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139 Cards in this Set
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Alpha 2 agonists |
Xylazine
Detomidine Dexmedetomidine Uses: Sedation and analgesia |
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Drugs that hit both Alpha and beta (non selective) |
Epinephrine
Norepinephrine |
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Which receptors does Dopamine hit |
Dopamine (low concentration), Beta (high range) and alpha (mid range) |
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Beta agonists (non selective) |
Isoproterenol Dobutamine (dopamine at high concentration) Uses: - renal blood flow - positive chronotrope - positive inotropes |
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Beta 2 agonists |
Terbutaline Albuterol Clenbuterol Uses: - bronchodilation - vasodilation |
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Positive inotropes |
Dopamine Dobutamine - little chronotropic effect = good! Pimobendan = inodilator - inotrope of choice in SA - THE CARDIAC DRUG! - increase cardiac contractility w/o increase myocardial oxygen consumption Digoxin - cardiac glycoside - inhibit Na/K ATPase pump to get accumulation of Ca in myocytes - increase vagal tone - good for atrial fibrillation with tachycardia - good for mitral valve insufficiency with tachycardia |
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Alpha 1 antagonists |
Phenoxybenzamine Acepromazine *Prazosin was the original* Uses: - Vasodilation - Decrease BP without increase HR |
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Dopamine antagonist |
Metoclopramide (anti-emetic) |
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Beta 1 antagonists (negative chronotrope/inotropes) |
Sotalol Atenolol - decrease HR - slow AV conduction - decrease sympathetic input (better survival) |
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Non selective beta antagonists |
Propranolol (negative chronotrope and inotrope) Carvedilol (also blocks alpha 1, may offset the vasoconstriction) - also get bronchoconstriction and vasoconstriction, plus bladder contraction |
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Cholinomimetics |
Acetylcholine Edrophonium (reverse neuromuscular blockade in anesthesia) Neostigmine Pyridostigmine (with neo, used for myasthenia gravis) Organophosphates (antiparasitic and insecticidal) - miotics (constrict pupil) |
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Anticholinergics (positive chronotropes) |
*muscarinic receptor antagonists* Atropine - cross BBB Glycopyrolate - not cross BBB - Anesthesia and sedation - treat vagal bradycardia - decrease resp. secretions - SA: decrease nausea and vomiting |
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Benzodiazepines |
Diazepam (Valium) - decrease anxiety, sedative and hypnotic - preanesthetci (higher doses) Midazolam - anticonvulsant (status epilepticus) - muscle relaxant |
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Benzodiazepine antagonist |
Flumazenil - reverse sedation |
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Anxiolytics |
Diazepam Midazolam Buspirone - urine spraying in cats - agonist at serotonin - antagonists at dopamine Cyproheptadine (antihistamine) - serotonin antagonist - appetite stimulation in cats - photic head shakin in horses |
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Old Anticonvulsants (DO NOT USE!) |
Phenytoin Primidone |
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New anticonvulsants |
Levetiracetam - high voltage calcium currents Zonisamide - not in Canada - block Ca and voltage gated Na channels Gabapentin - GABA analog, increases release/action of GABA - no toxicity reported Most common: Phenobarbital - epilepsy in dogs and cats - seizures in horses - hyperpolarization ----> less NT release Potassium Bromide (KBr) - use with phenobarbital - stabilize neuronal cell membrane by interfering with Cl transport Diazepam (benzodiazepine) - status epilepticus or cluster seizures - may do rectal infusion at home Pentobarbital - only status epilepticus - GABA mimetic effects, blocking NT release - drug of choice for CNS toxicity or seizures caused by convulsant agents Propofol - only status epilepticus - control acute seizures - preferable to pento (safer and easier to use) |
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Tricyclic Antidepressants |
Clomipramine - OCD and dominance aggression in dogs - block norepi and serotonin reuptake - block serotogenic, alpha, histaminic and muscarinic receptors |
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SSRIs |
Fluoxetine (reconcile, prozac) - reconcile = separation anxiety - urine marking in dogs and cats - more specific for serotonin than TCA, less ADR |
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Monoamine Oxidase Inhibitor (MAOI) |
Selegiline HCl (Anipryl, L-deprenyl) - Pituitary dependent hyperadrenocorticism - cognitive dysfunction (old dog dementia) - norepi, dopamine and serotonin accumulate (blocks breakdown of dopamine) |
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Class 1A anti-arrhythmics |
*open Sodium channel blockers, but also affect K channels to increase ERP* Procainamide - not for supraventricular tachycardias - use for ventricular tachycardias Quinide - vagolytic effect - atrial fibrillation in horses - second for ventricular tachycardias in dogs - use with digoxin to increase vagal tone |
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Class 1B Anti-arrhythmics |
*DO NOT affect K channels, blocks inactive sodium channels - no change in ERP* Lidocaine - drug of choice for ventricular arrhythmias - do not use with epinephrine if doing IV |
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Class 2 anti-arrhythmics |
Beta blockers! Negative chronotrope/inotropes Sympatholytics Propanalol - dogs and cats Carvedilol - protects against TPR (alpha 1 blocker) Atenolol - for hypertrophic cardiomyopathy |
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Class 3 anti-arrhythmics |
K channel blockers - prolong AP and increase ERP Sotalol - ventricular arrhythmia in boxers |
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Class 4 anti-arrhythmics |
Ca channel blockers (slow channels) - slow HR and AV conductance (rhythm control) - decrease myocardial contraction - peripheral dilation (decrease afterload) Diltiazam - pick this! (better than atenolol) - atrial fibrillation in dogs - hypertrophic cardiomyopathy in cats |
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Ino-dilators |
Pimobendan
- inotrope of choice in SA - THE CARDIAC DRUG! - increase cardiac contractility w/o increase myocardial oxygen consumption - modulates neurohormonal input to heart |
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Drugs that act on peripheral vasculature |
Alpha 1 agonists (postsynaptic) - phenylephrine - ephedrine - norepinephrine alpha 2 agonists - xylazine - detomedine - dexmedetomidine alpha antagonist - prazosin - acepromazine - quinidine - carvedilol Hydrazaline - unknown mechanism of dilation - use for mitral valve insufficiency but rarely Nitric Oxide producers - dilation - nitroglycerin (cream) - isorbide dinitrate (oral + cream) - nanitroprusside (IV) - all used for acute management of cardiac failure Amlodipine - calcium channel blocker, peripheral vasodilation - severe mitral valve regurgitation in dogs and systemic hypertension |
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Diuretics |
Furosemide Thiazide diuretics Spironolatone (aldosterone antagonist)
ACE inhibitors (decreased aldosterone production) - Enalapril - Benazepril (first choice) - Imidapril |
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Systemic Antifungals |
Azoles - Ketoconazole - Itriconazole - Fluconazole - Voriconazole Amphotericin B Na/K Iodide |
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Topical Antifungals |
Azoles - miconazole - enilconazole - clotrimazole Silver Sulfadiazine (primarily an antibiotic) Iodophores Lime sulfur Natamycin (rarely used) |
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Triazoles |
less ADR, longer duration - Fluconazole - Itraconazole - Voriconazole |
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Imidazoles |
Ketoconazole Miconazole Clotrimazole Enilconazole |
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Gastric ulcer groups |
Proton pump inhibitors H2 blockers Antacids Mucosal protectants |
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Proton Pump Inhibitors |
Omeprazole Pantoprazole |
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H2 antagonists |
Cimetidine Ranitidine (horses) Famotidine (small animals) |
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Antacids |
AIOH/MgOH Ca-carbonate |
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Mucosal protectants |
Sucralfate Misprostol |
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Central acting emetics |
Apomorphine Xylazine |
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Peripheral acting emetics |
H2O2 Saline Syrup of ipecac |
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Anti-emetics |
Maropitant Odansetron Phenothiazines - acepromazine - chlorpromazine - prochlorperazine Metocloproamide Glucocorticoids Antihistamines Anti-cholinergics/muscarinics |
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For motion sickness |
Maropitant (NK1 antagonist) Antihistamines - diphenhydramine - dimenhydrinate Anticholinergics/muscarinics - scopolamine derivatives |
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Anti-diarrheals |
Adsorbents - activated charcoal - ditrioctahedral smectite Mucosal protectants - Bismuth subsalicylate - Kaolin pectin Anti-cholinergics - Combo: Atropine + scopolamine + hyoscyamine - Isopropamide - Diphemanil methylsulfate - hyoscine butylbromide Opiates - Loperamide (no BBB) - Diphenoxylate (+atropine) |
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Prokinetics |
Lidocaine (choice in horses) Erythromycin Metoclopramide Cholinomimetics - bethanechol - cisapride Anticholinesterases - neostigmine - ranitidine/nizatidine |
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Laxatives |
Irritant: - castor oil Lubricant: - mineral oil Hyperosmotic cathartics - Mg salts - Na-biphosphate/Na phosphate - Lactulose (small animals choice) - Poly-ethylene glycol (small animals choice) Surfactants - dioctyl sodium succinate (DSS) Bulk laxatives - psyllium - prunes - methylcellulose |
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Immunosuppressives |
Glucocorticoids - first choice Azathioprine Cyclosporine Mycophenolate mofetil Cyclophosphamide Chlorambucil |
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Chemotherapy |
Alkylating agents - cross link DNA - for lymphoma - cyclophosphamide - chlorambucil Antitumour antibiotics - inhibit topoisomerase - Doxorubicin - lymphoma, carcinoma, sarcoma Antimetabolites - false purines/pyrimidines - Cytosine arabinoside - lymphoma( renal in cats), brain tumours, gran. meningoencephalitis Plant alkaloids - inhibit microtubule formation - Vin-cristine - Vin-blastine Platinum agents - cross links DNA - Cisplatin - Carboplatin
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Glucocorticoids for chemotherapy |
Prednisone - lymphoma, mast cell tumour, multiple myeloma, brain tumour |
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NSAIDs for chemotherapy |
Piroxicam Meloxicam - bladder transitional cell carcinoma - carcinomas |
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L-asparaginase for chemotherapy |
Lymphoma |
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Antihistamines |
Diphenhydramine Loratidine Cetirizine Mirtazapine Meclinizine |
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Local anesthetics |
Lidocaine Mepivacaine Bupivacaine |
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Peripherally acting depolarizing NMBAs |
Succinylcholine - 2 Ach bound together - get AP when binds to receptor, whole body fasiculations -> contraction -> flaccid - DO NOT USE IN HORSE EUTHANASIA (conscious of not being able to breathe) |
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Peripherally acting non-depolarizing NMBAs |
Atracurium Cisatracurium Competitive antagonists so ACh canot bind |
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Centrally acting NMBAs |
Guaifenesin - depress transmission of nerve impulses - induction of anesthesia Methocarbamol - block nerve impulses - not really used? Diazepam (benzodiazepine) Xylazine (alpha 2 agonist) |
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Direct acting NMBAs |
Dantrolene - stops excitation/contraction coupling in muscle cells - blocks ryanodine receptor - only treatment for malignant hyperthermia |
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Reversal of NMBAs |
Anthicholinesterases to reverse blockade - Neostigmine - Edrophonium To minimize ADR such as decreased HR, bronchoconstriction and salivation, use atropine and glycopyrrolate? |
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Small animal NSAIDs |
Meloxicam: both dogs and cats - COX2 Carprofen: dogs - COX2/weak Deracoxib: dogs - COX2 Robenacoxib: both - selectivity? |
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Cattle NSAIDs |
Flunixin: respiratory disease - non specific Meloxicam: pain - COX2 Ketoprofen: no milk withdrawal - non selective |
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Equine NSAIDs |
Flunixic: colic and endotoxemia - non specific Phenylbutazone: MSK pain - non specific Meloxicam, fioxib: - COX2 |
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Most toxic NSAIDs in small animals |
Dog:
- Ibuprofen - Naproxen - Flunixin - Phenylbutazone Cat: - flunixin - carprofen |
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Most toxic NSAIDs in large animals |
Phenylbutzone - do not use it at all in cattle!! |
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Opioids: pure agonists |
Morphine Hydromorphone Meperidine Fentanyl Tramadol |
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Opioids: partial agonists |
Buprenorphine |
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Opioids: Agonist-antagonist |
Butorphanol |
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Opioids: Antagonists (reveral) |
Naloxone Naltrexone |
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Opioids: moderate agonists |
Codeine Hydrocodone |
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Alpha 2 agonists for analgesia: |
Xylazine Medetomidine Detomidine Romifidine |
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alpha 2 antagonists for reversal of alpha agonists |
Yohimbine (a2 selective for dogs and deer) - for xylazine Atipamezole (alpha 2 selective for dogs) - for medetomidine Tolazoline (horses, NOT food animals; non-selective ) - for xylazine |
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Is acetaminophen an NSAID? |
No! MoA unkown Do not use in cats Okay in dogs who don't tolerate NSAIDs well |
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Macro-cyclic lactones (Avermectin) |
Ivermectin Moxidectin (encysted strongyles) Milbemycin (heartworm prevent) |
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Benzimidazoles |
Fenbendazole - 2x dose for larval cyathostomes - tapeworms - Taenia - Giardia - nematodes |
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Pyrimidines |
Pyrantel pamoate - roundworms, NOT tapeworms - mature GI cattle worms |
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Piperazine |
Piperazine - roundworms only! - dogs, cats, horses |
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Nitroscanate |
Isothiocyanate - roundworms, hookworms, tapeworms ( not echinococcus) - dogs only |
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Emodepside |
Emodepside - round worms, hookworms - cats only |
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Praziquantel/epsiprantel |
Cestocides! including echinococcus (injectable form of prazi) Epsi is oral only, doesn't get echino |
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Heartworm Drugs |
Avermectins: 1) Milbemycin - larvae and microfilariae - also hookworms, roundworms, whipworms 2) Ivermectin - only heartworm larvae Melarsomine dihydrochloride - organic arsenical - heartworm adulticide - toxic to cats |
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Coccidiostats in cattle |
Sulphonamides - treatment of clinical disease in calves Amprolium - prevention!! Decoquinate - prevention only Ionophores: - monensin - lasalocid |
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Giardia treatment in cats and dogs |
Fenbendazole - treatment of choice |
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Coccidia treatment in cats and dogs |
Sulphonamides - treatment of choice TMS used |
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Treatment of Equine protozoal myeloenchephalitis (EPM) |
Sulfadiazine + pyrimethamine Triazines - ponazuril (toltrazuril sulfone) - diclazuril(no ADR) |
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Treatments for mites |
Milbemycin / moxidectin Amitraz |
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Treatment for ticks and fleas |
Lufenuron - larvae only Selamectin - topical avermectin - fleas, heartworm prevent, ear mites, sarcoptes, ticks, roundworms, hookworms in cats Imidacloprid - topical - adult fleas and ear mites - contact larvicidal in environment |
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Insect growth regulators |
Methoprene Pyriproxyfen Pyrethrin (organic) / Permethrin (synthetic) - toxic in cats |
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Organophosphates |
Insecticide / mite tx - chlorpyrofos - coumaphos - cythioate - diazinon - dichlorvos - dioxathion - malathion |
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Carbamates |
Carbaryl Methomyl Propoxur |
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Osmotic diuretics |
Useful when GFR acutely decreased (poor renal hemodynamics) Mannitol - effects throughout the nephron wherever water absorbed |
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Carbonic Anhydrase inhibitors |
*Diuresis by increaed Na-bicarb* * weak effect in proximal conv. tubule* Acetazolamide Dichlorphenamide - lowest ADR Dorzolamide - avoid systemic, ADR - use for glaucoma! they decrease formation of aqueous humour |
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Loop diuretics |
Furosemide - most effective - thick ascending limb of LoH - More Na excreted, draws water with it - causes systemic venodilation and increased renal prostaglandin to increase GFR Use for: - edema - heart failure - ARF - oliguric renal failure - hypercalcemia (maintain fluid Na + K) - udder edema - horses: epistaxis and diuretic |
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Thiazide diuretics |
*work in distal convoluted tubule* *slower onset and longer duration than furosemide* Chlorothiazide Hydrochlorothiazide Tricholomethiazide Uses: - edema (with furosemide), not first choice - udder edema - nephrogenic (ADH-resistant) diabetes insipidus - Ca-oxalate uroliths |
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Potassium sparing diuretics |
*work at distal conv. tubule and collecting ducts* Spironolactone - aldosterone antagonist - similar to ACE inhibitors Uses: - with other diuretics for refractor edema - additional survival in heart failure (direct effects of aldosterone on the heart?) |
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Antidiuretic agents |
Vasopression (antidiuretic hormone, ADH) - promotes renal reabs. of H20 in distal conv. tubuel and collecting duct - also peripheral vasoconstrictor - used to Dx central diabetes insipidus Desmopressin - synthetic analogue - for chronic treatment - also causes platelet aggregation, vW dz |
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Drugs affecting renal hemodynamics |
Dopamine - low dose affects glomerulus NSAIDs - through inhibition of Pg production, leads to decrease renal blood flow |
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Manipulation of bladder tone |
*primarily parasympathetic* Bethanechol - musc. agonist - stimulates contraction of bladder - **urethra must be patent!!** Oxybutynin - musc. antagonist - inhibits contraction |
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Manipulation of external urethral sphincter |
**skeletal muscle, use muscle relaxants** Dantrolene - blocks Ca movement - blocks ryanodine Diazepam - most common - centrally acting muscle relaxant |
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Stimulation of urethral sphincter |
*for old dog incontinence* *primarily alpha adrenergic, smooth muscle* Ephedrine - alpha 1 agonist Phenylpropanolamine Diethylstilbesterol - estrogen analog - increase activity of alpha receptor - ADR: aplastic anemia |
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Inhibition of urethral sphincter |
Phenoxybenzamine - irreversible alpha antagonist - EDR - long duration Prazosin - a1 blocker - comp. antagonist - give just before going for a walk |
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Why do we give PGF2a |
Promotes lysis of CL Enhance uterine contraction relax cervic Uses: - estrus synch - abortion in cows - endometritis/pyometra - retained fetal membranes (cow) - induce parturition (cow) Examples - dinoprost -cloprostenol |
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Indications for GnRH |
Induce ovulation (cow and mare) Cystic ovaries (cow and camelids) Induce estrus (small animals) |
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Why do we give chorionic gonadotropin (hCG or eCG) |
Primarily LH activity - hCG = human - induces ovulation - prevent nympho behaviour (cow) eCG = mare = FSH activity - maintains primary CL - increase follicular growth |
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Indications for FSH |
superovulation in cows eFSH in horse -> stimulate follicle development -> off label use |
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Why do we give LH |
+FSH causes follicle maturation and induce ovulation Development of CL |
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Sulpiride indications |
induce ovulation - D2 antagonist Increase prolactin secretion Advance 1st ovulation in mares |
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Progesterone indications: |
decrease LH and FSH Estrus suppression/synch Maintain high risk preg - colic/placentitis mares |
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Examples of progesterone drugs |
Altrenogest (mares/gilts) Melengestrol (cow) = feed add. Syncromate B (cow) CIDR - intravag device with sustained release |
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Types of Estrogen drugs and what they're used for |
Estradiol cypionate - hasten post-partem uterine involution (cows) - metritis / retained placenta (cow, but poor evidence for efficacy) Diethylstilbesterol (DES) - dogs - urinary incontinence - enhance detrusor tone (bitches) - perianal gland adenoma |
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Induction of ovulation in mares |
GnRH (deslorelin) hCG Sulpiride |
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Estrus synch in the cow |
PGF2a GnRH + PGF2a MGA (melengestrol acetate) + GnRH + PGF2a CIDR (progesterone) |
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Estrus synch in mare |
Altrenogest - progesterone - suppress estrus |
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Maintain pregnancy in mare |
Altrenogest - in high risk preg - with concurrent illness/placentitis - or prior foaling probs |
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Induction of parturition |
Cow: PGF2a + dexamethasone Mare: oxytocin - within 1-2d of full term Bitch: oxytocin - dystocia due to uterine inertia |
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Expulsion of retained fetal membranes |
Oxytocin (all species) - dystocia (SA) - induce labour in mare - post partum metritis in LA PGF2a (cow) Estrogen (cow) |
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Promotion of milk let down |
Oxytocin - induces contraction of smooth muscle) |
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Testosterone and analogues |
Nandrolone Boldenone Stanozolol *improved performance, anabolic effects Can be used for estrus detection in cow NOT for infertility/low libido |
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Growth implants |
Combo products P4 + E2 + T Estrogens = increase somatotropin and insulin like growth factor Androgens = stimulate protein synthesis in muscle |
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Hypothyroid treament |
Ind ogs Levothyroxine T4 - treatment of choice since main secretory product Liothryonine T3 - prehormone - used if low T4 conversion |
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Hyperthyroid treatment |
Cats - surgery - radioactive isotope I131 - methimazole (inhibits iodidie oxidation therefore formation of thyroxine) |
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Anti-inflammatories for airway disease |
Systemic glucocorticoids: - dexmethazone - prednisone/prednisolone (predisone not orally bioav. in cats and horses) Inhaled GCs: - fluticasone - fluticasone + salmeterol (short term) |
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Adrenergics for bronchodilation |
Epinephrine - a and B agonist - ONLY use in anaphylaxis |
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B adrenergic agonist for bronchodilation |
Isoproterenol - non selective - short acting - rarely used Terbutaline - minimal B1 ativity - good for cats and dogs, not for horses |
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B2 agonists for bronchodilation |
Clenbuterol - oral - increase mucociliary clearing - DO NOT USE IN FOOD ANIMALS Salbutamol - inhaled, less side effects Salmeterol - inhaled - 6hr duration in horses |
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Anicholinergics for bronchodilation |
Inhibit formation of cGMP -> inhibition of bronchoconstriction - use in RAO in horses Ipratropium bromide - aerosol, lasts 4 hours |
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Methylxanthines for bronchodilation |
Theophylline (cats) Caffeine (resp. stim in foals) Theobromine - adenosine antaonist, bronchodilator, resp. stim. Respiratory effects: Theoph > caff > Theobrom - airway smooth muscle relax - decrease release of inflammatory mediators from mast cells - increase mucociliary transport CNS stimulation: caff > theoph > theobr Cardiac stim: theoph > caff> theobr |
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Antitussives |
Codeine Hydrocodone (dogs) Dextramethorphan (dogs, safest for cats ) Butorphanol (horses) Ioperamide (dogs) |
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Expectorants and mucolytics |
Acetylcysteine - nebulized - increases glutathione Saline/Iodide/Ammonium salts Ethylenediamine dihidryoiodide (EDDI) |
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Expectorants |
Volatile oils - irritant ->increased airway secretion Guafenesin - accelerate particle clearance Phenolic bensylamine - alters visocisity - enhances mucociliary clearance |
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Respiratory stimulants |
To decrease effects of opiates and barbiturates Doxapram - stimulate resp. center - activate aortic/carotid chemoreceptor Methylxanthines (caffeine) - stim. resp. center - antagonize adenosine |
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Oral glucocorticoids |
generally well absorbed Prednisolone - better with hepatic dz Prednisone - not effective in cats and horses |
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Corticosteroid use for emergencies |
use phsphate/succinate esters - rapid onset, used in shock Methyl-prednisolone Na succinate Prednisolone Na Succinate Dexametasone Na phosphate |
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Corticosteroid use for inflammation, allergic, immune disorders |
Systemic/free steroids or oral - dexametasone (flumethasone?) - prednisone - prednisolone |
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Long-acting glucocorticoids |
Acetate + acetonide esters - local use only such as intra-articular - triamcinalone acetate - methyl-prednisolone acetate |
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Adrenal replacement corticosteroids: |
For chronic (addison's) treatment - prednisone / prednisolone - daily Relative adrenal insufficiency - foals - hydro-cortisone? |
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Adjunctive treatment for Addison's |
Mineralocorticoids! - fludrocortisone acetate - gluco activity - desoxycorticosterone pivalate - no gluco activity |
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Which glucocorticoids have some mineralocorticoid activity? |
Hydrocortisone Prednisolone Prednisone |
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Which glucocorticoids have no mineralocorticoid activity? |
Triamcinalone dexamethasone betametasone |
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Treatment of Hyperadrenocorticism |
Mitotane - necrosis of zf and zr (min cort sparing) Trilostane - inhibit 3-B hydroxysteroid dehydrogeanse to get decreased steroid hormone production L-deprenyl - MAO inhibitor - inhibits ACTH - for pit. dependent cushing's |
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Treatment of PPID |
Pergolide mesylate - inhibit release of pars intermedia product (ACTH, a-MSH) |
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Cyclovirs |
*inhibits DNA polymerase and cause premature termination of DNA synthesis(* Acyclovir - guanosine analogue - herpes viruss Valacyclovir - oral prodrug for acyclovir - EHV1 - do not use in cats Pencyclovir /famcyclovir - rarely used, for FHV1 Gancyclovir/valgancyclvir |
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Other antivirals other than cyclovirs |
Idoxuridine + trifluridine - thymidine analogues - against DNA viruses (herpes + pox) - incorporated into DNA strands -> break easier - for herpetic keratitis - FHV1, EHV2? - NOT SYSTEMICALLY L-lysine - block avail. arginine (needed for herpes virus repl.) - only good if arginine depleted - FHV1 shedding |
