Therapeutics: Equine and Farm Animal Flashcards

1
Q

Name all 10 classes of antimicrobials

A
  1. Beta-lactams- penicillin
  2. Cephalosporins
  3. Aminoglycosides
  4. Chloramphenicol
  5. Pot. sulponamides
  6. Tetracyclines
  7. Fluoroquinolones
  8. Macrolides
  9. Rifampin
  10. Metronidazole
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2
Q

Why are beta-lactams commonly used?

What is their MOA?

What is their indications?

Describe their pharmacokinetics and adverse effects

A

Safety, efficacy and low cost

MOA- interfere with bacterial cell wall production- cell lysis

Indications-
Gram +ve, Strep in horses, anaerobic infections
Syngergisitc with aminoglycosides, additive to fluoroquinolones

Pharma-
Na and K penicillin- IV, Procaine- IM, oral
Elimination mainly kidney

AE- immune reactions (anaphylaxis, haemolytic anaemia, thrombocytopenia), Procaine to CNS if IV or hot

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3
Q

What are cephalosporins MOA?

How are they divided?

What is their pharmacokinetics and adverse effects?

A

MOA- same as penicillins but more resistant to bacterial defences

Divided into generations- varying efficacty on gram +/-ve, 4th very broad on both

Pharma- rapid absorpbtion, excreted unchanged in urine

AE- same as penicillins

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4
Q

What are aminoglycosides MOA?

When are they indicated?

What is their pharmacokinetics and AE?

A

MOA- penetrate bacteria, bind to 30s ribosome, cause misreading of genes, bactericidal- Concentration dependent

Indications- Gram -ve infections, pseudomonas
e.g- gentamycin, amikacin, neomycin, streptomycin, tobramycin

Pharma- Poor oral, good other routes, eliminated in glomeruli

AE-
Nephrotoxicity- avoid with other nephrotoxic drugs, enters tubules and uptaken, accumulates in lysosome- rupture cell damage
Monitor- creatinine/ GGT
Endotoxaemia
Ototoxicity- ear
Neuromuscular blockade

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5
Q

What is the MOA of chloramphenicol?

When is it indicated and forbidden?

What are its pharmacokinetics and AE?

A

MOA- binds to 50s ribosomes and inhibits proteins synthesis- bacteriostatic

Indications- broad spectrum- chlorampenicol/florphenicol
Forbidden in food animals

Pharma- v short half life IV, painful IM, increased absorption orally

AE- not with penicillin, aminoglycosides, fluoroquinolones, macrolides. Colitis

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6
Q

What are potentiated sulphonamides combinations of?

What are their MOA?

When are they indicated?

Pharmacokinetics?

AE?

A

Combinations of sulphonamide and diaminopyrimidine

MOA- inhibit folic acid pathway, block bacterial nucleic acid synthesis, ineffective in pus and necrotic tissue (increased PABA)

Indications- broad spectrum: strep, staph, some gram-ve (E.coli, salmonella)

Pharma- good oral, liver metabolism, renal excretion

Adverse- agranulocytosis, anaemia, thrombocytopenia, crystalluria, diarrhoea, rapid IV causes collapse

Dines- norodine, detomidine

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7
Q

Name three tetracyclines

What is their MOA?

Indications?

Pharma?

AE?

What can they be used for in foals?

A

Tetracycline, oxytetracycline, doxytetracyline

MOA- binds to 30s ribosome, inhibit protein synthesis, bacteriostatic

Indications- broad spec- gram + some anaerobes- chlamydia, mycoplasma, ehrlichia
Doxyclcine inhibits MMPs- affects eyes IMMK

Pharma-very lipid soluble, excreted unchanged in urine

AE- fatal colitis, rapid IV causes collapse and death, discolouration of teeth

Engemycin

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8
Q

Name three fluoroquinolones

MOA?

Indications?

Pharmaco?

AE?

A

Enrofloxacin, marbofloxacin, ciprofloxacin

MOA- inhibit bacterial DNA gyrase, abnormal configuration of DNA, autolysis, bactericidal- optimal activity

Indications- broad spec- most aeobic gram-, some +, mycoplasma, chlamydia, rickettsia
Very effective against enteris gram- (Salmonella), ineffective against anaerobic bacteria

Pharma- good oral absorption, lipid soluble, good distribution, excreted unchanged in urine

AE- cartilage lesions, antagonistic to antimicrobials that inhibit protein synthesis

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9
Q

Name some macrolides

MOA?

Indications?

Pharma?

AE?

A

Erythromycin, clarithromycin, azithomycin, clindamycin, lincomycin

MOA- binds to 50s ribosomal unit, inhibits protein synthesis, bacteriostatic, quick resistance

Indications- causes colitis in adult horses, rhodococcus equi in foals

Pharma- orally, good penetration, liver metabolism- entero-hepatic circulation- diarrhoea

AE- diarrhoea in adults, hyperthermia

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10
Q

What is the MOA of rifampins?

Indications?

Pharmaco?

AE?

A

MOA- inhibits bacterial RNA polymerase, decreased RNA synthesis

Indications- staph, rhodoccocus equi, mycobacteria

Pharmacokinetics- 40-70% oral bioavalability, lipophilic, liver metabilism, excreted in bile/urine

AE- Stains everything red- urine, faeces, tears, saliva

Rifampins- RED

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11
Q

What is the MOA of Metronidazoles?

Indications?

Pharma?

AE?

Why rectally given?

A

MOA- anaerobic bacteria take up and break into small free radicals causing DNA damage

Indications- anaerobic bacteria, protozoa

Pharma- good absorption, lipophilic, hepatic metabolism

AE- mutagenic, neurotoxicity, depression and decreases appetite

Doesn’t taste nice

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12
Q

What are the current concerns about antibiotics?

A

Fluoroquinolone

Extended spectrum- beta-lactamases

Colistin resistance

Possible to transfer resistance genes

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13
Q

How are sales of antibiotics changing?

A

Decreasing

Based on dose rate mg/k

resistance depends on dose, confusing for containers

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14
Q

How do the EU classify antibiotics?

A

Category A-D
A- not licensed for food producing animals- may be in companion animals- ‘Avoid’

B- ‘restrict’

C- ‘caution’ may result in mutation that reduces efficacy of A and B

D- ‘prudence’

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15
Q

What is the cascade?

Describe the sequence for choice of drug

A

When no authorised product exists for a condition affecting non-food producing species, in order to mitigate suffereing treat with the following sequence:

  1. Vet med authorised for use in another species, or for a different conditions in the same species
  2. No product- either- medicine for human use or in accordance with a import certificate a medicine authorised in another state
  3. In not above- a medicine made up at the time on a one off bases by veterinary surgeon
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16
Q

How is the cascade different for food producing animals?

A
  • Restricted to single holding
  • Medicine imported must be authorised for FPA in another state
  • Active substance must be in table 1
  • Vet specify appropriate withdrawal period
  • Vet must keep specific records
  • If there is authorised product- should be used
  • May judge there is no authorised product- resistance
  • Dosage and characteristics taken into account
  • Chronic infections- failure or authorised
  • Build up of resistance- rotation of authorised and cascaded product
  • Complex conditions- drug compatability
  • Product unavailable- diligent search
17
Q
A
18
Q

How should prescribing be approached?

A

What is wrong- idenfitgy targets for therapy
Use critically reviewed infro
Appreciate supporting and curing condition

What therapies available- licensed, cascade

Comment on alternatives- euthanasia, surgery

Cost

Be aware of risks- animal, clients, staff

Prevention- education

19
Q

What needs to be considered with treatment choice?

For example give every cow with mastitis synulox

A

One possible and expensive treatment, no diagnosis needed- could return though

Best long term is prevention which requires accurate diagnosis

Could be given other drugs to help- oxytocin to flush out bacteria

20
Q

List categories of antibiotics based of the following MOA:

  1. Disrupt cell wall production
  2. DNA action inhibitors
  3. Protein synthesis inhibitors
  4. Cell membrane function
A
  1. B-lactams, penicillins, cephalosporins
  2. Potentiated sulphonamides, fluoroquinolones
  3. Streptomycin, tetracycline, macrolides, florphenicol
  4. Monensin
21
Q

What considerations should be kept when prescribing antibiotics?

A

Some diseases have a high self-cure rate

Local resistance can vary a lot

Should antibiotic be left on the farm for future cases

Spectrum- broad (more successful) or narrow (better for resistance)

Does it enter correct tissue/serum

22
Q

What causes antibiotics to enter tissue or serums? and name examples

A

Acidic antibiotics enter serum- penicillin, amoxycillin, clavulanic acid, cephalosporin

Alkaline anter tissue- macrolides

Some neutral equal in both- oxytetracyline/sulphonamides

Remember inflammation changes barrier so will affect concentrations in tissues

23
Q

How long do antimicrobials need to be present for?

A

MOA dependent

Time over minimum inhibitory concentration (MIC)- penicillins, cephalosporins, tetracyclines, macrolides

Concentration dependent- aminoglycosides

Area under the curve dependent- fluoroquinolones

24
Q

What is synergism?

A

Potentiation of one drug action by another

Concnetration dependent

Phase of bacterial life cycle when active- growth/biofilms

Possible antagonism if concentrations wrong

25
Q

How should antibiotics be dosed?

A

Dose needs to be well over the MIC at least once daily- depends on half life

Can be dictated by formulation

26
Q

What affects withdrawal period?

How can drugs sush as excenel have short/no withdawals but a 24h dose interval?

A

Soluble- oil based not
pH
Organism sensitivity
Human toxicity

Soluble drug therefore no injection site residue
Acidic so doesnt enter the milk
Organisms are highly sensitive- low MIC- therefore below human toxicity dosage

27
Q

What NSAIDs are currently available for cattle?

A

Flunixin meglamine- Finadyne

Ketoprofen- ketofen

Telenamic acid- Tolfine

Meloxicam- metacam

Carprofen- Rimadyl

Aspirin- Solacyl