Steriods

Front 1

Most potent glucocorticoid?

Back 1

Flumethasone (30X)

Front 2

Trade name for Methylfenesulone and its use?

Back 2

Sulumedryl

Front 3

Hydrocortisone trade name?

Back 3

Solu- Cortef

Front 4

How do we give Hydrocortisone acetate?

Back 4

IM

Front 5

Trade name for Prednisolone Na Succinate?

Back 5

Solu- Delta Cortef) Short acting- onset 1-3 minutes

Front 6

Triamcinolone?

Back 6

Vetalog) Injectable

Front 7

Kenalog?

Back 7

Labeled for horses, but long acting. Not used as often as it suppresses the adrenal gland for an extended period of time- may cause laminitis.

Front 8

Fluroprednsiolone?

Back 8

Predef 2X) or ISoflupredone

Front 9

Names for Dexamethasone and Azium?

Back 9

Sodium phosphate and Benzyl Alcohol.

Front 10

Prednisone in the liver?

Back 10

metabolized to prednisolone- dosage exchangable with a functioning liver.

Front 11

If you have liver issues but want to use a steroid?

Back 11

Use, prednisilone -- doesn't have to go thru the liver. Made especially for animals!

Front 12

Methylprednisolone Na succinate and its uses?

Back 12

Solu-Medrol) IV Less sodium retention-
For trauma patients
Oral tablets ( acetate) ( about 2/3 dosage of prednisolone

Front 13

Name the best anti-inflammatory:

Back 13

Flumethasone

Front 14

Celestone is ½ acetate ½ Na phosphate, is it long acting or quick?

Back 14

Slow release, not fast acting!

Front 15

Name the anabolic steroids used in horses?

Back 15

Equipose- Boldenone- approved in horses, not for stallions or pregnant mares dues to absence of data.

Front 16

What is Equipose used for?

Back 16

to reverse tissue depleting processes and restore constructive metabolism. Anabolic therapy is intended primarily as an adjunct to other specific and supportive therapy, including a high protein diet.

Front 17

What is Nandrolone ( Durabolin)?

Back 17

Anabolic steriod - human product
used in small animals- for refractory anemia.
Now use erythropoetin as a replacement

Front 18

general effect of anabolic steroids?

Back 18

stimulation of the erythropoiesis process.

Front 19

What is the adverse effect that occurs from use of prednision/prednisilone ?

Back 19

Adrenal glands will atrophy so that when the medication is discontinued, animal unable to respond to stressful situation. Circulatory crisis can result.
Use the medication every other day, this allows the body's own adrenal glands to remain active

Front 20

Can we use corticosteroids for the eye?

Back 20

Yes. Topical application can cause systemic side effects. Prednisolone acetate 1.0% and dexamethasone 0.1% are the best choices for corneal and anterior uveal diseases. Most systemic steroids penetrate the blood-aqueous barrier and are used to treat intraocular inflammations.
Dexamethasone/prednisolone

Front 21

How do we use corticoisteriods in small animal opthalamology?

Back 21

Decrease cellular infiltration, inhibit fibroblastic and collagen-forming activity, retard epithelial regeneration, diminish neovascularization, and stabilize lysosomes.
Can cause increased intraocualar pressure
Cataracts in cats?

Front 22

Adverse effects of glucocorticoids -

Back 22

Glucocorticoid hormones can cause abortion in pregnant patients.
Never use at same time as NSAIDS
Spinal trauma, (solumedrol) and then switch to anti-inflammatory ???
Solumedrol is short acting, so you can then switch to anti-inflammatory
Steroids are contraindicated in head trauma /

Front 23

Effects of steroid withdrawl?

Back 23

Dullness
Depression
Decreased exercise tolerance
In-cordination
Weight loss
Loose stools
Behavior changes – can become vicious!

Front 24

Steriods in diabetic patients?

Back 24

Steroid-associated insulin resistance can make pre-existing diabetes much harder to treat, and can tip stable diabetics over into a diabetic crisis. Even the relatively minor systemic absorption of topical steroids, such as steroid eye drops or skin creams, can be enough to have an effect on diabetic control.

Front 25

Glucos?

Back 25

High dose has been a controversial issue in the treatment of hypovolemic shock
Inhibit the arachidonic acid cascade, while beneficial for decreasing cellular inflammation, can result in gastric ulceration and bleeding via inhibition of cyclooxygenase-1 formation. Hypoxic-induced gastrointestinal mucosa may be further damaged by corticosteroid therapy, even after 1 or 2 doses.

Front 26

Contradictions of glucocorticosteriod use?

Back 26

Infectious disease
Diabetes mellitus
Liver disease
Protein-losing nephropathy
Pregnancy…may induce abortion/congenital defects
Inhibit growth in immature animals
Wound or fracture healing inhibited
No corticosteroid in eye with infection/corneal ulceration=risks corneal perforation/delay repair/2nd infection

Front 27

Best times to use glucocorticoids?

Back 27

Documented shock from Addisonian crisisAsthma attacksBad itchy skin dogs??IBDChronic active hepatitisLymphomaUveitis

Front 28

Adverse effects of glucocorticoids?

Back 28

Metabolic: diabetes mellitus, hyperlipidemia, hepatopathy
 Musculoskeletal: muscle atrophy, ligament weakness
 Immunosuppression: increased risk of infection and septicemia
 Endocrine: hypothalamo/pituitary axis suppression, thyroid and parathyroid suppression
 GI: gastric ulcers, pancreatitis
 Fluid balance: water retention, PU/PD
 Anaphylactic reactions
 Abortion

Front 29

Metabolic effects of glucocorticoids?

Back 29

glucocorticoids raise blood glucose through increasing gluconeogenesis and antagonizing insulin. They also alter protein and fat metabolism.

Front 30

Antiinflammatory effects?

Back 30

inhibits arachidonic acid formation leading to prostaglandin, thromboxane, and leukotrienes. Can also neutrophil migration into tissue and increase membrane stability.

Front 31

Effects on water balance?

Back 31

increase in glucose and/or sodium can osmotically increase plasma volume, often resulting in PU/PD (especially in dogs).

Front 32

CNS effects?

Back 32

: steroids can improve mood, behavior, and appetite, but may lower seizure threshold.

Front 33

Immunosupression?

Back 33

at high doses, the anti-inflammatory effects resulting from altered leukocyte movement and function can become immunosuppressive.

Front 34

GI?

Back 34

ulcerogenic due to increased secretion of gastric acid, pepsin, and trypsin. This effect is synergistic with NSAIDs.

Front 35

Adrenal axis supression:

Back 35

exogenous glucocorticoids will suppress ACTH secretion, which can lead to adrenal gland atrophy.

Front 36

Cox 1 stimulates what?

Back 36

renal flow
GI flow
hemostasis
GI mucus production

Front 37

Cox 2 stimulations?

Back 37

inflammation
pain, fever,
vascular problems
increased deleterious enzymes that cause cartilage breakdown and laminar degeneration
cancer

Front 38

Prostaglandin receptor signaling causes:

Back 38

physiologic response
disease response

Front 39

COX 2 has a dual role:

Back 39

regulates inflammatory response
increased by inflammatory stimuli (synoviocytes)

Front 40

What induces Cox 1?

Back 40

induced in monocytes

Front 41

What is COX 1 really imp for?

Back 41

in the initial stages of inflammation - first 30 minutes, may be imp in positive physiologic response

Front 42

What is the best way to fight inflammation?

Back 42

COX 2 inbibitors

Front 43

At a higher dose can cox 2 inhibitors inhibit cox 1 also?

Back 43

YES. SO, we dont want to lose cox1 and also a higher cox 2 dose can decrease selectivity for cox 2.

Front 44

How powerful are COX 2 inhibitors?

Back 44

Most Cox 2 inhibitors show equal or lower efficacy to non-selective NSAIDS. BUT THEY ARE SAFER!!!

Front 45

non selective cox inhibitors

Back 45

Phenobutazone
ketoprofen
banamine
asprin

Front 46

Bute in dogs?

Back 46

Sodium and water retention
Decreased renal blood flow
Anorexia
Reduced plasma proteins
Leukopenia
Anemia
Increased BUN

Front 47

Banamine in small animals ADR?

Back 47

In dogs, GI distress is the most likely adverse reaction. Symptoms may include, vomiting, diarrhea, and ulceration with very high doses or chronic use.

Front 48

What will reduce ulcers from NSAIDS in dogs?

Back 48

Misoprostol is the only drug shown to help prevent NSAID (but not corticosteroid) induced ulcers in dogs

Front 49

tepoxalin?

Back 49

a COX-1-selective inhibitor and COX-2, and the inhibition of lipoxygenase lasts approximately five hours.

Front 50

Metacamms selectivity?

Back 50

Its COX-2 selectivity is considered weak to moderate

Front 51

) is the most recently approved veterinary NSAID?

Back 51

Firocoxib (Previcox) is the most recently approved veterinary NSAID. It is a coxib-class drug with highly selective COX-2 inhibition. It has efficacy comparable to etodolac in small animal
Previcox RX

Front 52

Equiiox?

Back 52

Highly COX-2 selective (265-fold vs. COX-1) in horse blood.
Equally effective as PBZ in lame-
ness model (sole pressure with
adjustable screw in shoe)

Front 53

Good side effect with Equiiox comapred to other NSAIDS?

Back 53

Less gastric ulceration

Front 54

Side effects of Kenalog?

Back 54

laminitis! Not used as often as it suppresses the adrenal gland for an extended period of time- may cause laminitis.

Front 55

Vetalog?

Back 55

Used same as solu delta cortef...etc