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Test 3 Flashcards

1
Q
    • Volume of distribution definition/equation
A

V= amount of drug in the body / concentration measured in plasma.
A hypothetical volume of body fluid that would be required to dissolve the total amount of drug needed to achieve the same concentration as that found in the blood.

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2
Q
    • Cephalosporins:
      Metabolism:
      Elimination:
      Legalities:
A

Metabolism: ONLY CEFTIOFUR IS METABOLIZED (ceftiofur is not active until metabolized).
Elimination: Most are eliminated by the kidney as the parent drug. Good for urinary tract infections.
Legalities: (excluding Cephapirin) Illegal for extralabel (except for EL purpose) use in cattle, swine, poultry

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3
Q

Drugs in 2nd Generation Cephalosporins

A

Cefoxitin

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4
Q

Drugs in 3rd Generation Cephalosporins

A

Cefotaxime
Ceftiofur
Cefpodoxime
Cefovecin

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5
Q

Drugs in 4th Generation Cephalosporins

A

Cefepime

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6
Q

Drugs in Group 7 Cephalosporins

A

Cefepime

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7
Q

Drugs in Group 5 Cephalosporins

A

Cefpodoxime

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8
Q

Drugs in Group 4 Cephalosporins

A

Cefotaxime
Ceftiofur
Cefovecin

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9
Q

Drugs in Group 3 Cephalosporins

A

Cefoxitin

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10
Q

Drugs in Group 2 Cephalosporins

A

Cephalexin

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11
Q

Drugs in Group 1 Cephalosporins

A

Cephapirin

Cefazolin

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12
Q

1st Generation Cephalosporins

MOA:
AE:
CI: 
Legal:
What do they Treat?
A

MOA: Inhib cell wall synth
AE: Allergies, bleeding problems
CI: not for animals allergic to beta lac, rec. warfarin anticoag.
Legal: Cephapirin = withdrawal for milk/cattle
TX: Gram+,
cephapirin used for mastitis

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13
Q

2nd generation cephalosporins

MOA:
AE:
CI:
TX:

A
  • MOA: inhib cell wall synth.
  • AE: allergies, agg. bldg problems
  • Not for animals allegic to beta lac./rec. warfarin anticoag.
  • TX: enterobac, anaerobes
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14
Q

3rd generation cephalosporins

list them:
MOA:
AE:
CI:
TX:
Legal:
A

List: Cefotaxime, Cefpodoxime, Ceftiofur, Cefovexin
MOA: inhib. cell wall synth
AE: allergies, agg. bldg problems
- Ceftiofur: BM suppression, thrombocytopenia, anemia, diarrhea in horses
- Cefovecin: vomit/dia in dogs/cats, inj. site irr. and edema, long half life at site of inj. GI upset
CI: allergies and warfarn normal but:
- Ceftiofur - don’t give IV, High doses, don’t combine formulations
TX: NOT Staph. aureus, pseudomonas, Gram - Anaerobes
Legal: Ceftiofur withdrawal, Cefovecin not for FA

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15
Q

4th Generation Cephalosporins

List them:
MOA:
AE:
CI:
TX:
A

List: Cefepime (grp7)
MOA: inhib. cell wall synth.
AE: allergies, bldg disorders, vomit/dia
CI: nor for Blactam allergic, reduce to less intervals w/patients w/renal failure
TX: Respiratory, Enterobacteriacea, Pseudomonas

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16
Q

Carpabenems

List them

A

Imipenem

Meropenem

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17
Q

Imipenem

MOA:
AE:
CI:
TX:

A

MOA: binds PBP-1 and weakens cell wall faster than other beta lactams
AE: allergies, rapid infusion = neurotox., nephrotox, vomit, nausea, IM painful
CI: use caution in animals prone to seizure. DRUG OF LAST RESORT.
TX: Everything (not mycoplasma, spirochetes)

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18
Q

Meropenem

MOA:
AE:
CI:
TX:

A

MOA: binds PBP-1 which weakens cell wall faster than other beta lactams
AE: less prone to seizures than imipenem, allergies, SQ injections may experience hair loss
CI: yellow discoloration when reconstituted, dark indicates loss of potency. DRUG OF LAST RESORT.
TX: Everything (not spyro or myco)

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19
Q

Metronidazole

  • MOA:
  • AE:
  • CI:
  • TX:
  • Legal:
A
  • MOA: reduced in anaerobic environment, (electron sink) to toxic intermediate.
  • AE: CNS Toxicity via inhib. of GABA; mutagen, vomiting, anorexia, benzoic acid toxic to cats, Type II idiopathic
    CI: caution w/seizure animals esp. w/renal failure
    TX: Anaerobes, protozoa
    legal: ILLEGAL FOR EXTRALABEL USE IN FA
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20
Q

Polymixins

MOA:
AE:
TX:

A

MOA: interfere w/bacterial cell membrane function, inhib. formation and prot. synth
AE: narrow therapeutic index, renal injury at long/high doses, hydrate or kidney dmg, doesn’t work w/puss/detergents
TX: Enterobacteriacea

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21
Q

Bacitracin

MOA:
AE:
TX:

A

MOA: interferes with bacterial cell membrane function.
AE: Nephrotox, hypersens. rxns
TX: most Gram -

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22
Q

Nitrofurans

MOA: 
AE:
CI: 
TX:
Legal:
A

MOA: Urinary antiseptic, thera conc. reached only in urine, inhib. bac. DNA/RNA
AE: naus, vomit, dia, urine turns rust yellow/brwn,
CI: not while prego, can cause hemoly. anemia in newborn, not for neonates
TX: UTI’s
Legal: Illegal in FA

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23
Q

Rifampin

MOA:
AE:
TX:

A

MOA: inh. bac. RNA synth
lipid sol. can enter cells and conc. in leuko to inhib intracell. bac.; complexes w/beta subunit of DNA dependant RNA polymerase to inactivate it.
AE: people - hypersens/flu like symptoms
- hepatotox in dogs, elevated liver enzymes, urine orange to red/organge, may discolor saliva, teaers, feces, sclera and mucousm., ubpalatable, pancreatitis
- INDUCES CytP450 so may increase met. of other drugs
TX: Gram+, used w/macrolides

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24
Q

Amphoteracin B

Class of Drug:
MOA: 
AE: 
CI:
Effect:
A

CoD: Antifungal
MOA: binds to ergosterol in cell membrane causing loss of integrity, leaking, cell death
AE: Dose dep. nephrotox., fever phlebitis, tremors, renal potassium wasting, CHECK FOR CASTS, BUN, CREATINE, Nyastatin - PU/PD, V/D
CI: NOT FOR PTNTS W/RENAL DZ OR IN DEHYDRATED
Effect: fungicidal drug for systemic fungi, some protozoa

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25
Caspofungin MOA; AE: CI: Effect:
MOA: inhib. Glucan in fungal cell wall; inhib. cell wall synth AE: hepatic sens, GI symptoms, increased liver enzymes CI: acts w/cyclosp. cause elevated liver enz and tacrolimus Effect: Fungicidal
26
Flucytosine MOA: AE: CI: Effect:
MOA: converted to flurorouracil, acts as antimetabolite, pen. fungal cell wall AE: anemia, thrombocytopenia, cutaneous and mucocutaneous eruptions in dogs CI: Not for dogs Effect: tx cryptococcal meningitis often in combo w/Amphoteracin
27
Griseofulvin ``` Class of drug: MOA: AE: CI: TX: Legal: ```
Class: Antifungal MOA: inhib mitosis of fungal cells, kills them AE: teratogen, anemia, leukopenia, anorexia, depression, v/d, FIV-marrow toxicosis w/irrevers. pancytopenia CI: not for prego cats, caution if have FIV TX: DOC for systemic dermatophyte treatment Legal: not for for FA as it's teratogenic
28
Terbinafine ``` COD: MOA: AE: CI: TX ```
COD: Allylamin antifungal MOA: targets squalene epoxidase to inhibit ergosterol synth. AE: Vomit, nausea, anorexia, increased liver enzymes, facial puritis, hapatotoxic CI: none; note, stays longer in hair than does systemic TX: used for dermatophyte and Malazzezia yeast infections
29
Flucanoazole ``` COD: MOA: AE: CI: TX: Legal: ```
COD: Azole antifungal MOA: inhib ergosterol synth. in cell membrane AE: hepatopathy, increased liver enzyme, endocrine dysfunction CI: caution in prego animals, fetal abnormalities in lab animals TX: works on dermatophytes, systemic fungi and yeasts (candida, coccidiodes and cryptococcus) Legal: none
30
Itraconazole ``` COD: MOA: AE: CI: TX: ```
COD: Azole antifungal MOA: inhib ergosterol synth. in cell membrane AE: hepatotoxicity, INC. LIVER ENZYMES, NO endocrine dysf., vaculitis and skin lesions in dogs, vomiting in cats, anemia CI: caution w/liver dz and prego, fetal abnormalities in lab animals. TX: works on dermatophytes, systemic fungi, blastomyces, histoplasma, coccidiodes
31
ketoconazole ``` COD: MOA: AE: CI: TX: Legal: ```
COD: Azole antifungal MOA: inhib ergosterol synth. in cell membrane, INHIBITS CYT. P450 enzyme in fungi AE: hepatotox, increased liver enzyes, endocrine dys., low cortisol and testosterone, V/D, hepatic injury, lighter hair, cataracts, lower hormone synthesis CI: not for prego, embryotoxic and fetal abnormalities in lab animals TX: works on dermatophytes, systemic fungi and histoplasma, blastomyces, coccidiodes, malassezia Legal: NA
32
Posaconazole ``` COD MOA AE CI TX Legal ```
COD: Azole antifungal MOA: inhib ergosterol synth. in cell membrane AE: headache, diarrhea, nausea, increased liver enzymes, neuronal vacuolation CI: not prego, lab abnormalities TX: works on dermatophytes, systemic fungi and yeasts (as do all azoles) Legal: NA
33
Voriconazole ``` COD: MOA AE CI TX Legal ```
COD: Azole antifungal MOA: inhib ergosterol synth. in cell membrane (prev. P450 enzyme) AE: neurotox in cats, vomit, hepatotox, ocular problems in ppl; CNS signs that resolve after disuse CI: prego, lab animal abnormal., use PO form in animals with renal issues TX: works on dermatophytes, systemic fungi, yeasts
34
Miconazole used for: Class of drug:
``` OTC topical (vag cream) COD: antifungal ```
35
Nystatin how administered: MOA: AE: CI:
- Topical only - MOA: binds ergosterol in cell membrane causing leaking, cell death - AE: NEPHROTOXIC, fever, phlebitis, tremors, renal K wasting, PU/PD, V/D - CI: not for ptnts w/renal dz or dehydrated animals
36
Drugs in 1st Generation Cephalosporins
- Cefazolin - Cephapirin - Cefalexin
37
assume these adverse effects with all of the -azole antifungals
- Increased liver enzymes - possible liver disease (hepatopathy) - inhibit P450 enzyme
38
Bethanechol ``` Class of Drug: Effect: MOA: AE: CI: ```
- COD: Promote Urination - Effect: Muscarinic Cholinergic agonist - MOA: stimulates gastric/intestinal motility and contraction of urinary bladder ; resists acetylcholinesterase - AE: Increase GI mot resulting in diarrhea, circulatory depression - CI: not w/obstruction
39
Phenoxybenzamine - Class of Drug: - Effect: - MOA: - AE: - CI:
- COD: Promote urination - Effect: adrenergic antagonist (relax urethral sm. mm), vasodilator - MOA: alpha 1 antagonist - AE: hypotension, tachycardia, weakness, syncope, diarrhea in horses - CI: not with heart problems, not if dehydrated
40
Phenylpropanolamine ``` COD: Effect: MOA: AE: CI: ```
COD: Reduce incontinence Effect: adrenergic agonist (const. sm. mm) MOA: nonselective adrenergic agonist (A&B) AE: tachycardia, cardiac effects, CNS excitement, restlessness, appetite stimulation, increased BP, stroke CI: not with cardiovasc. dz
41
Diethylstilbestrol ``` COD: Effect: MOA: AE: CI: ```
COD: reducing incontinence Effect: synthetic estrogen MOA: synth estrogen, increases sens. of alpha receptors in urinary sphincter AE: increased risk of pyometra, estrogen sens. tumors, rarely bone marrow depression and anemia CI: risk of cancer in humans
42
Estriol ``` COD: Effect: MOA: AE: CI: ```
``` COD: Reduce Incontinence Effect: estrogen hormone MOA: estrogen, increases sens. to alpha 1 receptors in urinary sphincter AE: NONE CI: not for prego animals or FERRETS ```
43
Ammonium Chloride ``` COD: Effect: MOA: AE: CI: ```
COD: Reduce urinary calculi Effect: urine acidifier (manages crystal calc. and chronit UTI's) MOA: induces acidic urine AE: bitter taste in food, aacidemia in high doses CI: not w/systemic acidemia or renal dz
44
Potassium Citrate ``` COD: Effect: MOA: AE: CI: ```
- COD: reduce urinary calculi - Effect: urine alkalinizer (brks up urinary calculi) - MOA: alkalinizes urine and increases urine citric acid which decreases urinary calcium oxalate crystallization - AE: toxicity, hyperkalemia leading to cardiovasc tox., muscular weakness, nausea, stomach irritation - CI: renal dz, not with other K drugs
45
Acronym for Diuretics:
FMASH ``` F - Furosemide M - Mannitol A - Acetazolamide S - Spiranolactone H - Hydrochlorothiazide ```
46
Acetazolamide ``` Effect: COD: MOA: AE: CI: ```
- COD: Diuretic - Effect: Carbonic anhydrase inhibitor diuretic (used to lower intra-ocular pressure) - MOA: carbonic anhydrase inhibitor; inhibits uptake of bicarb in PROXIMAL renal tubule, which resuts in loss of bicarb, water, and alkaline urine - AE:hypokalemia, bicarb loss, REP RXN due to RESP ACIDOSIS - CI: not w/acidemia or those sensitive to sulfonamides
47
Mannitol ``` COD: Effect: MOA: AE: CI: ```
- COD: Diuretic - Effect: osmotic Diuretic (increases osm. of plasm that dec. edema, intracranial and intra-ocular pressures) - MOA: filtered in glomerulus (PROX TUBULE, LOH) but not reabsorbed, increases osmolarity of urine, leads to inhibition of reabsorption - AE: fluid loss, electrolyte imbalance, rapid infusion = excessive ECF expansion - CI: not dehydrated or w/intracranial bldg
48
Furosemide ``` COD: Effect: MOA: AE: CI: ```
- COD: Diuretic - Effect: Loop Diuretic (used for edema) - MOA: Na/K/Cl symporter inhibitor - AE: hyponatremia more common than hypokalemia in dogs, tolerance and activation of RAAS with repeated admin. - CI: caution w/RAAS inhib. to decrease risk of azotemia (elev. BUN/cr)
49
Hydrochlorothiazide ``` COD: Effect: MOA: AE: CI: ```
- COD: Diuretic - Effect: thiazide diuretic (decrease Na and water reabsorption, not a strong diuretic as occurs so late in the process) - MOA: inhibits Na reabsorption in DISTAL TUBULE (incr. Na, K and Water, decreases Ca excretion) - AE: Hypokalemia - CI: not w/high serum calcium (prevents Ca excretion)
50
Spironolactone ``` COD: Effect: MOA: AE: CI: ```
- COD: Diuretic - Effect: Aldosterone antagonist diuretic - MOA: potassium sparing diuretic, inhib. aldosterone; interferes w/ Na reabsorption in DISTAL TUBULE - AE: hyperkalemia, high doses have steroid like effects, facial dermatitis in cats - CI: not if dehydrated, Gi problems, NSAIDS interfere, don't give w/K supp.
51
Most Diuretics cause K to be high or low?
Low (all but Spironolactone)
52
put these in order of importance when using diuretics: Hyponatremia, Dehydration, Hypokalemia
1. Dehydration 2. Hypokalemia 3. Hyponatremia
53
most common alteration in patients relating to fluid balance:
- acid/base imbalance - electrolyte imbalance - water imbalance (dehydration, Hypovolemia) - hypoproteinemia
54
Therapeutic Goals for fluid therapy alterations: water imbalance hypoproteinemia electrolyte imbalance, etc.
- Improve tissue perfusion by replacing intravascular volume - meet maintenance needs - correct dehydration by replacing interstitial volume - replace on going losses
55
Water accounts for what % of total body weight? ``` ECF ICF Blood Plasma Interstitial ```
Water: 60% ``` ECF: 20% Plasma: 5% of ECF interstitial: 15% of ECF ICF: 40% Blood: 7% of ICF ```
56
what's Higher in ECF vs. ICF Na K Cl Ca
Inside: - K Outside: - Na - Cl - Ca
57
Drug (fluid therapy) options less commonly used for physio alterations resulting in the need for use of therapy include:
- hemoglobin based oxygen carrying compounds - blood products - parenteral nutrition
58
drug (fluid therapy) options most commonly used for physio alterations resulting in fluid therapy:
colloids | crystalloids
59
main difference between maintenance and replacement crystalloid fluids:
Na concentration | Lesser importance: generally higher conc of K in maintenance
60
maintenance fluids have Na content that resembles: ECF or ICF
Replacement fluid Na conc resembles ECF conc of Na ICF, Na is lower. replacement fluids would be higher in Na while Maintenance fluids would be lower in Na
61
what % remains in the IV space after 1 hour? - Replacement Crystalloids - Maintenance Crystalloids If concerned about volume, what should you do? (not answered on card)
- Replacement: 25% | - Maintenance: 10%
62
Commonly used colloids: distinguishing characteristic of colloids from crystalloids?
- plasma - albumen - synthetic colloids - oncotic (colloid osmotic properties)
63
parameters to be monitored during fluid therapy:
- normal bronchiovesicular lung sounds (pulm. edema w/fluids) - PCV (diluted w/fluids) - total protein (decreases) - electrolytes (change) - arterial pH - arterial pCO2 - Urine Output (increase) - Hemodynamics (hypervolemia)
65
Fluids that contain Mg:
Plasma Lyte-M Plasma Lyte-A Normosol M Normosol R
66
Fluids that contain Calcium:
- Lactated Ringers - Ringers - Plasma Lyte M
67
Replacement Fluids which are acidic Which are alkalinic
``` Acidic: - ringers - Normal Saline Alkalinic: - Lactated Ringers - Normosol R - Plasma Lyte-A ```
68
Maintenance fluids: List them Are they acidic or alkalinic
- Normosol M - Plasma Lyte-M - Acid
69
Volume increasing fluids: List them:
- Hypertonic Saline | - Hetastarch
70
Hetastarch ``` COD: Therapeutic Goal: MOA: AE: CI: ```
- COD: Fluids - TG: decrease dehydration, correct hypovolemia (expander circ. shock) - MOA: Colloid-like, expander; maint. vascular volume w/circulatory shock (synthetic starch molecule) - AE: allergic rxn, hyperosmotic renal dysfunction, dec function of platelets - CI: not for bldg patients, or coagulopathies
71
Hypertonic Saline (7.5%) ``` COD: Therapeutic Goal: MOA/contains: AE: CI: ```
COD: Fluids TG: decrease dehydration, increase vascular volume/ correct hypovolemia, increase electrolytes (only Na and Cl) MOA: Creates an osmotic gradient in the vascular space by high concentrations of Na and Cl to pull water from the ICF and interstitial spaces into the vascular space Contains: Na, Cl AE: long term infusion can lead to electrolyte imbalance CI: hypernatremic or renal insufficiency; hyperosmolality can result
72
Lactated Ringers ``` COD: Therapeutic Goal: MOA: Contains: AE: CI: ```
COD: Fluids TG: dec. dehydration, correct hypovolemia, increase electrolytes and increase alkalinity MOA: replacement fluid (see above) Contains: alkalinizing BES - Na, K, Cl, Ca AE/CI: none
73
normal saline (.9%) ``` COD: Therapeutic goal: MOA: Contains: AE: CI: ```
COD: Fluids TG: dec. dehy and/or hypovol, increase electrolytes MOA: replacement fluid Contains: acidifying BES - Na, Cl AE: long term may cause electrolyte imbalance, acidema due to bicarb loss, hypokalemia CI: none
74
Normosol - R ``` COD: Therapeutic Goal: MOA: Contains: AE: CI: ```
COD: Fluids TG: dec. dehy and/or hypovol. increase electrolytes. MOA: replacement fluid contains: alkalinizing BES - Na, K, CL, Mg AE/CI: None Caution: congestive heart failure, renal insufficiency, edema, Na retention
75
Plasma-Lyte A ``` COD: Therapeutic goal: MOA: contains: AE: CI: ```
COD: Fluids TG: dec. dehy, or hypovol, inc. electrol. MOA: replacement fluid contains: alkalinizing BES - Na, K, Cl, Mg AE/CI: None
76
Ringers ``` COD: Therapeutic goal: MOA: Contains: AE: CI: ```
- COD: Fluids - TG: dec. dehy, or hypovol., inc. electorlytes - MOA: Replacement fluid - Contains: acidifying BES - Na, K, Cl, Ca - AE: inc acidity of blood due to inc. renal excretion of bicarb after prolonged use - CI: don't exceed 80ml/kg/hr - consider supp. w/K
77
Plasma-Lyte M ``` COD: Therapeutic Goal: MOA: Contains: AE: CI: ```
``` COD: Fluids TG: dec. dehy and/or hypovol, inc. electrolytes MOA: maintenance fluid contains: acidifying - Na, K, Cl, Ca, Mg AE/CI: None ```
78
Normosol - M ``` COD: Therapeutic Goal: MOA: Contains: AE: CI: ```
``` COD: Fluids TG: dec. dehyd, or hypovol. increase electorlytes MOA: maintenance fluid Contains: acidifying - Na, K, Cl, Mg AE/CI: None ```
79
List the Depolarizing and non-depolarizing drugs that induce muscle paralysis:
``` Depolarizing: - Succinylcholine Non-Depolarizing: - Atracurium - Cisatracurium - Pancuronium ```
80
Atracurium ``` COD: Effect: MOA: AE: CI: ```
- COD: muscle parlaytic - Effect: Neuromuscular blocking agent - nondepolarizing, used to inhibit mm contractions - MOA: Competes w/acetylcholine at the neuromuscular end plate - AE: Produces resp. depression and parlaysis, no analgesic (pain) effect - CI: dont admin. w/out Ventilation, will be antag. by ACh-ases, don't give w/aminoglycosides b/c of potentiated NMB Note: Circulates in Plasma, shorter duration than Pancuronium
81
Cisatracurium ``` COD: Effect: MOA: AE: CI: ```
- COD: Muscle paralytic - Effect: neuromuscular blocking agent - nondepolarizing, used to inhib. mm contractions - MOA: competes w/acetylcholine at the neuromuscular end plate - AE: produces resp. depression and paralysis, no analgesic effect - CI: don't admin w/out ventilation, will be antag. by ACh-ases, don't give w/aminoglycosides b/c of potentiated NMB
82
Pancuronium ``` COD: Effect: MOA: AE: CI: ```
- COD: Muscle paralytic - Effect: neuromuscular blocking agent - nondepolarizing, used to inhib. mm contractions - MOA: competes w/acetylcholine at the neuromuscular end plate - AE: produces resp. depression and paralysis, no analgesic effect - CI: don't admin w/out ventilation, will be antag. by ACh-ases, don't give w/aminoglycosides b/c of potentiated NMB Note: METABOLIZED IN LIVER, EXC. THROUGH KIDNEY
83
Succinylcholine ``` COD: Effect: MOA: AE: CI: ```
- COD: Muscle Paralytic - Effect: Depolarizing Neuromuscular blocking agent (BAD) - MOA: binds to receptor, depolarizes it, stays and continues to block - AE: DEATH - CI:
84
Muscle Paralytic Drugs:
- Atracurium - Cisatracurium - Pancuronium - Succinylcholine
85
Saying for mm relaxants:
``` Go : Guafenesin Find: Flumazenil My: Midazolam Lazy: Lorazopam Dog: Diazepam ```
86
Muscle relaxant drugs
- diazepam - midazolam - lorazepam - flumazenil - Guaifenesin
87
Diazepam ``` COD: Effect: MOA: AE: CI: Note: ```
- COD: mm relaxant - Effect: anticonvulsant - benzodiazepine - MOA: ativates GABA receptors, increasing CI conductance leading to hyperpolarization; not water soluble - AE: sedation; dogs: ataxia, excitement, agitation, increased appetite; cats: fatal hepatic necrosis; withdrawal when stopped - CI: not w/impaired liver function or long term use in cats - NOTE: Not water soluble, withdrawal once removed
88
Midazolam ``` COD: Effect: MOA: AE: CI: Note: ```
- COD: muscle relaxant - Effect: anticonvulsant - benzodiazepine - MOA: activates GABA receptors increasing Cl conductance, hyperpolarization, water soluble - AE: IV can cause cardioresp. depression, paradoxial excitement, withdrawal syndromes when discontinued - CI: caution IV, esp. w/opiates - Note: water soluble
89
Lorazepam ``` COD: Effect: MOA: AE: CI: ```
- COD: MM relaxant - Effect: anticonvulsant - benzodiazepine - MOA: activates GABA receptors increasing Cl conductance - hyperpolarization - AE: sedation, polyphagia, excitement, withdrawal syndrome - CI: liver injury in cats
90
Guaifenesin ``` COD: Effect: MOA: AE: CI: therapeutic goal: ```
- COD: mm relaxant - Effect: expecorant mm relaxant (stim. vagal trans.) - MOA: centrally reduces nerve transmission - PO: stimulates vagal transmission for more viscous bronchiol secretions - IV: centrally acting mm relaxant - AE: thrombophlebitis from IV, hypotension, hemolysis - CI: don't give IV if precipitated; don't use human oral formulations THERAPEUTIC GOAL: increase mm relaxation
91
Flumazenil ``` COD: Effect: MOA: AE: CI: ```
COD: mm relaxant Effect: antidote - benzodiazepine receptor antagonist MOA: blocks action of benzodiazopines on GABA receptors AE: none CI: may precipitate seizures (high first pass effect)
92
Estradiol MOA: AE: CI:
``` MOA: estrogen replacement, also used to induce abortion AE: - endometrial hyperplasia - pyometra - bone marrow toxicity - leukopenia - thrombocytopenia - fatal aplastic anemia CI: not in prego animals, not for ferrets ```
93
Edrophonium ``` COD: MOA: AE: Effect: CI: ```
COD: Counteract neuromuscular blockade MOA: anticholinesterase AE: Salivation, Vomiting, diarrhea Effect: Antimyasthenic, anticholinesterase; short lasting effects good for dx CI: cats sens.; caution w/other cholinergic drugs
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Neostigmine ``` COD: MOA: AE: CI: Use: ```
COD: counteract neuromusc. blockade MOA: anticholinesterase, Ach isn't broken down AE: Diarrhea, increased secretions, miosis, bradycardia, mm twitching, weakness, constriction of bronchi and ureters CI: not w/urinary or intestinal obstruction, asthma or bronchoconstriction, pneumonia, cardiac arrhythmias Use: tx or myasthenia gravis, ileus and NM blockade
95
physostigmine ``` COD: MOA: AE: Effect: CI: ```
COD: counteract neuromuscular blockade MOA: anticholinesterase, X's BBB AE: diarrhea, increased secretions, miosis, bradycardia, mm twitching, weakness, constriction of bronchi and ureters Effect: prokinetic; anticholinesterase - treating myesthenia gravis, ileus, NM blockade CI: not w/choline esters like bethanechol
96
Progesterone therapeutic goal: See notes to update:
increases production of somatotropin, IGF1 (growth factor) which increases mm mass - implant in ear
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Testosterone What do they do: Therapeutic goal:
``` and trenbalone: work directly (unlike progesterone and estradiol) to increase mm mass. Implant in ear ``` Therapeutic goal: increase muscle mass
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trenbolone Therapeutic goal - see ppt for more to put here
increase mm mass
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epinephrine ``` COD: MOA: AE EFFECT: CI: ```
COD: increase cardiac contractions/Heart Rate MOA: alpha1, b adrenergic receptor agonist (very potent, prompt onset, short duration) AE: excessive vasoconstriction, hypertension, ventricular arrhythmias Effect: tx for cradiopulmonary arrest and anaphylactic shock CI: avoid repeat admin, incompatible w/alkaline solutions and salts
100
Isoproterenol ``` COD: MOA: AE: Effect: CI: ```
COD: increase force of cardiac contractions/heart rate MOA: b adrenergic agonist (stim. adenyl cyclase, more pot. than epi) AE: tachycardia, tachyarrhthymias, myocardial calcium accum, K imbalance Effect: adrenergic agonist - increases HR, conduction, contractility of cardiac mm CI: if formulation is pink/dark be careful; caution w. arrhthmogenic drugs
101
Dopamine ``` COD: MOA: AE: Effect: CI: ```
COD: inc. force of cardiac contractions and HR MOA: - precursor to norepinephrine (low doses incr. GFR) - moderate doses (chronotropy and ionotropy) - high dose (alpha 1 agonist - vasoconstriction) AE: high dose sens. patients: tachycardia and etricular arrhythmias Effect: adrenergic agonist CI: unstable in alkaline fluids
102
dobutamine ``` COD: MOA: AE: Effect: CI: ```
COD: incr. force of cardiac contractions and HR MOA: B agonist (favors B1) - mixed agonist and antagonist effect on alpha receptors AE: tachycardia, ventricular arrhythmias at high dose in sens. patients Effect:adrenergic agonist CI: not w/ventricular arrythmias, alkaline solutions or IV w/heparin, cephalosporins or penicillins
103
Digoxin ``` COD: MOA: AE: Effect: CI: ```
COD: increase force of cardiac contractions MOA: inactivates Na-K ATPase and increases intracellular Ca (increased contractility, decreased HR by baroreceptors) AE: narrow therapeutic index, arrhythmia, vomiting, anorexia, diarrhea, all potentiated by hypokalemia Effect:Cardiac inotropic agent CI: dobermans and cats sens, high K diminishes effect
104
Pimobendan ``` COD: MOA: AE: Effect: CI: ```
COD: increase contractility and vasodilation MOA: vasodilation via inhibition of phosphodiesterase 3 to increase cAMP - also is a CA SENSITIZER increasing interaction w/troponin C w/contractile proteins AE: Arrhythmogenic, doesn't activate RAAS at some doses Effect: cardiac inotropic agent CI: animals prone to arrythmias
105
Atropine ``` COD: MOA: AE: Effect: CI: ```
COD: incr. contractility and HR MOA: acetylcholine antagonist - blocks Ach effects at Muscarinic receptors AE: xerostomia (dry mouth), ileus, constipation, tachycardia, urine retention Effect: muscarinic blocker CI: not w/glaucoma, ileus, gastroparesis, tachycardia, use w/O2
106
Glycopyrrolate ``` COD: MOA: AE: Effect; CI: ```
COD: incr. contractility and HR MOA: acetylcholine antagonist - blocks Ach effects at muscarinic receptors AE: xerostomia (dry mouth), ileus, constipation, tachycardia, urine retention Effect: muscarinic blocker CI: not for patients w/glaucoma, ileus, gastroparessis, or tachycardia
107
Hydralazine ``` COD: MOA: AE: Effect: CI: ```
``` COD: vasodilation MOA: - relaxes sm. mm - reduces BP and vascular resistance - decreases afterload AE: vasodilation, hypotension, tachycardia, dangerous high cardiac output, triggers RAAS Effect: vasodilator CI: not w/hypotensive animals ```
108
Diltiazem ``` COD: MOA: AE: Effect: CI: ```
COD: vasodilation MOA: Ca channel blocker AE: hypotension, myocardial depression, bradycardia, AV block, cats GI Effect:antiarrythmic and vasodilator - , neg. chronotropy/inotropy CI: caution IV, not hypotensive patients w/furosemide
109
Amlodipine ``` COD: MOA: AE: Effect: CI: ```
COD: vasodilation MOA: Ca channel blocker - dec. Ca influx in cardiac and sm mm, vasodilates AE: hypotension, bradycardia, dogs: gingival hyperplasia Effect: Ca channel blocker CI: not for cardiac or hypotensive patients or dehydrated
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Carvedilol ``` COD: MOA: AE: Effect: CI: ```
COD: vasodilator MOA: B blocker, some alpha blocking AE: bradycardia, myocardial depression and decreased CO Effect: Antiarrhythmic, vasodilator CI: not for cardiac, dehydrated, or hypotensive; caution in respiratory cases
111
Benazepril ``` COD: MOA: AE: Effect: CI: ```
COD: Vasodilator MOA: ACE inhibitor: inhibits conversion of angiotensin I to angiotensin II - causes vasodilation and Na/H20 retention since all stimulate aldosterone AE: azotemia, monitor renal values effect:Vasodilator, ACE inhibitor - tx chronic heart failure and hypertension CI: not for prego, ACE inhb. cross placenta - teratogen
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Phenylephrine ``` COD: MOA: AE: Effect: CI; ```
COD: vasoconstriction MOA: a1 receptor agonist, causes vascular sm. mm contraction AE: prolonged peripheral vasoconstr., reflex bradcardia, prolonged topical use results in tissue inflammation Effect: vasopressor - used to constrict superficial vessels CI: not if compromised cariocascular status
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acronym for decreasing sympathetic output:
BE CAP'T - Benazapril - Enalapril - Carvedilol - Atenolol - Propanolol - Timolol
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Dopamine ``` COD: MOA: AE: Effect: CI: ```
COD: vasoconstriction MOA: - precursor to norepi: low doses - increases GFR - moderate doses: chronotropy and inotropy - high doses: a1 agonist - vasoconstriction AE: sens. patients cuases tachycardia and ventricular arrhythmias Effect: adrenergic agonist CI: unsatble in alkaline fluids
116
Atenolol ``` COD: MOA: AE: Effect: CI: ```
COD: Decrease symp. effects MOA: B1 receptor antagonist (B blocker) - relies on kidneys for clearance AE: bradycardia, heart block, bronchospasm Effect: Beta antagonist - decrease HR, cardiac conduction, BP, control tacharrhythmias CI: caution w/airway and cardiac disease
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Propranolol ``` COD: MOA: AE: Effect: CI: ```
COD: decr. symp effects MOA: Unselective (B1 and B2), lipophilic B blocker AE: - B1: cardiac compression, decreased CO - B2: broncho-constriction, decreased insulin production Effect: beta antagonist (decrease HR, cariac conduction, BP control tacharrhythmias) CI: not w/poor cardiac or systolic function or resp. problems
118
Timolol ``` COD: MOA: AE: Effect: CI: ```
COD: Decr. symp. effects MOA: lipophilic, non-selective B blocker (dbl check ppt) AE: - B1: cardiac depression, decreased CO - B2: broncho-constriction, decreased insulin production Effect: beta antagonist (decr. HR, cardiac conduction, BP , control tacharrhythmias) CI: not w/poor cardiac, systolic fxn, or resp. problems, used w/optholmic issues
119
Benazepril ``` COD: MOA: AE: Effect: CI: ```
COD: decr. symp. effects MOA: ACE inhibitor (inhib. angiotensin 1-2, Angio II is vasoconstrictor, decreases aldosterone which dec. Na/H20 retention AE: azotemia Effect: vasodilator, ACE inhibotor, treats chronic heart failure and hypertension CI: not for prego, ACE inhib. cross placenta and are teratogens
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Enalapril ``` COD: MOA: AE: Effect: CI: ```
COD: decr. symp effects MOA: ACE inhibitor (decrease aldosterone, so lower Na/H20 retention) AE: azotemia Effect: vasodilation, ACE inhibitor CI: not prego, ACE inhib. cross placenta and is a teratogen
121
Aspirin ``` COD: MOA: AE: Effect: CI: ```
COD: anticoagulant MOA: binds irreversibly to COX enzymes- more specific to cox1 at lower doses AE: vomiting, increased risk of bldg and ulcers Effect: analgesic, anti-inflammatory, anti-platelet drug CI: cats susc. to intox. since slow clearance, not w/coagulopathies, not for those prone to ulcers
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Clopidogrel ``` COD: MOA: AE: Effect: CI: ```
``` COD: anticoagulant MOA: inhib. ADP receptor mediated platelet activity AE: Bldg in susc. patients Effect: anti-platelet drug CI: not for those prone to bldg ```
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Dalteparin ``` COD: MOA: AE: Effect: CI: ```
``` COD: Anticoagulant MOA: low weight molecular heparin AE: bldg in susceptible patients Effect: Anti-coagulant drug CI: renal dz will prolong clearance ```
124
Amiodarone ``` COD: MOA: AE: Effect; CI: carvedilol, diltiazem, lidocaine, procainamide, qunidine, sotalol ```
COD: Class 3 MOA: prolong AP duration by blocking K channels thus prolonging time before myocardial cells can contract again. AE: dec appetite, bradycardia, AV block, CHF, hypotension, thyroid dysfunction, pulmonary fibrosis, neutropenia, anemia, hepatopathy (dog), lethargy, vomiting, puritis, edema, hindlimb weakness (horses) Effect: fix V arrythmias CI: caution in dogs, only use if its the only option
125
Carvedilol ``` COD: MOA: AE: Effect; CI: ```
COD: Class 2 MOA: Non-specific beta blocker (slow heart rate) with some alpha blocking (vasodilation) AE: Bradycardia, myocardial depression, dec CO, other effects related to beta blocking in other tissues (bronchioles) Effect: Fix arrythmias CI: Dehydrated, hypotension. Caution: respiratory dz, limited cardiac reserve.
126
Diltiazem ``` COD: MOA: AE: Effect; CI: ```
COD: Class 2 beta blockers MOA: Blocks Ca entry into the cells via voltage gated slow Ca channels causing negative chronotropic and neg ionotropic effects with some vasodilation. AE: Hypotension, bradycardia, myocardial depression, AV block, anorexia, vomiting, lethargy Effect; Fix supraventricular arrythmias CI: hypotension, rapid IV injections
127
Lidocaine ``` COD: MOA: AE: Effect; CI: ```
COD: Class 1 local anesthetis/membrane stabalizer MOA: Among other things it decreases phase 0 depolarization AE: CNS effects, vomiting. Cats: death, dec CO, cardiovascular depression, dec purfusion, methemoglobinemia, hemolysis Effect: Fix V arrythmias CI: None
127
Quinidine ``` COD: MOA: AE: Effect; CI: ```
COD: Class 1 local anesthetis/membrane stabalizer MOA: block Na channels to inhibit Na influx thus suppressing phase 0 action potential AE: Nausea, vomiting , hypotension, tackycardia, sudden cardiac death (horses) Effect: Fix atrial fibrilation CI: caution in heart dz
127
Sotalol ``` COD: MOA: AE: Effect; CI: ```
COD: Class 2 and 3 MOA: nonspecific beta blocker and blocks K channel thus causing a longer refractory period AE: Cardiac depression, dec CO, bronchoconstriction low insulin, weakness, proarrhthmic activity, neg inotropy Effect: CI: Caution in heart failure and AV block
128
Procainamide ``` COD: MOA: AE: Effect; CI: ```
COD: Class 1 MOA: Blocks Na channels to prevent Na influx AE: cardiac arrhythmias, cardiac depression, tachycardia, hypotension Effect; CI: Proarrhthmic effects, dont use with digoxin
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Which drugs specifically cause bronchiole dilation. which drugs CAN cause bronchiole dilation (not main fxn)
DO: - Albuterol - Clebuterol CAN: - Epinepherine - Isoproterenol - Dopamine - Dobutamine
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Albuterol ``` COD: MOA: AE: Effect: CI: ```
- COD: bronchiole dilator - MOA: B2 agonist (also inhib. inflamm. mediators from mast cells) - AE: tachycardia - mm tremors - arrythmias - inhibit uterine contractions at end of gestation - Possible hypokalemia - Effect: relieves bronchospasm/bronchoconstriction - CI: not for prego, IM/SQ can be painful
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Clenbuterol ``` COD: MOA: AE: Effect: CI: ```
- COD: bronchiole dilator - MOA: Beta 2 agonist (longer half life than other b agonists, better oral absorption than other beta ag. in horses) - may inhib. rls of inflamm. mdtrs from mast cells - stimulates dvlpmt of more mm and less fat - AE: tachycardia - tremors - arrhythmias - adverse effect on cardiac fxn in horses w/chronic use -Effect: relieves animals w/reversible bronchoconstriction - CI: potential for human and livestock show abuse NEVER for animals intended for food
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Hydrocodone COD: MOA: AE: CI:
- COD: antitussive, analgesic - MOA: MU opioid, Kappa agonist- inhib. rls of neurotrans involved w/pain, analgesic - AE: sedation, constipation, bradycardia, resp. depression , paradoxical excitement - CI: not in ptnts sens to opiods. oral use prep involves atropine so not with animals that aren't supposed to have atropine
133
Most Common antineoplastic Adverse Effects:
Bone Marrow Suppression | GI issues
134
Antineoplastic Drugs: - List them
- Cisplatin - Methotrexate - Toceranib - Cyclophosphamide - Doxorubicin - Lomustine - L-Asparaginase - 5-FU - Vincristine - Cytarabine - Piroxicam
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Cisplatin ``` COD: MOA: AE: Effect: CI: Legal: ```
- COD: Antineoplastic - MOA: alkylates DNA forming a reactive carbonium ion and cross links DNA - AE: NEPHROTOXIC, K wasting, Mg depleting - cats: PULMONARY TOXICOSIS (DON"T USE: SPLATS CATS) - dogs: vomit, thrombocytopenia - Effect: Cell cycle independant (all alkylating agents),alkylating agent - treats solid tumors - CI: NOT IN CATS - Legal: NOT for animals intended for food
136
Cyclophosphamide ``` COD: MOA: AE: CI: Legal: ```
- COD: Antineoplastic; in nitrogen mustard group - MOA: alkylating N7 of guanine base of DNA; requires metabolization via P450 to become active - AE: bone marrow tox, V/D, HEMORRHAGIC CYSTITIS, hair loss in dogs - CI:bone marrow and immuno suppressive, caution for those at risk of infection, teratogenic, embryotoxic (not for prego) - Legal: NOT for animals intended for food - NOTE: - Effect: Cell cycle independant (all alkylating agents),
137
Lomustine ``` COD: MOA: AE: Effect: CI: Legal: ```
- COD: Antineoplastic - MOA: alkylates O6 on guanine and causes interstrand links - AE: myelosuppression, thrombocytopenia, pulmonary fibrosis, hepatotoxicity, cats: neutropenia - Effect: nitrosureas alkylating agent (for CNS, mast cell tumors and lymphoma) - CI: bone marrow risk in small animals - Legal: NOT for animals intended for food
138
5-FU ``` COD: MOA: AE: Effect: CI: Legal: Phase: ```
- COD: Antineoplastic - MOA: inhib. nucleic acid synth - AE: leukopenia, thrombocytopenia, CNS tox. - Effect: pyrimidine antimetabolite; dogs - CI: not for cats - Legal: NOT for animals intended for food - Phase: S phase
139
Cytarabine ``` COD: MOA: AE: Effect: CI: Legal: ```
- COD: Antineoplastic - MOA: inhib DNA synth - AE: bone marrow suppression, granulocytopenia, nausea, vomit - Effect: Pyrimidine antimetabolite, used for lymphoma and leukemia - CI: caution if given marrow suppression drugs - Legal: NOT for animals intended for food
140
Methotrexate ``` COD: MOA: AE: Effect: CI: Legal: Phase: ```
- COD: Antineoplastic - MOA: inhib. dihydrofolate reductase (nec. for purine synth from folic acid) - AE: anorexia, nausea, myelosuppression, vomit, heptotox. - Effect: folic acid antimetabolite - Legal: NOT for animals intended for food - Phase: S Phase
141
Doxirubicin ``` COD MOA AE Effect CI Legal Phase ```
- COD: Antineoplastic - MOA: inhib. topoisomerase II causing DNA dmg and stops transcription - AE: CARDIOTOXICITY, bone marrow tox, alopecia, anorexia, vomit, diarrhea, hypersens. rxns (NECROSIS IF OUTSIDE OF VEINS) - Effect: natural antibiotic, anticancer agent; used for lymphoma, osteosarcoma, carcinoma, sarcoma - CI: not w/cardiomyopathy, monitor CBS, caution MDR (prone to tox) - Legal: NOT for animals intended for food - Phase: S phase
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L-Asparaginase ``` COD: MOA: AE: Effect: CI: Legal: Phase: ```
- COD: antineoplastic - MOA: destroys asparagine (needed for DNA/RNA synth) - AE: hypersens, heptotox, pancreatitis, hyperglycemia - Effect: natural enzyme - Legal: NOT for animals intended for food - G1 Phase
143
Vincristine ``` COD: MOA: AE: Effect: CI: Legal: Phase ```
- COD: Antineoplastic - MOA: blocks polymerization of tubulin (arrests microtubules needed for metaphase) - AE: peripheral neurophathy, constipation, irritating to tissues (NECROSIS IF OUTSIDE OF VEINS), less myelosuppressive than other drugs - Effect: natural Vinca Alkaloid - CI: flush area w/fluids after admin, dogs w/ABCB-1 mutation can tox. - Legal: NOT for animals intended for food - M phase
144
Piroxicam ``` COD: MOA: AE: Effect: CI: Legal: ```
- COD: Antineoplastic - MOA: COX inhibitor - AE: GI tox, renal tox, toxic epidermal necrolysis - Effect: COX inhib, transitional and squamous cell carcinoma - CI: dogs; increased risk of ulcers, not for prego or renal dz - Legal: NOT for animals intended for food
145
Sedatives
Acepromazine, Diazepam, Midazolam, Detomidine, Dexmedetomidine, Romifidine, Xylazine
146
Reversals
Atipamezole, Flumazenil, Naloxone, Naltrexone, Tolazoline, Yohimbine
147
``` Diazepam: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Sedation, tranquilization, inc appetite and muscle relaxation, reduce seizures, anxiety, and inappropriate behavior. MOA: Potentiate GABA receptors in CNS. AE: IM/SQ pain and irritation, IV phlebitis, sedation. Dogs: ataxia, polyphagia, excitement, agitation. Cats: idiopathic fatal hepatic necrosis. Chronic: withdrawal syndrome. CI: Impaired liver function.
147
Reversals that are opiate antagonists. | Which drugs would they compete against?
Reversals: Naloxone, Naltrexone. | Opiate agonists: morphine, oxymorphone, butorphanol, hydromorphone, and other opioids
148
Reversals that are GABA potentiator antagonists. | Which drugs would they compete against?
Reversals: Flumazenil. | GABA potentiators/Benzodiazepines: Diazepam, lorazepam, midazolam.
149
``` Romifidine: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Sedation. MOA: Alpha2 agonist. AE: Dec sympathetic, initial hypertension followed by hypotension, paradoxical excitement, hyperglycemia/diuresis, sinoatrial block, AV block, sinus arrhythmia. Horse: ataxia, head droop, sweat. High dose: facial edema. CI: older with cardiac disease.
150
Dopamine antagonists
Acepromazine, Chlorpromazine
151
``` Acepromazine: Theraputic goal, MOA, AE, CI. Effect: ```
Theraputic goal: Sedation, antiemetic. MOA: Centrally acting dopamine antagonist, antimuscarinic, alpha receptor antagonist. AE: VASODILATION/HYPOTENSION, Sedation, ataxia Horses- persistent penile prolapse (PARAPHIMOSIS). Brachyceph- inc vagal tone. CI: Dystonia, history of extrapyramidal effects. Effect: antiemesis, mm relaxation, sedation/tranqu.
152
``` Chlorpromazine: Theraputic goal: MOA: AE: CI: Effect: ```
Therapeutic goal: Tranquilizer. MOA: Centrally acting dopamine (D2) antagonist. AE: Sedation, VASODILATION (HYPOTENSION), anticholinergic. Horse: violent reactions, penile prolapse (paraphimosis), EXTRAPYRIMDAL EFFECTS (looks excited but is mm related) CI: Horses. caution in seizures and hypotensive prone animals Effect: anti-emetic, mm. relaxation, sedation/tranqu
153
``` Diazepam: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Sedation, tranquilization, inc appetite and muscle relaxation, reduce seizures, anxiety, and inappropriate behavior. MOA: Potentiate GABA receptors in CNS. AE: IM/SQ pain and irritation, IV phlebitis, sedation. Dogs: ataxia, polyphagia, excitement, agitation. Cats: idiopathic fatal hepatic necrosis. Chronic: withdrawal syndrome. CI: Impaired liver function.
154
Gabapentin ``` COD: MOA: AE: Effect: CI: ```
- COD: anticonvulsant - MOA: analog of GABA (NOT agonist), may block Ca dependent channels - AE: sedation, ataxia, oral solution has xylitol (toxic) produces hypoglycemia and liver injury w/high doses - Effect: anticonvulsant, analgesic - tx neuropathic pain that won't respond to NSAIDS - CI: antacids decrease oral absorption
155
Levetiracetam COD: MOA: AE: CI:
- COD: anticonvulsants - MOA: inhib. burst firing of neurons w/out affecting normal neuronal excitement - AE: weakness, lethargy, dizziness, decrease appetite - CI: phenobarb. can enhance clearance
156
Phenobarbital ``` COD: MOA: AE: CI: Note: ```
- COD: anticonvulsant - MOA: stabilizes neuron by increased CL conductance due to GABA mediated channels - AE: dose related: polyphagia, sedation, ataxia, lethargy, hepatotox, neutropenia, anemia, thrombocytopenia, superficial necrolytic derm. in dogs - CI: caution w/liver issues, induces its own metabolism, prego animals can seizure - NOTE: can measure the levels in the animal and adjust your dosage accordingly. ENDUCES IT"S OWN METABOLISM
157
Phenytoin ``` COD: MOA: AE: Effect: CI: ```
- COD: Anticonvulsant - MOA: depress nn conduction via block Na channels, Class 1 cardiac antiarrythmic, increases threshold and decreases conduction - AE: sedation, gingival hyperplasia, skin rxn, CNS tox, - Horses: recumbency, excitement at high doses - Effect: anticonvulsant, antiarrythmic - used for ventricular arrythmia, myotonia, rhabdomyolysis, hyperkalemic paresis and stringhalt - CI: not for prego, P450 inducer
158
Potassium Bromide COD: MOA: AE: CI:
- COD: anticonvulsant - MOA: changes Cl conductance - AE: PU/PD, polyphagia, ataxia, sedation, GI CNS signs, nausea, cat bronchitis - CI: not prego, P450 inducer
159
Zonisamide COD: MOA: AE: CI:
- COD: anticonvulsant - MOA: potentiates GABA stabilizing membranes w/changes in Na & Cl channels - AE: none at clinical doses (lethargy, ataxia, vomit w/overdose) - CI: caution w/ allergies to sulfonamides
160
``` Lorazepam: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Tranquilizer. MOA: Potentiate GABA receptors in CNS. AE: Sedation, polyphagia, paradoxical excitement. CI: None.
161
``` Midazolam: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Sedation. MOA: Potentiate GABA receptors in CNS. AE: Paradoxical excitement, chronic leads to withdrawl syndrome, IV can cause serious cardiorespiratory depression. CI: IV, concurrent with opiates.
162
``` Detomidine: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Sedation. MOA: Alpha2 agonist. AE: Sedation ataxia, sweating, bradycardia, hyperglycemia/diuresis. High dose- cardiac depression, AV block, hypotension. Horses: hyperresponsiveness. CI: can be absorbed through human skin.
163
``` Dexmedetomidine: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Sedation. MOA: Alpha2 agonist. AE: Dec sympathetic, initial hypertension followed by hypotension, paradoxical excitement, hyperglycemia/diuresis. Sm: vomiting. CI: Older with cardiac disease. Can be absorbed through human skin.
164
``` Yohimbine: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Reversal. MOA: Alpha2 antagonist. AE: High dose- tremors and seizures. CI: None.
165
``` Xylazine: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Sedation. MOA: Alpha2 agonist. AE: Dec sympathetic, initial hypertension followed by hypotension, paradoxical excitement, hyperglycemia/diuresis, AV block, sinus arrhythmia. Sm: vomiting. CI: Older with cardiac disease. Can be absorbed through human skin.
166
``` Atipamezole: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Reversal. MOA: Alpha2 antagonist. AE: Initial excitement, transient decrease in blood pressure. CI: None.
167
``` Flumazenil: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Reversal. MOA: Benzodiazepine (GABA potentiator) receptor antagonist. AE: None. CI: None.
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``` Naloxone: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Reversal. MOA: Opiate antagonist. AE: Tachycardia, hypertension, excitement, pain, cardiac arrhythmias. CI: Animals in pain.
169
``` Naltrexone: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Reversal. MOA: Opiate antagonist. AE: None. CI: Animals in pain.
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How to calculate Replacement fluid - Maintenance Fluid - 24 hr needs
Kg in weight X % dehydrated (gives you L, so convert to ml if needed) - M: 30 x kg wt + 70 (gives you ml) - 24 hr: Add Replacement + Maintenance + Loss
172
``` Tolazoline: Theraputic goal: MOA: AE: CI: ```
Theraputic goal: Reversal. MOA: Alpha2 antagonist. AE: Hypertension, tachycardia, peripheral vasodilation. CI: Animals in stress, debilitation, cardiac disease, sympathetic blockage, hypovolemia, shock.
173
``` Toceranib Therapeutic goal MOA AE CI ```
TG: Antineoplastic MOA: inhibits receptor tyrosine kinase AE: GI problems, anorexia, lameness, weight loss, blood in feces CI: Prego

Pharmacology (8 decks)

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