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65 Cards in this Set

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Corticosteroids
1. Where produced?
2. 2 types?
1. In the cortex (outer layer) of the adrenal gland
2. glucocorticosteroids=anti-inflammatory
mineralocorticosteroids= acid base balance, H2O and salt balance, electrolytes.
What does the medulla (center) of the adrenal gland produce?
epinephrine (adrenalin) and norepinephrine.
What is the process for natural production of corticosteroids?
The hypothalamus in the brain detects low levels, releases corticotropin-releasing factor (CRF) to pituitary gland-which releases adrenocorticotropic hormone (ACTH) into blood. The adrenals are stimulated to release cortisol.
Which type of corticosteroids are used clinically?
Gluco-corticosteroids
What effect do glucocorticosteroids have?
Anti-inflammatory, immunosuppressive.
Replacement.
Tx of shock is controversial.
What are the adverse effects of corticosteroids?
PU/PD, thin skin, muscle loss, slow healing. GASTRIC ULCERS. immunosuppression.
Hyper or hypoadrenalcortiscism(lag time).
What is iatrogenic?
Produced by medical treatment.
What routes are available for corticosteroids?
Parental= IV,IM,SC,ID(dermal)
Oral
Inhalation
Topical
Rectal
Why are cortisone doses tapered?
To allow the body to return to manufacturing cortisol on it's own.
Contraindications for corticosteroids?
Peptic ulcers, diabetes, blood dyscrasias, kidney, liver or heart disease, pregnant, glaucoma
Dexamethasone/Betamethasone
Corticosteroid
Avail as: Azium, Dexasone, Betasone.
Dex-2mg/ml Dex Sp=4mg/ml
oral, parenteral and topical
Lasts over 48 hrs
Not good for cats
used for musculoskeletal, cerebral swelling, hypovolemic shock
Prednisone/Prednisolone
Corticosteroid
Prednisone converted to prednisolone by liver. Pred given orally.
Intermediate- 12-36 hrs
methylprednisolone
Corticosteroid
Depo Medrol= good for cats
oral and injectable
lasts 2 weeks- intermediate
skin, asthma, allergies
Prednisolone sodium succinate
Corticosteroid
Solu Delta Cortef
ultra-short acting (<12 hrs)
IV only for shock, acute disc disorders
Triamcinolone
Corticosteroid
Vetalog, Anamax, Panalog
Intermediate
not for cats
what does positive inotropic mean?
To increase force of contractions
what does negative chronotropic mean?
To decrease rate
What action do cardicac glycosides have on heart?
positive inotropic- inc force, negative chronotropic-slows rate.
digitalis
Cardiac glycoside
from foxglove plant,
digoxin(cardoxin, lanoxin) for maintenance
digitoxin- IVfor emergency
side effects of digitalis
vomiting, diahrrea, anorexia, muscle weakness, visual problems, stupor, arrythmia, death.
Check digitalis levels
what drugs reduce effectiveness of digitalis?
barbiturates, bute, cimetidine, reglan, diazepam, atropine and glyco
what drugs increase toxicity of digitalis?
antibiotics: aminoglycocides, tetracyclines, choramphenicol, some sulfa, antacids, anti-diarhhea meds
Quinidine
anti-arrythmia- class 1A
depresses myocardial excitability.
For atrial/ventricular fibrillations, tachyarrhythmia, PVC,
oral for maintenance
Procainamide
Anti-arrythmic
Class 1A
Inj and oral.
depresses myocardial excitability.
For atrial/ventricular fib, tachyarrythmia, PVC
Lidocaine w/o epi
Anti-arrythmia
Class 1B
decreases cell automaticity-blocks inflow of sodium, prevents repolarization.
venticular arryhthmias
IV, CRI
Propanolol, Atenelol
Beta blockers, Class 2
Reduce automaticity by blocking receptor sites for electrical impulses
<HR, <CO. For arrythia, hypertension.
Cats with cardiomyopathy
cardizem (dilatizem)
verapifil
anti-arrythmia, class 4
calcium channel blocker, depresses contractility and automaticity.
tachychardia, atrial fib
Anti-arrythmia, Class 1A
depress myocardial excitability, prolong refractory period, decrease automaticity,
atrial, vent fib
quinidine and procainamide
Anti-arrythmia- Class 1B
stabilize myocardial cell membranes, block influx of sodium. Prevent depolarization and decrease cell automaticity
ventricular arrythmia-off label
lidocaine
Class II anti-arrythmic
beta-adrenergic blockers
reduce automaticity: reduces heart rate, cardiac output and blood pressure
Propranolol
Not for CHF
Anti-arrythmias, Class IV
block calcium-decrease contracability, automaticity
Verapamil, Cardizem(dilatizem)
Side effects of anti-arrythmia drugs
lethargy, anorexia, muscle weakness, allergic skin rx, GI disturbances, ataxia, atrial or vent stand-still
What is automaticity?
The ability of the heart muscle to generate impulses
what action do catecholamines have on the heart?
Promote contraction- used for anaphylaxis, asthma, cardiac arrest
Epinephrine
Catecholamine
used for anaphylaxis, asthma, cardiac arrest
IV, IT,
Dopamine/ Dobutamine
Catecholamine
inc rate/force of contraction
for hypotension, hypovolemia
emergency use, IV
Lasix (Furosemide)
Diuretic
Inhibits reabsorbtion in the loop of Henle- inc urine
Inc renal blood flow
IV, IM, SC, oral
cardiac and pulmonary edema
Thiazides
Diuril, Naturetin
Diuretics- not used often
last longer, IV IM oral
Mannitol
Diuretic IV only
osmotic- exerts high osmotic pressure in the kidney tubules. Draws fluid into blood.
Cerebral edema, glaucoma (small spaces)
Give slow IV or will vomit
hydralazine
vasodilator- arterial dilator used with diuretics for tx of CHF.
Oral, Inj
Nitroglycerin Ointment
Vasodilator- venous dilator Reduces pre-load, increases CO. Applied as ointment
ACE inhibitors
Vasodilator
Enalopril (Enacard)
Captopril (Capoten)
Vasotec-inj
blocks conversion of angiotension 1 to antiotension 2 by blocking ACE
What is ACE?
Angio-tensin-converting enzyme.
Doxapram/Dopram
Resp stimulant
1 drop under tongue for neonates.
For slow breathing , not stopped breathing
Aminophylline
Bronchodilator
inj, oral
inhibits smooth muscle contraction
Theophylline
Brochodilator
inj. oral
use if aminophylline does not work
Albuterol
brochodilator
opens bronchioles by blocking histamine
inhalation, syrup
side effects of bronchodilators
tachycardia
uses for bronchodilators
asyhma, anaphyllactic shock, CHF (in conjunctive tx)
Butorphanol
Torbugesic-synthetic opioid
inj, oral
analgesia and anti-tussive
Hydrocodone
Respiratory drug
Tussigon, Hycodan
Opiate- Class III
Anti-tussive
Side effects of anti-tussives
sedation, constipation
chlorpheniramine
anti-histamine
tablet
causes drowsiness
diphenhydramine
benadryl
capsules, inj
anti-histamine
hydroxazine
atarax
tablet
anti-histamine
treats allergic dermatitis
follow up after pred
clemestine
tavist, oral
anti-histamine
cats for asthma
Cimetidine
Tagamet
anti-ulcer medication
H2 receptor antagonist. reduces secretion of Hydorchloric acid.
If using with other GI drugs seperate by 2 hours
Ranitidine
Zantac
anti-ulcer
Famotidine
Pepcied
anti-ulcer
Diphenoxylate/Atropine
Lomotil-anti-diarrhea
Narcotic alagesia- constricts intestines
Atropine added to prevent substance abuse
Loperamide
Immodium.
anti-diahhrea
constricts intestines
Cisapride
Propulsid
laxative
stimulates GI motility
used for megacolon,GI stasis in rabbits
Metoclopramide
Reglan- antiemetic
Speeds gastric emptying, inc cardiac sphincter tone. blocks CNS vomiting center
Oral, parenteral
side effects of metoclopramide
behavioral changes, constipation, CNS disorders(hyperactivity after 5 dys of tx) panting, ataxia, seizures
Sulcrafate
Carafate-mucosal protectant
oral, gastric, duodenal ulcer
esophagitis.
Side effect= constipation
wait 1/2 hr to feed, give meds