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