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38 Cards in this Set
- Front
- Back
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Review --- What's the key thing to remember about the Meloxone antidote?
---What's the key thing to remember about the Digoxin Fab Abs |
Duration of Action is very short
Digoxin can come from more things than just hospital grade Digoxin. (Foxglove, Bufo Frog, an old rodenticide) |
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What are the Ca-Channel blocking OTCs? (4)
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Verapamil
Diltiazem Nifedipine Amlodipine |
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What do SR, XL, and CD stand for?
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all just mean sustained release or long duration
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Review - how do we want to decontaminate for these SL drugs?
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Whole Bowel Irrigation -- clears the prep (others may not catch every piece, and since it is SL it will continue to have deleterious fx)
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What are the effects of the Ca Blocking drugs?
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Prevent Contraction
Hypotension Bradycardia (w/reflex Tach) Pulmonary Edema Hyperglycemia |
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How do you treat these animals? (Ca Channel blockers)
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SYMPTOMATIC
-Ca Gluconate (to restore Ca) -Vasopressors (to increase BP) -Insulin-Dextrose (helps myocardial cells get E) |
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Cough and Cold:
Decongestants: Pseudoephedrine Phenylephrine |
*alpha-1 (also hits Beta-R's)
hypertension, tachycardia also vomiting, mydriasis, hyperthermia, disorientation |
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Decongestants in Dogs?
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Dogs have higher risk - and narrow therapeutic range.
(Rx for urinary incontinence - 0.4mg) (Clinical signs at 5mg, Death at 10mg) |
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Treating Decongestants in Dogs (or anyone)?
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Supportive Care
Bring the HR down BDZ, (Ace, Chlorpromazine, Phenobarb) |
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Cough and Cold:
Antihistamines |
H1 Blockers
Chlorpheniramine Diphenhydramine Meclizine **absorb really well Orally |
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Antihistamines
Signs and Tx? |
CNS depression, ataxia, dry mm's
Supportive Care and Decontamination |
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Cough and Cold:
Analgesics |
NSAIDS
Acetaminophen (APAP) Aspirin (ASA) |
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Analgesics
NSAIDS (4) |
Ibuprofen
Carprofen (Rimadyl) Naproxen Etodolac (Etogesic) |
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NSAIDS and ____ do NOT mix
NSAIDS and ____ have a narrow margin of safety |
Cats
Dogs |
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Effects of NSAIDs (+ and -)
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Decrease Pain, Fever, Inflamm
...Decrease renal blood flow, gastric mucous production, platelet agg |
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Clinical signs of NSAID tox
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vomiting, diarrhea, hematemesis, melena. Liver enzymes elevation, Renal Failure
Cats way more sensitive than dogs -- but not the safest drug for either |
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Tx of NSAID tox
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Supportive Care -- possibly GI protectants (sucralfate, misoprostol, H2 antagonists)
AVOID Pepto (Bi-subSALICYLATE) |
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Cough and Cold:
Acetaminophen (N-aceTYL-para-amino-phENOL) |
Toxicity:
1 500mg tab in a 5kg dog 1 325mg tab in a 5kg cat |
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Signs of Acetaminophen Tox
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Dogs - Renal
Cats - Methemoglobinemia |
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Tx of Acetaminophen Tox
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NAC (oral or IV)
oral - GI upset IV - anaphylactoid rxn |
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Cough and Cold:
Aspirin (ASA) where else is it found besides aspirin? |
BenGay (muscle rubs)
1 table spoon of BenGay = 4.5gm salicylate (6.3 grams of aspirin!) Pepto - 1Tbl = 0.262 gram |
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What are the signs of ASA tox?
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Vomiting, Hyperventilation, Fever, METABOLIC ACIDOSIS
once acidosis is developed - you hit a slippery slope, aspiring now more easily crosses BBB and causes CNS fx. |
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Safe doses of aspirin for:
Dog Cat |
Dog - 10-20 mg/kg max 100mg/day
Cats - there is NO SAFE DOSE 25mgs can cause acute tox |
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Tx for ASA tox?
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Support and Decontaminate
*Ion Trapping: NaHCO3 -- Alkanalize urine - prevents metabolic acidosis (prevents CNS fx) |
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Cough and Cold:
Antitussives (2) |
Opioids (Codeine)
Dextromethorphan (poor man's PCP) Naloxone can be used for either |
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Cough and Cold:
Expectorants - Guaifenesin |
PO -- GI upset only adverse
IV -- Toxic! |
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Alpha 2 agonists
Clonidine Visine |
Poorly absorbed systemically from eye... but can cause alpha-2 issues if ingested
CNS depression, Apnea, Bradycardia, Hypotension |
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Tx for Alpha 2 agonist tox?
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Naloxone is worth a try (40% success)
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GI OTCs
Antacids Laxative Antidiarrheals |
Antacids - AlOH, MgOH, CaCO3
minimal tox - maybe GI upset Laxative - concern is fluid/e- loss Fleet (NaPO4) enemas -> high PO4, high Na --> dehydration and shock Antidiarrheals Lomotil (Anticholinergic and Opioid) Pepto (salicylate) Loperamide (Imodium) - (Opioid-like) |
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Tx for GIs?
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Antacids - meh
Laxatives - hydration/e- status Antidiarrheals - Support - Decontamination AND Naloxone for Opioids (Lomotil, Loperamide) |
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Topical OTCs
Zinc Oxide ZnO |
Diaper Rash Ointment, Sunscreen, Calamine Lotion
Ingested - Zn Poison (though GI irritant so usually vomit anyway) Tx - support |
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Topical OTCs
Vitamin A and D ointments |
Toxicity minimal - but can have laxative effect from emollient base
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Topical OTCs
Calcipotriene |
D3 analogue (Dovonex)
Ingestion is HIGHLY TOXIC Severe Hypercalcemia, Renal Failure, Soft Tissue Mineralization |
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Calcipotriene
Signs and Tx |
Vomiting, CNS, depression, Anorexia, Diarrhea, PU
Decontaminate and Intensive Support --Bisphosphonate for high Ca --though cardiac tissue calcification may kill you weeks later |
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Topical OTCs
5-Fluorouracil (5-FU) |
Efudex (for basal cell skin cancer in humans)
Ingestion - Highly Toxic - Rapid Absorption. 1/2 a 25gm tube lethal to a 70lb dog |
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Signs and Tx for 5-FU tox
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Severe SEIZURES
Vomiting, GI mucosa sloughing Delayed LEUKOPENIA Prognosis is poor: Try Tx seizure with diazepam, leukopenia with filgastrim |
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So what do the following have in common:
Oil of Winter Green (Methyl Salicylate) Lomotil Ca-Blockers Imidazoline Decongestants Clonidine Oral Hypoglycemics (Sufonylureas) Beta Blockers Toxic Alcohols |
DANGEROUS IN SMALL AMOUNTS!!
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Big Worries for Small Amounts:
DOGS CATS BOTH |
Dogs - NSAIDs, Pseudoephedrine, Caffeine, Albuterol
Cats - Acetaminophen, NSAIDs, ASA, Benzocaine Both - 5-FU, Calcipotriene, Isoniazid |
