagging of the eyelid. Many times, the conjunctiva is plainly visible.
effector
A gland, organ, or tissue that responds to nerve stimulation with a specific action.
efficacy
The extent to which a drug causes the intended effects in a patient.
electrolyte
A substance that dissociates into ions when placed in solution, becoming capable of conducting electricity
elixir
A hydroalcoholic liquid that contains sweeteners, flavoring, and a medicinal agent.
emesis
The act of vomiting.
emetic
A substance or drug that induces vomiting.
empirical
Based on observation and personal experience
emulsion
A medicinal agent that consists of oily substances dispersed in an aqueous medium with an additive to stabilize the dispersion.
endometrium
The mucous membrane lining of the uterus.
endoparasite
A parasite that lives inside the body of its host.
endothelial layer
The smooth layer of epithelial cells that line blood vessels.
enteric coating
Acid resistant coating on a tablet that prevents it from being dissolved in an acid environment such as the stomach and are activated (dissolved) only when they reach an alkaline environment such as the small intestine.
Entropion
A rolling inward (i.e., toward the cornea) of the eyelid
equivalent weight
One gram molecular weight (from periodic chart) divided by the total positive valence of the material.
erythema
Redness of the skin caused by congestion of the capillaries
erythropoiesis
The formation of erythrocytes.
erythropoietin
A glycoprotein hormone secreted mainly by the kidney; it acts on stem cells of the bone marrow to stimulate red blood cell production.
euthyroid
A normal thyroid gland.
expectorant
A drug that enhances the expulsion of secretions from the respiratory tract
extralabel use
The use of a drug that is not specifically listed on the U.S. Food and Drug Administration (FDA)-approved label.
exudation
Leakage of fluid, cells, or cellular debris from blood vessels and their deposition in or on the tissue.
fatty acid
Organic compound of carbon, hydrogen, and oxygen that is esterified with glycerol to form fat.
feed efficiency
The rate at which animals convert feed into tissue. It is expressed as the number of pounds or kilograms of feed needed to produce 1 lb or 1 kg of animal.
feedback
The return of some of the output product of a process as input in a way that controls the process.
fibrinolysis
Fibrin (clot) breakdown through the action of the enzyme plasmin.
FIFO
Acronym for “first in, first out.”
first-pass effect
Some orally administered drugs are rapidly metabolized in the liver; the concentration of the drug is greatly reduced before it reaches systemic circulation.
FOB
Acronym for “free on board.”
FOB destination
FOB destination Title of possession passes from the pharmaceutic company to the buyer (i.e., the purchaser) when the shipment is delivered to the buyer’s business destination (i.e., the veterinary facility).
FOB shipping point
Title passes from the pharmaceutic company to the purchaser when the vendor places the goods in the possession of the carrier (e.g., United Parcel Service, Federal Express, Averitt Express).
full-service company
A pharmaceutic company that offers full service (e.g., the company employs sales representatives [reps] who visit veterinary facilities), usually with a limited number of products.
fungicidal
An agent that kills fungi.
fungistatic
An agent that inhibits the growth of fungi.
furuncle
(furunculosis) A focal suppurative inflammation of the skin and subcutaneous tissue; also known as a boil.
ganglionic synapse
The site of the synapse between neuron one and neuron two of the autonomic nervous system.
glaucoma
A group of eye diseases characterized by increased intraocular pressure that results in damage to the retina and the optic nerve.
gonadotropin
A hormone that stimulates the ovaries or testes.
granulation tissue
New tissue formed in the healing of wounds of the soft tissue, consisting of connective tissue cells and ingrown young vessels; it ultimately forms a scar.
Green Book
An on-line resource listing all FDA-approved animal drugs.
half-life
The amount of time (usually expressed in hours) that it takes for the quantity of a drug in the body to be reduced by 50%.
helminths
Parasitic worms, including nematodes, cestodes, and trematodes.
hematemesis
Vomiting of blood (the vomitus often resembles coffee grounds).
hematuria
Blood in the urine
histamine
A chemical mediator of the inflammatory response released from mast cells. Histamine may cause dilation and increased permeability of small blood vessels, constriction of small airways, increased secretion of mucus in the airways, and pain.
Horner’s syndrome
Paralysis of the sympathetic nerve supply to the eye that may cause enophthalmos, ptosis of the upper eyelid, slight elevation of the lower eyelid, constriction of the pupil, and narrowing of the palpebral tissue.
humidification
Addition of moisture to the air.
hybridoma
A cell culture that consists of a clone of a hybrid cell formed by fusing cells of different types, such as stimulated mouse plasma cells and myeloma cells.
hyperalgesia
A heightened sense of pain
hyperkalemia
An excess of potassium in the blood.
hypernatremia
An excess of sodium in the blood.
hypertension
Persistently high blood pressure.
hypertonic solution
Having an osmolality higher than 300 mOsm/L.
hypertonus
The state characterized by an increased tonicity or tension.
hyphema
A condition in which red blood cells are present in the anterior chamber of the eye(s).
hypokalemia
Abnormally low potassium concentration in the blood.
hyponatremia
A deficiency of sodium in the blood.
hypophyseal portal system
This is the portal system of the pituitary gland in which venules from the hypothalamus connect with capillaries of the anterior pituitary.
hypotonic solution
Having an osmolality less than 300 mOsm/L (D5W)
hypovolemia
Decreased volume of circulating blood.
iatrogenic
Caused by the physician (veterinarian).
immunoglobulin A
(IgA) Class of antibody produced on mucous membrane surfaces, such as those of the respiratory tract.
in vitro
Within an artificial environment.
in vivo
Within the living body.
inotrope
A drug that affects the strength or force of cardiac muscle contractions.
inotropic
inotropic Affecting the force of cardiac muscle contraction.
inspissated
Thickened or dried out.
integumentary system
Pertaining to, or composed of, skin.
interleukins
A group of polypeptide cytokines that carry signals between cells in the immune system.
intracameral injection
An injection into the anterior chamber of the eye.
intravenous bolus
A single, precise amount of medication or fluids given, one time intravenously.
intravenous infusion
A controlled administration of fluids, including drugs, directly into the vein, over a period of time. The most common method used is an infusion pump.
inventory
The quantity of goods or assets that a veterinary facility possesses, requiring proactive control to keep supplies stable and current.
nventory control manager (ICM) A person
(many times a licensed veterinary medical technician [LVMT]) responsible for monitoring, ordering, and maintaining inventory in a veterinary facility.
invoice
A form generated by a company that documents the quantity and price of each item ordered by the inventory control manager.
involution (partuition)
The return of a reproductive organ to normal size after delivery
iodophor
An iodine compound with a longer activity period that results from the combination of iodine and a carrier molecule that releases iodine over time.
isotonic solution
Having an osmolality equal to 300 mOsm/L. ( normal saline, LRS, Normosol-R)
keratitis
Inflammation of the cornea
keratolytic
An agent that promotes loosening or separation of the horny layer of the epidermis.
keratoplastic
An agent that promotes normalization of the development of keratin.
ketone bodies
Excessive ketones made from fat as an emergency fuel source. Ketone levels increase causing a shift in the acid/base balance.
legend drug
Legend drugs are required by law to be dispensed on or by the order of a licensed veterinarian or physician.
levo isomer
Left-sided arrangement of a molecule that may exist in a left- or a right-sided configuration. Levo and dextro isomers have the same molecular formula.
liniment
A medicine in an oily, soapy, or alcoholic vehicle to be rubbed on the skin to relieve pain or to act as a counterirritant.
loading dose
It is an initial higher dose of a drug given at the beginning of a treatment to rapidly achieve a therapeutic concentration in the body.
lower motor neurons
Peripheral neurons whose cell bodies lie in the central gray columns of the spinal cord and whose terminations lie in skeletal muscle. A sufficient number of lesions of lower motor neurons cause muscles supplied by the nerve to atrophy, resulting in weak reflexes and flaccid paralysis.
Mail Order Discount House
a company that accepts orders from the buyer by telephone; a good source for ordering items such as gauze, cotton, isopropyl alcohol, or paper towels.
manufacturing
The bulk production of drugs for resale outside of the veterinarian–client–patient relationship.
margin (profit)
The actual profit a practice makes on each sale
markup
The amount of money over cost for which a product sells. Markup percentages vary from practice to practice, but all markups reflect a retail value over wholesale value
matrix
The intercellular substance of tissues like cartilage and bone.
melena
Dark or black stools that result from blood staining. Bleeding has occurred in the anterior part of the gastrointestinal tract.
metabolic acidosis
Decreased body pH caused by excess hydrogen ions in the extracellular fluid
metabolic alkalosis
Increased body pH caused by excess bicarbonate in the extracellular fluid.
metabolism
Biotransformation. The biochemical process that alters a drug from an active form to a form that is inactive or that can be eliminated from the body.
metastasis
Generally refers to the transfer of cancer cells from one site to another.
metered dose inhaler
(MDI) A hand held device that uses a propellant to deliver a specific amount of medication that is inhaled into the lungs by the patient.
methemoglobinemia
The presence of methemoglobin in the blood caused by injury or toxic agents that convert a larger-than-normal proportion of hemoglobin into methemoglobin, which does not function as an oxygen carrier. AKA, Iron not binding to hemoglobin
microfilaria
A prelarval stage of a filarial worm transmitted to the biting insect from the principal host (e.g., filarial stage of Dirofilaria immitis).
microorganism
An organism that is microscopic (e.g., bacterium, protozoan, Rickettsia, virus, and fungus)
milliequivalent
mEq. term used to express the concentration of electrolytes in a solution; 1/1000 of an equivalent weight.
minimum alveolar concentration (MAC)
A measure of potency and is the alveolar concentration that prevents movement in 50% of patients in response to a painful stimulus. Lower numbers indicate more potent agents.
miosis
Contraction of the pupil.
miotic
A drug used to constrict the pupil.
modulation
The modification of nociceptive transmission.
monovalent
A vaccine, antiserum, or antitoxin developed specifically for a single antigen or organism.
motilin
A hormone secreted by cells in the duodenal mucosa that causes contraction of intestinal smooth muscle.
MRSA
Methicillin-resistant Staphylococcus aureus.
mucolytic
Having the ability to break down mucus.
multimodal analgesia
The use of different drugs with different actions to produce optimal analgesia and minimize individual drug quantities when possible.
muscarinic receptors
Receptors activated by acetylcholine and muscarine that are found in glands, the heart, and smooth muscle. An acronym for remembering muscarinic effects is SLUD: S, salivation; L, lacrimation; U, urination; D, defecation.
mydriasis
Dilation of the pupil.
myeloma
A malignant neoplasm of plasma cells (B lymphocytes).
myelosuppression
Inhibition of bone marrow activity that results in decreased production of blood cells and platelets.
myofibril
A muscle fibril composed of numerous myofilaments
nasogastric (intubation)
Passing a flexible tube through the nasal passages into the stomach.
nebulization
The process of converting liquid medications into a spray that can be carried into the respiratory system by inhaled air.
nematodes
Parasitic worms, including intestinal roundworms, filarial worms, lungworms, kidney worms, heartworms, and others
nephrology
The study of the urinary (renal) system.
nephron
The basic functional unit of the kidney.
nephrotoxic
Toxic to the kidneys.
nerve block
A loss of feeling or sensation produced by injecting an anesthetic agent around a nerve to interfere with its ability to conduct impulses.
neuroleptanalgesia
A combination of an opioid with a tranquilizer or sedative.
neuropathic pain
Pain that originates from injury or involvement of the peripheral or central nervous system.
nicotinic receptors
Receptors activated by acetylcholine and nicotine found at the neuromuscular junction of the skeletal muscle and at the ganglionic synapses.
nitrogen balance
The condition of the body as it relates to protein intake and use. Positive nitrogen balance implies a net gain in body protein.
nociception
The reception, conduction, and central nervous system processing of nerve signals generated by nociceptors.
nociceptor
A receptor for pain caused by injury to body tissue. Pain sensation arises in the terminal ends of sensory nerve fibers.
noncore vaccine
Optional vaccines that are considered for animals at risk for developing disease based on geographic location and the lifestyle of the animal.
nonproductive cough
A cough that does not result in coughing up of mucus, secretions, or debris (a dry cough).
nutraceutical
Any nontoxic food component that has scientifically proven health benefits.
ointment
A semisolid preparation that contains medicinal agents for application to the skin or eyes.
oncotic pressure
The osmotic pressure generated by plasma proteins in the blood.
open-angle glaucoma
A type of primary glaucoma of the eye in which the angle of the anterior chamber remains open, but filtration of the aqueous humor is gradually reduced, causing an increase in intraocular pressure.
organophosphate
A substance that can interfere with the function of the nervous system by inhibiting the enzyme cholinesterase.
osmotic pressure
The ability of solute molecules to attract water.
otoacariasis
Infestation of ear mites.
ototoxic
Toxic to the ears.
over-the-counter drug
A drug that can be purchased without a prescription; these drugs contain ingredients that are safe or have low concentrations of an active ingredient.
packing slip
A document supplied by the vendor that accompanies a purchase. A packing slip generally reflects quantities ordered, not prices.
parasitiasis
A condition in which an animal harbors an endoparasite or an ectoparasite but no clinical signs of infection or infestation are evident.
parasitosis
A condition in which an animal harbors an endoparasite or an ectoparasite and clinical signs of infection or infestation are evident
Parasympathetic Nervous System
That portion of the autonomic nervous system that arises from the craniosacral portion of the spinal cord, is mediated by the neurotransmitter acetylcholine, and is concerned primarily with conserving and restoring a steady state in the body.
parasympatholytic
A drug used to inhibit the activity of the parasympathetic nervous system.
parasympathomimetic
A drug that mimics the effects of stimulating the parasympathetic nervous system.
parenteral
The route of administration of injectable drugs
parenteral administration
By a route other than the alimentary canal (e.g., intramuscular, subcutaneous, intravenous).
parietal cell
A cell located in the gastric mucosa that secretes hydrochloric acid.
partition coefficient
The ratio of the solubility of substances (e.g., gas anesthetics) between two states in which they may be found (e.g., blood and gas, gas and rubber goods).
passive immunity
Immunity that occurs by administration of antibody produced in another individual.
pathologic pain
Pain with an exaggerated response; it is often associated with tissue injury due to trauma or surgery.
percent concentration
An expression of the strength of a substance based on the ratio of parts per hundred (e.g., 25%).
Perception (pain)
The processing and recognition of pain in the cerebral hemispheres.
peristalsis
A wave of smooth muscle contraction that passes along a tubular structure (gastrointestinal or other) and moves the contents of that structure forward.
physiologic pain
The protective sensation of pain that allows individuals to move away from potential tissue damage.
polydipsia
Excessive thirst manifested by increased water consumption.
polyuria
Excessive urination.
polyvalent
A vaccine, antiserum, or antitoxin active against multiple antigens or organisms; mixed vaccine.
precision vaporizer
A part of the anesthesia machine, located out of the circuit, used to convert a liquid anesthetic to a gas state and produce a precise concentration of anesthetic vapor in the carrier gas (oxygen) passing through the vaporizer and delivered to the patient. They are designed for use with only one specific anesthetic agent.
preemptive analgesia
Analgesia administered before the painful stimulus to help prevent sensitization and windup.
preload
The volume of blood in the ventricles at the end of diastole.
premature ventricular contraction
(PVC) Contraction of the ventricles without a corresponding contraction of the atria. PVCs arise from an irritable focus or foci in the ventricles.
prescription (legend) drug
A drug that is limited to use under the supervision of a veterinarian because of potential danger, difficulty of administration, or other considerations. The legend that designates a prescription drug states the following: “Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian.”
preservative
A substance, such as an antibiotic, antiinfective, or fungistat, that is added to a product to destroy or inhibit multiplication of microorganisms.
primary hypothyroidism
Hypothyroidism resulting from a pathologic condition in the thyroid.
primary intention healing
Healing of a clean, uninfected, surgical incision that is approximated by sutures.
productive cough
A cough that results in coughing up of mucus, secretions, or debris.
prostaglandin
A substance synthesized by cells from arachidonic acid that serves as a mediator of inflammation and has other physiologic functions.
pruritus
Itching.
pseudomembranous colitis
A severe acute inflammation of the bowel mucosa.
pyoderma
Any skin disease characterized by the presence or formation of pus.
ratio concentration
An expression of the strength of a substance based on the ratio of its parts (e.g., 1:32).
recombinant DNA technology
A process that removes a gene from one organism or pathogen and inserts it into the DNA of another. This also may be referred to as gene splicing.
(drug) regimen
A program for administration of a drug that includes the route, the dose (how much), the frequency (how often), and the duration (for how long) of administration.
regional anesthesia
Loss of feeling or sensation in a large area (region) of the body after injection of an anesthetic agent into the spinal canal or around peripheral nerves.
regurgitation
Casting up of undigested or semidigested (ruminant) foodstuff from the esophagus or rumen.
releasing factor (releasing hormone)
A hormone produced by the hypothalamus and transported to the anterior pituitary to stimulate the release of trophic hormones.
repolarization
The return of the cell membrane to its resting polarity after depolarization.
residue
An amount of a drug still present in animal tissue or products (e.g., meat, milk, eggs) at a particular point (slaughter or collection).
retroperitoneal
Located behind the peritoneum.
reverse sneeze
Aspiration reflex—short periods of noisy inspiratory effort in dogs.
scheduled drug
(or controlled drug) Controlled substances are regulated by federal and state laws. They are placed into five categories based on their abuse potential.
seborrhea
An increase in scaling of the skin; sebum production may or may not be increased.
seborrhea oleosa
Condition characterized by scaling and excess lipid production that forms brownish yellow clumps, which adhere to the hair and skin.
Characterized by dry skin and white to gray scales that do not adhere to the hair or skin.
Characterized by dry skin and white to gray scales that do not adhere to the hair or skin.
seborrheic dermatitis
An inflammatory type of seborrhea characterized by scaling and greasiness.
secondary intention healing
Healing of a wound by granulation tissue formation, contraction, and epithelization to achieve structural integrity.
sedative
A drug used to suppress brain activity and awareness; reduced excitement by causing sleepiness.
segmentation
Periodic constriction of segments of the intestine without movement backward or forward; a mixing rather than a propulsive movement.
solute
A substance dissolved in a solvent to form a solution.
solution
A mixture of two or more substances that are combined with each other.
solvent
A solution capable of dissolving other substances
somatic pain
Pain arising from bones, joints, muscle, or skin. Somatic pain is described in humans as localized, sharp, constant, aching, or throbbing.
speculum
An instrument for dilating a body orifice or cavity to allow visual inspection.
sporicidal
An agent capable of killing spores.
statement (billing)
A document generated by the vendor that details the quantity and pricing of all goods purchased (usually in 1 month) by the buyer. The total balance is generally expected to be paid in full within 30 days.
stem cell
Cells found in embryonic tissue and the adult animal that have the ability for self-renewal, a lack of cellular specialization, and can give rise to other more specialized cells.
stock solution
A concentrated solution that will be diluted to a weaker solution for use.
stroke volume
The amount of blood ejected by the left ventricle with each beat.
surfactant (pulmonary)
A mixture of phospholipids secreted by type II alveolar cells that reduce surface tension in pulmonary fluids.
suspension
A preparation of solid particles dispersed in a liquid but not dissolved in it.
symbiosis
Two living organisms of different species living together.
sympathetic nervous system
That portion of the autonomic nervous system that arises from the thoracolumbar spinal cord, is mediated by catecholamines, and is concerned with the fight-or-flight response.
sympatholytic
A drug used to inhibit the activity of the sympathetic nervous system; block the effects of the adrenergic neurotransmitters.
sympathomimetic
A drug that mimics the effects of stimulating the sympathetic nervous system.
systole
Contraction of the heart muscle
tachyarrhythmia
Tachycardia associated with an irregularity in normal heart rhythm.
tachycardia
A faster-than-normal heart rate.
tachypnea
Rapid breathing.
teratogenic
An agent that causes harm to the developing fetus.
therapeutic index
Relationship between a drug’s ability to achieve the desired effect and its tendency to produce toxic effects.
thrombocytopenia
A decreased number of platelets.
thromboembolism
The condition that occurs when thrombus material becomes dislodged and is transported by the bloodstream to another site.
thrombophlebitis
Inflammation of a vein associated with a thrombus formation.
thrombus
A clot in the circulatory system.
total cost
A measure that includes the cost of an item plus tax.
total nutrient admixture
total nutrient admixture A solution used for parenteral administration that contains amino acids, lipids, dextrose, vitamins, and minerals.
totipotent (stem cell)
A cell existing in the zygote and fertilized oocyte that is capable of creating an entire animal including extra-embryonic membranes.
toxoid
Inactivated toxin that has been weakened by a chemical or heat treatment to eliminate the toxic qualities but retain antigenic properties.
tranquilizer
A drug used to calm a patient by decreasing anxiety, not necessarily reduce awareness.
transcellular fluid
Cerebrospinal fluid, aqueous humor of the eye, synovial fluid, gastrointestinal fluid, lymph, bile, and glandular and respiratory secretions.
transdermal application
The use of a patch applied to the skin to deliver a drug through an intact cutaneous surface to the systemic circulation.
transduction
The process that involves translation of noxious stimuli into electric activity at sensory nerve endings.
transmission
Conduction of pain impulses from peripheral pain receptors to the spinal cord.
triage
Process of sorting patients in an emergency based on medical priority. The goal is to quickly and systematically evaluate an animal for their injuries and determine which body system or which animal needs attention first.
trophic hormone
A hormone that results in production of a second hormone in a target gland.
turgor
Degree of fullness or congestion; describes the degree of elasticity of the skin.
turnover
The number of times a product is sold or used up in a veterinary facility. The minimum turnover rate should be established at four times a year.
upper motor neurons
Neurons in the cerebral cortex that conduct impulses from the motor cortex to the motor nuclei of the cerebral nerves or to the ventral gray columns of the spinal column. A sufficient number of lesions of upper motor neurons interrupt the inhibitory effect that upper motor neurons have on lower motor neurons, resulting in exaggerated or hyperactive reflexes.
upregulation
An increase in the number of cellular receptors to a molecule resulting in an increased sensitivity to the molecule.
uremia
Abnormally high concentrations of urea, creatinine, and other nitrogenous end products of protein and amino acid metabolism in the blood.
urinary incontinence
Lack of voluntary control over the normal excretion of urine.
urinary tract infection
Infection of the urinary tract. Infection may be localized or may affect the entire urinary tract.
Uvea
The vascular layer of the eye that comprises the iris, ciliary body, and choroid.
uveitis
Inflammation of the uvea.
vapor pressure
Vapor pressure of an agent indicates how volatile it is and the maximum concentration that can be achieved. Vapor pressure of an inhalant anesthetic is a measure of its tendency to evaporate.
vermicide
A drug that kills internal parasites.
vermifuge
A drug that paralyzes the internal parasite and gets expelled from the gastrointestinal tract into the feces.
vesicant
A substance that causes blister formation.
veterinarian–client–patient relationship
The set of circumstances that must exist between the veterinarian, the client, and the patient before the dispensing of prescription drugs is appropriate.
veterinary supply distributor
An intermediate company (i.e., not full service, not mail order) that generally stocks a large inventory and employs sales representatives who visit veterinary facilities.
virulence
The ability of an infectious agent to produce pathologic effects.
visceral pain
Pain arising from stretching, distension, or inflammation of viscera, described in humans as deep, cramping, or aching and difficult to localize.
viscid
Sticky.
vomiting center
An area in the medulla that may be stimulated by the chemoreceptor trigger zone, the cerebrum, or peripheral receptors to induce vomiting.
withdrawal time
The period of time from when the last dose of medication is administered to when the animal can be slaughtered for food or milk and eggs can be consumed safely.
wolbachia
A gram-negative intracellular bacteria living in the body of both the immature and adult heartworms; they play an important role in the worm’s survival and pathogenesis of the disease.
Acidifying agent; drug names
Ammonium chloride
Racemethionine
Adrenal suppressant; drug names
Trilostane
Adrenergic agonist; drug names
Ephedrine hydrochloride Epinephrine Fenoldopam mesylate Phenylpropanolamine hydrochloride Pseudoephedrine hydrochloride
Adrenolytic agent; drug names
Mitotane
Alkalinizing agent; drug names
Potassium citrate
Sodium bicarbonate
Alpha-2 antagonist; drug names
Atipamezole hydrochloride
Tolazoline
Yohimbine
Analgesic; drug names
Acetaminophen Amantadine Gabapentin Pregabalin Tramadol
Analgesic, opioid; drug names
Acetaminophen–codeine Buprenorphine hydrochloride Butorphanol tartrate Fentanyl citrate Fentanyl transdermal Hydrocodone Hydromorphone Meperidine Methadone hydrochloride Morphine sulfate Oxymorphone hydrochloride Pentazocine Remifentanil Sufentanil citrate
Analgesic, nonsteroidal antiinflammatory drug; names
Aspirin Carprofen Deracoxib Etodolac Firocoxib Flunixin meglumine Ibuprofen Indomethacin Ketoprofen Ketorolac tromethamine Meclofenamate sodium; Meclofenamic acid Meloxicam Naproxen Phenylbutazone Piroxicam Robenacoxib Tepoxalin
Analgesic, opioid, antitussive; drug names
Butorphanol
Codeine
Hydrocodone
Anesthetic (injectable); drug names
Alfaxalone
Ketamine hydrochloride
Propofol
Tiletamine–zolazepam
Anesthetic, alpha-2 agonist; drug names
Detomidine hydrochloride Dexmedetomidine Medetomidine hydrochloride Romifidine hydrochloride Xylazine hydrochloride
Anesthetic, barbiturate; drug names
Methohexital sodium
Pentobarbital sodium
Thiopental sodium
Anesthetic, inhalant (drug names)
Enflurane Halothane Isoflurane Methoxyflurane Sevoflurane
Antacid (drug names)
Aluminum hydroxide and aluminum carbonate
Antiarrhythmic (drug names)
Amiodarone Carvedilol Disopyramide Lidocaine Mexiletine Procainamide hydrochloride Quinidine Quinidine gluconate Quinidine polygalacturonate Quinidine sulfate Tocainide hydrochloride
antiarrhythmic, calcium channel blocker; drug names
ntiarrhythmic, calcium channel blocker
Diltiazem hydrochloride
Verapamil hydrochloride
Antiarthritic agent; drug names
Chondroitin sulfate
Glucosamine–chondroitin sulfate
Antibacterial; drug names
Chloramphenicol Dapsone Florfenicol Fosfomycin Isoniazid Linezolid Methenamine Nitrofurantoin Polymyxin B Pyrimethamine Rifampin
Antibacterial, aminoglycoside; drug names
Amikacin Gentamicin sulfate Kanamycin sulfate Neomycin Tobramycin sulfate
Antibacterial, antidiarrheal; drug names
Sulfasalazine
Antibacterial, antiparasitic; drug names
Metronidazole
Ronidazole
Antibacterial, beta-lactam; drug names
Amoxicillin Amoxicillin–clavulanate potassium Ampicillin Ampicillin–sulbactam Carbenicillin Cefaclor Cefadroxil Cefazolin sodium Cefdinir Cefepime Cefixime Cefotaxime sodium Cefotetan disodium Cefovecin Cefoxitin sodium Cefpodoxime proxetil Cefquinome Ceftazidime Ceftiofur crystalline free acid Ceftiofur hydrochloride Ceftiofur sodium Cephalexin Cloxacillin sodium Dicloxacillin sodium Doripenem Ertapenem Imipenem–cilastatin Meropenem Oxacillin sodium Penicillin G Piperacillin sodium Piperacillin-tazobactam Ticarcillin–clavulanate potassium Ticarcillin disodium
Antibacterial, fluoroquinolone; drug names
Ciprofloxacin hydrochloride Danofloxacin mesylate Difloxacin hydrochloride Enrofloxacin Marbofloxacin Moxifloxacin Norfloxacin Orbifloxacin Pradofloxacin
Antibacterial, glycopeptide; drug names
Vancomycin
Antibacterial, lincosamide drug names
Clindamycin hydrochloride Clindamycin palmitate Clindamycin phosphate Lincomycin hydrochloride Lincomycin hydrochloride monohydrate
Antibacterial, macrolide; drug names
Azithromycin Clarithromycin Erythromycin Tilmicosin phosphate Tulathromycin Tylosin
Antibacterial, potentiated sulfonamide; drug names
Ormetoprim–sulfadimethoxine
Trimethoprim–sulfadiazine
Trimethoprim–sulfamethoxazole
Antibacterial, sulfonamide; drug names
Sulfachlorpyridazine Sulfadiazine Sulfadimethoxine Sulfamethazine Sulfamethoxazole Sulfaquinoxaline
Antibacterial, tetracycline; drug names
Chlortetracycline Doxycycline Minocycline hydrochloride Oxytetracycline Tetracycline
Antibiotic, aminocyclitol; drug names
Spectinomycin
Anticancer agent; drug names
Asparaginase (L-asparaginase) Bleomycin sulfate Busulfan Carboplatin Chlorambucil Cisplatin Cyclophosphamide Cytarabine Dacarbazine Doxorubicin hydrochloride Fluorouracil Hydroxyurea Lomustine Melphalan Mercaptopurine Methotrexate Mitoxantrone hydrochloride Plicamycin Streptozocin Thioguanine Thiotepa Toceranib Vinblastine sulfate Vincristine sulfate Vinorelbine
Anticholinergic; drug names
Atropine sulfate
Glycopyrrolate
Hyoscyamine
Oxybutynin chloride
Anticholinesterase agent; drug names
Neostigmine
Physostigmine
Pyridostigmine bromide
Anticoagulant; drug names
Dalteparin
Enoxaparin
Heparin sodium
Warfarin sodium
Anticonvulsant; drug names
Bromide Clonazepam Clorazepate dipotassium Felbamate Levetiracetam Lorazepam Midazolam hydrochloride Oxazepam Phenobarbital Phenobarbital sodium Phenytoin Phenytoin sodium Primidone Valproate sodium Valproic acid Zonisamide
Anticonvulsant, analgesic; drug names
Gabapentin
Pregabalin
Anticonvulsant, tranquilizer; drug names
Diazepam
Midazolam
Antidiarrheal; drug names
Bismuth subsalicylate Diphenoxylate Kaolin–pectin Loperamide Mesalamine Olsalazine sodium Paregoric Propantheline bromide
Antidote; drug names
Charcoal, activated Deferoxamine mesylate Dimercaprol Edetate calcium disodium Flumazenil Fomepizole Leucovorin calcium Methylene blue 0.1% Penicillamine Pralidoxime chloride Succimer Trientine hydrochloride
Antiemetic; drug names
Aprepitant Dolasetron mesylate Dronabinol Granisetron hydrochloride Maropitant Meclizine Mirtazapine Ondansetron hydrochloride Trimethobenzamide
Antiemetic, antidiarrheal; drug names
Prochlorperazine edisylate Prochlorperazine maleate (with isopropamide iodide)
Antiemetic, phenothiazine; drug names
Chlorpromazine Prochlorperazine edisylate Prochlorperazine maleate Trifluoperazine hydrochloride Triflupromazine hydrochloride Trimeprazine tartrate
Antiemetic, phenothiazine, antihistamine; drug names
Promethazine hydrochloride
Propiopromazine hydrochloride
Antiemetic, prokinetic agent; drug names
Metoclopramide hydrochloride
Antiestrogen; drug names
Tamoxifen citrate
Antifungal; drug names
Amphotericin B Enilconazole Fluconazole Flucytosine Griseofulvin Itraconazole Ketoconazole Posaconazole Terbinafine hydrochloride Voriconazole
Antifungal, expectorant; drug names
Potassium iodide
Antihistamine; drug names
Cetirizine hydrochloride Chlorpheniramine maleate Cyproheptadine hydrochloride Dimenhydrinate Diphenhydramine hydrochloride Hydroxyzine Tripelennamine citrate
antihypercalcemic agent; drug names
Alendronate Etidronate disodium Pamidronate disodium Tiludronate disodium Zoledronate
Antihyperglycemic agent; drug names
Glipizide
Glyburide
Metformin
Antihyperlipidemic; drug names
Gemfibrozil
Antiinflammatory; drug names
Allopurinol Colchicine Dimethyl sulfoxide (DMSO) Niacinamide Pentoxifylline
Antiinflammatory, corticosteroid; drug names
Betamethasone Budesonide Desoxycorticosterone pivalate Dexamethasone Dexamethasone sodium phosphate Flumethasone Hydrocortisone Isoflupredone acetate Methylprednisolone Prednisolone Prednisolone acetate Prednisolone sodium succinate Prednisone Triamcinolone acetonide Triamcinolone diacetate Triamcinolone hexacetonide
Antimyasthenic; drug names
Edrophonium chloride
Antiobesity; drug names
Dirlotapide
Mitratapide
Antiparasitic; drug names
Afoxolaner Albendazole Amitraz Amprolium Bunamidine hydrochloride Dichlorvos Diethylcarbamazine citrate Dithiazanine iodide Doramectin Epsiprantel Febantel Fenbendazole Fluralaner Furazolidone Ivermectin Ivermectin-clorsuon Ivermectin–praziquantel Levamisole hydrochloride Lotilaner Lufenuron Lufenuron–milbemycin oxime Mebendazole Melarsomine Metaflumizone Milbemycin oxime Moxidectin Nitenpyram Oxfendazole Oxibendazole Paromomycin sulfate Piperazine Praziquantel Pyrantel pamoate Pyrantel tartrate Quinacrine hydrochloride Sarolaner Selamectin Spinosad Thenium closylate Thiabendazole Thiacetarsamide sodium
Antiplatelet agent; drug names
Clopidogrel
Dipyridamole
Antiprotozoal; drug names
Atovaquone Diclazuril Imidocarb hydrochloride Metronidazole Nitazoxanide Ponazuril Pyrimethamine–sulfadiazine Ronidazole Tinidazole Toltrazuril
Antispasmodic; drug names
N-Butylscopolammonium bromide
Antithyroid agent; drug names
Carbimazole
Iopanoic acid
Methimazole
Propylthiouracil
Antitussive, analgesic; drug names
Butorphanol
Dextromethorphan
Hydrocodone bitartrate
Antiulcer agent; drug names
Misoprostol
Sucralfate
Antiulcer agent, H2-blocker; drug names
Cimetidine hydrochloride
Famotidine
Nizatidine
Ranitidine hydrochloride
Antiulcer agent, proton-pump inhibitor; drug names
Omeprazole
Pantoprazole
Antiviral; drug names
Acyclovir Famciclovir Lysine (L-Lysine) Valacyclovir Zidovudine
Antiviral analgesic; drug names
Amantadine
Behavior-modifying drug; drug names
Buspirone hydrochloride
Trazodone
Behavior-modifying drug, SSRI; drug names
Fluoxetine hydrochloride
Paroxetine
Behavior-modifying drug, tricyclic; drug names
Amitriptyline hydrochloride
Clomipramine hydrochloride
Doxepin
Imipramine hydrochloride
Beta-agonist; drug names
Isoproterenol hydrochloride
Beta-blocker; drug names
Atenolol Bisoprolol Esmolol hydrochloride Metoprolol tartrate Propranolol hydrochloride Sotalol
Bronchodilator; drug names
Aminophylline
Oxtriphylline
Theophylline
Bronchodilator, beta-agonist; drug names
Albuterol sulfate Clenbuterol Metaproterenol sulfate Terbutaline sulfate Zilpaterol
Calcium supplement; drug names
Calcium carbonate Calcium chloride Calcium citrate Calcium gluconate and calcium borogluconate Calcium lactate
Cardiac inotropic agent; drug names
Digitoxin
Digoxin
Dobutamine hydrochloride
Pimobendan
Cholinergic; drug names
Bethanechol chloride
Corticosteroid, hormone; drug names
Fludrocortisone acetate
Dermatologic agent; drug names
Isotretinoin
Diuretic; drug names
Acetazolamide Bumetanide Chlorothiazide Dichlorphenamide Furosemide Hydrochlorothiazide Mannitol Methazolamide Spironolactone Torsemide Triamterene
Diuretic, laxative; drug names
Glycerin
Dopamine agonist; drug names
Bromocriptine mesylate Levodopa Pergolide Pergolide mesylate Selegiline hydrochloride
Emetic; drug names
Apomorphine hydrochloride
Ipecac
Expectorant; muscle relaxant; drug names
Guaifenesin
Fluid replacement; solution names
Dextran Dextrose solution Hetastarch Lactated Ringer’s solution Pentastarch Ringer’s solution Sodium chloride 0.9% Sodium chloride 7.2%
Hepatic protectant; drug names
S-adenosylmethionine (SAMe)
Silymarin
Hormone; drug names
Altrenogest Colony-stimulating factors Corticotropin Cosyntropin Danazol Darbepoietin Desmopressin acetate Diethylstilbestrol Epoetin alpha (erythropoietin) Estradiol cypionate Estriol Gonadorelin hydrochloride, gonadorelin diacetate tetrahydrate Gonadotropin, chorionic Growth hormone Insulin Levothyroxine sodium Liothyronine sodium Medroxyprogesterone acetate Megestrol acetate Testosterone Urofollitropin Vasopressin
Hormone, anabolic agent; drug names
Boldenone undecylenate Methyltestosterone Mibolerone Oxymetholone Stanozolol
Hormone, antagonist; drug names
Finasteride
Hormone, labor induction; drug names
Oxytocin
Hormone, thyroid; drug names
Thyroid-releasing hormone
Thyrotropin
Immunostimulant; drug names
Interferon
Lithium carbonate
Immunosuppressive agent; drug names
Auranofin Aurothioglucose Azathioprine Cyclophosphamide Cyclosporine Gold sodium thiomalate Leflunomide Mycophenolate Tacrolimus
Iodine supplement; drug names
Iodide
Potassium iodide
Sodium iodide (20%)
Laxative; drug names
Bisacodyl Cascara sagrada Castor oil Docusate Lactulose Magnesium citrate Magnesium hydroxide Mineral oil Polyethylene glycol electrolyte solution Psyllium Senna Ursodeoxycholic acid Ursodiol
Laxative, antiarrhythmic; drug names
Magnesium sulfate
Local anesthetic; drug names
Bupivacaine hydrochloride
Mepivacaine
Local anesthetic, antiarrhythmic; drug names
Lidocaine hydrochloride
Mucolytic; drug names
Dembrexine
Mucolytic, antidote; drug names
Acetylcysteine
Muscle relaxant; drug names
Atracurium besylate
Dantrolene sodium
Methocarbamol
Pancuronium bromide
Nutritional supplement; drug names
Ferrous sulfate Iron dextran MCT oil Taurine Zinc
Opioid antagonist; drug names
Naloxone hydrochloride
Naltrexone
Pancreatic enzyme; drug names
Pancrelipase
Phosphate supplement, urine acidifier; drug names
Potassium phosphate
Potassium supplement; drug names
Potassium chloride
Potassium gluconate
Prokinetic agent; drug names
Cisapride Domperidone Methylnaltrexone Metoclopramide Tegaserod
Prostaglandin; drug names
Cloprostenol
Dinoprost tromethamine
Prostaglandin F2 alpha
Respiratory stimulant; drug names
Doxapram hydrochloride
Tranquilizer, benzodiazepine; drug names
Alprazolam
Tranquilizer, phenothiazine; drug names
Acepromazine maleate
Vasodilator; drug names
Hydralazine hydrochloride Irbesartan Isosorbide dinitrate Isosorbide mononitrate Isoxsuprine Nitroglycerin Nitroprusside (sodium nitroprusside) Phenoxybenzamine hydrochloride Phentolamine mesylate Prazosin Sildenafil
Vasodilator, ACE inhibitor; drug names
Benazepril hydrochloride Captopril Enalapril maleate Irbesartan Lisinopril Losartan Ramipril Telmisartan Trandolapril
Vasodilator, calcium channel blocker; drug names
Amlodipine besylate
Nifedipine
Vasopressor; drug names
Arginine vasopressin
Methoxamine
Phenylephrine hydrochloride
Vitamin; drug names
Ascorbic acid Cyanocobalamin Dihydrotachysterol Ergocalciferol Phytonadione Riboflavin Thiamine hydrochloride Vitamin A Vitamin E Vitamin K
The Metric System of Weight
1 microgram (mcg) = 0.000001 gram (g) 1 microgram (mcg) = 0.001 mg 1 milligram (mg) = 0.001 g 1 milligram (mg) = 1000 mcg 1 gram (g) = 1000 mg 1 gram (g) = 0.001 kilogram (kg) 1 kilogram (kg) = 1000 g
The Metric System of Liquid Measure
1 milliliter (mL) = 1000 microliters (μL or mcL) 1 milliliter (mL) = 1 cubic centimeter (cc) 1 milliliter (mL) = 0.001 L 1 liter (L) = 1000 mL 1 liter (L) = 10 deciliters (dL) 1 teaspoon (tsp) = 5 mL 1 tablespoon (Tbsp) = 15 mL 1 tablespoon (Tbsp) = 3 teaspoons
The Avoirdupois Weights
1 grain (gr) = 65 milligrams (mg) 1 ounce (oz) = 437.5 grains (gr) 16 oz = 1 pound (lb) 1 pound (lb) = 0.454 kilograms (kg) 1 kilogram (kg) = 2.2 pounds (lb)
Equivalents (measurements)
1 grain (gr) 64.8 mg 1 ounce (oz) 28.35 g 1 pound (lb) 453.6 g 1 dram 1.772 g 1 minim 0.06 mL 1 fluid dram 3.7 mL 1 fluid ounce 29.57 mL 1 pint 473 mL 1 gallon 3786 mL 1 mg 0.0154 gr 1 g 15.432 gr 1 kg 2.2 lbs 1 gallon 8.35 lbs 1 mL 1 cubic centimeter 1 liquid pint 473.18 mL 1 liquid quart 946.35 mL 1 drop 0.05 mL 1 tsp 5 mL 3 tsp 1 Tbsp 1 Tbsp 15 mL
W/V
weight/ volume = grams/deciliter
(v/w * %) means: v/w * 10 = mg/ mL
mg/mL * 1000 = mcg/mL
see pg 428 for conversions
Dry Weight/ Volume Conversions
1 lb 454 g 1 g 0.0022 lbs 1 g 1000 mg 1 g 1,000,000 mcg 1 kg 1000 g 1 kg 2.2 lbs 1 mg 0.001 g 1 mcg 0.001 mg 1 μg/g 1 ppm 1 L 1000 mL 1 mL 1000 mcL
millimeters of mercury
mm Hg
Conversions
1 dram 1.772 g 1 drop (gt) 0.05 mL 20 drops 1 cc or mL 1 glass (8 oz) 240 mL 1 gr 0.065 g or 65 mg 1 g 15.43 gr 1 L 1.06 qt 1 L 33.81 fl. oz 1 cup 236.59 mLs 1 mg 0.015432 gr 1 mL 16.23 minims 1 oz 28.35 g 1 oz 29.574 mLs 1 pt 473 mLs 1 qt 946 mLs 1 tablespoon 15 mLs 1 teaspoon 5 mLs
temperature conversions
°Fahrenheit to °Celsius: (°F − 32°) (5/9) °Celsius to °Fahrenheit: (°C) (9/5) + 32° 98.6 37.0 99.0 37.2 100.0 37.7 101.0 38.3 102.0 38.8 103.0 39.4 104.0 40.0 105.0 40.5 106.0 41.1
Ear Abbreviations
AD right ear
AL left ear
AU each ear
Eye Abbreviations
OD right eye
OS left eye
OU both eyes
Cholinergic Agents
drugs that stimulate receptor sites mediated by acetylcholine. They achieve these effects by mimicking the action of acetylcholine (direct-acting) or by inhibiting its breakdown (indirect-acting). Cholinergic agents are also called parasympathomimetic
Cholinergic Agent Actions
- Aid in the diagnosis of myasthenia gravis
- Reduce the intraocular pressure of glaucoma
- Stimulate GI motility
- Treat urinary retention
- Control vomiting
- Act as an antidote for neuromuscular blockers
Organophosphate compounds
Cholinergic Agent.
Antidote is Atropine sulfate:
0.02–0.04 mg/kg, as needed
Cholinergic Blocking Agents
(Anticholinergic) drugs that block the action of acetylcholine at muscarinic receptors of the parasympathetic nervous system. Anticholinergic agents are also called parasympatholytic
Cholinergic Blocking Agent Actions
- Treatment of diarrhea and vomiting via a decrease in GI motility
- Drying of secretions and prevention of bradycardia before anesthesia
- Dilation of the pupils for ophthalmic examination
- Relief of ciliary spasm of the eye
- Treatment of sinus bradycardia
Adrenergic Agents
(sympathomimetic) action at receptors mediated by epinephrine or norepinephrine; mimic “fight or flight” response. Adrenergic agents. Classified as catecholamines or noncatecholamines, and also classified according to the specific receptors (alpha-1, alpha-2, beta-1, beta-2).
Adrenergic Agent Receptor Activity
In most cases, alpha receptor activity causes an excitatory response (except in the GI tract), and beta stimulation causes an inhibitory response (except in the heart).
Adrenergic Agent Activity
To stimulate the heart to beat during cardiac arrest
• To reverse the hypotension and bronchoconstriction of anaphylactic shock
• To strengthen the heart during congestive heart failure
• To correct hypotension through vasoconstriction
• To reduce capillary bleeding through vasoconstriction
• To treat urinary incontinence
• To reduce mucous membrane congestion (vasoconstriction) in allergic conditions
• To prolong the effects of local anesthetic agents by causing vasoconstriction of blood vessels at the injection site, thereby prolonging their absorption
• To treat glaucoma (alpha stimulation increases the outflow of and beta stimulation decreases the production of aqueous humor)
Adrenergic Agent Side Effects
tachycardia, hypertension, nervousness, and cardiac arrhythmias. Hypertension, arrhythmia, and pulmonary edema may occur with an overdose.
cholinergic blockers side effects
Dose related. Overdoses can cause drowsiness, disorientation, tachycardia, photophobia, constipation, anxiety, and burning at the injection site.
cholinergic drugs Side Effects
May include bradycardia, hypotension, heart block, lacrimation, diarrhea, vomiting, increased intestinal activity, intestinal rupture, and increased bronchial secretions.
Adrenergic Blocking Agents
(sympatholytic) agents disrupt/inhibit the activity of the sympathetic nervous system. Classified according to the site of their action as an alpha blocker, beta blocker, or ganglionic blocker. Drugs usually block only one category of receptor.
Alpha blockers
Have had limited use in veterinary medicine. Phenoxybenzamine has been advocated by some clinicians for the treatment of laminitis in horses and urethral obstruction in cats.
Alpha Blockers used in Vet Med
- Phenoxybenzamine: vasodilator. blocked cats and laminitis in horses
- Acepromazine: tranquilizer, sedative, causes vasodilation.
- Prazosin: Prazosin is a hypotensive agent. It is also used to treat urethral spasms
- Yohimbine (Yobine): Yohimbine= antidote for xylazine toxicity.
- Atipamezole (Antisedan): Atipamezole =reversal agent for dexmedetomidine
Alpha Blockers Side Effects
May include hypotension (phenoxybenzamine, tranquilizers, prazosin), tachycardia (phenoxybenzamine), muscle tremors (yohimbine), and seizures (acepromazine).
Beta blockers
Used to treat glaucoma, arrhythmias, and hypertrophic cardiomyopathy.
Beta Blockers Side Effects
include bradycardia, hypotension, worsening of heart failure, bronchoconstriction, heart block, and syncope.
Ganglionic Blockers
Ganglionic blockers are seldom used in veterinary medicine.
Central Nervous System Drugs
- Tranquilizers
- Barbiturates
- Dissociatives
- Opioid/antagonists
- Neuroleptanalgesics/antagonists
- Drugs to prevent or control seizures
- Inhalants
- Miscellaneous CNS drugs
- CNS stimulants
- Euthanasia agents
Tranquilizers: action
CNS drug. decrease anxiety without causing excessive sedation or drowsiness; animals are usually aware of their surroundings but do not appear to care. Tranquilizers do not provide analgesia. (Phenothiazine derivative tranquilizers = acepromazine)
Sedatives: Action
CNS drug. used to suppress brain activity and awareness to prevent movement for some short medical procedures; animals are usually unaware of their surroundings and are drowsy. Sedatives offer some analgesia.
Phenothiazine Derivatives
The mechanism of action of the phenothiazine derivatives on the CNS is not well understood. However, it has been proposed that they are dopamine blockers The effects on the cardiovascular system are a result of alpha-adrenergic blockade. tranquilizers produce an antiemetic effect by depressing the chemoreceptor trigger zone in the brain and have a mild antipruritic effect. These agents also reduce the tendency of epinephrine to induce cardiac arrhythmias. Most are metabolized by the liver and excreted by the kidneys.
Phenothiazine derivative tranquilizers side effects
can cause hypotension and hypothermia through their vasodilator effects (alpha blockade). Acepromazine has been avoided in epileptic animals as it was previously cautioned that it lowered the seizure threshold and caused seizures. However, there is no clinical evidence to support this claim and some studies have shown that it has some anticonvulsant activity. Phenothiazine derivatives should not be used within 1 month of worming with an organophosphate anthelmintic.The tranquilizing effect may be reduced in an excited animal.
Benzodiazepine Derivatives
mechanism of action of diazepam occurs through depression of the thalamic and hypothalamic areas of the brain. This drug produces sedation, muscle relaxation, appetite stimulation (especially in cats), and anticonvulsant activity. Diazepam also produces minimal depression of the cardiovascular and respiratory systems when compared with other CNS depressants. Diazepam is painful if administered intramuscularly. Midazolam is very similar to diazepam but has a greater potency. Midazolam is water soluble and absorbed well after intramuscular injection. Clinical uses include sedation, relief of anxiety and behavioral disorders, treatment of seizures, and appetite stimulation. Diazepam can be used as an injectable anesthetic
Benzodiazepine Derivatives side effects
Several potential drug interactions can occur when diazepam is administered simultaneously with other drugs, and appropriate references should be consulted.
side effects are limited when used as directed. Dogs can exhibit excitement. An overdose may cause excessive CNS depression.
Benzodiazepine Derivatives considerations
Diazepam should be stored at room temperature and protected from light.
• Diazepam should not be stored in plastic syringes or in solution bags because it can be absorbed into the plastic.
• Manufacturers recommend that it not be mixed with other medications or solutions.
Diazepam is metabolized by the liver and eliminated by the kidneys.
• Alprazolam is also used as an appetite stimulant.
Alpha-2 Agonists
sedative analgesics used commonly in veterinary medicine. They provide sedation, analgesia, muscle relaxation, and antianxiety. The CNS effects of alpha-2 agonists can be antagonized by alpha-2 receptor antagonists such as yohimbine, tolazoline, and atipamezole.
Xylazine Hydrochloride
alpha-2 agonist with sedative, analgesic, and muscle relaxant properties. It is approved for use in dogs, cats, horses, deer, and elk. This agent causes vomiting in a large percentage of cats and in some dogs. Xylazine is antagonized by yohimbine. It produces effective analgesia in horses and is often used for treating the pain associated with colic and for sedation for minor procedures.
Xylazine Hydrochloride Side Effects
These include bradycardia, hypotension, respiratory depression, and increased sensitivity to epinephrine, resulting in cardiac arrhythmias. An overdose increases the potential for these effects. Because of the potential of xylazine to cause bradycardia or heart block in dogs, atropine should be used as a premedicant in this species.
• Xylazine is used in cattle at one-tenth of the equine dose.
• Horses may appear heavily sedated with xylazine and still respond to painful stimuli by kicking.
• Small-animal (20 mg/mL) and large-animal (100 mg/mL) concentrations are available. Care should be taken not to confuse them when administering a drug dose to an animal.
Detomidine Hydrochloride
similar to xylazine, is an alpha-2 agonist. It is approved as a sedative/analgesic for horses,
Detomidine Hydrochloride Side Effects
These may include sweating, muscle tremors, penile prolapse, bradycardia, and heart block.
The manufacturer warns that detomidine should be used very carefully with other sedative drugs and that it should not be used with potentiated sulfa drugs such as trimethoprim/sulfamethoxazole.
Medetomidine
is an alpha-2-adrenergic agonist labeled for use as a sedative and analgesic in dogs older than 12 weeks. Atipamezole (Antisedan) is the reversal agent for this drug.
Uses include facilitating clinical examination, minor surgical procedures, and minor dental procedures that do not require intubation.
Medetomidine Side effects
include bradycardia (product insert states that hemodynamics are maintained), atrioventricular heart block, decreased respirations, hypothermia, urination, vomiting, hyperglycemia, and pain at the injection site.
Dexmedetomidine
is an alpha-2-adrenergic agonist labeled for use as a sedative and analgesic in dogs and cats. It is a “right-handed” enantiomer (isomer) of medetomidine. considered to be more potent than medetomidine in terms of its ability to produce analgesia and sedation. Atipamezole is the reversal agent for dexmedetomidine.
opioids and ketamine to produce surgical anesthetic levels. A combination of these three products for cats is sometimes called “kitty magic.”
Dexmedetomidine Side Effects
These include bradycardia, hypertension, vomiting, atrioventricular block, muscle tremors, and others.
Dexmedetomidine should not be used in dogs or cats with cardiovascular, respiratory, kidney, or liver disease or in patients with shock or severe debilitation or stress due to heat, cold, or fatigue.
Before the use of dexmedetomidine in combination with other sedatives is attempted, references should be consulted for potential side effects and dosages.
Romifidine
Romifidine is an alpha-2-adrenergic agonist labeled for use in horses.
Barbiturates
one of the oldest categories of CNS depressants. sedatives, anticonvulsants, general anesthetics, and euthanasia agents.
great potential for complications because of their potent depressing effects on the cardiac and pulmonary systems (especially in cats) and because they are nonreversible and must be metabolized by the liver before elimination can occur.
classified as long-acting, short-acting, and ultrashort-acting.
Phenobarbital
is used primarily as an anticonvulsant and is the drug of choice for long-term control of epileptic seizures. It is administered by the oral route. Phenobarbital is a Class IV controlled substance. a barbiturate. 8-12 hrs
Pentobarbital sodium
provides 1 to 2 hours of general anesthesia. used primarily for controlling seizures in progress and as a euthanasia agent. Intravenous administration of glucose or concurrent use of chloramphenicol may prolong the recovery period. Pentobarbital is a Class II controlled substance.
Thiobarbiturates
Thiobarbiturates are very alkaline. must be given intravenously to avoid necrosis and subsequent sloughing of tissue. Thiobarbiturates are redistributed into the fat stores of the body within 5 to 30 minutes. can also cause a period of CNS excitement when administered intravenously if they are given too slowly. It is often recommended to give one-third to one-half of the calculated dose rapidly to avoid the excitement phase. remainder of the dose is administered in increments until the desired effect is achieved.
Barbiturates Side Effects
These include excessive CNS depression, paradoxical CNS excitement, severe respiratory depression, and cardiovascular depression. Tissue irritation may occur when barbiturates are injected perivascularly.
- Recovery from pentobarbital is often prolonged, and dogs exhibit padding limb movements during this time.
- Thiobarbiturates should not be used in sighthounds or in any very thin animal.
- Giving additional doses of thiobarbiturates may prolong recovery.
- Barbiturates are potent depressors of the respiratory system.
dissociative agents
belong to the cyclohexylamine family, inclluding phencyclidine, ketamine, and tiletamine. Involuntary muscle rigidity (catalepsy), amnesia, and analgesia characterize dissociative anesthesia. Pharyngeal/laryngeal reflexes maintained, and muscle tone is increased. deep abdominal pain not eliminated with dissociative anesthesia; recommended only for restraint, diagnostic procedures, and minor surgery. Increased salivation may occur and can be controlled or prevented with the use of atropine or glycopyrrolate
dissociative agents side effects
usually associated with high doses and include spastic jerking movement, convulsions, respiratory depression, burning at the intramuscular injection site, and drying of the cornea.
Metabolites of the dissociative agents are excreted through the kidneys. These drugs may be contraindicated in animals with compromised kidney function.
• Use in animals with certain cardiac conditions (potentially hypertensive) may be dangerous.
opioid Agonists
is any compound derived from opium poppy alkaloids and synthetic drugs with similar pharmacologic properties. These drugs produce analgesia and sedation (hypnosis) while reducing anxiety and fear. Narcotic effects are produced in combination with opiate receptors at deep levels of the brain (e.g., thalamus, hypothalamus, limbic system)
At low doses, the opioids have antitussive (cough suppression) properties because of depression of the cough center in the brain; they also have antidiarrheal action because of a reduction in peristalsis or segmental contractions.
Opioid receptors
- Mu—found in pain-regulating areas of the brain; contribute to analgesia, euphoria, respiratory depression, physical dependence, and hypothermic actions.
- Kappa—found in the cerebral cortex and spinal cord; contribute to analgesia, sedation, depression, and miosis.
- Sigma—may be responsible for struggling, whining, hallucinations, and mydriatic effects.
- Delta—modify mu receptor activity; contribute to analgesia.
Opioid side effects
These can include respiratory depression, excitement (cats and horses), nausea, vomiting, diarrhea, defecation, panting, and convulsions. Overdose causes profound respiratory depression.
Naturally Occurring Narcotics
Opium
Morphine sulfate
Synthetic Narcotics
Meperidine; mu agonist, acute pain
Oxymorphone; semisynthetic; mu agonist.
Butorphanol tartrate; synthetic, opioid agonist/antagonist. agonist on kappa and sigma receptors, antagonist activity occurs at the mu receptor. should not be used as the only analgesic agent; antitussive agent in dogs.
Fentanyl; opioid agonist
Hydrocodone bitartrate; antitussive agent in dogs.
Etorphine (M-99): produces analgesic effects 1000 times those of morphine. It is restricted to use in zoo or exotic animal practice. lethal to people who accidentally inject themselves (it also can be absorbed through intact skin) if the antagonist (diprenorphine) is not administered immediately.
Codeine; an antitussive in dogs
tramadol
Apomorphine
a dopamine agonist derived from morphine with the principal effect of inducing vomiting by stimulating the chemoreceptor trigger zone in the brain. This drug is often administered by placing a portion of a tablet in the conjunctival sac for absorption. synthetic narcotic
Buprenorphine
partial mu agonist–antagonist. It is a potent analgesic that is used in several small animal species with especially good results in the cat. Buprenorphine has a longer duration of action than butorphanol.
Opioid antagonists
block the effects of opioids by binding with opiate receptors, displacing narcotic molecules already present, and preventing further narcotic binding at the sites. classified as pure antagonists or as partial antagonists. partial antagonists may have some agonist activity (analgesic and respiratory depressant effects).
Opioid Antagonists Side Effects
Nalorphine may induce respiratory depression. Naloxone usually has few adverse effects if given in the correct dose.
Opioid Antagonist Drug Names
Naloxone: is a pure opioid antagonist that is chemically similar to oxymorphone, with high affinity for mu receptors. It has no agonist activity. It is commonly used to reverse the CNS and respiratory depression caused by administration of opioid drugs.
• Nalorphine (Nalline): Nalorphine is a partial antagonist that may produce unpleasant analgesic and respiratory depressant effects.
• Butorphanol: This is a mu antagonist used primarily as a sedative or analgesic. It is rarely used as an antagonist.
neuroleptanalgesic agent
consists of an opioid and a tranquilizer. Animals that receive neuroleptanalgesics may or may not remain conscious. They often defecate and are highly responsive to sound stimuli.
Any combination of an opioid analgesic, and a tranquilizer (ace-hydro, dexmed-hydro etc.)
neuroleptanalgesic agent
These can include panting, flatulence, personality changes, increased sound sensitivity, and bradycardia. An overdose may cause severe depression of the CNS, respiratory system, and cardiovascular system.
Causes of Seizures
include but not limited to: unknown (idiopathic), infectious (postdistemper), traumatic (head injury), toxic (strychnine poisoning), and metabolic (heatstroke) factors.
Anti-Seizure Drugs
Diazepam: give IV or rectally, 3- to 4-hour duration of action.
Pentobarbital: give IV, 1- to 3-hour duration.
Phenobarbital: oral and parenteral formulations. injectable form is used in horses (foals) by some clinicians. Drowsiness may occur.
.Bromide: old anticonvulsant. use as adjunct to phenobarbital or primidone.
• Gabapentin: use as an adjunctive treatment of difficult to control seizures, partial complex seizures or pain control.
• Levetiracetam (Kappra): May be useful as an adjunct for refractory canine epilepsy.
Anti-Seizure medication side effects
may include drowsiness, CNS depression, anxiety, agitation, polyuria, polydipsia, and hepatotoxicity (phenobarbital and primidone)
Inadequate compliance is a frequent cause of failure of anticonvulsant therapy.
Reserpine and phenothiazine drugs should not be given to epileptic animals.
Inhalant anesthetic agents mechanism of action
From the alveoli of the lungs, they are absorbed into the bloodstream and delivered to the CNS, where they produce unconsciousness, analgesia, and muscle relaxation through mechanisms not fully understood. Generally require little biotransformation for elimination from the body. They enter and exit the body through the lungs
MAC
Minimum Alveolar Concentration. Value of an anesthetic agent is a measure of potency and is the alveolar concentration that prevents gross purposeful movement in 50% of patients in response to a standardized painful stimulus. a low MAC is a more potent anesthetic than an agent with a high MAC. lower the MAC the less gas it takes
partition coefficient
is the ratio of the number of molecules of an anesthetic gas that exist in two phases (blood/gas). indicates the solubility of an inhalation agent in blood as compared with alveolar gas. The key factor determining the speed of induction and recovery from inhalation anesthesia is the blood-gas partition coefficient.
vapor pressure
indicates how volatile it is and the maximum concentration that can be achieved. a measure of an inhalant anesthetic’s tendency to evaporate.
Precision vaporizers
Are located out of the circuit and are designed for use with only one specific anesthetic agent. purpose is to convert liquid anesthetic to gas and produce a precise concentration of anesthetic vapor in the carrier gas (oxygen) passing through the vaporizer and delivered to the patient.
Isoflurane
Isoflurane: A halogenated ether, it is one of the least soluble of the inhalant agents. Isoflurane allows a stable heart rhythm and does not decrease cardiac output at clinically used levels. It is metabolized at a very low rate (<0.2%)
Sevoflurane
halogenated ether with little odor, cardiovascular and respiratory effects are similar to those of isoflurane. Sevoflurane is often used in high-risk, small-animal patients because of its safety and rapid, smooth induction. Only 3% is metabolized.
Halothane
halogenated hydrocarbon. sensitizes the heart to the catecholamines; this may result in cardiac dysrhythmias. metabolized at the rate of 25%. inhalant anesthetic. No longer available in USA
Methoxyflurane
a methyl-ethyl-ether that is highly soluble in blood and other tissues. A very slow induction and recovery time. most potent (MAC, 0.23%–0.27%) of the agents in this section. Biotransformation at 50%, associated with renal toxicity in humans. Not available in USA.
Nitrous oxide
inorganic gas, may be used with more potent agents during mask induction to speed up induction of GA, which cannot be produced with nitrous oxide alone. lowest solubility coefficient. displaces nitrogen from the alveoli, blood, and gas-filled cavities of the body. it will diffuse into and potentially cause distention of gas-filled areas. always give with Oxygen to prevent hypoxia, and give O2 for several minutes after its turned off to prevent diffusion hypoxia.
Propofol
short-acting hypnotic. an alkylphenol derivative. Give slow IV. Sedation, restraint, or unconsciousness, depending on the dose. A bolus lasts 2 to 5 minutes. Some are without a preservative and are only good for 6 hrs refrigerated. Used for Anesthetic induction, a substitute for barbiturates in sighthounds, for patients with preexisting cardiac arrhythmia, and dogs undergoing a c-section because it does not cross the placental barrier.
Propofol Side-Effects
Apnea may occur if propofol is given too rapidly intravenously. Occasional seizure-like signs may be seen. Prolonged recovery and/or Heinz body production may be seen in cats with repeated use.
Guaifenesin
skeletal muscle relaxant that effects the connecting neurons of the spinal cord and brainstem. used in equine medicine to induce general anesthesia, extend the anesthetic activity of other injectable field anesthetics, or enhance muscle relaxation of anesthetized patients. Use as a 5% or 10% solution in 5% dextrose
GKX- Guaifenesin, Ketamine, Xylazine.
Warming 5% dextrose before mixing may aid preparation. Mix immediately before use because a precipitate forms if the solution is allowed to stand.
Guaifenesin side effects
Adverse side effects are limited. Hemolysis has been reported when greater than 5% solutions are used.
Doxapram
activates the respiratory system by stimulating respiratory centers in the medulla. stimulate respiration in newborns and use during or after anesthesia in which the respiratory rate and depth of respirations need to be increased. Can be used in CPA; not a substitute for artificial respiratory support. May be contraindicated in states of apnea. Give IV, under the tongue (one to two drops) or into the umbilical vein.
Doxapram Side Effects
Adverse side effects are rare and usually are associated with overdoses. Hypertension, seizures, and hyperventilation may occur. safety of doxapram in pregnant animals has not been established
Neuromuscular blocking agents
Used as an adjunct to general anesthesia. And to facilitate endotracheal intubation. Muscle Relaxants. Don’t provide analgesia or sedation. They do stop ventilation.
Neuromuscular Blocking Agents- Depolarizing Agents.
Depolarizing agents act in a way that is similar to that of acetylcholine at the neuromuscular synapse, but the effects last longer, leading to muscle paralysis (phase I block). Are not broken down by acetylcholinesterase and have no antagonist.
Neuromuscular Blocking Agents- Non-Depolarizing Agents.
Prevent acetylcholine from binding to receptor sites (phase II block). These drugs are not degraded by cholinesterase, but they can be antagonized by edrophonium or neostigmine.
Neurotransmitters Involved in Behavioral Pharmacology
Dopamine, norepinephrine, and serotonin are monoamine neurotransmitters. found in large quantities in areas of the brain often associated with expression and control of emotions. primary method by which monoamines are inactivated is through their reuptake from the synapse back into synaptic vesicles in nerve endings. Drugs that block or inhibit their reuptake increase their activity.
Acetylcholine is the most widely distributed neurotransmitter in the body. It is associated with a variety of behavioral effects and is inactivated by cholinesterase at the synapse
GABA is considered to be an inhibitory neurotransmitter and is widely distributed in the brain.
Anti-Anxiety Medications
benzodiazepines: treatment of fears and phobias, separation anxiety, aggression, anxiety-induced stereotypes, urine marking in cats, and appetite stimulation.
azapirone agent = Buspirone. The antianxiety effect is thought to be caused by blocking serotonin receptors. control of urine spraying/marking and the control of fearfulness and anxiety.
Dexmedetomidine Oromucosal Gel. highly potent and selective alpha-2 adrenoceptor agonist. preventing release of norepinephrine and reducing the levels leading to decreased anxiey.
Tricyclics: amitriptyline, imipramine, and clomipramine. prevent reuptake of norepinephrine and serotonin. Clomipramine is apparently a selective inhibitor of serotonin reuptake. for Separation anxiety, obsessive disorders, fearful aggression, hyperactivity, hypervocalization, and urine marking.
Serotonin reuptake inhibitors: fluoxetine, sertraline, and paroxetine. inhibit serotonin reuptake back into the nerve terminal. obsessive disorders, phobias, aggression, inappropriate urine marking, and separation anxiety.
Anti-Anxiety Medication Side Effects
Benzodiazepines: include lethargy, ataxia, polyuria and polydipsia (PUPD), hyperexcitability, and hepatic necrosis (cats).
Azapirones: Few serious side effects appear to exist.
Dexmedetomidine Oral Get: Temporary pale mucous membranes may occur at the site of application. It may also cause hypotension, bradycardia, and drowsiness.
Tricyclics: sedation, tachycardia, heart block, mydriasis, dry mouth, reduced tear production, urine retention, and constipation.
SSRIs: anorexia, nausea, lethargy, anxiety, and diarrhea.
Trazodone
serotonin antagonist and reuptake inhibitor used in anxiety and noise aversion. Causes serotonin to remain in the brainstem longer allowing for less anxiety. short-term anxiety relief in dogs and cats.
Trazadone Side Effects
Adverse effects may include sedation, aggression, and nausea
Monoamine Oxidase-B Inhibitors
Anipryl. treatment of old-dog dementia and treatment of canine Cushing’s disease. Dopamine broken down by MAO-B. this inhibits MAO-B and allow dopamine levels to increase.
Monoamine Oxidase-B Inhibitor side effects
Side effects include vomiting, diarrhea, anorexia, restlessness, lethargy, salivation, shaking, and deafness.
Synthetic progestins (as behaviour modifying drugs)
Mechanisms associated with changing hormonal levels (reduced gonadotropins) or through some direct effect on the cerebral cortex. treatment of urine spraying/marking, intermale aggression, and dominance aggression.
Synthetic Progestins Side Effects
Transient diabetes mellitus (cats), PUPD, increased weight gain, personality changes, endometritis, endometrial hyperplasia, mammary hypertrophy, mammary tumor, adrenal atrophy, and lactation are side effects.
Miscellaneous Behavioral Agents
- Gabapentin: used for anxiety or social phobias.
- Clorazepate: used for anxiety or social phobias
- Methylphenidate: used for hyperactivity in dogs
Euthanasia Agents
These agents are used to produce a rapid, humane death. usually some combination of Pentobarbital sodium. Twitching may occur, death may be delayed if given outside the vein
Functions that the respiratory system
- Oxygen–carbon dioxide exchange
- Regulation of acid–base balance
- Body temperature regulation
- Voice production
work of the respiratory system
Ventilation—movement of air into and out of the lungs. The inspiratory portion of ventilation is usually an active process, whereas expiration is usually a passive process.
Distribution—distributing of inspired gases throughout the lungs.
Diffusion—movement of gases across the alveolar membrane.
Perfusion—supply of blood to the alveoli. The ratio of perfusion to ventilation of the alveoli is normally close to 1:1.
Goals of Respiratory Disease Therapy
control of secretions, Control of reflexes, Maintaining normal airflow to the alveoli
Aerosolization
(nebulization) allows delivery at high concentrations directly into the airways while minimizing their blood levels— this may reduce the chance of a toxic reaction. optimum particle size 1-5 microns.
nebulizers
produce and deliver smaller particles that reach deep into the respiratory system. use compressors to create an aerosol that can be inhaled without the necessity of using positive pressure to force the aerosol into the airways. Ultrasonic and jet nebulizers available. used primarily in the treatment of respiratory infections. provide airway humidification (saline), mucolytics, bronchodilators, and antimicrobials.
metered dose inhaler
MDIs deliver particles to the upper airways. designed for home use. aerosol of an MDI is driven by a propellant- chlorofluorocarbons (CFCs) (older) or hydrofluoroalkanes (HFAs), which contain no chlorine and do not affect the ozone. (newer). used primarily for feline lower airway disease (asthma), lower airway disease in horses, lower airway disease (bronchitis) in dogs. frequently contain bronchodilators like albuterol or clenbuterol and/or corticosteroids. Aerochamber.
Expectorants
liquefy and dilute viscid secretions of the respiratory tract, thereby helping in evacuation of those secretions. Most administered orally, a few are given by inhalation or parenterally. indicated with a productive cough.
Guaifenesin, Ethylenediamine dihydriodide (iodide preparation), Hypertonic Saline
Mucolytics
decrease the viscosity of respiratory secretions by altering the chemical composition of the mucus through the breakdown of chemical (disulfide) bonds. Acetylcysteine is the only one in vet med. administered by nebulization for pulmonary uses.
Mucolytic Side Effects
are few when acetylcysteine is nebulized. However, the drug may cause nausea or vomiting when administered orally.
Antitussives
inhibit or suppress coughing. used to treat dry, nonproductive coughs such as tracheobronchitis (kennel cough) in dogs. Centrally acting agents suppress coughing by depressing the cough center in the brain, peripherally acting agents depress cough receptors in the airways (rarely used).
Hydrocodone
Hydrocodone is used primarily as an antitussive for harsh, nonproductive coughs.
Hydrocodone side effects
These include potential sedation, constipation, and gastrointestinal upset.
Codeine
help manage moderate pain and may be used in some cases as a cough suppressant and antidiarrheal.
Orally administered codeine is poorly absorbed in the dog and not commonly used.
Codeine
Adverse side effects include sedation and constipation.
Dextromethorphan
nonnarcotic antitussive that is chemically similar to codeine. It has no analgesic or addictive properties. It acts centrally and elevates the cough threshold. may be used in cats without acetaminophen. in dogs is poorly absorbed and does not attain effective concentrations after oral administration
Dextromethorphan
Adverse side effects are rare when this drug is given in the correct dose but can include drowsiness and gastrointestinal upset.
Temaril-P (Vanectyl-P)
contains a centrally acting antitussive (trimeprazine tartrate) and a corticosteroid (prednisolone). antitussive, an antipruritic and an antiinflammatory.
Temaril-P (Vanectyl-P) side effects
sedation, depression, hypotension, and minor central nervous system signs.
mechanisms of bronchoconstriction
Contraction of smooth muscle fibers can result from three basic mechanisms:
- Release of acetylcholine at parasympathetic nerve endings or inhibition of acetylcholinesterase. Increased acetylcholine levels also tend to increase secretions of the respiratory tract, thus reducing airflow and adding to the level of dyspnea.
- Release of histamine through allergic or inflammatory mechanisms. Histamine combines with H1 receptors on smooth muscle fibers to cause bronchoconstriction. Histamine also increases the inflammatory response in the airways, further leading to increased levels of secretion and viscosity.
- Blockade of beta2-adrenergic receptors by drugs such as propranolol results in bronchoconstriction. Stimulation of beta2-adrenergic receptors, however, produces bronchodilation.
Cholinergic blockers
produce bronchodilation by combining with acetylcholine receptors on smooth muscle fibers and preventing the bronchoconstrictive effects of acetylcholine
Beta2-adrenergic agonists (bronchodilation)
combine with appropriate receptors on the smooth muscle fibers and effect relaxation of those fibers. They also stabilize mast cells and reduce the amount of histamine released. preferred that they have limited beta1 activity because beta1 stimulation can produce tachycardia.
Epinephrine, Pseudoephedrine, Albuterol
Beta2-adrenergic agonists (bronchodilation) side effects
include tachycardia and hypertension.
Methylxanthines
inhibit phosphodiesterase. When beta2 receptors are stimulated, cyclic adenosine monophosphate (cyclic AMP), released in the smooth muscle cell, completes relaxation response to allow dilation. Phosphodiesterase inhibits cyclic AMP in the cell, promoting bronchoconstriction. By inhibiting the inhibitor (phosphodiesterase) and allowing cyclic AMP to accumulate, the methylxanthines tend to promote bronchodilation. also cause mild stimulation of the heart and respiratory muscles and minor diuresis. Theophylline and Aminophylline
Methylxanthines side effects
include GI upset, central nervous system stimulation, tachycardia, ataxia, and arrhythmia.
theophylline may interact adversely with many drugs, including phenobarbital, cimetidine, erythromycin, thiabendazole, clindamycin, and lincomycin, appropriate precautions should be taken before this drug is administered.
Decongestants
reduce the congestion of nasal membranes by reducing associated swelling through vasoconstriction of nasal blood vessels. limited use in vet med, their effectiveness has not been demonstrated
Antihistamines
block the effects of histamine. Histamine is released from mast cells by the allergic response and combines with H1 receptors on bronchiole smooth muscle to cause bronchoconstriction. may be useful in treating respiratory disease. thought to be more effective when used prophylactically because they do not replace histamine that has already combined with receptors
Antihistamine side effects
These include sedation and, occasionally, gastrointestinal effects.
Corticosteroids
treatment of allergic respiratory conditions. They are considered the most effective drugs in the treatment of equine chronic obstructive pulmonary disease. for inhalation therapy, have strong antiinflammatory effects locally in the lungs, and are rapidly biodegraded when absorbed into the general circulation. Oral (prednisone or prednisolone) are the drugs of choice for chronic airway inflammation. Oral prednisolone should be used in cats as they do not absorb or convert prednisone to prednisolone as well as dogs
Corticosteroid side effects
associated with long-term use of the drug. Some of the effects include polyphagia, polydipsia/polyuria, behavior changes, gastrointestinal ulceration, delayed wound healing, and immunosuppression.
Mast Cell Stabilizers
(Cromolyn Sodium for Inhalation) inhibits the release of histamine and leukotrienes from sensitized mast cells found in nasal and lung mucosa and in the eyes. It may also inhibit bronchospasm. It is used primarily in the treatment of horses with RAO (recurrent airway obstruction—heaves).
Leukotriene Antagonists
Leukotrienes are proinflammatory products of arachidonic acid released from mast cells and eosinophils. used in veterinary medicine to treat feline asthma, inflammatory bowel disease (IBD), heartworm respiratory disease syndrome, and upper respiratory infection,canine atopic dermatitis.
Diuretics
used to remove excess extracellular fluid by increasing urine flow and sodium excretion and by reducing hypertension.
Loop Diuretic
highly potent diuretics that inhibit the tubular reabsorption of sodium. promote the excretion of chloride, potassium, and water.
Uses of Loop Diuretics
treatment of congestive heart failure (CHF) in canines and felines, pulmonary edema, udder edema, hypercalcemic nephropathy, and uremia, as an adjunct in the treatment of hyperkalemia, and sometimes as an antihypertensive agent
Side Effects of Loop Diuretics
hypokalemia, other fluid and electrolyte abnormalities, ototoxicity, gastrointestinal distress, hematologic effects, weakness, and restlessness
Osmotic diuretics
give IV to promote diuresis by exerting high osmotic pressure in the kidney tubules and limiting tubular reabsorption. Water is drawn into the glomerular filtrate, which reduces its reabsorption rate and increases the excretion of water.
Indications of Osmotic Diuretics
oliguric renal failure, reduction of intraocular and cerebrospinal fluid (intracerebral) pressure, and rapid reduction of edema or ascites
Osmotic Diuretic Side Effects
should not be used in patients with anuria secondary to renal disease, in patients that are severely dehydrated, or in patients with pulmonary congestion or edema. Osmotic diuretics may cause fluid and electrolyte imbalances
Thiazide diuretics
reduce edema by inhibiting reabsorption of sodium, chloride, and water. Their duration of action is longer than that of loop diuretics. These drugs cross the placental border.
Thiazide Diuretic Indications
used for the treatment of nephrogenic diabetes insipidus and hypertension in dogs. Hydrochlorothiazide may be used in the treatment of calcium oxalate uroliths, hypoglycemia, and as a diuretic for patients with heart failure
Thiazide Diuretic Side Effects
hypokalemia, hypersensitivity, should not be used during pregnancy or with severe renal disease, preexisting electrolyte/water balance abnormalities, hepatic disease, or diabetes mellitus. The drugs may cause gastrointestinal upset
Potassium-sparing diuretics
weaker diuretic and antihypertensive effects than other diuretics. conserve potassium. aldosterone antagonists. enhances the excretion of sodium and water and reduces the excretion of potassium.
potassium-sparing diuretic indications
used to help manage edema or fluid retention due to congestive heart failure, ascites, hypertension and other conditions where the body retains excess fluids. It may be used along with furosemide, digoxin, or angiotensin-converting enzyme (ACE) inhibitors in cases of congestive heart failure or fluid retention due to liver failure
Potassium-Sparing Diuretic Side Effects
uncommon, but hyperkalemia may result if administered with potassium supplements or ACE inhibitors. Do not give to patients with hyperkalemia, Addison’s disease, anuria, acute renal failure, or significant renal impairment
carbonic anhydrase inhibitor
decreases the rate of carbonic acid and hydrogen production in the kidney, promoting excretion of solutes and increasing the rate of urinary output. reduce intraocular pressure by reducing the production of aqueous humor
Carbonic Anhydrase Inhibitor Indications
metabolic alkalosis, glaucoma, and hyperkalemic periodic paralysis (HYPP) in horses
Carbonic Anhydrase Inhibitor side effects.
Hypokalemia. Don’t give acetazolamide to patients with hepatic, renal, pulmonary, or adrenocortical insufficiency; hyponatremia; hypokalemia; or electrolyte imbalances. Don’t give Dichlorphenamide and methazolamide to patients with hyperchloremic acidosis
Cholinergic Agonists in Renal/Urinary conditions.
parasympathomimetic. These drugs are used primarily to increase the contractility of the urinary bladder.
Cholinergic Agonists side effects
cholinergic toxicity, SLUD. Don’t give to patients with gastrointestinal obstructions or if integrity of urinary bladder wall is unknown.
cholinergic crisis may occur if this drug is injected IV or SQ, so atropine should be readily available (vomiting, defecation, dyspnea, and tremors)
Anticholinergic drugs in Renal/Urinary conditions.
parasympatholytic. treats urge incontinence by promoting the retention of urine in the urinary bladder.
Anticholinergic Drug Side Effects
decreased gastric motility and delayed gastric emptying, which may decrease the absorption of other medications.
Adrenergic Antagonists
sympatholytic. Classified based on which receptors they antagonize.
Alpha-adrenergic antagonists
relax vascular smooth muscle, enhance peripheral vasodilation, and decrease blood pressure by interrupting the actions of sympathomimetic agents at alpha-adrenergic receptor sites.
Alpha-adrenergic antagonists in the renal/ urinary system indications
internal sphincter tone when the urethral sphincter is in hypertonus. Metabolized by the liver
Alpha-adrenergic antagonists in the renal/ urinary system side effects
rapid decrease in blood pressure, resulting in weakness or syncope after the first dose of prazosin. This is usually self-limiting. Phenoxybenzamine hydrogen chloride (HCl) should not be used in horses exhibiting clinical signs of colic and can cause increased intraocular pressure, tachycardia, nasal congestion, inhibition of ejaculation, weakness/dizziness, gastrointestinal effects, and constipation in equines.
Beta-Adrenergic Antagonists in the renal/urinary system
inhibit the action of catecholamines and other sympathomimetic agents at beta-adrenergic receptor sites. AKA: inhibiting stimulation of the sympathetic nervous system. Control of mild to moderate hypertension associated with chronic renal failure.
Beta-Adrenergic Antagonist side effects.
Decreased cardiac output and the promotion of bronchospasm.
Combination with a diuretic is common because of the tendency of beta-adrenergic antagonists to cause salt and fluid retention.
Angiotensin-Converting Enzyme Inhibitors
ACE Inhibitors: block the conversion of angiotensin I to angiotensin II (both produced in the liver), decrease aldosterone secretion, reduce peripheral arterial resistance, and alleviate vasoconstriction. treat heart failure, hypertension, chronic renal failure, and protein-losing glomerulonephropathies in dogs and cats.
Angiotensin-Converting Enzyme Inhibitor Side Effects
include complications in patients with renal insufficiency caused by excretion by the kidneys.
Vasodilators and Calcium Channel Blockers in Urinary/ Renal Conditions.
treat nonresponding hypertension. Dopamine may be used to promote diuresis in patients unresponsive to loop or osmotic diuretics.
Vasodilators and Calcium Channel Blockers in Urinary/ Renal Conditions side effects
hypotension, edema, conduction disturbances, heart failure, and bradycardia.
Anti-Diuretic Hormone.
Used to treat diabetes insipidus. Side effects uncommon.
Urinary Acidifiers
preventing formation of struvite uroliths. Since the introduction of urinary acidifying diets, urinary acidifiers have not been routinely prescribed.
Urinary Acidifiers Side Effects
preventing formation of struvite uroliths. Since the introduction of urinary acidifying diets, urinary acidifiers have not been routinely prescribed.
It is very important to inform clients who may change from using an acidifier to one of the available acidifying diets that while the diet is being administered, no acidifiers, salt, vitamin or mineral supplements, or any other food items—other than what is allowed in the diet—should be given to the patient.
Xanthine Oxidase Inhibitors
decrease the production of uric acid and are used in combination with a urate calculolytic diet for the dissolution of ammonium acid urate uroliths. Once dissolution occurs, a urine-alkalizing, low-protein, low-purine, low-oxalate diet is usually prescribed to prevent recurrence of uroliths.
Xanthine Oxidase Inhibitor Side Effects
These are uncommon, but Hypersensitivity and hepatic and renal effects can occur.
Urinary Alkalizers
used in the management of ammonium acid urate, calcium oxalate, and cystine urolithiasis.
Urinary Alkalizer Side Effects
These include possible fluid and electrolyte imbalance with the use of sodium bicarbonate.
Epoetin Alpha
a last ditch effort to treat renal patients with anemia. Product is a human recombinant, no animal ones available on the market.
Epoetin Alpha Side Effects
include local or systemic allergic reactions in animals and pain occurring at the injection site.
Neurogenic Urinary Disorder.
Pharmacologic agents are selected for management of urinary incontinence when urinary tract infection, morphologic abnormalities, and mechanical types of excessive outlet resistance have been excluded as possible causes of the problem, which is evidenced by a neurologic lesion that affects the upper motor neuron segments or the lower motor neuron segments. the detrusor muscle contractions are normal, but bladder and urethral functions are abnormal.
Urinary Tract Analgesics and SIde Effects
Phenazopyridine
Amitriptyline
dry mouth, rapid heart rate, and sedation (i.e., antihistamine effects) are associated with this drug. High doses can cause heart toxicity. Sometimes it may cause cats to be less interested in grooming themselves. Additionally, weight gain may occur
Glycosaminoglycans
(GAGs) Urothelial GAGs have the ability to keep microorganisms and crystals from adhering to the urinary bladder wall and limit the transepithelial movement of urine proteins and solutes.
Glycosaminoglycan Side Effects
The safety and efficacy of GAGs for the treatment of FLUTD have not been reported. In canines, vomiting, anorexia, lethargy, or mild depression are possible. Pentosan has some anticoagulant effects, so bleeding is possible in any species
Epakitin
chitosan-based nutritional supplement made from a polysaccharide extracted from crab and shrimp shells. binds phosphorus in the intestine, causing phosphorus to be eliminated through the intestinal tract- used for renal failure
Azodyl
nutritional supplement that has the potential to reduce the azotemia of renal failure by flushing out uremic toxins and slowing down uremic toxin buildup to help prevent further damage to the kidney.
A&P of the Heart
Artria- two dorsal chambers, right and left
ventricals - two ventral chambers, right and left.
Both composed of Myocardium (muscle).
Vena Cava- brings blood to the R Atrium, which goes through the tricuspid (atrioventricular valve) into the R ventricle, and then to pulmonary artery (and to the lungs)
Pulmonary vein- brings blood back and into the left atrium, which then goes through the bicuspid (mitral) valve, into the L ventricle, and out the aorta to systemic circulation.
SA node impulses
Impulses generated by the sinoatrial node travel over the atria to the atrioventricular node, face a brief delay (about 0.1 second) in the atrioventricular node, travel down the bundle of His to its left and right branches, and pass into the ventricular muscle via the Purkinje fibers (located at the apex of the heart).
Depolarization
rapid influx of sodium ions into the cell through channels, and the slower influx of calcium ions, and the outflow of potassium ions
Repolarization
return of the ions to their original positions is brought about in part by the sodium-potassium pump
Impact of the autonomic nervous system on the heart:
sympathetic portion of the autonomic nervous system, through beta1 receptors, produces positive chronotropic and inotropic effects on the heart. The parasympathetic branch of the autonomic nervous system causes negative chronotropic effects through cholinergic receptors.
four basic factors of cardiac reserve or compensation
- Increasing the heart rate. (there will be inadequate time for ventricular filling)
- Increasing the stroke volume.
- Increasing the efficiency of the heart muscle.
- Cardiac remodeling. The heart responds by increasing its size and becoming stronger. This change usually precedes the development of heart failure signs by months or years.
Valvular disease.
Valvular insufficiency, a backflow or leakage of blood backward through the valve
Myocardial Disease
Cardiomyopathy. congestive (the myocardium becomes thin and ineffective in its pumping action) or hypertrophic (the myocardium becomes thickened and restricts ventricular filling). may be accompanied by arrhythmias.
Congestive Heart Failure
occurs when the pumping ability of the heart is impaired so sodium and water are retained in an effort to compensate for inadequate cardiac output. - exercise intolerance, pulmonary edema, and ascites, usually heart re-modelling
Basic objectives in controlling heart failure
• Control rhythm disturbances
• Maintain or increase cardiac output
• Increase the strength of contraction
• Decrease the afterload
Arteriolar dilator
Decrease the preload
Venodilator
Relieve fluid accumulations
Diuretics
Dietary salt restriction
• Increase the oxygenation of the blood
Bronchodilation
• Ancillary treatment
Narcotics/sedatives
OxygenCardiac Disease Stage A
1 of 4. High risk for development of heart failure but no structural abnormality of the heart. No treatment at this time
Cardiac Disease Stage B
2 of 4. Structural abnormality present but no signs of heart failure.
Beta Blockers, ACE Inhibitors, Low-Sodium Diet,
Cardiac Disease Stage C
3 of 4. Structural abnormality present, and current or previous signs of heart failure/coughing, reduced exercise tolerance
Dog: diuretic, pimobendan ACEI, sodium restricted diet
Cat: diuretic, ACEI
Cardiac Disease Stage D
4 of 4. End stage signs of heart failure resistant to standard treatment/dyspnea at rest
multimodal therapy
Positive Inotropic Drugs
cautious use of positive inotropic drugs because these can increase the oxygen demand of cardiac muscle, can potentially damage the contractile apparatus, and can increase the tendency for arrhythmias. Proof of clinical efficacy of positive inotropic drugs is lacking, and their use is controversial
Cardiac Glycosides (Digitalis)
Digoxin and Digitoxin. Positive Inotropic Drugs.
-improved cardiac contractility, decreased heart rate, antiarrhythmic effects, decreased signs of dyspnea.
increases level of Ca+ available to contractile filaments at the inhibition of the sodium- potassium-ATPase.
-increase the force of contraction, decrease the rate of contraction, and, improve baroreceptor function
indications and side effects of cardiac glycosides
indications: CHF, atrial fibrillation, and supraventricular tachycardia.
Side effects: associated with high or toxic serum levels- anorexia, vomiting, diarrhea, and various arrhythmias. Cats are relatively more sensitive than dogs to toxic effects. Give lower doses to renal patients. these compounds are adversely affected when given concurrently with many drugs. bioavailability changes with drug form
Catecholamines
sympathomimetics (adrenergics) that increase the force and rate of heart contraction (increase in cardiac output), constrict peripheral blood vessels (increase blood pressure), and elevate blood glucose levels. increased cardiac contractility mostly by beta1 receptors. short term managment (short serum half lives)
Epinephrine
Positive Inotropic Cardiac drug. a catecholamine. stimulation for contraction of the heart and support of the circulatory system after CPA. intracardiac, intratracheal, or intravenous. Not used for CHF because of greatly increased heart workload, and increased tendency of arrhythmias.
Isoproterenol
Positive Inotropic Cardiac drug. for cardiac arrhythmias and acute bronchial constriction, atropine-resistant bradycardia. Not commonly used.
side effects: tachycardia and ventricular arrhythmias.
Dopamine
a positive inotropic drug, catecholamine. biosynthetic precursor of norepinephrine. stimulates dopaminergic receptors in coronary, mesenteric, renal, and cerebral vascular beds. Can stimulate alpha- and beta-adrenergic receptors to increase heart contractility, HR, and blood pressure. use is limited to heart failure associated with anesthetic emergencies or after CPR, oliguric renal failure and for the supportive treatment of shock. vomiting, tachycardia, dyspnea, and blood pressure variations.
Dobutamine
synthetic (positive) inotropic agent related structurally to dopamine. causes increased cardiac contractility, but doesn’t produce dilation of selected vascular beds. direct beta1-adrenergic agent. produces increased cardiac output with little tendency to cause arrhythmias or increased heart rate. Give diluted by IV infusion. For acute heart failure like DCM. can cause tachycardia and ventricular arrhythmias.
