Final Exam Drugs Flashcards
5HT Antagonists
Appetite stimulants. Cyproheptadine (Effective in cats, given orally, can cause sedation) and Mirtazapine (MOA: blocks 5HT1 and 5HT2 receptors, used more in dogs).
Acepromazine
A Phenothiazine. Blocks dopamine receptors in the CNS. Effects: sedation, moderate muscle relaxation, no analgesia, hypotension. Reduced hematocrit and antihistamine (H1 antagonists).
Contraindicated with vasodilation. Boxers more sensitive to CV effects. Stallions can have penile prolapse and injury (paraphimosis). Not approved in food animals because can cause ruminal regurgitation. Aggressive dogs may startle easily. Excited patients may have reduced effect. Contraindicated in liver disease. Do not have concurrent administration of epinephrine.
Alfaxalone
MOA: Potentiates GABA receptors. Effects similar to propofol. Neurosteroid which is an analog of progesterone. Does not bind to usual “steroid” receptors (no glucocorticoid, mineralocorticoid, or sex hormones effects). Approved (class IV controlled substance). Labeled for IV usage only. Similar pharmacokinetics to propofol but no accumulation seen. Full anesthesia, no analgesia.
Amantadine
NMDA antagonist sometimes used as adjunctive analgesic in small animals. Also oral drug.
Amide Local Anesthetics
Metabolized by the liver - Lidocaine, Bupivacaine, Mepivacaine, Ropivacaine
Antimetabolites
Impair nucleic acid synthesis (DNA) in rapidly dividing immune cells and block T-cell signaling. Azothioprine, Mycophenolate mofetil, and Leflunomide.
Apomorphine
Mostly used an an emetic in dogs. Considered another opioids. Stimulates dopamine receptors. Can be given by all routes. Used in dogs. Overdose can lead to respiratory depression. Can reverse with naxolone but this will not reverse emetic effect.
Artificial Tears
Natural tear is 3 layers (mucin, water, and lipid film). “Lacrimomimetic agents” provide lubrication but do not perfectly replicate natural tears.
Aspirin
COX-1 selective inhibitor aka Acetylsalicyclic acid
Atipamezole and Yohimbine
Reversal - Alpha-2 Antagonists. Atipamezole high alpha 2 selectivity. Match receptor affinity ratio to the alpha 2 agonist used. Usually to reverse sedation (small animal) or when adverse events occur. Analgesia will also be reversed!
Atracurium
Spontaneous degradation (no liver/kidney involvement). Non-depolarizing NM blockers. Competitive antagonism with Ach for nicotinic receptors at the motor end plate; causes flaccid paralysis. Given IV. Poor penetrators of membranes. More potent in horses.
Atropine
Direct acting parasympatholytic (mydriasis). Causes cycloplegia (blurred vision), this can cause horses to panic. Indicated to reduce pain associated with corneal or iris disease (uveitis) or to break up synechiae in uveitis. DO NOT USED IN PRIMARY GLAUCOMA! Cats froth at the mouth due to bitter taste.
Azathioprine
Antimetabolite used for immunosuppressive therapy. Use with prednisone. DO NOT USE IN CATS (toxicity for liver/bone marrow). Oral medication. Ester LA - Used topically. Allows for corneal and conjunctival manipulation. Rapid onset and short duration.
Benzodiazepines
MOA: Act by stimulating GABA and inhibiting the satiety center to increase appetite. More effective in cats than dogs. Generally short term use only. Most common side effect is sedation. Diazepam and Midazolam.
Brimonidine
Alpha agonists. Ophthalmic alpha agonist. Sometimes used in dogs to treat glaucoma. Not most likely choice.
Bromide
Salt/chemical compounded into pills or liquid (KBr from most common). Unknown MOA but raises seizures threshold by competing with Cl- transport. Long half-life; once a day administration. Must use loading dose or it will take 8-9 weeks to reach effective levels. Dogs on high salt diet may need higher dose because high Cl- increases Br loss in urine and lowers serum concentration. Not metabolized by liver - good for patients with hepatopathies. As effective as phenobarbital. Avoid in cats (asthma). PU/PD, sedation, pancreatitis, ataxia, rear limb weakness, dysphagis, megaesophagus.
Bupivacaine
Frequently used. 0.5% solution for injection. Amide LA. Slow onset and long duration. MOST cardiotoxic of the LAs and more potent than lidocaine. Diazepam may increase cardiopressant effects.
Buprenorphine
Partial u agonists. Semi-synthetic opioid. Ceiling effect - more potent than morphine but less max effect because it is a partial agonist. Less negative effects than morphine. Slower onset and longer duration than morphine. IV, IM , SC, transmucosal. Useful for at-home analgesia, especially in cats.
Butorphanol
Mixed agonist/antagonist. Synthetic k agonist and u antagonist. IV, IM, SC, PO. Analgesia in cats, dogs and horses. Antitussive in dogs. Better for visceral pain than somatic. Commonly used in equine. Used in small animals to “partially” reverse a full mu agonist. Lower ceiling effect.
Carprofen, Meloxicam and Deracoxib
COX-2 preferential. Commonly used in small animal medicine as analgesics and anti-inflammatory agents. Available in a variety of oral options (tablets, liquids, transmucosal oral spray) and injectable (SQ). Meloxicam is approved for SINGLE injection use in cats.
Cimetidine
Antacid H2 blocker, inhibit gastric acid and pepsin secretion, competitive inhibition of H2 receptor. Low potency, short duration. Inhibits microsomal enzymes.
Cisapride
Serotonin 5HT4 agonists. Increases PNS input; Only available by compounding; used to treat megacolon and megaesophagus in cats.
COX-1 Selective Inhibitors
Aspirin/Acetylsalicyclic acid (ASA)
COX-2 Preferential Inhibitors
Deracoxib, caprofen, meloxicam
COX-2 Selective Inhibitors
Firocoxib, robenacoxib
Dexmedetomidine
Alpha-2 Agonists. Very good sedation, good muscle relaxation, mild analgesia, and mild respiratory depression. Emetics in cats (cats have more a2 and less D2 receptors). Used for dogs, cats and exotics. Highest alpha 2 selectivity.
Diazepam and Midazolam
Benzodiazepines. Bind to and activated benzodiazepine binding site on GABA receptors to cause hyperpolarization of neurons. Effects: Mild sedative, good muscle relaxation, no analgesia, minimal cardio respiratory effect, anticonvulsant, appetite stimulant.
Diazepam: Usually given IV, can be given orally. Can cause hepatic necrosis in cats. Painful IM injection because it contains propylene glycol.
Midazolam: can be given IM (or IV or orally).
Dorzolamide/Brinozolamide
Topical Carbonic Anhydrase Inhibitors. Reversible inhibition of CA - decreases aqueous humor. Dorzolamide + Timolol = Cosopt.
Ester Local Anesthetics
Hydrolyzed by plasma esterases - Procaine and Proparacaine
Famotidine
Antacid H2 blocker, inhibit gastric acid and pepsin secretion, competitive inhibition of H2 receptor. More potent, longer duration, less enzyme inhibition than cimetidine.
Fentanyl
U agonist. Synthetic opioid, extremely potent. Rapid onset and short duration. Can give as transdermal patch. Lag time to onset, lasts a few days.
Firocoxib
COX-2 selective. Oral paste for horses, chewable tablets for dogs. Commonly used in SA medicine as analgesics and anti-inflammatory agents.
Flumazenil
Benzodiazepine antagonist. Used for reversal in the rare cases it is necessary.
Flunixin meglumine
Large animal NSAID (lots of adverse effects in SA). Used for soft tissue disease in horses. Only NSAID labeled for cattle (control of pyrexia associated with bovine respiratory disease, endotoxemia and acute mastitis). Muscle necrosis with IM administration. Anaphylaxis seen rarely after IV administration.
Flurbiprofen and Diclofenac
Topical NSAIDs. Use when a higher local concentration and lower systemic concentration is desired. Used in management of uveitis and some keratitis. May be used in patients to manage inflammation associated with cataracts. Contraindicated in corneal ulcerations, glaucoma, or coagulopathies.
Gabapentin
Used for control of neuropathic pain (e.g. phantom limb pain). Alters Ca influx in neuronal cells. May cause sedation/ataxia, frequent dosing required. Do not use human oral liquid in dogs.
Gancyclovir
Antiviral agent. Most often used to manage feline viral infections (e.g. herpes) and generally reserved for more severe cases. Potential adverse effects (bone marrow, hepatic and renal toxicity). Greater risk with systemic antivirals.