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
Q

Caspofungin

MOA;
AE:
CI:
Effect:

A

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

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26
Q

Flucytosine

MOA:
AE:
CI:
Effect:

A

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

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27
Q

Griseofulvin

Class of drug:
MOA:
AE:
CI:
TX:
Legal:
A

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

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28
Q

Terbinafine

COD: 
MOA: 
AE: 
CI:
TX
A

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

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29
Q

Flucanoazole

COD:
MOA: 
AE: 
CI:
TX: 
Legal:
A

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

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30
Q

Itraconazole

COD:
MOA: 
AE:
CI:
TX:
A

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

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31
Q

ketoconazole

COD:
MOA:
AE:
CI:
TX:
Legal:
A

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

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32
Q

Posaconazole

COD
MOA
AE
CI
TX
Legal
A

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

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33
Q

Voriconazole

COD:
MOA
AE
CI
TX
Legal
A

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

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34
Q

Miconazole

used for:
Class of drug:

A
OTC topical (vag cream)
COD: antifungal
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35
Q

Nystatin

how administered:
MOA:
AE:
CI:

A
  • 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
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36
Q

Drugs in 1st Generation Cephalosporins

A
  • Cefazolin
  • Cephapirin
  • Cefalexin
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37
Q

assume these adverse effects with all of the -azole antifungals

A
  • Increased liver enzymes
  • possible liver disease (hepatopathy)
  • inhibit P450 enzyme
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38
Q

Bethanechol

Class of Drug:
Effect: 
MOA:
AE:
CI:
A
  • 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
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39
Q

Phenoxybenzamine

  • Class of Drug:
  • Effect:
  • MOA:
  • AE:
  • CI:
A
  • 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
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40
Q

Phenylpropanolamine

COD:
Effect:
MOA: 
AE:
CI:
A

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

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41
Q

Diethylstilbestrol

COD:
Effect:
MOA:
AE:
CI:
A

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

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42
Q

Estriol

COD: 
Effect:
MOA: 
AE:
CI:
A
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
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43
Q

Ammonium Chloride

COD:
Effect:
MOA:
AE:
CI:
A

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

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44
Q

Potassium Citrate

COD:
Effect:
MOA:
AE:
CI:
A
  • 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
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45
Q

Acronym for Diuretics:

A

FMASH

F - Furosemide
M - Mannitol
A - Acetazolamide
S - Spiranolactone
H - Hydrochlorothiazide
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46
Q

Acetazolamide

Effect: 
COD: 
MOA: 
AE: 
CI:
A
  • 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
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47
Q

Mannitol

COD: 
Effect: 
MOA:
AE:
CI:
A
  • 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
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48
Q

Furosemide

COD:
Effect:
MOA:
AE:
CI:
A
  • 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)
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49
Q

Hydrochlorothiazide

COD: 
Effect:
MOA:
AE:
CI:
A
  • 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)
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50
Q

Spironolactone

COD: 
Effect:
MOA:
AE:
CI:
A
  • 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.
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51
Q

Most Diuretics cause K to be high or low?

A

Low (all but Spironolactone)

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52
Q

put these in order of importance when using diuretics:

Hyponatremia, Dehydration, Hypokalemia

A
  1. Dehydration
  2. Hypokalemia
  3. Hyponatremia
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53
Q

most common alteration in patients relating to fluid balance:

A
  • acid/base imbalance
  • electrolyte imbalance
  • water imbalance (dehydration, Hypovolemia)
  • hypoproteinemia
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54
Q

Therapeutic Goals for fluid therapy alterations:

water imbalance
hypoproteinemia
electrolyte imbalance, etc.

A
  • Improve tissue perfusion by replacing intravascular volume
  • meet maintenance needs
  • correct dehydration by replacing interstitial volume
  • replace on going losses
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55
Q

Water accounts for what % of total body weight?

ECF
ICF
Blood
Plasma
Interstitial
A

Water: 60%

ECF: 20%
Plasma: 5% of ECF
interstitial: 15% of ECF
ICF: 40%
Blood: 7% of ICF
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56
Q

what’s Higher in ECF vs. ICF

Na
K
Cl
Ca

A

Inside:
- K

Outside:

  • Na
  • Cl
  • Ca
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57
Q

Drug (fluid therapy) options less commonly used for physio alterations resulting in the need for use of therapy include:

A
  • hemoglobin based oxygen carrying compounds
  • blood products
  • parenteral nutrition
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58
Q

drug (fluid therapy) options most commonly used for physio alterations resulting in fluid therapy:

A

colloids

crystalloids

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59
Q

main difference between maintenance and replacement crystalloid fluids:

A

Na concentration

Lesser importance: generally higher conc of K in maintenance

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60
Q

maintenance fluids have Na content that resembles:

ECF or ICF

A

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

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61
Q

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)

A
  • Replacement: 25%

- Maintenance: 10%

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62
Q

Commonly used colloids:

distinguishing characteristic of colloids from crystalloids?

A
  • plasma
  • albumen
  • synthetic colloids
  • oncotic (colloid osmotic properties)
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63
Q

parameters to be monitored during fluid therapy:

A
  • 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)
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65
Q

Fluids that contain Mg:

A

Plasma Lyte-M
Plasma Lyte-A
Normosol M
Normosol R

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66
Q

Fluids that contain Calcium:

A
  • Lactated Ringers
  • Ringers
  • Plasma Lyte M
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67
Q

Replacement Fluids

which are acidic
Which are alkalinic

A
Acidic:
 - ringers
 - Normal Saline
Alkalinic:
 - Lactated Ringers
 - Normosol R
 - Plasma Lyte-A
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68
Q

Maintenance fluids:

List them
Are they acidic or alkalinic

A
  • Normosol M
  • Plasma Lyte-M
  • Acid
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69
Q

Volume increasing fluids:

List them:

A
  • Hypertonic Saline

- Hetastarch

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70
Q

Hetastarch

COD:
Therapeutic Goal:
MOA:
AE:
CI:
A
  • 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
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71
Q

Hypertonic Saline (7.5%)

COD:
Therapeutic Goal:
MOA/contains:
AE:
CI:
A

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
Q

Lactated Ringers

COD:
Therapeutic Goal:
MOA:
Contains:
AE:
CI:
A

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
Q

normal saline (.9%)

COD:
Therapeutic goal:
MOA:
Contains:
AE: 
CI:
A

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
Q

Normosol - R

COD: 
Therapeutic Goal:
MOA: 
Contains:
AE:
CI:
A

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
Q

Plasma-Lyte A

COD:
Therapeutic goal:
MOA:
contains:
AE: 
CI:
A

COD: Fluids
TG: dec. dehy, or hypovol, inc. electrol.
MOA: replacement fluid
contains: alkalinizing BES - Na, K, Cl, Mg
AE/CI: None

76
Q

Ringers

COD:
Therapeutic goal:
MOA:
Contains:
AE: 
CI:
A
  • 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
Q

Plasma-Lyte M

COD:
Therapeutic Goal:
MOA:
Contains:
AE: 
CI:
A
COD: Fluids
TG: dec. dehy and/or hypovol, inc. electrolytes
MOA: maintenance fluid
contains: acidifying - Na, K, Cl, Ca, Mg
AE/CI: None
78
Q

Normosol - M

COD: 
Therapeutic Goal:
MOA: Contains:
AE:
CI:
A
COD: Fluids
TG: dec. dehyd, or hypovol. increase electorlytes
MOA: maintenance fluid
Contains: acidifying - Na, K, Cl, Mg
AE/CI: None
79
Q

List the Depolarizing and non-depolarizing drugs that induce muscle paralysis:

A
Depolarizing: 
  - Succinylcholine
Non-Depolarizing:
  - Atracurium
  - Cisatracurium
  - Pancuronium
80
Q

Atracurium

COD: 
Effect:
MOA:
AE:
CI:
A
  • 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
Q

Cisatracurium

COD:
Effect:
MOA:
AE:
CI:
A
  • 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
Q

Pancuronium

COD:
Effect:
MOA:
AE:
CI:
A
  • 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
Q

Succinylcholine

COD:
Effect:
MOA:
AE:
CI:
A
  • COD: Muscle Paralytic
  • Effect: Depolarizing Neuromuscular blocking agent (BAD)
  • MOA: binds to receptor, depolarizes it, stays and continues to block
  • AE: DEATH
  • CI:
84
Q

Muscle Paralytic Drugs:

A
  • Atracurium
  • Cisatracurium
  • Pancuronium
  • Succinylcholine
85
Q

Saying for mm relaxants:

A
Go : Guafenesin
Find: Flumazenil
My: Midazolam
Lazy: Lorazopam
Dog: Diazepam
86
Q

Muscle relaxant drugs

A
  • diazepam
  • midazolam
  • lorazepam
  • flumazenil
  • Guaifenesin
87
Q

Diazepam

COD: 
Effect:
MOA:
AE:
CI:
Note:
A
  • 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
Q

Midazolam

COD: 
Effect:
MOA:
AE:
CI:
Note:
A
  • 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
Q

Lorazepam

COD:
Effect:
MOA:
AE:
CI:
A
  • 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
Q

Guaifenesin

COD: 
Effect: 
MOA: 
AE:
CI: 
therapeutic goal:
A
  • 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
Q

Flumazenil

COD:
Effect:
MOA: 
AE: 
CI:
A

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
Q

Estradiol

MOA:
AE:
CI:

A
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
Q

Edrophonium

COD: 
MOA:
AE:
Effect:
CI:
A

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

94
Q

Neostigmine

COD: 
MOA:
AE:
CI:
Use:
A

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
Q

physostigmine

COD:
MOA:
AE:
Effect:
CI:
A

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
Q

Progesterone

therapeutic goal: See notes to update:

A

increases production of somatotropin, IGF1 (growth factor) which increases mm mass - implant in ear

97
Q

Testosterone

What do they do:
Therapeutic goal:

A
and trenbalone:
work directly (unlike progesterone and estradiol) to increase mm mass.  Implant in ear

Therapeutic goal: increase muscle mass

98
Q

trenbolone

Therapeutic goal - see ppt for more to put here

A

increase mm mass

99
Q

epinephrine

COD:
MOA:
AE
EFFECT: 
CI:
A

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
Q

Isoproterenol

COD: 
MOA:
AE:
Effect:
CI:
A

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
Q

Dopamine

COD: 
MOA:
AE:
Effect: 
CI:
A

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
Q

dobutamine

COD:
MOA:
AE:
Effect:
CI:
A

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
Q

Digoxin

COD:
MOA:
AE:
Effect:
CI:
A

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
Q

Pimobendan

COD:
MOA:
AE:
Effect:
CI:
A

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
Q

Atropine

COD: 
MOA: 
AE:
Effect:
CI:
A

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
Q

Glycopyrrolate

COD: 
MOA:
AE:
Effect;
CI:
A

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
Q

Hydralazine

COD: 
MOA:
AE:
Effect:
CI:
A
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
Q

Diltiazem

COD: 
MOA:
AE:
Effect:
CI:
A

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
Q

Amlodipine

COD: 
MOA:
AE:
Effect:
CI:
A

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

110
Q

Carvedilol

COD: 
MOA: 
AE:
Effect:
CI:
A

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
Q

Benazepril

COD:
MOA:
AE:
Effect:
CI:
A

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

112
Q

Phenylephrine

COD:
MOA:
AE:
Effect:
CI;
A

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

113
Q

acronym for decreasing sympathetic output:

A

BE CAP’T

  • Benazapril
  • Enalapril
  • Carvedilol
  • Atenolol
  • Propanolol
  • Timolol
114
Q

Dopamine

COD: 
MOA:
AE:
Effect:
CI:
A

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
Q

Atenolol

COD: 
MOA: 
AE:
Effect:
CI:
A

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

117
Q

Propranolol

COD:
MOA:
AE:
Effect:
CI:
A

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
Q

Timolol

COD: 
MOA:
AE:
Effect:
CI:
A

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
Q

Benazepril

COD: 
MOA:
AE:
Effect:
CI:
A

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

120
Q

Enalapril

COD:
MOA:
AE:
Effect:
CI:
A

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
Q

Aspirin

COD: 
MOA:
AE:
Effect:
CI:
A

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

122
Q

Clopidogrel

COD: 
MOA: 
AE:
Effect:
CI:
A
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
123
Q

Dalteparin

COD:
MOA:
AE:
Effect:
CI:
A
COD: Anticoagulant
MOA: low weight molecular heparin
AE: bldg in susceptible patients
Effect: Anti-coagulant drug
CI: renal dz will prolong clearance
124
Q

Amiodarone

COD: 
MOA:
AE:
Effect;
CI:
carvedilol, diltiazem, lidocaine, procainamide, qunidine, sotalol
A

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
Q

Carvedilol

COD: 
MOA:
AE:
Effect;
CI:
A

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
Q

Diltiazem

COD: 
MOA:
AE:
Effect;
CI:
A

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
Q

Lidocaine

COD: 
MOA:
AE:
Effect;
CI:
A

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
Q

Quinidine

COD: 
MOA:
AE:
Effect;
CI:
A

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
Q

Sotalol

COD: 
MOA:
AE:
Effect;
CI:
A

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
Q

Procainamide

COD: 
MOA:
AE:
Effect;
CI:
A

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

129
Q

Which drugs specifically cause bronchiole dilation.

which drugs CAN cause bronchiole dilation (not main fxn)

A

DO:

  • Albuterol
  • Clebuterol

CAN:

  • Epinepherine
  • Isoproterenol
  • Dopamine
  • Dobutamine
130
Q

Albuterol

COD:
MOA:
AE:
Effect:
CI:
A
  • 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
131
Q

Clenbuterol

COD:
MOA:
AE:
Effect:
CI:
A
  • 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
132
Q

Hydrocodone

COD:
MOA:
AE:
CI:

A
  • 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
Q

Most Common antineoplastic Adverse Effects:

A

Bone Marrow Suppression

GI issues

134
Q

Antineoplastic Drugs:

  • List them
A
  • Cisplatin - Methotrexate - Toceranib
  • Cyclophosphamide - Doxorubicin
  • Lomustine - L-Asparaginase
  • 5-FU - Vincristine
  • Cytarabine - Piroxicam
135
Q

Cisplatin

COD: 
MOA: 
AE:
Effect:
CI:
Legal:
A
  • 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
Q

Cyclophosphamide

COD:
MOA: 
AE:
CI:
Legal:
A
  • 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
Q

Lomustine

COD:
MOA:
AE:
Effect:
CI:
Legal:
A
  • 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
Q

5-FU

COD: 
MOA:
AE:
Effect:
CI:
Legal: 
Phase:
A
  • 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
Q

Cytarabine

COD: 
MOA:
AE:
Effect:
CI: 
Legal:
A
  • 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
Q

Methotrexate

COD: 
MOA:
AE:
Effect: 
CI:
Legal:
Phase:
A
  • 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
Q

Doxirubicin

COD
MOA
AE
Effect
CI
Legal
Phase
A
  • 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
142
Q

L-Asparaginase

COD:
MOA:
AE:
Effect:
CI:
Legal:
Phase:
A
  • 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
Q

Vincristine

COD: 
MOA: 
AE:
Effect:
CI:
Legal:
Phase
A
  • 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
Q

Piroxicam

COD:
MOA:
AE:
Effect:
CI: 
Legal:
A
  • 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
Q

Sedatives

A

Acepromazine, Diazepam, Midazolam, Detomidine, Dexmedetomidine, Romifidine, Xylazine

146
Q

Reversals

A

Atipamezole, Flumazenil, Naloxone, Naltrexone, Tolazoline, Yohimbine

147
Q
Diazepam:
Theraputic goal: 
MOA: 
AE: 
CI:
A

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
Q

Reversals that are opiate antagonists.

Which drugs would they compete against?

A

Reversals: Naloxone, Naltrexone.

Opiate agonists: morphine, oxymorphone, butorphanol, hydromorphone, and other opioids

148
Q

Reversals that are GABA potentiator antagonists.

Which drugs would they compete against?

A

Reversals: Flumazenil.

GABA potentiators/Benzodiazepines: Diazepam, lorazepam, midazolam.

149
Q
Romifidine: 
Theraputic goal: 
MOA: 
AE: 
CI:
A

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
Q

Dopamine antagonists

A

Acepromazine, Chlorpromazine

151
Q
Acepromazine: 
Theraputic goal,
MOA, 
AE,
CI. 
Effect:
A

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
Q
Chlorpromazine: 
Theraputic goal: 
MOA: 
AE: 
CI: 
Effect:
A

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
Q
Diazepam:
Theraputic goal: 
MOA: 
AE: 
CI:
A

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
Q

Gabapentin

COD:
MOA:
AE: 
Effect: 
CI:
A
  • 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
Q

Levetiracetam

COD:
MOA:
AE:
CI:

A
  • 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
Q

Phenobarbital

COD: 
MOA: 
AE: 
CI: 
Note:
A
  • 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
Q

Phenytoin

COD: 
MOA: 
AE: 
Effect:
CI:
A
  • 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
Q

Potassium Bromide

COD:
MOA:
AE:
CI:

A
  • COD: anticonvulsant
  • MOA: changes Cl conductance
  • AE: PU/PD, polyphagia, ataxia, sedation, GI CNS signs, nausea, cat bronchitis
  • CI: not prego, P450 inducer
159
Q

Zonisamide

COD:
MOA:
AE:
CI:

A
  • 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
Q
Lorazepam:
Theraputic goal: 
MOA: 
AE: 
CI:
A

Theraputic goal: Tranquilizer.
MOA: Potentiate GABA receptors in CNS.
AE: Sedation, polyphagia, paradoxical excitement.
CI: None.

161
Q
Midazolam: 
Theraputic goal: 
MOA: 
AE: 
CI:
A

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
Q
Detomidine: 
Theraputic goal: 
MOA: 
AE: 
CI:
A

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
Q
Dexmedetomidine: 
Theraputic goal: 
MOA: 
AE: 
CI:
A

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
Q
Yohimbine: 
Theraputic goal: 
MOA: 
AE: 
CI:
A

Theraputic goal: Reversal.
MOA: Alpha2 antagonist.
AE: High dose- tremors and seizures.
CI: None.

165
Q
Xylazine: 
Theraputic goal: 
MOA: 
AE: 
CI:
A

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
Q
Atipamezole: 
Theraputic goal: 
MOA: 
AE: 
CI:
A

Theraputic goal: Reversal.
MOA: Alpha2 antagonist.
AE: Initial excitement, transient decrease in blood pressure.
CI: None.

167
Q
Flumazenil: 
Theraputic goal: 
MOA: 
AE: 
CI:
A

Theraputic goal: Reversal.
MOA: Benzodiazepine (GABA potentiator) receptor antagonist.
AE: None.
CI: None.

168
Q
Naloxone:
Theraputic goal: 
MOA: 
AE: 
CI:
A

Theraputic goal: Reversal.
MOA: Opiate antagonist.
AE: Tachycardia, hypertension, excitement, pain, cardiac arrhythmias.
CI: Animals in pain.

169
Q
Naltrexone: 
Theraputic goal: 
MOA: 
AE: 
CI:
A

Theraputic goal: Reversal.
MOA: Opiate antagonist.
AE: None.
CI: Animals in pain.

171
Q

How to calculate Replacement fluid

  • Maintenance Fluid
  • 24 hr needs
A

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
Q
Tolazoline: 
Theraputic goal: 
MOA: 
AE: 
CI:
A

Theraputic goal: Reversal.
MOA: Alpha2 antagonist.
AE: Hypertension, tachycardia, peripheral vasodilation.
CI: Animals in stress, debilitation, cardiac disease, sympathetic blockage, hypovolemia, shock.

173
Q
Toceranib
Therapeutic goal
MOA
AE
CI
A

TG: Antineoplastic
MOA: inhibits receptor tyrosine kinase
AE: GI problems, anorexia, lameness, weight loss, blood in feces
CI: Prego