Drugs Affecting Blood

Question 1

Hematinics

Answer 1

Increase biosynthesis of Hb
Vitamin B12/ complexes, Folic acid, Iron, copper, cobalt

Question 2

Microcytic Anemia

Answer 2

Iron deficiency anemia of baby pigs
Protein deficiency in diet
Copper deficiency

Question 3

Macrocytic anemia

Answer 3

Vitamin B12 deficiency
Cobalt deficiency in ruminants

Question 4

Vitamin B12: Cobalamine

Answer 4

Acquired from diet (meats) and GIT microbes (large intestine)
Needed for DNA synthesis

Question 5

Cobalamine formulations

Answer 5

Pure cyanocobalamin- synthetic form (oral, inj or nasal spray)
Hydroxycobalamine: IM/ IV for severe deficiencies
Intracellular forms (methyl and adenosylcobaminine)

Question 6

Feline B12 deficiency effects

Answer 6

Irritable bowel syndrome and pancreatic insufficiency

Question 7

Erythropoietin (EPO/ rhEPO)

Answer 7

Endogenous glycoprotein hormone
Source: liver and kidney cells
Precautions: cases of hypertension

Question 8

Epoetin alfa uses

Answer 8

IV/SC- dogs and cats with renal disease/ chronic anemia (decreased EPO)

Question 9

Iron therapy

Answer 9

Corrects physical symptoms and decreased Hb levels
Used when dogs/cats on erythropoietin or darbepoetin therapy
Indicated by blood loss
Toxic effect: microcytic hypochromic anemia

Question 10

Ferrous sulfate

Answer 10

Oral iron preparation (tablets or drops)
Replenishes Fe stores

Question 11

Iron Dextran

Answer 11

Parenteral prep of Fe
IM: treat prophylaxis of iron deficiency in neonatal food animals
Dogs, cats and swine

Question 12

4 types of coagulation modifers

Answer 12

Anticoagulants
Hemostatics
Thrombolytics/ fibrolytics
Antiplatelet agents

Question 13

Anticoagulants

Answer 13

Prevent venous and arterial clot formation
Inhibits specific clotting factors
Drug: heparin, Vit. K antagonist (coumarin)

Question 14

Hemostatics

Answer 14

Promote clot stability
Inhibits fibrin destruction
Drug: topical agents, vitamin K, desmopressin acetate, protamine

Question 15

Thrombolytics/ fibrinolytics

Answer 15

Removal of existing clot
Dissolution of fibrin clot by drug action

Question 16

Antiplatelet Agents

Answer 16

Prevents arterial clot formation
Inhibition of platelet actions
Drugs: Clopidogrel, Ticlopidine, Dipyrimadole, Aspirin

Question 17

Acid citrate dextrose (ACD)

Answer 17

Blood transfusions: anticoagulant
Maintains high levels of erythrocytes post-transfusion (20 days in dogs)

Question 18

Heparin LMW

Answer 18

Molecular weight: 5,000
Safe: only binds to AT- inhibits Xa, less IIa

Question 19

Heparin clinical uses

Answer 19

Management of DIC
Arterial thrombi in cats
Low dose to decrease complication of HW adulticide treatment
Pulmonary thromboembolism

Question 20

Heparin adverse effects

Answer 20

Transient thrombocytopenia, hypersensitivity, hemorrhage and anaphylaxis

Question 21

Contraindicated heparin

Answer 21

Bleeding disorders, severe hypertension
Recent trauma (intra-cranial hemorrhage)
Bacterial endocarditis

Question 22

Reversal agent of Heparin

Answer 22

Protamine sulfate, IV

Question 23

Dicumoarol and Warfarin

Answer 23

Vit. K antagonists/ Courmarin derivatives
Inhibits synthesis of Vit. K- dependent clotting factors
Reversed with IV/PO Vit. K

Question 24

Dicumoarol and Warfarin uses

Answer 24

Main: rodenticides
Rarely used in cats for thromboembolism

Question 25

Thromboplastin (TH)

Answer 25

Promotes prothrombin to thrombin conversion Local hemostatic, measure PT time

Question 26

Thrombin (TH)

Answer 26

Promotes fibrinogen to fibrin conversion Controls bleeding Adhesive skin graft

Question 27

Fibrinogen

Answer 27

Converted by thrombin to fibrin Skin graft adhesive Restores norm. plasma fibrinogen

Question 28

Fibrin foam (TH)

Answer 28

Applied directly with pressure to stop hemorrhage

Question 29

Absorbable Gelatin Sponge (TH)

Answer 29

Soaked in thrombin and absorbs bleeding after closing operating wounds Used in capillary or venous bleeding

Question 30

Microcrystalline collagen (TH)

Answer 30

Adheres to wet surfaces Controls hemostasis or venoarterial anastomosis or surgery of spleen and liver

Question 31

Epinephrine and NE (TH)

Answer 31

Local control of bleeding from small vessels

Question 32

Styptics (TH)

Answer 32

Oldest blood clotting drugs Ex: ferric sulphate, alum, tannic acids, zince chloride

Question 33

Oxidized Cellulose (TH)

Answer 33

Aids in coagulation between Hb and celluosic acid forming the gummy matrix for clot formation

Question 34

Vitamin K

Answer 34

Systemic hemostatic drug Treats vit. K antagonist rodenticide intoxication Aids in production of clotting factors

Question 35

3 forms of Vitamin K

Answer 35

K1- Phytonadione (plant) K2- Menaquinone (microorganisms) K3- Menadione (Synthetic)

Question 36

How vit. K given

Answer 36

Orally and SC

Question 37

Why shouldn't you give Vit. K in other ways

Answer 37

IM: fatal hemorrhage IV: anaphylactic rx

Question 38

What does vit. K do in birds?

Answer 38

Coccidiosis treatment by sulfonamides by destroying intestinal microorganisms

Question 39

What does vit. K do in pigs

Answer 39

Treat low levels of vit. K with in swine porcine hemorrhagic syndrome in weaned pigs

Question 40

What does vit. K do in cats?

Answer 40

Treats heredity vit. K deficiency in Devon Rex Cats

Question 41

Desmopressin Acetate (SH)

Answer 41

Controls bleedings in animals with low Wilebrand factor (dobermans, shepherds, pinschers, retrievers) Given SC

Question 42

Protamine (SH)

Answer 42

Neutralizes acidic heparin Treats heparin overdosing Derived sperm of salmon

Question 43

How are antiplatelet agents used clinically?

Answer 43

Prevent thrombotic diseases Prevents thrombi (feline cardiomyopathy) Reduce pulmonary endateritis (HW disease) Laminitis and naviculae disease in horses

Question 44

Aspirin/ Acetyl salicylic acid

Answer 44

NSAID, inhibition of primary hemostasis and thromboxane syntheisis in platelets Prevents platelet aggregation

Question 45

What does aspirin do at low doses?

Answer 45

Anti-inflammatory and anticoagulant: 1.DIC 2. Pulmonary arterial disease secondary to heart worm infestation 3. Cardiomyopathy in cats 4. Adjunctive treatment of glomerular disease