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Therapeutics in Disease Management Flashcards

1
Q

prescription drugs

A

anything with a label that states:

only use on approval by licensed veterinarian

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2
Q

over the counter drugs (OTC)

A

can be purchased and administered (according to label directions) without a prescription

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3
Q

AMDUCA

A

Animal Medicinal Drug Use Clarification Act

provides veterinarians acting within
a veterinarian-client-patient relationship (VCPR) with
greater prescribing and dispensing options so that
animals can receive the medications they need when
they need them. This is critical given the relatively few
numbers of drugs labeled for use in animals

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4
Q

ELDU

A

-guidelines for the Extra Label Drug Use

the term that describes
the use of an approved drug in a manner that differs
in any way from the drug’s approved labeling. This
includes deviations from FDA-approved labeling such
as using the drug in any of the following ways.

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5
Q

Important points

A

 ELDU permitted only under veterinary supervision
 ELDU for therapeutic purposes only
 ELDU is prohibited for drugs used in feed.
 ELDU cannot be applied to drugs used to
enhance production
 In a species not listed on the label
 For an indication not listed on the label
 At a different dose or frequency than listed on
the label
 Via a different route of administration than listed
on the labe

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6
Q

difference between previcox and equioxx

A

Previcox is a pill labeled for use in dogs, Equioxx is labeled for use in horses.

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7
Q

FARAD

A

Food Animal Residue Avoidance Databank

veterinarians who treat food animals with drugs
in an extralabel manner must use evidence
“…derived from food safety data or other
scientific information…” in order to determine an
appropriate withdrawal interval (WDI) that allows
for a conservative estimate of drug residue level
in edible animal tissues.

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8
Q

drugs prohibited for use in food producing animals

A 
Chloramphenicol Clenbuterol
Diethylstilbestrol
Pronidazole Dipyrone
Other Nitroimidazoles Furazolidones &
Nitrofurazone(except approved topicals)
Major vs minor food animal species
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9
Q

can you use sulfonamides in dairy cattle

A

Currently, use of
any sulfonamide other than SDM in dairy
cattle older than 20 months is illegal.
Additionally, extralabel use of SDM in
lactating dairy cattle is prohibited (for
example, use of a higher dose or slow-release
SDM boluses in dairy cattle is not permitted).

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10
Q

glycopeptide antibiotic

A

vancomycin- used for treatment of MRSA in humans and used in european feeds as a growth promoter.. no prohibited

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11
Q

which two drugs are not currently prohibited in dairy cattle but result in “debits”

A

dimethyl sulfoxide

collodial silver

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12
Q

VFD

A

veterinary feed directive

-Developed in response to microbial resistance issues associated with our livestock animals.
-Removal of OTC available
antibiotics. (medically important)
-Veterinary oversight of antibiotic use
in feed and water.
Documentation at the veterinary,
owner, and feed mill levels.

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13
Q

Beef/Dairy Quality Assurance

A

Prevent inappropriate:

  • Biologics
  • Therapeutics
  • Handling

Quality Assurance (goals)

  • residue avoidance
  • improve milk/meat quality
  • minimize injection size lesions
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14
Q

Dairy Quality Assurance

A

 Dairy Quality Assurance Handbook
 Voluntary use vs. mandatory use
 Some states offer incentives if a dairy goes
through the handbook on a voluntary basis
 Concepts very similar to BQA
 Additional measure beyond BQA include
residue avoidance in fluid milk, appropriate
storage of lactating and non-lactating cow
therapeutics, accordance with the
Pasteurized Milk Ordinance (PMO), etc.
 Dairy animals => meat processing.

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15
Q

National Cattleman’s Beef Association’s BQA- National Guidelines

A

 Feedstuffs
- Maintain records of any pesticide/herbicide
use on pasture or crops that could potentially
lead to violative residues in grazing cattle or
feedlot cattle.
- Adequate quality programs are in place for
incoming feedstuffs.
- Analyze suspect feedstuffs prior to use
- Ruminant-derived protein sources cannot be
fed (FDA)
- Feeding by-product ingredients should be
supported with science

Feed additives and medications: 
Only FDA approved medicated feed
additives will be used in rations
Medicated feed additives will be used in accordance with the FDA Good Manufacturing Practices (GMP)
regulations
Extra label use of feed additives is
illegal and strictly prohibited
VFD
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16
Q

extralabel use of medicated feed

A

AMDUCA specifically prohibits the “extralabel use of an approved new animal
drug or human drug in or on an animal feed.”

Withdrawal times must be strictly
adhered to
Complete records must be kept when formulating or feeding medicated feed rations
Records must be kept for a minimum of 2 years
Operator will assure that all additives are withdrawn at the proper time to
avoid violative residues

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17
Q

processing/treatment and records

A

Follow all FDA/USDA/EPA
guidelines for products used
Use all products as per label directions
Extra label drug use shall be kept to a minimum, and used only when prescribed by a veterinarian working under a Valid Veterinary
Client Patient Relationship (VCPR)
All cattle (fed and non-fed) shipped to
slaughter will be checked by appropriate
personnel to assure that animals that have been treated meet or exceed label or prescription withdrawal times for all animal health products administered.
All processing and treatment records should
be transferred with the cattle to next production level. Inform buyers of cattle which have not met their withdrawal time.

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18
Q

maintenance of treatment records

A 
Individual animal or group identification
Date treated
Product administered and
manufacturer’s lot and serial #
Dosage used
Route and location of administration
Earliest date animal will have cleared
withdrawal time
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19
Q

injectable animal health products

A

 Injectable animal health products
Products labeled for subcutaneous(SQ)
use should be administered ahead of the shoulder
All products labeled for intramuscular(IM) use shall be given in the neck region only.
All products cause tissue damage when injected IM, therefore IM usage should be
avoided.
Products cleared for SQ, IV or oral administration are recommended

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20
Q

where do you never inject?

A

the hindquarters

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21
Q

products with what size dosage are recommended?

A

low

no greater than 10 ml should be injected per IM injection site

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22
Q

correct needle size is important

A

SQ= 16 or 18 gauge
IM= 16 or 18 gauge
14 gauge is not recommended

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23
Q

why is 14 gauge not recommended?

A

increases tissue trauma

more likely to get drainage from the site

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24
Q

care and husbandry practices

A

All cattle will be
handled/transported in such a
manner as to minimize stress, injury and/or bruising.
Facilities should be inspected
regularly to ensure proper care and ease of handling
Strive to keep feed and water handling equipment clean.
Provide appropriate nutrition and feedstuffs management
Strive to maintain an environment
appropriate to the production
setting
Bio-security should be evaluated
Records should be kept for a minimum of 2 years (3 for restricted use pesticides).

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25
handle vaccines and medications with care
 Store in refrigerator  Don’t mix two different products in same syringe  Use separate needles for filling syringes and injecting (minimizes product contamination and maintains use of sharp needles)  Sanitation is essential  Disinfectant residues in syringes can inactivate MLV vaccines
26
antimocrobial therapy
Antimicrobial- kills microorganisms or inhibits their multiplication/growth Antibiotics – a chemical produced by a microorganism that has the ability in dilute solutions to inhibit microbial growth or kill microorganisms
27
minimum inhibitory concentration (MIC)
the lowest concentration of drug that inhibits bacterial growth (kills 99.9% of the bacteria)
28
bactericidal
an antibiotic have a MBC:MIC ratio < 4:6
29
bacteristatic
inhibits bacterial growth
30
post-antibiotic effect
persistence of anti- microbial activity after drug concentrations have fallen below MIC
31
pharmacokinetics
the study of absorption, distribution, biotransformation, and excretion of drugs
32
pharmacodynamics
the study of the effects of drugs, mechanism of | action (MOA), and concentration-effect relationships
33
MIC determination
 Measures the minimum concentration of each antimicrobial agent (microgram/ml) that is inhibitory for a given bacterial isolate.  Dilutions of each antibiotic are incubated with a standard number of bacteria; bacterial growth is measured over time.  Comparison of above concentration with that achievable in tissue = susceptible or resistant.
34
Antimicrobial Sensitivity Testing
Agar Disk Diffusion ``` Kirby-Bauer Disk Diffusion Test Meuller-Hinton Agar Paper disk impregnated with antibiotic Diameter of zone inhibition is measured and correlates to the MIC Interpretation – not standardized for veterinary medicine ```
35
problems with sensitivity testing
 Overestimates antimicrobial activity in CSF, prostatic fluid and udder  Underestimates antimicrobial activity in topical treatments, local infusions, and urine  Underestimates activity at concentrations < MIC  Assumes plasma and tissue concentrations are equal Doesn’t assess combination therapy (synergistic effects) Cannot assess local factors that influence antimicrobial activity
36
inhibitors of cell wall synthesis
beta-lactam antibiotics penicillins cephalosporins
37
benzylpenicillin
procaine pencillin G (PPG), benzathine penicillin, potassium penicillin
38
aminopenicillins
ampicillin, amoxicillin
39
anti-staphylococcal penicillins
cloxacillin (Dariclox)
40
which generations of cephalosporins do we use
1st and 3rd generations
41
inhibitors of protein synthesis
``` aminoglycosides tetracyclines chloramohenicols macrolides lincosamides sulfonamides ```
42
inhibitors of nucleic acid synthesis
fluroquinolones (Baytril)
43
penicillin use
many pyogenic infections in ruminants, camelids, and swine
44
withdrawal time for penicillin
milk-120 hours, meat- 30 days
45
uses for aminopenicillin
foot rot, shipping fever, mastitis
46
withdrawal time for aminopenicillins
amoxi-inject: milk- 96 hours, meat: 25 days polyflex: milk- 96 hours, meat- 6 days amoxi-mast: milk- 60 hours, meat: 12 days
47
cephalosporins (1st generation) uses
lactating and dry cow mastitis pathogens
48
cephalosporins (1st generation) withdrawal time
Cefa-Lak, Today (milk – 96 hrs., meat – 4 days), Cefa-Dri, Tomorrow (milk – 72 hrs., meat – 42 days)
49
cephalosporins (3rd generation) uses
shipping fever
50
cephalosporins (3rd generation) withdrawal times
Naxcel (milk – 0 days, meat – 0 days), Excenel ( milk – 0 days, meat – 48 hours)
51
dihydrostreptomycin uses
dry cow treatment
52
dihydrostreptomycin withdrawal times
Quartmaster (Dry cows, | Meat 60 days)
53
oxytetracycline uses
Shipping fever, Wooden Tongue, Pinkeye, Foot Rot, Diphtheria, Bacterial enteritis, Leptospirosis, Wound infections, Acute metritis
54
oxytetracycline withdrawal times
LA-200 (milk – 96 hrs., meat – 28 days); varies according to formulation, dose and route of administration.
55
florfenicol uses
shipping fever
56
forfenicol withdrawal times
Nu-Flor(meat 28-38 days) Not approved for use in lactating dairy cattle
57
erythromycin uses
lactating and dry cow mastitis pathogens; | metritis; foot rot; Pneumonia ( Shipping fever)
58
erythromycin withdrawal times
Erythro-100,200(milk – 72 hrs., meat – cattle 14 days, sheep 3 days, swine 7 days); Erthro-36, Dry (milk – 36 hrs., meat – 14 days)
59
tylosin uses
shipping fever Mycoplasma pneumonia, foot rot diphtheria, metritis, swine dysentery, Erysipelothrix
60
tylosin withdrawal times
Not approved for use in lactating dairy cattle; meat-cattle 21 days, Swine 14 days
61
tilmicosin uses
shipping fever
62
tilmicosin withdrawal times
Not approved for use in lactating dairy cattle, meat – 28 days.
63
lincocin uses
Swine – arthritis, Mycoplasma | pneumonia
64
lincocin withdrawal times
slaughter 48 hours (swine)
65
pirlimycin uses
gram positive mastitis pathogens
66
pirlimycin withdrawal times
milk- 36 hours, meat- 28 days
67
sulfadimethoxine uses
Foot Rot, Pneumonia, Corybacterium, | Salmonella
68
sulfadimethoxine withdrawal times
Albon(milk – 60 hrs., meat – 7 days), Albon SR (not for use in lactating dairy cattle; meat - 21 days)
69
enrofloxacin uses
Only approved livestock use is for the treatment of pneumonia in cattle.
70
enrofloxacin withdrawal time
not for use in lactating | or preruminant dairy calves, meat – 28 days.
71
antimicrobial resistance
Emergence of resistant strains of bacteria is a major potential public health risk. Bacteria have two types of genetic structure through which resistance can be conferred Chromosomes Plasmids (extrachromosomal) (R-factors)
72
chromosomes in antimicrobial resistance
-Depends on mutation of bacterial genes -Antimicrobial compounds act as selective agents that allow resistant mutants to emerge
73
plasmids in antimicrobial resistance
-Acquired: Insert into bacterial genome -Plasmids may contain 20 – 500 genes that carry resistance to a number of antimicrobial agents (Multidrug Resistant strains.)
74
three areas of concern for antimicrobial resistance
 Intestinal infections – reservoir of Rfactors may be carried by commensal bacteria in the gut  The use of low levels of antibiotics (e.g feed additives, or improper dosing) may lead to a high occurrence of R-factors in the bacterial population  Indiscriminate use of antibiotics=>eliminate effectiveness of antimicrobial substances in future
75
principles of rational antimicrobial therapy
``` Know your patient Know the infection Viruses don’t respond to antibiotics Location – tissue perfusion,etc. Culture and Sensitivity ( bacteria) Remove the pathogen or source if possible Select an appropriate antimicrobial agent and dose regimen Dose adequately Maintain the dosage Monitor treatment outcome Recording keeping Investigate therapeutic failures Recognize and address adverse drug reactions ```
76
inflammation
 Immune cells distributed throughout the body  Need to focus the response to a specific site during infection=>Inflammation
77
three major events of inflammation
 Increased blood supply to infected region.  Increased capillary permeability permitting larger than normal molecules to breach the vessel wall (soluble mediators e.g.complement)  Leukocytes migrate out of venules into surrounding tissue ( Diapedesis) Neutrophils, Monocytes and Lymphocytes
78
anti-inflammatories
glucocorticoids | non-steroidal anti-inflammatory agents (nsaids)
79
glucocorticoids uses
Treatment of edema, insect bites/stings, nerve injury, ketosis, and aseptic laminitis. Termination of pregnancy.
80
glucocordicoid withdrawal time
none
81
NSAIDs uses
Control of pyrexia (fever) associated with bovine respiratory disease and endotoxemia and for control of inflammation associated with endotoxemia. Banamine
82
mechanisms of edema
``` Increased Vascular Permeability Decreased Plasma Colloid Oncotic Pressure Increased Hydrostatic Pressure Decreased Lymphatic Drainage ```
83
diuretics uses
Treatment of udder edema; | Label – treatment not to exceed 48 hours post-partum
84
diueretics uses withdrawal time
milk and meat 48 hours
85
Thaizide/Glucocorticoid | Combination use
udder edema withdrawal for milk in 72 hours side effect- abortion
86
other therapeutics
``` Reproductive Drugs Parasiticides Sedatives, Anesthetics and Tranquilizers Growth Promoting Hormones Fluid therapy ```
87
metaphylaxis
Term for the use of specific products (Mycotil, tilmicosin) upon entry into feedlots Data suggest beneficial effects (reduced morbidity) Administration on arrival (post shipment) was superior to pre-shipment treatment* More work…timing, other stresses, etc.

AVS 471 (9 decks)

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