Pharmacology Flashcards
1
Q
Trilostane
A
- Steroid analogue
- competitive inhibitor of 3 β-hydroxysteroid dehydrogenase enzyme system and thus interferes with adrenal steroid biosynthesis
- Following oral administration in dogs, peak trilostane concentrations are seen in 1.5 hours and decrease to baseline values in about 18 hours
-
Dose: 2–5 mg/kg daily per os
- dosage can be adjusted according to response. Treatment should be monitored using the ACTH stimulation test trying to get the post stimulation cortisol down to below 120 nmol/l starting 2 to 4 hours after oral administration.
- In some individuals trilostane may need to be given twice daily.
- Trilostane should be used with caution in dogs with impaired renal function and may cause reversible hypoadrenocorticism in some dogs. Hypoadrenocorticism does occur with over-dosage, but should resolve on withdrawal of the drug.
- The prevalence of side effects with trilostane is generally considered to be lower than with mitotane.
- If failure to respond is regarded as an adverse effect then it is probably the most common adverse effect of trilostane administration
- Another common side effect is an increase in the size of the adrenal glands and a change in the echotexture
- The most serious side effect of trilostane that has been identified to date is acute adrenal necrosis
2
Q
Mitotane
A
- Mitotane is the treatment of choice for pituitary-dependent hyperadrenocorticism.
- During its evaluation as an insecticide, mitotane was discovered to have adrenocorticolytic effects.
- It selectively destroys the zona fasciculata (glucocorticoids) and zona reticularis (sex hormones - androgens) while tending to preserve the zona glomerulosa (mineralocorticoids).
- Mitotane therapy should only be considered once the diagnosis of hyperadrenocorticism has been confirmed. Because of its powerful effects, it should never be used empirically.
- Maintenance therapy: Mitotane is given at a dose of 50 mg/kg/week with food
3
Q
Mitotane and Trilostane Therapy
A
- effective and relatively safe in dogs with adrenal-dependent hyperadrenocorticism.
- Dogs with adrenal tumours however, tend to be more resistant to mitotane and trilostane than dogs with pituitary-dependent hyperadrenocorticism.
- Generally dogs with adrenal-dependent hyperadrenocorticism require higher daily induction doses of mitotane (50–75 mg/kg/day) and a longer period of induction (> 14 days) than dogs with pituitary-dependent hyperadrenocorticism.
- Frequent monitoring of treatment by ACTH stimulation testing is important to ensure adequate control of the hyperadrenocorticism
4
Q
Florinef
(fludrocortisone acetate)
A
Tx for Hypoadrenocorticism (Addisons)
- mineralocorticoid used to treat adrenal gland insufficiency or hypoadrenocorticism (Addison’s disease). It may also be used with other medications to treat hyperkalemia.
-
Florinef is given usually twice a day at a dose determined by the patient’s sodium and potassium blood tests.
- At first, these electrolytes are monitored weekly.
- When levels seem stable, these blood tests are repeated two to four times per year.
- Often with time, it will be found that the Florinef dose needed will increase.
- This increase is unfortunate as the medication is relatively expensive.
- Since Florinef has glucocorticoid activity as well as mineralocorticoid activity, it is usually not necessary to use additional medications for treatment.
5
Q
DOCP injection
(Desoxycorticosterone pivalate)
A
- an injectable medication approved by the FDA for treatment of Addison’s disease in dogs.
- It is injected every 3–4 weeks, depending on the patient, and replaces the missing mineralocorticoid aldosterone.
- Electrolytes are measured prior to injections at first but testing can usually eventually be tapered to once or twice a year. There is some feeling among experts that DOCP produces better regulation of electrolytes than does oral Florinef.
- Dogs on DOCP, however, do require glucocorticoid supplementation (such as a low dose of prednisone)
6
Q
Metronidazole
A
- Metronidazole (also known by the brand names Flagyl, Metizol, Protostat, Metrogel) is a strong antibiotic primarily used as an antidiarrheal to treat inflammation of the large intestine.
- It’s also used for other illnesses and conditions in dogs, cats, and horses, as well as to treat bacterial infections in humans.
7
Q
Albuterol
A
- Used primarily as a bronchodilator; available in oral and inhaled dosage forms
- Use with caution in patients with cardiac dysrhythmias or dysfunction, seizure disorders, hypertension, or hyperthyroidism
DOG:
- 0.02 – 0.05 mg/kg (20 – 50 µg/kg) PO every 8 to 12 hours
CAT: (feline asthma)
- 1 puff (90 µg) may be repeated up to 3 times every 5 to 15 minutes
8
Q
Fluticasone
(Flovent HFA)
A
- Glucocorticoid used most commonly in veterinary medicine as an inhaled aerosol as local treatment of a condition while minimizing systemic adverse effects.
- Has shown efficacy in the treatment of feline asthma, as well as chronic inflammatory airway disease in dogs and horses
- Must be used with a species-appropriate delivery device
9
Q
Milbemycin Oxime
(Sentinel®, Sentinel Spectrum®, Trifexis®, Interceptor Plus, Interceptor)
A
- Milbemycin tablets for dogs are labeled as a once-a-month heartworm preventative (Dirofilaria immitis) and for hookworm control (Ancylostoma caninum). It is also labeled for control and removal of adult roundworms (Toxocara canis, Toxascaris leonina) and whipworms (Trichuris vulpis). - 6 WEEKS OR OLDER
- Heartworm and Tapeworm Coverage
- Milbemycin tablets for cats are labeled as a once-a-month heartworm preventative (D. immitis) and as removal for hookworms (Ancylostoma tubaeforme). It is also used for removal of adult roundworms (Toxocara cati).
10
Q
Pyrantel
A
- Pyrantel is FDA approved for removal of ascarids (eg, Toxocara canis, Toxascaris leonina) and hookworms
11
Q
Nexgard
(Afoxolaner)
A
- Chewable oral tablet for use in dogs and puppies 8 weeks of age and older and weighing at least 1.8 kg (4 lb)
- flea and tick prevention
- puppy friendly
- Labeled for monthly treatment and prevention of flea infestations and for monthly treatment and control of American dog tick, black-legged tick, lone star tick, and brown dog tick infestations
- Indicated for the prevention of Borrelia burgdorferi (Lyme Disease) infections as a direct result of killing Ixodes scapularis vector ticks before disease transmission occurs
12
Q
Simbadol or Buprenex
A
Buprenorphine
- Partial μ-opioid agonist used primarily as an injectable and buccal (ie, oral transmucosal [OTM]) analgesic, especially cats
- Often used as a component of short-term immobilization drug combinations
- Buccal/OTM administration well-tolerated and can be effective
13
Q
Proin
(phenylpropanolamine hydrochloride)
A
Sympathomimetic
Sympathomimetic used primarily to treat acquired urethral sphincter hypotonus in spayed dogs
Should be used with caution in animals with glaucoma, prostatic hypertrophy, hyperthyroidism, diabetes mellitus, cardiovascular disorders, and/or hypertension
14
Q
Cerenia
A
Maropitant
FDA approved for use in dogs and cats as an antiemetic
Because maropitant acts at the emetic center, it is effective for the treatment of emesis mediated via either peripheral or central mechanisms.
The SC injection is FDA-approved for the prevention and treatment of acute vomiting (dogs) and treatment of vomiting (cats). SC injections may cause pain and swelling at injection site. Refrigerating the injection may reduce pain
1mg/kg SQ
15
Q
Balance It Canine
A
Vitamin, mineral, and amino acid powder to create homemade dog food. Just mix with fresh foods you like to feed and your dog enjoys.
