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- What are most corticosteriods administered for in Vet Med
- anti-inflammatory effects
- Name w naturally occuring corticosteriods
-
1. Glucocorticosteriod (cortisol
2. Mineraocorticosetroid (aldasterone) - what is a primary mediator of immune response
- prostaglandin
- Pain sensation arises in free nerve endings called
- nociceptors
- NSAID that selectively inhibit _____ are thought to produce fewer GI side effects
- Cox-2
- Common side effects of NSAID
- GI ulceration or bleeding
- What do mineralocorticoids do in teh body
- regulate electrolyte & water balance
- Clinical considerations of NSAID administrateio
-
1 not curative, only ameloriative
2. close observatin
3. Blood tx - long term effect adreanl, kidney * liver
4. Loading dose & diminish to maintenance levels
5.NEVER abruptly discontinue
6 DO NOT USE for corneal ulcers - Short term side-effects of corticost?
-
1. Polyuria/polydipsia
2. thining skin, muscle wasting & impaired healing
3. polyphagia & wt. gain - Long term effects of corticosteroids
-
1. thinning skin
2. gastric ulcers
3. osteoporosis
4. iatrogenic Cushing's Dz - Clinical use of corticost
-
1. ANTI-INFLAMMATORY
2.Immunosuppressive
3. replacement therapy - Contraindications for corticosteroids
-
1. Steriods irrite peptic ulcers
2. Diabetes
3. Blood dyscrasias (blood cancer
4. Kidney, liver or heart dz
5. pregnant animals - xx placenta
6. glaucoma - increased fluid retension - 5 types of corticosteroids
-
1. Dexamethisone (Azium, Dexasone)
2. Prednisone, prenisolone
3. methylprednisolone (Depo=Medrol
4. prednisolone sodium succinate (Solu-Delta-Crortef)
5. Triamcinolone (vetalog) - Uses for dexamethisone, duration of effect & names
-
MOST COMMON
1. Head trauma &
2. hypovolemic shock
3. Long acting - 48 HR
4. NOT FOR CATS
Azium, Dexasone - Duration of effect of prenisolone/prednisone
-
2nd MOST COMMON
1. intermediate acting (12-36hr) -
Which corticosteroid is good for cats
& what is the duration of effect -
methylprednisoone (depo-medrol
intermediate acting - Which corticosteriod is for emergency use only & what is the duration of effect
-
1. prednisolone sodium succinate
acute disk disorder
TX of shock
ULTER-SHORT ACTING ( <12HR) - Common corticosteriod used for skin allergies & duration of effect
-
Triamcinolone (vetalog, panalog)
intermediate actin, but strong HALF LIFE(time to excrete 1/2of administered dose - Which corticosteriod is ultra short acting
- prednisolone sodium succinate (Sole-Delta-Cortef)
- What is a potential electrolyte imbalance in a small animal when using loopdiurectics
- hypokalemia
- What is the effect of ACE INHIBITORS ON THE BODY
- Decrease pre-load and afterload on the heart in CHF - by preventing retension of Na & H2O
- What is the action oof diltiazem
- Calcium channel blocker to relax the heart with thikened walls & poor contractility
- Lidocaine is used to control what abnormality
- premature ventricular contractions & ventricular tahcycardia
- Which osmotic diuretic is used to reduce intracranial pressure or tx oliguric renal failure cases
- Mannitol pulls the fluid into the intravascular space
- Which GI drug stimulates GI motility
- cisapride (propulsid)
- What is the drug of choice for tx seizures in cats
- Phenobarbitol
- 4 types of anti-convulsanats
-
1. primidone
2. phenobarbitol
3. dilantin
4. Soduim Bromide - Which anti-seizure is contraindicated in cats
- primadone - cats have trouble metabolizing barbiturates
- Define seizure
- irregular electrical impulse in the brain
- Concept of anti-seizure therapy
- Start low until reach control
- Most CNS drugs work by_______or ______ the effects of neurotransmitters
-
interrupting the generation or conduction of nerve impulses
interferring with - How does dilantin work
-
1. prohibits the spread of abnormal electrical activity but depressoing
2. Prohibits arcing btwn hemis -
good for generalized seizures
NOT FOR CATS - How does phenobarbital work
-
1. sedative for excited
2. anti-seizure for epileptic type seizures - how does primadone work
- elevates seizure threshold so a stronger electrical impulse is needed to cause a seizure
- 4 maintenance anti-convulsant drugs
-
1. primidone
2. phenobarbitl
3. Dilantin
4. Sodium Bromide - When to use Sodium Bromide
-
adjunct to phenobarbital or primidone therapy
Monitor for vomiting and ataxiz(trouble walking) - Side Effects of anti-seizure drugs
-
1. drowsiness
2. CNS depression
3. anxiety
4. agitatin
5. pu/pd
6. hepatotoxicity - Primidone & phenobarbitol - What class of drugs is contraindicated in seizure patients
- phenothiazines (Ace, chlorpromazine
- 2 purposes for hormone therapy
-
1. correct deficiency
2. obtain desired effect - When to use oxytocin
-
1."milk let down"
2.stimulate uterine contractionsie. induce labor or expel retained placenta
3. Birds - expel bound eggs - What is the diff btwn exogenous & endogenmous
-
exogenous are administered
endogenouse are naturally produced by body - Medical uses of estrogen
-
1.control urinary incontinence
2. induce abortion - Use of testosterone
-
1. control urinary incontinency
2. TX false pregnancy
3. Large animals - improve libido & fertility (esp stallions
4. control estrus in female dogs - Ex of androgens
-
1. testosterone
2. anabolic steriods - Use of anabolic steriods in vet
-
2. increase muscle mass
3. stimulate appetite -
4. Boost racinganimals - Example of controlled anabolic steriod
-
Winstrol - V
Class IV - Pituitary hormones for reproduction
-
1. FSH - follicle stimulating
2. LH - lutenizing stimulates ovulation
3. oxytocin - milk letdown -
Where are progestins naturally produced
Name 2: -
corpus luteum.
1. Ovaban
2. Depo-Medrol - Uses of MPA
-
medroxyprogesterone acetate "Depo-Medrol"
1.tx male behavior problems
2.suppress estrus in D&C
3. Tx Derm. conditions
3. - Uses of megesterol acetate
-
aka Ovaban
1. control estrus
2. prevent vaginal hyperplasia
3.control unacceptable male behavior
4. tx dermatoses - Adverse side effects of estrogen therapy
-
1. temporary endometriosis which could lead to pyometra
2. Anemia
3. bone marrow suppression
4. cystic ovaries
5 - 2 examples of estrogens
-
1. DES oral
2. ECP injecxtion - Uses for progesterone
-
1. dog birth control
2. alleviate false preg
3. tx some dermatitis
4. inhibit spraying of cats
5. reduces territorial aggression in birds -
What is the common thyroid dz in dogs
In cats -
D- hypothyroidism
c- hyperthyroidism - Medical uses for thyroid therapy
-
1. replacement for inadequate thyrosin (T4) production
2. tx dermatoses - Clinical considerations of thyroid therapy
-
1. Assess thyroid fct w/ blood test
2. lifelong therapy
3. most common in older dogs - Examples of Levothyroxine (oral)
-
1. Soloxine
2. synthroid - Uses of insulin
- 1. tx diabetes melitus
- Where is insulin naturally produced in teh body
- Pancreas to decrease blood glucose levels by facilitating cellular uptake & storage of blood glucose
- How are insulins catagorized
-
Duration of action:
Short
Intermediate
Long - Examples of short acting insulin
-
1. Regular insulin
2. semilente - Examples of intermediate acting insulin
-
1. NPH (isophane)
2. Lente - Examples of long acting insulin
-
1. PZI -protamine zinc insulin
2. ultra lente - A chronotropic agent affects what
- rate of contraction
- A inotropic agent affects what
- force of contraction
-
Which type of drugs affect positive inotrophic activity
& what is their primary use -
Cardiac glycoside (digitalis)
control congestive heart failure - Examples of cardiac glycoside (digitalis
-
1. digoxin
2. digitoxin - Define congestive heart failure
- condition of an enlaarged heart w/ poor myocardium contractibility
- Prostaglandins may not be used effectively to
- Induce partrtion
- Action of cardiac glycosides
- Positive inotrophic - increase force of contraction & slow down the heart rate
- Side effects of dgitalis
-
1. VOMITTING
2. Diarrhea
3. anorexia
4. depressin
5. Muscle weakness
6. diff ambulating
7. visual disturbances
ADVANCED:
1. stupor
2. arrhthymias
3/ death - Uses for digitalis
-
1. Tx CHF
2. Atrial fibrillatin
3. supravnetricular tachycardia - Concerns when using digitalis
-
1. anticipate toxicity (foxglove
2. toxic to humans
3. metab. by liver & excreted by kidneya - so ck. those organs functions
4. Lots of drug interactions - Ex. of digoxin
-
1. cardoxin
2. lanoxin - When is digitoxin most likely to be used
- Emergency only
- What happens during right sided heart failure
- Blood backs up into the liver, then kidneys try to conserve fluid
- Drug interactions w/ digitalis
-
1. drugs reducing the effectiveness of by enhancing excretion
1. Butyl hyocine
2. reglan
3. tagament
4. diazepam
Drugs that increase dig. toxicity:
1. Antibiotics
2. amninoglycosides (neomycin
3. Tetracyclin
4. Sulfa drugs
5. Antiacids
6.anti-diarrhea - kayoline, pectolyn - Classes of anti-arrhythmia drugs
-
Class 1A- depress myocardial excitability (ex. quinidine & procainamide)
Class1B -decrease cell automaticity (lidocaine)
Class II- betablockers (propranolol)
ClassIv - Ca channel blockers
(diltiazem, verapamil - Adverse side effects of anti-arrhythmics
-
1. Hi risk patient messing . strong drugs
2. Allergic reaction
3.V&D to constipation
4. Dry mouth
5.incoordination & Other CNS (aka ataxia
6.atrial or ventricular standstill
7. acute & cumulative toxcities -
What do Class 1A anti-arryth do
Examples -
Depress myocardial excitability
(slow down the heart rate)
1. quinidine - ventricular arrythmias, ventricular tachycardia, atrial fib.
2. procainamide - PVC, ventricular tachyc & some atrial tachycardia -
How do Class 1B anti-arryth work
Examples -
Decrease cell automaticity by blocking Na into cells to prevent depolaarization
Lidocaine allows the cells to relax so it can repolarize
Mostly for ventricular tachy & control PVC - What concern might the vet have when using lidocaine in cats
- Potentially sensitive to CNS effects - MONITOR
-
When might you use lidocaine w/ epinephrine
when not? -
1. as local anesthesia ONLY - constrict vessesls to slow bleeding & keep lidocaine the the area
NO EPI WITH HEART PROBLEMS - predisposes heart to arrythmias -
Action of Class II anti-arrhy
Example: -
beta-blockers, reduce automaticity by blocking receptor sites for electrical impulses
Slow down HR & BP & decrease cardiac output
Ex: Propranolog "Inderal" - Uses of Class II anti-arrythmia
-
1. hypertension
2. venricular or atrial arryth.
3. cats w/ systemic hypertension & hyperthyroidism - Who should NOT take Class II beta-blockers
- NOT for CHF
- Uses for propranolol
-
1. hypertrophic cardiomyopathy,
2. various atrial & ventricular arrhyth,
3.cats - hypertension & hyperthyroidism - Function of Class IV anti-arr
-
Ca channel blockers which depresses contractibility & reduces automaticity
IE slows the rate of contraction - What makes the heart contract & relax
- flow of ions
-
Uses of Class IV anti-arr
Examples of Class IV anti-arr -
1. tachycardia- esp ventricular
2. atrial fib in large dogs
Cardizem, Verapamil - When to use catecholamines
- 1. short term management of severe heart failure or anaphylaxis
- Examples of catecholamines
-
1. epi
2,dopamine { Emergency
3.dobutamine {
**doxapram - respiratory stimulant gives you time to deal with - Uses for epinephrine
-
1. anaphylaxix
2. cardiac resusciation
3. asthma
NOT FOR CHRONIC HEART FAILURE b/c increases workload of heart, thus increasing chances for arrhythmias -
Emergency catecholamine drugs
& how do they work
Limitations -
1. dopamine
2. dobutamine
1.Increase rate & force of contraction
2. Increase BP
Ltd to heart failure asso. w/ anesthetic emervencies or cardiac resus. - # types of diurectics
-
1. loop
2. osmotic
3. inhibit resorption of Na in Henle's loop - mainly maintenance - 3 examples of diurectics
-
1.Furosemide (lasix) "loop"
2.Thiazides (Diuril) - more sustained eft than lasix but less dramatic
3.Mannitol- osmotic - When to use a loop diuretic
-
Furosemide -
1.increases urine excretion
2. increases renal bloodflow to increase filtratin& output
A. relief of cardiac & pulmonary edema - When to use thiazides
-
Diuril - for maintenance
Use lasix to deal with large accumulations then switch for more maintenance - How does mannitol work
-
"osmotic" limits tubular resorption of H2O by exerting hi osmotic pressure on kidney tubules
Drasm fluid out of extracellular space into blood & out of system
1. head trauma
2. interocular pressures
3.cerebral edema
4. acute oliguric renal failure - How do vasodilators work
-
open constricted blood vessels in tx of CHF
dilate arteries,veins, or both - Ex of vasodilators
-
1. hydralazine
2. nitroglycerine ointment
3. ACE Inhibitors(Angiotension Converting Enzyes - Action of ACE Inhibitors
-
Blocks ACE from converting angiotension1 to angiotension II so less vaso constriction & more vessel dilation increasing blood flow
ACE is the enzyme that converts -
ACE Inhibitors are used in cases of
Examples -
CHF
Enacard, captopril - Side effects of ACE inhibitors
-
1. lethargy
2. ex intolerance
3. hypotension
4. azotemia (nitro uremia) - Most common side effects of drugs that cause vaso-dilation
- BP drops resulting in hypotension
- Most common diuretic drug for CHF
- furosemide