Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
20 Cards in this Set
- Front
- Back
|
Where did the anticoagulant drugs originally come from?
|
Coumarin in Moldy Sweet Clover (metabolized to dicoumarol)
|
|
|
What are the 2 basic drugs that all of the anticoags are based off of today?
|
Warfarin (coumadin)
Indandione Both are 1st Gen drugs |
|
|
What are the more potent 2nd Gen Drugs?
|
Coumarin 2G
Brodifacoum, Difenacoum, Bromadiolone Indandione 2G Diphacinone and Chlorphacinone |
|
|
Can you get secondary toxicosis? (ie - bird eats rat that ate rat poison)
|
Yes!
Unlikely with warfarin - but can happen with 2G drugs if ample concentration inside. |
|
|
Absorption
|
GI
High Fat Meal increases Absorption |
|
|
Distribution
|
carried on Albumin
concentrated in Liver Less Available Albumin = more free toxin = greater Toxicity |
|
|
Metabolism
|
MFOs in Liver
|
|
|
Elimination
|
Warfarin
Dog t1/2 = 14.5hrs (human 48hrs) 2Gs - Human t1/2 15-20 days |
|
|
Mechanism of Action
|
Primarily effects Liver's ability to produce Factors 2, 7, 9, and 10
(by blocking a Vitamin K dependent Epoxide Reductase) |
|
|
Treatment
|
VITAMIN K!
|
|
|
Which factor (2, 7, 9 10) has the shortest half life... and what is it?
|
Factor 7 = 6.2 hours
|
|
|
Presenting Complaint (top 4)
|
Lethargy/Collapse
Anorexia Vomiting Dyspnea or Cough |
|
|
Clinical Signs
|
Usually take 3-5 days to show
Depression, anorexia, anemia, pale mms Dyspena (bleed into thorax - *common) Hematemesis, Epistaxis Acute Death not common, can happen if bleed into CNS, Pericardia |
|
|
How do you test a possible ingestion of rodenticide?
|
OSPT will be prolonged at 1-2 days post ingestion
APTT will be prolonged at greater than 2 days post ingestion |
|
|
What are the biggest indicators for Dx?
|
Rodenticide in Environment
Green Feces (packaging often green/blue) Coagulopathy Response to Vitamin K |
|
|
Post-Mortem Findings
|
Hemorrhages...everywhere
Flaccid Heart Centrilobular Hepatic Necrosis secondary to anemia/hypoxemia |
|
|
Treatment - Acute Ingestion
A - If less than 1 hour since ingestion B - If greater than 1 hour since ingestions |
A - Induce Emesis - then AC and Cathartic - then VitK 2.5mg/kg PO q12 for 4 weeks
OR check OSPT at 2-3 days post ingestion and start VitK if prolonged ---Then RECHECK OSPT, if prolonged treat 2 more weeks. B - Same..but no emetic |
|
|
Treatment - Symptomatic Animal
|
Anemic = FWB or FFP and pRBCs --- Need Clotting Factors
(not anemic, just FFP) VitK 5mg/kg SQ once continue 2.5mg/kg PO q12 for 4 weeks Recheck OPST, 2 more weeks if needed |
|
|
Prognosis
|
depends where the bleed is...
but 98% of the cases coming into VHUP survived |
|
|
Ddx for a nasty coagulopathy
|
Liver Dz
Inadequate VitK intake/absorb Hereditary DIC Trauma IMHA, ITP |
