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Flashcards in Exam 2 Deck (202):
1

Acetazolamide

CAI, used to treat udder edema. Administed orally. Rapid onset and short duration. Eliminated by kidneys

2

Acute Hypocalcemia Clinical Signs

Clinical signs can include hyperesthesia/pawing at face, tremors progressing to flaccid paralysis, seizures, hyperthermia, bradycardia.

3

ADH (Vasopressin)

Stimulates the reabsorption of water in the distal tubules and collecting ducts. This results in increased water in ECF and decreased ECF osmolality. Administered IM or IV over 1 hour in lactated Ringer’s or 5% dextrose.

4

Adverse Effects - Glucocorticoids

PU/PD, Catabolic, antagonize insulin, "stress" leukogram, impair healing, caclinosis cutis, osteoporosis, risk of ulcers (caution with NSAIDs)

5

Adverse Effects - ACE Inhibitors

Hypotension, may lower intraglomerular pressure decreasing GFR in animals with systemic hypertension and azotemia

6

Adverse Effects - Calcium Channel Blockers

Bradycardia and AV block, Hypotension, GIT side effects, Elevated liver enzymes (temporary)

7

Adverse Effects - Carbonic Anhydrase Inhibitors

Acidosis, hypokalemia, hyperglycemia, vomit diarrhea, hyperventilation, PU/PD, behavioral changes, pruritus of paws.

8

Adverse Effects - Loop or High Ceiling Diuretics

Ototoxicity, Hypokalemia, Hypomagnesemia, Acute hypovolemia, Hypotension, Cardiac arrhythmias, Hyperglycemia, Hyperuricemia, Systemic alkalosis. Hypersensitivity reactions in patients allergic to sulfonamides

9

Adverse Effects - Thiazide Diuretics

Electrolyte imbalance, hyperglycemia, hyperlipidemia, Hypersensitivity reactions in patients allergic to sulfonamides.

10

Amlopdipine

Calcium channel blocker that is recommended as the first-line antihypertensive in cats unless the cause is hyperthyroidism, in this case a B-blocker is used.

11

Angiotensin II

A potent vasoconstrictor, stimulates aldosterone secretion, Inhibits renin release

12

Benazepril

ACE Inhibitors, Treats chronic renal insufficiency in cats. Available orally. Long acting and administered once daily. Activated in the liver. Least likely to require dosage modification in renal failure patients because of significant excretion in bile (50%).

13

Bimatoprost

PG agonists that increase uveoscleral outflow by stimulating FP receptors in the eye. Used topically on the eye in the treatment of openangle glaucoma or ocular hypertension

14

Bretylium

Class III (Potassium Channel Blocker). Refractory and recurrent tachyarrhythmias.

15

Calcitonin

Decreases calcium

16

Calcitriol

Inability of the body to convert Vitamin D to the active form calcitriol leads to hypoparathyroidism. Is the most potent activated form of vitamin D. Most rapid.

17

Calcium Chloride

Oral calcium. Is Caustic NEVER given SQ/IM. More likely to cause GI irritation. If given parenterally it must be IV

18

Calcium Gluconate

Should be giving SQ (IV is better). Small amount of calcium so not good for dosing large patients.

19

Calcium proprionate

Used in catte as a food supplement

20

Calcium Regulation

Increases from PTH and calcitriol and decreases from calcitonin

21

Captopril

ACE Inhibitors, Food reduces intestinal absorption. Faster onset and shorter duration than enalapril in the dog. May cause idiosyncratic glomerular disease in some dogs. Has more GI side effects than enalapril. May cause neutropenia, proteinuria and skin rash in some humans.

22

Carbimazole

Converted in the body to methimazole.

23

Carvedilol

Nonselective beta blocker and alpha1 blocker. Inhibits endothelin release. Used to treat CHF.

24

Central diabetes insipidus (CDI)

Caused by ADH deficiency

25

Chlorpropamide

An oral hypoglycemic sulfonylurea drug. Requires the presence of some endogenous ADH to act. Is not very effective for treatment of CDI in dogs and cats.

26

Cimedtidine

H2 Antagonist; Immunomodulatory effects including inhibiting suppressor T cells and enhancing cell‐mediated immunity. Is used in the treatment of equine melanoma (as immunomodulator)

27

Cisapride

Serotonin (5HT) Agonists; 5HT4 receptor agonist in enteric neurons. Prokinetc.

28

Classification - Antiarrhythmic drugs for Tachyarrhythmias - Class I

Sodium channel blockers (local anesthetics - membrane stabilizers)

29

Classification - Antiarrhythmic drugs for Tachyarrhythmias - Class II

Beta blockers

30

Classification - Antiarrhythmic drugs for Tachyarrhythmias - Class III

Potassium channel blockers - prolong action potential duration

31

Classification - Antiarrhythmic drugs for Tachyarrhythmias - Class IV

Ca 2+ channel blockers

32

Classification - Arrhythmias

Defined as abnormalities in heart rate and rhythm (any rhythm that is not normal sinus rhythm)

33

Classification - Diuretics

Diuretics are drugs that increase the rate of urine flow. They also increase the rate of sodium excretion usually as sodium chloride.

34

Concentration of Insulin

Human approved are 100 IU/mL and Veterinary formulas are 40 IU/mL. Must use appropriate syringe.

35

Contraindications - Glucocorticoids

Diabetes mellitus - Opposes the effects of insulin. Catabolic disease - Overall catabolic effect. Infections - Immunosuppression. Corneal ulceration/wounds - Wound healing is slowed. Young animals - Slowed growth; immunosuppression. Pregnancy - Teratogenic. Concurrent use with NSAIDs - Greatly increased risk of GI ulcers.

36

Cyproheptadine

Serotonin Antagonists; Blocks H1‐receptors, blocks serotonin receptors, inhibition of serotonin inhibits ACTH. Used as an antihistamine, to stimulate appetite in small animals, in the treatment of “serotonin syndrome” in dogs and cats.

37

Desmopressin, DDAVP (1-desamino-8-D arginine vasopressin)

synthetic ADH analog. Longer duration of action than natural ADH. Given parenterally (SC, IM or IV) and the nasal drops.

38

Detemir

Long Acting Insulin, Given SC only. Has much higher potency in dogs (4x), requires special dosing and may be difficult to dose for small dogs

39

Dextrose 50% solution

Mucosal absorption is decent - owners can give Karo syrup or similar sugary substance on the gums. Generally do not give dextrose SQ (risk of tissue irritation). Intravenous bolus of dextrose can be used in an emergency. Dilute 1:4. Ongoing IV dextrose - NO MORE than 5% concentration.

40

Diabetes Mellitus

The primary goal of therapy is to address the insulin deficiency, not to "bring down the blood glucose"

41

Digoxin

Digitalis glycoside, inhibition of Na/K ATPase which results in increase in intracellular Ca. Positive inotrope and negative chronotrope. Administered orally or given slow IV in emergency. Small amount is metabolized in the liver. Undergoes eneterohepatic recycling. Excretion is mainly renal in dogs and horses BUT renal and hepatic in cats. Treats CHF and atrial arrhythmias in dogs. Narrow safety margin. Adverse effects: cardiac related.

42

Diphenhydramine

H1 Antagonist; Used as an antiemetic, antitussive and sedative

43

DOCP

A mineralocorticoid. Given parenterally (IM, SC) q 25 days or longer.

44

Dorzolamide and Brinzolamide

CAIs, administered topically on the eye.

45

Drugs - ACE Inhibitors

Captopril, Enalapril, Lisinopril, and Benazepril

46

Drugs - Angiotensin II Antagonist

ACE Inhibitors

47

Drugs - Angiotensin II Receptor Antagonist

Losartan

48

Drugs - Beta and Alpha1 Blockers

Sympatholytic Vasodilators - Carvedilol

49

Drugs - Beta Blockers

Carvedilol, Atenolol, and Propranolol

50

Drugs - Calcium Channel Blockers

Verapamil, Diltiazem, Amlodipine, and Nitedipine

51

Drugs - Carbonic Anhydrase Inhibitors (CAIs)

Acetazolamide, Methazolamide, Dorzolamide and Brinzolamide

52

Drugs - Cardiac Stimulants

B1 Agonists (Dopamine, Dobutamine, Isoproterenol, Epinephrine, and Norepinephrine); Phosphodiesterase Inhibitors; Glucagon and Calcium Salts

53

Drugs - Cardiovascular Diuretics

Digitalis (Digoxin) and Phosphodisterase Inhibitors (Aminophylline, Inamrinone, and Milrinone)

54

Drugs - Central DI

Desmopressin, DDVAP, Thiazide diuretics or Chloropropamide

55

Drugs - Class IA Tachyarrythmic Antiarrhythmic

Quinidine, Procainamide, Disopyramine

56

Drugs - Class IB Tachyarrhythmic Antiarrhythmic

Lidocaine, Phenytoin, Tocainide, Mexiletine, Aprinidine

57

Drugs - Class IC Tachyarrhythmic Antiarrhythmic

Flecainide, Ecainide, and Lorcainide

58

Drugs - Class II Tachyarrhythmic Antiarrhythmic

Propranolol, Timolol, Pindolol, Oxyprenolol, Alprenolol, Atenolol, Esmolol, Metoprolol (your Beta Blockers)

59

Drugs - Class IV Tachyarrythmic Antiarrhythmic

Veraparmil and Diltiazem

60

Drugs - Direct Acting Vasodilators

Hydralazine and Nitrates (Sodium Nitroprusside, Nitroglycerin, and Isosorbide dinitrate)

61

Drugs - Direct and indirect Sympathomimetics

Vasoconstrict - Ephedrine, pseudoephedrine, phenylpropanolamine (PPA)

62

Drugs - Glucocorticoids

Prednisone/prednisolone, Dexamethasone, Triamcinolone, Methylprednisolone, Fluticasone.

63

Drugs - H1 Antagonists - First generation

Pyrilamine, diphenhydramine, dimenydrinate, chlorpheniramine, meclizine, promethazine, trimeprazine, cyproheptadine

64

Drugs - H1 Antagonists - Second generation

Ketotifen and Piperidines (Terfenadine, Astemizole, Loratadine, and Fexofenadine)

65

Drugs - H2 Antagonists

Cimetidine, Ranitidine, Famotidine, and Nizatidine

66

Drugs - Indirect Sympatholytics

Sympatholytic Vasodilators - Bretylium

67

Drugs - Inhibit histamine release

Cromolyn sodium, catecholamines, phosphodiesterase inhibitors glucocorticoids

68

Drugs - Inodilators

Pimobendan, Inamrinone, and Milrinone

69

Drugs - Janus Kinase Inhibitor

Oclacitinib

70

Drugs - Leukotriene Inhibitors

Zafirlukast and Zileuton

71

Drugs - Loop or High Ceiling Diuretics

Furosemid, Bumentadine, and Ethacrynic acid

72

Drugs - Mineralocorticoids

DOCP, Fludrocortisone

73

Drugs - Nephrogenic DI

Thiazide diuretics or Chloropropamide

74

Drugs - Neurokinins Antagonist

Maropitant citrate

75

Drugs - Nonselective Alpha Agonists

Vasoconstrict - Epinephrine and norepinephrine

76

Drugs - Nonselective Alpha Blockers

Sympatholytic Vasodilators - Phentolamine, phenoxybenzamine

77

Drugs - Nonselective Beta Blocker

Sympatholytic Vasodilators - Propranolol

78

Drugs - Osmotic Diuretics

Mannitol, Urea, Glycerin, and Isosorbide

79

Drugs - Positive Inotropic

Digitalis glycoside (Digitoxin, Digoxin and ouabain) and B1 agonists

80

Drugs - Potassium Sparing Diuretics

Spironolactone, Triamterene and Amiloride

81

Drugs - Presynaptic Alpha2 Agonist

Sympatholytic Vasodilators - Clonidine

82

Drugs - Prostaglandin Inhibitors

Cyclooxygenase Inhibitors (NSAIDs) and Phospholipase A2 Inhibitors (Corticosteroids - also inhibit COX-2)

83

Drugs - Prostaglandins

Misoprostol, Dinoprost tromethamine, Cloprostenol, Fenprostalene, Fluprostenol, Latanoprost, Travoprost, and Bimatoprost

84

Drugs - Selective Alpha 1 Agonist

Vasoconstrict - Phenylephrine

85

Drugs - Selective Alpha1 Blockers

Sympatholytic Vasodilators - Prazosin, terazosin, doxazosin

86

Drugs - Selective Beta1 Blockers

Sympatholytic Vasodilators - Atenolol

87

Drugs - Serotonin Agonist

Cisapride and Fluoxetine

88

Drugs - Serotonin Antagonist

Cyproheptadine, Ondansetron (Zofran), Metoclopramide, Mirtazapine

89

Drugs - Thiazide Diuretics

Hydrochlorothiazide and Chlorothiazide

90

Drugs - Vasoconstrictors

Nonselective Alpha Agonists, Selective Alpha 1 Agonist, and Direct and indirect Sympathomimetics

91

Drugs - Vasodilators

Sympatholytic drugs, ACE inhibitors, Angiotensin II antagonists, Direct-acting vasodilators, Ca channel blockers. Hydralazine, Nitrates (Sodium nitroprusside, nitroglycerin, isosorbide) and Prazosin

92

Drugs - Antihypertensive

Diuretics, Beta blockers, Vasodilators and Calcium channel blockers

93

Drugs that could interefere with thyroid tests results

Phenobarbital, zonisamide, sulfonamides, glucocorticoids, phenylbutazone, quinidine. Should measure about 4 weeks after starting therapy.

94

Dugs - Class III Tachyarrhythmic Antiarrhythmic

Bretylium, Amiodarone, Sotalol

95

Enalapril

ACE Inhibitors, Available orally and parenterally. Has a slow onset and long duration in the dog. Activated in the liver.

96

Fludrocortisone

A mineralocorticoid. Given orally BID. NOT FLUTICASONE!!

97

Fluoxetine

Serotonin Agonists; Selective serotonin reuptake inhibitor (SRRI) antidepressant. Increases serotonin levels in the brain. Treatment of canine separation anxiety in dogs and cats to treat other behavioral disorders. Treats cats with inappropriate elimination and urine marking. Side effects: Nausea, anorexia, anxiety, irritability, and sleeping disturbances

98

Fluprostenol

A prostaglandin causes luteolysis, stimulate motility of the smooth muscles of the reproductive tract

99

Furosemide

Loop/High Ceiling Diuretic. Used for treatment of exercise-induced pulmonary hemorrhage in horses. Administered orally and IV. Rapid action and short duration.

100

Glargine

Long Acting Insulin, Given SC only. Forms microprecipitates in physiologic pH which results in very gradual absorption (‘flat’ curve)

101

Glipizide

Oral hypoglycemic agent. The only clinically relevant ones used in veterinary medicine at this time are sulfonylurea drugs. Only effective in ~20-30% of cats. Can cause significant hypoglycemia, so glucose must be monitored as it is with insulin therapy. May accelerate beta cell loss.

102

Glucagon (hormone)

Not commonly used. IV injection (dosed in nanograms)

103

Glucocorticoids

Cortisol is the endogenous hormone. Regulated by the hypothalamus/pituitary through release of CRH and ACTH. Use for anti-inflammator effects. Well absorbed orally or parenterally. Protein bound by transcortin or albumin. Metabolites excreted in urine.

104

Glycerin and Isosorbide

Administered orally.

105

H3 Mediated Effect

Inhibiting release of histamine, serotonin,
norepinephrine and acetylcholine

106

Histamine Antagonists

Absorbed orally. 1st generation: sedating and cross BBB 2nd generation: non-sedating and does not cross BBB. Metabolized by the liver and excreted in urine. Most are enzyme inducers.

107

Histamine Storage

Present in many tissues especially the lung, skin, GI, mucosa and the CNS (hypothalamus). Mainly stored in mast cells and basophils

108

How much serum calcium is bound to plasma protein?

50%, only unbound calcium is active

109

Hydralazine

Arteriolar vasodilator. Increasing local concentrations of PGI2. May be by inhibiting calcium influx into smooth muscles of arteries

110

Hydrochlorothiazide and Chlorothiazide

Administered orally, absorption is slow, bind to plasma protein, decreased RBF decreases effectiveness

111

Hyperglycemia

Too little insulin

112

Hypoglycemia

Too much Insulin

113

Inhibition of renin secretion

Angiotensin II, ADH, Hypertension, Increased reabsorption of sodium, B1-adrenergic blockers

114

Insoluble esters (pivalate, acetate, acetonide)

Used for glucocorticoids as an injectable excipient. The less soluble the ester the longer it will take to absorb (delayed onset, long duration) - "depot". Opaque suspension - NOT for IV use!!

115

Insulin

Regular, NPH, Vetsulin, PZI, Glargine, Detemir. Produced by the beta cells of the islets of Langerhands in endocrine pancreas.

116

Iodides and Iodinated contrast agents

Inhibit thyroid hormone synthesis, inhibit release of preformed hormone, inhibit T3>T4 conversion in periphery (contrast agents). Efficacy is variable and often transient.

117

Ketotifen

H1 Antagonist; Available as ophthalmic for treatment of allergic conjunctivitis, and orally as adjunctive for prevention of asthma

118

Levothryoxine

T4 replacement for hypothyroidism in dogs. Requires less frequent dosing and has lower risk of causing thyrotoxicosis (excessive T4 levels than liothyronine. Typically dose in mg/kg. Reduce risk of oversupplementation in large patients (>50lb) by dosing mg/m2 instead. Given orally BID (sometimes SID - half-life is variable). Injectably only used for rare situations like myxedema coma. Must be given for the rest of the patient's life.

119

Lidocaine

Class IB. The intravenous drug of choice for ventricular arrhythmias due to general anesthetics, surgery, ischemia, and trauma. Digitalis-induced arrhythmias.

120

Lifelong management

Calcitriol, DHT (dihydrotachysterol), ergocalciferol

121

Liothyronine

T3 hormone replacement

122

Lisinopril

ACE Inhibitors, long acting and administered once daily.

123

Losartan

Angiotensin II antagonists. Competitive antagonist of angiotensin II receptors. Clinical use - antihypertensive.

124

Major H1 Mediated Effects

Contraction of smooth muscles, vasodilation stimulate exocrine secretion, postive inotropic effect, CNS stimulation and inhibition of appetite

125

Major H2 Mediated Effect

Gastric acid secretion and positive inotropic effect and increased heart rate

126

Mannitol

An osmotic diuretic. administered IV. Not metabolized and eliminated rapidly by the kidneys.

127

Maropitant citrate

Neurokinins Antagonists; Blocks neurokinin 1 (NK1) receptors preventing substance P from binding resulting in antiemetic effect. Used only in dogs (over 16 weeks of age) as tablets or injection for the prevention of acute vomiting due to motion sickness and may be effective in treating vomiting due to viral infections and anticancer chemotherapy.

128

Methimazole

Inhibits hormone synthesis. Consistently efficacious. Side effects uncommon and most are manageable. Tapazole (humans), Felimazole (cats), Transdermal methimazole. Used to treat hyperthyroidism in cats.

129

Metoclopramide

Serotonin Antagonists; 5HT3 receptor antagonist and D1 and D2 receptor antagonist. Antiemetic and prokinetic

130

Mild/Common Side Effects of Methimazole

GI signs (vomiting), transient hematologic changes on CBC

131

Mineralocorticoids

Produced by the zona glomerulosa. Aldostertone is the endogenous hormone. Regulate Na retention/ K excretion.

132

Mirtazapine

Serotonin Antagonists; Enhances noradrenergic and serotonergic activity. A potent antagonist of 5HT2 and 5HT3 receptors. Antidepressant and antiemetic

133

Misoprostol

A synthetic prostaglandin E1 that causes GI cytoprotection and decreases acid secretion. Given orally as anti‐ulcer drug

134

MOA - ACE Inhibitors

Inhibition of: angiotensin-converting enzyme (kininase), angiotensin II synthesis and aldosterone.

135

MOA - Calcium Channel Blockers

Inhibit the influx of extracellular calcium which inhibits myocardial contraction and results in vasodilation. Results in negative inotropic effect and negative chronotropic effect.

136

MOA - Carbonic Anhydrase Inhibitors

Reversible inhibition of carbonic anhydrase (CA) inhibits the exchange of H for Na in PCT. Lower intraocular pressure.

137

MOA - Glucocorticoids - Genomic Effects

Nuclear type GCRs in the cytoplasm - after binding move into the nucleus to increase or decrease gene expression.

138

MOA - Glucocorticoids - Non-genomic Effects

Glucocorticoid receptors in the membrane - rapid effects

139

MOA - Loop or High Ceiling Diuretics

Inhibit Na/K/2Cl symporter at ALOH. Most effective bc 25% of Na is reabsorbed at ALOH. Negative lumen results in hypokalemia and systemic alkalosis.

140

MOA - Osmotic Diuretics

Acts 1st in the ALOH and 2nd in PCT. Interferes with transport mechanism. Increasing urinary excretion of electrolytes. Also reduces medullary tonicity, increase renal blood flow.

141

MOA - Thiazide Diuretics

Inhibit Na/Cl symporter in DCT. results in inhibition of re-absorption of Na and Cl. Moderate efficacy bc of 5% Na. Inhibits K and Mg re-absorption but increases re-absorption of Ca.

142

Nephrogenic diabetes insipidus (NDI)

Caused by impaired responsiveness of the kidney to ADH

143

Neutral Protamine Hagedorn (NPH) and Vetsulin

Intermediate Insulins. Given SC only (degraded if given orally and may cause anaphylaxis if given IV). Most common form of insulin for maintenance in dogs; may be too short for felines. Difficult to dose less than 1U. Vetsulin has a pen that allows accurate dosing down to 0.5U.

144

Nitrates

Sodium nitroprusside, Nitroglycerin, Isosorbide dinitrate. Formation of the reactive radical nitric oxide (NO). Relaxation of smooth muscle of blood vessels.

145

Oclacitinib (Apoquel)

Janus kinase (JAK) inhibitor. Inhibits pruritogenic and pro‐inflammatory cytokines by inhibiting JAK1 and JAK3 without inhibiting cytokines involved in hematopoiesis that are dependent on JAK2. For the control of pruritus associated with allergic dermatitis and atopic dermatitis in dogs over 12 months of age.

146

Ondansetron (Zofran)

Serotonin Antagonists; 5HT3 receptor antagonist (central and peripheral). Prevention and treatment of anticancer chemotherapyinduced nausea and vomiting. Antiemetic and prokinetic

147

Oral Calcium options

Calcium gluconate/lactate, calcium carbonate calcium chloride, calcium acetate and calcium proprionate

148

Parenteral Calcium

Calcium gluconate and Calcium chloride

149

Periparturient hypocalcemia

"Milk fever" for large animals and "eclampsia" for small animals. Sudden increase in calcium usage for which the patient cannot adapt rapidly enough - generally associated with birth/lactation.

150

Phenytoin

Class IB. Digitalis-induced arrhythmias in dogs only.

151

Pheochromocytoma-induced hypertension

Phenoxybenzamine is the drug of choice.

152

Physiological Effects - Glucocorticoids

Increased calcium excretion, reduced fever, suppress immune response (dose dependent), lymphotoxic

153

Pimobendan

An inodilator, positive inotrope, vasodilator, and positive chronotrope. Sensitizaion to calcium by enhancing interaction between calcium and troponin C complex.Increase intracellular calcium. Inhibits PDE III and V. Balanced vasodilation leads to reduction in both cardiac preload and afterload. Treats CHF in dogs. Effective with heart failure due to both dilated cardiomyopathy (DCM) and chronic degenerative valvular disease (CVD). Can cause seizures. DO NOT USE IN HYPERTROPHIC CARDIOMYOPATHY PATIENTS! Oral ingestion and metabolically activated in liver. Bound to plasma proteins.

154

Procainamide

Class IA. More effective for ventricular arrhythmias than atrial arrhythmias.

155

Propranolol

Class II. Paroxysmal supraventricular tachycardia. Digitalis-induced tachyarrhythmias. Arrhythmias due to inhalation anesthesia

156

Propylthiouracil (PTU)

Inhibit thyroid hormone synthesis and inhibit conversion of T4 to T3 in tissues. Also efficacious. Higher incidence of serious side-effects (higher risk)

157

Protamin Zine/PZI (Prozinc)

Long Acting Insulin, Given SC only. A veterinary approved product (40 IU/mL). May have shorter duration than the rest of the long-acting insulin types listed, particularly in cats.

158

Quinidine

Class IA. Used for ventricular arrhythmias and atrial fibrillation in horses (drug of choice), cattle and large breeds of dogs.

159

Ranitidine and Nizatidine

H2 Antagonist; Not Cimetidine or Famotidine have cholineregic activity by inhibiting acetyl cholinesterase (AchE) stimulating gastrointestinal motility. Can be use as a prokinetic.

160

Regular Insulin

Short Acting insulin. Can be given IV, IM or SC. IV CRI (not boluses). Used for critical care patients (DKA, hyperosmolar). Fast onset and short duration. Require at least TID dosing so not good long term.

161

Renin

converts angiotensinogen to angiotensin I

162

Salt esters (Na Succinate, Na Phosphate)

Used for glucocorticoids as an injectable excipient. Make the steroid soluble. Makes it suitable for IV administration. Onset is faster but duration unchanged.

163

Severe/uncommon Side Effects of Methimazole

Refractory GI signs, idiosyncratic reactions (facial excoriation, hepatopathy, bone marrow suppression)

164

Side Effects - Histamine Antagonists

Anticholinergic effect, Gastrointestinal irritation, alpha-adrenergic blocking effect (phenothiazines)

165

Side Effects - short term - Glucocorticoid

(~3-5 days). Usually not serious unless concurrent factors. Lab changes (stress leukogram, decrease thyroid). Polyuria, polydipsia, polyphagia. Fetal abnormalities/abortion. More severe side effects ~can~ occur

166

Side Effects – long term - Glucocorticoid

Increased susceptibility to infection. Skin changes (hyperpigmentation, thinning, alopecia). Collagen disease (cruciate injury), delayed wound healing. Hypertension, thromboembolic disease. Panting. Addisonian signs (with withdrawal – ‘iatrogenic Addison’s. Dose must be tapered if on steroids more than a few days

167

Spironolactone

Potassium sparing diuretic. Competiviely blocks aldosterone binding. Results in excretion of NaCl and retains K and H. Efficacy is mild because of 2% Na reabsortion in DCT. Treatment of primary and secondary hyperaldosteronism. Adverse effects: Hyperkalemia and acidosis. Administered orally, bound to plasma protein, metabolized in liver to active metabolite. Action is slow and duration is long.

168

Supraventricular Tachyarrhythmias

Atrial fibrilation, atrial flutter, and atrial tachycardia

169

Terfenadine and Astemizole

H1 2nd generation; Have been associated with cardiac arrhythmias

170

Therapeutic Use - ACE Inhibitors

CHF, hypertension, CHRONIC renal insufficiency in cats

171

Therapeutic Use - Carbonic Anhydrase Inhibitors

Treatment of open-angle glaucoma and udder edema

172

Therapeutic Use - Cardiovascular Diuretics

Treatment of edema associated with congestive heart failure (CHF).

173

Therapeutic Use - Osmotic Diuretics

Treatment of: Cerebral edema, glaucoma, ACUTE renal failure. Mobilization of edema fluid. Used in patients with drug overdose.

174

Therapeutic Use - Histamine Antagonists

Allergy and anaphylaxis, antimotion sickness

175

Therapeutic Use - Loop or High Ceiling Diuretics

Treatment of: acute pulmonary edema, pulmonary congestion, generalized edema and CHRONIC and ACUTE renal failure, udder edema. Effective in the treatment of edema of nephrotic syndrome.

176

Therapeutic Use - Thiazide Diuretics

Treatment of edema of CHF, hypertension, udder edema, and nephrogenic diabetes insipidus.

177

Therapeutic Uses - Glucocortioids

Diagnostic testing: low or high dose dexamethasone suppression tests to test for hyperadrenocorticism. Allergies, Suppress inflammation, Immunosuppression, Replacement therapy (Addison's)

178

Therapeutic Uses - H2 Antagonists

Peptic ulcer, Gastric erosive disease, Gastroesophageal reflux disease, Duodenal ulcer

179

Thioureylenes

Methimazole, carbimazole, propylthiouracil (PTU)

180

Thyro-tabs

Are the only veterinary approved product.

181

Treatment for Hypocalcemia

Replace the calcium deficit until the patient can "catch up"

182

Treatment of Acute/Transient Hypoglycemia

Diet, Dextrose 50% solution (crystalloid fluid), Glucagon (hormone)

183

Treatment of Atrial Fibrilation in Dogs

Digoxin, Propranolol, Quinidine, Procainamide

184

Treatment of Atrial Flutter in Dogs

Digoxin, Quinidine, Procainamide, Propranolol

185

Treatment of Atrial Tachycardia in Dogs

Digoxin, Procainamide, Propranolol, Quinidine, Phenytoin

186

Treatment of Cardiac asystole (cardiac resuscitation)

Epinephrine

187

Treatment of CHF

Positive inotropic drugs, inodilators, vasodilators, diuretics, B-blockers. Also: oxygen therapy, morphine sulfate, aminophylline, nebulization of ethanol (20%)

188

Treatment of Chronic Glycemia

Diet and corticosteroids

189

Treatment of Hypoglycemia

Corticosteroids - Combat hypoglycemia by increasing gluconeogenesis, decreasing glucose uptake and stimulating glucagon secretion

190

Treatment of Second degree AV block

Atropine, Isoproterenol, Glucagon

191

Treatment of Sinus Bradycardia

Atropine and Isoproterenol

192

Treatment of Tachyarrhythmias in Cats

Beta blockers are the drugs of choice for both supraventricular and ventricular tachyarrhythmias

193

Treatment of Ventricular Premature Complexes in Dogs

Quinidine, Procainamide, Lidocaine, Phenytoin, Propranolol

194

Treatment of Ventricular tachycardia in Dogs

Procainamide, Lidocaine, Quinidine, Phenytoin, Propranolol

195

Triamterene and Amiloride

Potassium sparing diuretic. Blocks epithelial Na channels at DCT. Results in excretion of Na and retention of K and H. Treatment of hypokalemia and hypomagnesemia, edematous disorders and hypertension. Adverse effects: hyperkalemia and acidosis. Administered orally. Amiloride is excreted by the kidneys and Triamterene is converted to an active metabolite in the liver.

196

Type 1: Insulin dependent

Hyperglycemia mostly seen in dogs. Absolute deficiency of insulin from autoimmune destruction of B cells. Can only be treated by insulin replacement.

197

Type 2: Non-insulin dependent

Mostly seen in cats. Insulin deficiency and resistance.

198

Types of Bradyarrhythimias

Cardiac asystole (cardiac resuscitation), Second degree AV block, and Sinus Bradycardia

199

Ventricular tachyarrhythmias

Ventricular Premature Complexes and Ventricular tachycardia

200

Verapamil and Diltiazem

Supraventricular tachyarrhythmias and Myocardial hypertrophy. Diltiazem is a drug of choice in cats.

201

Zafirlukast

Leukotriene receptor antagonists (selective competitive antagonists for LTD4 and LTE4 receptors. Prevention of bronchoconstriction in bronchial asthma in cats.

202

Zileuton

5‐Lipoxygenase (5‐LO) inhibitors, (inhibit formation of leukotrienes). Prevention of bronchoconstriction in bronchial asthma.