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pharmacology III

Terms

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treatment of nasal parasites
milbemycin (best for Eucoleus)
Ivermectin
selmectin
vomiting center is located in the ________
medulla of the brain
emetic drugs stimulate ___________
afferent input to the vomiting center
antiemetic drugs block _______
either afferent receptors or directly at the vomiting center
chemoreceptor trigger zone (CRTZ) is located _________________. This area does not have a ____________________. Neurons are responsive to _________
1)in the 3rd ventricle of the brain stem.
2)complete blood brain barrier
3)blood borne chemical compounds
specific receptors of the chemoreceptor trigger zone
dopamine
serotonin (5HT)
histamine
CRTZ is responsive to: (general)
certain drugs
uremic toxins
ammonia
endotoxins
emetic peripheral input
1.results from receptor stimulation due to irritation, distension or stretching
2.pharyngeal afferent (CN 9)
3.sympathetic and vagal afferents (CN 10). acetylcholine is major neurotransmitter. receptors are found in the heart or great vessels and abdominal organs and peritoneum
peripherally acting emetics
1.salt solution
2.3% hydrogen peroxide
3.ipecac syrup: contains an alkaloid emetine which works both through peripheral and central (CRTZ) stimulation
central acting emetics
1.apomorphine:stimulates dopaminergric receptors in the CRTZ. cats are not responsive to apomorphine
2.xylazine (rompun):alpha adenergic agonist drug generally used for sedation but also has emetic in cats, less so in dogs
antiemetics which act at the vestibular apparatus
1.antihistamines
2.scopolamine (belladonna alkaloids)
CRTZ antiemetics
1.phenothiazine:tranquilizers when given at low dose have a central antiemtic action). cosidered to be a broad spectrum antiemetic with actions at both CRTZ and vomiting center. Antihistaminergic effects. antidopaminergic effects. caution can cause alpha adenergic blockage and peripheral hypotension. may lower seizure threshold
2.Metoclopramide:anitdopaminergic effects
3.glucocorticoids (dex):unknown action possibly being synergic with other antiemetics
4.serotonin (5HT3) antagonists: used to block chemotherapy induced vomiting, ondansetron, delansetron, cyproheptadine
central antiemetics
1.phenobarbital
2.benzodiazepines (valium)
peripheral acitng antiemetics
1.anticholinergic drugs:block muscarinic receptors or peripherial cholinergic transmission to the vomiting center (vagal afferents). will also inhibit GI motility and secretion and thus may be contraindicated in some situations
2.protectants and prokinetics
3 pathways that stimulate gastric acid secretion
1.acetylcholine
2.gastrin
3.histamine (H2 receptors)
gastric antisecretory drugs
1.anticholinergics
2.H2 receptor antagonist
3.proton pump inhibitors
4.prostaglandin E2
H2 receptor antagonsists
are reversible and competitive reducing acid and pepsin secretion. drugs vary in potency and duration of action.
1.cimetidine
2.ranitidine
3.famotidine
4.nizatidine
specific facts about H2 receptor antagonists to remember
1.cimetidine will inhibit hepatic cytochrome P450 enzymes and can alter hepatic metabolism of other drugs
2.they have variable effect in preventing ulceration but rapidly promote healing of ulcers
3.have partial renal excretion and in renal failure dosage should be reduced (possibly as high as 50% original dose)
H2 receptor antagonsists uses
1.gastric ulcers
2.gastroesophageal reflux
3.gastroduodenal reflux
4.helicobacteria therapy
5.chronic gastritis
proton pump inhibitors
irreversible antagonists of the enzyme H+, K+ ATPase at the proton pump which is the final step in gastric acid secretion
1.greater potency than the H2 receptor antagonists
2.may alter hepatic metabolism of other drugs via cytochrome P450 enzymes
3.indicated when the H2 receptor blockers fail to reduce acid production
common antacids used in small animals
1.aluminum hydroxide:binds phosphates (for this reason often used in renal disease to lower blood phosphate concentrations)
2.Magnesium hydoxide
3.calcium carbonate
problems with antacid therapy
1. the vomiting patient
2. may absorb other drugs
3. may cause constipation
sucralfate
a sucrose aluminum hydroxide compound that binds to and protects the ulcer form damage thus acting like a surface band aid
Actions
1.surcose compound binds to damaged anions of GI epithelial membranes
2.inactivates acid, bile acids, and pepsin
3.stimulates formation of local prostaglandins
4.stimulates epidermal growth factors and may be a free radical scavenger
5.increases local mucosal blood flow.
will bind other drugs. if used with H2 receptor antagonists dosing bt drugs should be separated by several hours. also has protection for esophagitis, enteritis and colitis
prostaglandin E analogues
1.misoprostol is syntetic prostaglandin compound with antisecretory and cytoprotective actions. the drug effectively replaces local tissue prostaglandins
Actions:
1.inhibits HCL secretion
2.increases mucus and bicarbonate secretion
3.enhances gastric epithelial renewal
4.increases mucosal blood flow
major indication for use
1.prevention of NSAID associated gastric ulceration
cholinergic motor neuron gastic motility receptors
1.serotonin(5HT4) increases
2.motilin increases
3.dopamine decreases
metoclopramide
antidopaminergic agent that will block dopamine receptors of cholinergic nerves innervating smoooth muscle
actions:
1.increases tone of lower esophageal sphincter
2.increases gastric motility
3.opens pylorus
4.increases motility of duodenum
clinical uses:
1.gastroesophageal reflux
2.gastric hypomotility
3.duodunal gastric reflux
antiemetic at CRTZ
side effects:
systemic CNS associated side effects
cisapride
broad spectrum prokeinetic agent.causes direct stimulation of cholinergic nerves mediated through activation of serotonin (5HT4) receptors.
actions:
1.increases tone of lower esophageal shpincter
2.increases gastric, small and large intestine motility
(smooth muscle)
clinical uses:
1.gastroesophageal reflux
2.gastric hypomotility
3.feline megacolon
side effects:
1.none noted in dogs and cats
2.humans reported sudden cardiac death consequently the drug has recently been taken off the market-still available through veterinary compounding pharmacies
tegaserod
newer serotonin (5HT4) receptor agonist.
limited clinical experience to date with drug
increases gastric and colonic motility
erythromycin
antibiotic that also stimulates motilin receptors on cholinergic neuron.
low doses will stimulate GI motility
actions:
1.increases tone of lower esophageal sphincter
2.increases gastric motility
3.increases colonic motility in dogs but not cats
clinical uses:
1.gastroesophageal reflux
2.gastric hypomotility
3.canine constipation
side effects:
high doses can cause nausea and vomiting
pathophysiological mechanisms of diarrhea
1.secretory diarrhea
2.altered intestinal motility
3.osmotic diarrhea
4.increased intestinal permeability
anticholinergic agents for diarrhea treatment
Uses:
acute nonspecific diarrhea. main benefit of agents is related to ability to reduce intestinal secretions
drug examples:
1.atropine
2.aminopentamide
side effects:
1.dry mouth, urinary retention, constipation
2.do not use with invasive bacterial diarrheas
3.do not use longer than 3 days- prolonged use can result in marked GI hypomotility
opioids in diarrhea treatment
most common drug classification used for nonspecific diarrhea
actions:
1.increases segmentations of small instestine
2.decreases propulsive contractions (net effect is increased resistance to flow through GI tract)
3.increased fluid and water absorption
opoid drugs:
diphenoxylate
loperamide
sepcific facts:
1.diphenoxylate is a regulated narcotic
2.loperamide does not cross blood brain barrier and is not regulated and is available as an OTC drug
uses:
acute nonspecific diarrhea
intestinal protectants and adsorbents
1.kaolin and pectin
2.activated charcoal
3.bismuth subsalicyate
laxatives promote
soft formed stools
cathartics promote
fluid evacuation
emollient laxatives
1.lubrication or fecal softeners
2.are not absorbed
3.examples:
mineral oil
parafins-laxatone
anionic surfactants-DSS
bulk laxatives
1.hydrophilic compounds that adsorb water and swell forming an emollient gel. The bulking action increases colonic peristalitc activity
2. examples:
psyllium
wheat bran
osmotic cathartics
1.are salts or compounds that retain or attract water into the lumen via osmotic forces
2. agents are contraindiacated in the dehydrated patient
3.examples:
magnesium sulfate
sodium phsophates
lactulose
lactulose
osmotic cathartic
fermented by bacteria in the colon producing organic acids.
is used to treat hepatic encephalopathy: traps ammonia in colon preventing absorption. colonic acids produced from lactulose convert NH3 to NH4 that is poorly absorbed
irritant cathartics
1.colonic contact with irritant drug stimulates intestinal transit. exact mechanism of action is unclear
2.examples:
castor oil
bisacodyl-actions occur by altering smooth muscle motor activity of the large intestine
enema solutions
1.warm water
2.hypertonic saline solutions
3.phosphate containing solutions
a.phosphate salts will pull fluid and electorlytes into the colon
b.do not use in cats or debilitated animals
c.results in hyperphosphatemia, hypocalcemia and hypernatremia in cats that is often fatal
choleretic agents
drugs that stimulate bile flow
Ursodeoxycholic acid
bear bile
1.a synthetic bile acid that is hydrophilic and not toxic to liver cells
2.promotes increased bile secretion and flow via bile salt dependent mechansim
3.displaces more toxic bile acids
4.other hepatoprotective effects (antioxidants)
Indications:
cholestatic liver disease
patients having abnormal bile acid concentrations
toxicities:
none
copper chelators
1.drugs that bind hepatic copper and remove it through the urine.
2.certain liver diseases in dogs accumulate abnormal concentrations of copper that causes hepatotoxicity
3.indication- high hepatic copper concentrations are identified drugs:
penicallimine
syprine
antifibrotic agents
1.drugs that prevent formation of collagen or promote their removal from an organ
2.cirrhosis or other fibrosing liver diseases are often treated with antifibrotic agents
3.drugs:
colchicine
anit inflammatory agents also have antifibrotic effects because inflammation is the factor stimulates collagen deposition
s-adensoyl methionine
1.a nutraceutical compound that is reported to have hepatoprotective properties.
2.antioxidant function by replacing tissue glutathione concentrations
3.methyl donor improving lipid membrane fluidity
silymarin
a derrivative of milk thistle
1.shown to have antioxidant and hepatoprotective properties
2.sometimes used as an adjunct therapy however there are a few good controlled clinical studies in animals
antioxidants
there is a trend in veterinary medicine to use antioxidants in liver disease
vitamin E commonly used
zinc
often used in liver disease
1.antioxidant function
2.replaces zinc depletion
3.blocks intestinal copper absorption
appetite control
controlled primarily by the hypothalamus
several neurotransmitters are identified to control appetite
1.stimulatory
norepinepherine
dopamine
GABA-inhibit serotoin release
2.inhibitory:
serotonin
appetite stimulates
1.benzodiazepines (GABA effects)
2.cyproheptadine (serotonin antagonists)
3.other drugs that may effect appetite
a.megesterol acetate
b.corticosteroids
c.b vitamins
Neuropathic Pain:
spontaneous pain and hypersensitivity to pain in association with damage to or lesion of the nervous system
Functional Pain:
hypersensitivity to pain resulting from abnormal central processing of normal input
BDNF (Brain Derived Neurotrophic Factor; binds to TrkB receptor)
up regulated with inflammation, hypersensitization
NMDA Antagonists
Ketamine
Dextromethorphan
Memantine
Opioids
3 receptor subtypes
(all G-protein coupled receptors)
MOP (m) – enkephalins, b-endorphin, endomorphin
KOP (k) - dynorphin
DOP (d) - enkephalins
Opioid Receptors – Inhibit
Voltage-Gated Ca2+ Channels
Role of Serotonin (5HT)
Electrical stimulation of the RVM evokes release of 5HT
5HT applied directly to the dorsal horn blocks nociceptive transmission
Under normal conditions – slow tonic release
5HT release is regulated by behavioral state (level of alertness, sleep)
5HT1 Receptors Inhibit
Voltage-Gd ateCa2+ Channels
Clinically Useful 5HT Agonists
Sumatriptan
Zolmitriptan
Almotriptan
not effective at spinal cord level
a2 Receptors – Inhibit
Voltage-Gated Ca2+ Channels
The GABA-A Receptor
The GABA-A Receptor is a Chloride Channel
Expressed throughout the nervous system
GABA- major inhibitory neurotransmitter
Variety of drugs potentiate the effects of GABA on GABA-A receptors
Anesthetic induction agents (barbiturates, propofol, etomidate)
Benzodiazepines (valium, midazolam)
Inhalation agents (isoflurane, sevoflurane)
Clinically useful a2 adrenergic agonists
Medetomidine
Dexmedetomidine
Detomidine
Xylazine
a2 Adrenergic Receptors – Inhibit
Voltage-Gated Ca2+ Channels
Morphine receptors act largely through presynaptic voltage-gated
Ca2+ channels
a2 adrenergics act largely through
postsynaptic GIRK channels
Mechanisms of Peripheral Sensitization
Tissue injury: release of inflammatory mediators: Bradykinin, ATP, 5-HT Prostaglandin E2, and NGF


Release of substance P and CGRP further activates inflammatory cells and potentiates the inflammatory “soup”
5Cs of addiction
1.chronic disease
2.impaired control
3.compulsive use
4.continued use despite harm
5.craving
loss of sensitvity to pain, may completely elimate the sensation of pain or may simply improve the patients' ability to cope with pain
analgesia
total loss of sensation in a body part or in the whole body, generally induced by a drug or drugs that depress the activity of nervous tissue either locally or generally
anesthesia
general anesthesia: loss of consciousness in addition to the loss of sensation; ideally includes ________, _________, __________, ________, and _________
amnesia
hypnosis
hyporeflexia
analgesia
muscle relaxation
term derived form the greek term for stupor and was used to denote any drug that induced sleep. It is often used in legal context to refer to a variety of substances with abuse or addictive potential
narcotic
opioid
broadly refers to all compounds related to opium
opiates
substances derived from the opium poppy that have analgesic properties and include natural (morphine), semi-synthetic compounds (codeine, thebaine, heroin), and synthetic compounds (methadone, pentazocine, meperidine, fentanyl
physical dependence
a biological phenomenon and is the state that develops as a result of the adaptation (tolerance) produced by repeated drug administration and is produced by the resetting of homeostatic mechanisms. a patient in this altered state requires continued administration of the drug to maintain normal function
any chemical substance naturallly formed in the body that exhibits pharmacological properties of morphine
endorphin
opiate receptors
Mu, delta, kappa currently reffered to as MOP DOP and KOP. a fourth opioid peptide receptor termed nociceptin/orphanin FQ was coloned in 1994. It appears to play impotant roles in the hippocampus, cortex and numerous sensory sites and have effects on drug reward and reinforcement, stress responsiveness, learning and memory processes
pro opiomelanocortin- derived peptides
beta endorphin; the most potent of the natural opioids. Is a precursor for ACTH and melanocyte stimulating hormone. distributed primarily in the anterior and intermediate lobes of the pituitary gland. Modulating/hormonal effect on the CNS. stimulates mu receptors primarily and delta receptors to a lesser extent. mediates analgesia
pro enkephalin derived peptides
met-enkephalin and Leu-enkephalin. widely distributed throughout the CNS.
have a short acting, neurotransmitter function and stimulate delta receptors and mediate analgesia
CNS areas related to the perception of pain
laminae I and II of the spinal cord.
spinal trigeminal nucleus
periaqueductal gray
pro dynorphin-derived peptides
dynorphin. widley distributed thoughout the CNS. similar distribution as pro enkaephalin. dynorphin stimulates the kappa receptor- mediates spinal analgesia, possibly dysphoria
binding of opioids to receptors stimulates a cascade of intracellular events, leading to
the hyperpolariztion of cell membranes, decrease in nociceptive neurotransmitter release, and inhibition of the nociceptive pathways
affinity
a drug's ability to bind to its receptor sites in the body. for example, buprenophine has a high affinity for mu-opiate recetors and is difficult to antagonize with an opioid antagonist such as naloxone
opioid potency
is directly related to the affinity of the drug for opiate receptor sites. clinically, potency is used to determine the dose of a given opioid, but does not indicate the ability of the drug to provide analgesia
how do opioids cause respiratory depression
rerduction in the responsiveness of the brainstem respiratory centers to carbon dioxide, and opioids depress the pontine and meduallary centers involved in regulating respiratory rhythmicity
do opioids cause miosis or mydriasis
they casue miosis in the dog, rabbit, rat, and human. cause mydriasis in the monkey, cat, sheep, and horse
T/F opioids are not contraindicated in animals with a history of seizures
T. opioids may cause convulsions at excessively high doses (overdose). Morphine like drugs excite hippocampal cells, possibly due to inhibition of GABA by inhibitory interneurons
opioids and vasodilation
vasodilation is generally a result of morphine or meperidine induced histamine release. Histamine release can occur with hdromorphone, but clinically appears to be minimal. vasodilation may also occur as a result of pain relieve and withdrawal of sympathetic tone
why would you consider avoiding morphine in dogs with pancreatitis
in dogs morphine can induce contraction of the sphincter of Oddi, resulting in an inhibition of pancreatic secretions and abdominal pain
What speices of animal is the constipating effects of morphine a serious concern
horses
epidural morphine in dogs and cats may cause retention of urine for a period of __________
24 hours or more
which type of opioids should not be used during sedation/anesthesia for skin allergy testing.
ones that have histamine releasing effects:
morphine, meperidine
tramadol
is a syntheically derived analgesic that possesses weak mu-opioid activity and inhibits norepineprine and serotonin re-uptake. Not a controlled drug
phenothiazines
tranquilizers
examples:
acepromazine
chlorpromazine
promazine
what is the significance of hepatic metabolism and urinary excretion of phenothiazines
aged individuals and those with liver disease may have a prolonged duration of effect
The calming effects of phenothiazines are enhanced with the concurrent administration of
opioids or alpha 2 agonsits
do phenothiazines provide analgesia
No, but are givin freuently in combination with opioids to provide analgesia
What is the significance of hepatic metabolism and urinary excretion or phenothiazines
aged indivdiuals and those with liver disease may have a prolonged duration of effect
Do pheonthiazines have an analgesic effect
No, but are frequently administered in combination with opioids to provide analgesia
decreased motor activity of phenothiazines is assoicated with ataxia in horses givin ________ but not _________
chlorpromazine
acepromazine
cardiopulmonary effects of phenothiazines
vasodilation
systemic hypotension
reflex tachycardia
central mediated bradycardia (uncommon side effect)
anti-arrhythmic effect
respiratory depression (minimal)
Why do you avoid use of phenothiazines when skin testing for allergies
they have an anti-histaminic effect
what side effect can phenothiazines produce in the eye
nictitating membrane prolapse
Why are phenothiazines sometimes avoided in stallions
may cause erection and temporary or permanent prolapse of the penis
phenothaizines inhibit the function of what type of cells in the blood
platelets
butyrophenones
similar to phenothiazines
minimal use in veterinary medicine
alhpa 2 agonists mechanism of action
stimulation of presynaptic alpha 2 adrenoceptors (G-protein linked receptors). Stimulation of central alpha 2 adrenoceptors decreases the release of norepinephrine decreased syaptheric outflow. alpha 2 adrenoceptors subtypes may play a role in specific effects observed with various alpha 2 agonists. stimulation of alpha 1 adrenoceptors (central and peripheral). central parasympathomimetic effect. Muscle relaxation- inhibition of interneuronal transmission of impulses in the CNS. local anesthetic effect- xylazine as a membrane stabilizing effect which is most evident when xylazine is administered via the epidural route. This effect is not as profound as with local anesthetic drugs.
alpha 2 agonists CNS effects
sedation-may be profound, can be overridden with sufficient stimulation, enhanced with concurrent opioid administration; markedly decreases the dose of anestheic induction and maintenance drugs.
Analgesia- profound analgesic effect, particularly for visceral pain, analgesia not antagonized by naloxone.
Analgesia enhanced by opioid administration.
Muscle relaxation.
Uncommon CNS effects: aggression, transient excitemment, aggression
alpha 2 agonist cardiac effects
marked negative cadiovascular effects are possible, negative effects greatest with IV administration.
Hypertension(transient) alpha 1 and 2 mediated peripheral pressor effect.
Bradycardia and brady-arrhythmias (central vagal effect).
Xylazine sensitizes the myocardium to epinephrine- induced arrhythmias.
decreased cardiac output (by 30 to 50%)
Hypotension (decreased sympathetic output, decreased cardiac output)
alpha 2 agonist respiratory effects
mild to moderate respiratory depression.
depress respiratory center centrally- decreased sensitivity and increased threshold to carbon dioxide.
May induce stridor and dyspnea in horses and brachycephalic dogs with upper airway obstruction (relaxation of upper airway).
Sheep- IV xylazine may induce pulmonary edema secondary to alterations in the alveolar- capillary membrane
GI, endocrine, temp regulation effects of alpha 2 agonist
emesis (dog, cats)-stimulation of chemoreceptor trigger zone
decreased GI motility.
depressed swallowing reflex
suppresses insulin release by stimulating presynaptic alpha 2 receptor in the pancreas- increased plasma glucose- glucosuria.
Inhibition of ADH release- diuresis.
Temperature regulation- variable effects (hyperthermia, hypothermia)
Ataxia (horses)
increased uterine tone (oxytocin-like effect) in ruminants
alpha 2 antagonist safety and side effects
safe but deaths have been reported following rapid IV administration
side effects:
prfound hypotension
reflex tachycardia
excitement/pain
yohimbine
alpha 2 antagonist
60x more selective for a2 than a1
enhances release of excitatory neurotransmitters (norepinephrine)
may induce anxiety, pacing, and panting in dogs, rough recoveries in aany species
tolazoline
alpha 2 antagonist
least specific of a2 antagonsits
-in osme cases, may be more effective and provide a smoother recovery form xylazine than yohimbine
potent H2 receptor agonsit- the significance of this effect in veterinary species is unclear
immediate and delayed deaths have occurred in llamas administered tolazoline
atipamezole
alpha 2 antagonist
most specific and most effective a2 antagonist
no appreciable effects at other receptors
4 types of pain
nociceptive
inflammatory
neuropathic
functional
adaptive pain
nociceptive
inflammatory
maladaptive pain
neuropathic
functional
in the modes of the dorsal horn mode 2 ________ and mode 3 ________
suppresses pain
sensities pain
Aspirin
1.cox1
2.cox2
3.class
4.other
1.++++
2.++++
3.Salicylic acid
4.inhibits platelets/irreverable
Flunixin and meglumine
1.cox1
2.cox2
3.class
1.++++
2.++++
3.Fenamic acid
Ketoprofen
1.cox1
2.cox2
3.class
1.+++
2.+++
3.Proprionic
acid
Carprofen
1.cox1
2.cox2
3.class
1.++
2.+++
3.Proprionic
acid
Meloxicam
1.cox1
2.cox2
3.class
1.++
2.+++
3.Enolic acid
Phenylbutazone
1.cox1
2.cox2
3.class
1.+++
2.+++
3.Enolic acid
Deracoxib
1.cox1
2.cox2
3.class
1.++
2.++++
3.Coxib
Firocoxib
1.cox1
2.cox2
3.class
1.+
2.++++
3.Coxib
Tepoxalin
1.cox1
2.cox2
3.class
1.++++
2.++++
3.lox
Side Effects of NSAIDs
Gastrointestinal ulceration and intolerance
Inhibit platelet aggregation
Inhibition of prostaglandin-mediated renal function (especially in patients with decreased renal blood flow)
Na+ and H20 retention; antagonizes effects of ACE inhibitors
DO NOT USE WITH STEROIDS
mucopurulent rhinitis
primary and secondary bacterial speices
primary:
1.bordetella bronchiseptica
2.chlamydophila felis (cat only)
3.mycoplasma spp.
4.bartonella spp.??
secondary:
1.pasteurella
2.staphylococcus
3.sreptococcus
4.anaerobes
bacterial rhinitis
first choice and rescue drugs
first choice:
1.doxycyline
2.clindamycin
3.penicillins
rescue drugs:
1.fluoroquinoiones
2.azithromycin
bacterial rhinitis
treatment with doxycyline
gets all primary pathogens
-bordetella, mycoplasma, chlamydophila, bartonella
antiinflammatory
once daily
bacterial rhinitis treatment with clindamycin
mycoplasma
gram +
anaerobes
great for flora
great for bone
once daily
bacterial rhinitis treatment with clavamox
bordetella
chlamydophilla
gram+
anaerobes
some gram-
bacterial rhinitis treatment with quinolones
gram-
mycoplasma
some gram+
poor anaerobic effect
resistant infections only
respiratory infections treatment with azithromycin
gram+
anaerobes
mycoplasma
bordetella
some gram-
T. gondi
canine viral rhinitis
organisms and treatment
parainfluenza
k9 flu
adenovirus 2
distemper
herpesvirus
acute disease supportive care
feline viral rhinitis organims and treatment
feline herpesvirus 1: rhinitis and ocular disease
treatment lysine, famcyclovir, interferons topical vaccine
calicivirus: rhintitis and stomatitis
treatment: interferons, topical vaccine
nasal aspergillosis treatment
clotrimazole 1%
bilateral instilation
multiple head postions
1 hour treatment time
fungal drugs static and cidal
static
itracnazole
fluconazole
ketaconazole
cidal:
amphotericin B
cryptococcus treatment
fluconazole
28/29 cats responed
itracnazole
16/28 responded
ketoconazole
9/26 responded most toxic
systemic fungi treatment
amphotericin B
bacterial bronchitis treatment
Quinolones
azithromycin
bladder sphincter incompetence
diethylstlbesterol
testosterone cypionate
phenylpropanolamine
refractory incontinence
combination DES/PPA
urethral injection
surgical procedures
sphincter hypertonicity
phenoxybenamine:
smooth muscle
alapha antagonist
hypotension
skeletal muscle:
diazepam
detrusor atony
bethanochol
cisapride
detrusor hyperactivity
oxybutynin
propantheline
substance P
1.inhibitory or excitatory
2.receptor
3.drug example
1.excitatory
2.NK1
3.experimental
Enkephalin, dynorphin, endorphins
1.inhibitory or excitatory
2.receptor
3.drug example
1.inhibitory
2.MOP, DOP, KOP
3.morphine, fentanyl, butorphanol ect.
serotonin (5HT)
1.inhibitory or excitatory
2.receptor
3.drug example
1.inhibitory
2.5HT1
3.sumatriptan
noradrenaline
1.inhibitory or excitatory
2.receptor
3.drug example
1.inhibitory
2.alpha 2
3.medetomidine, xylazine
glutamate, aspartate
1.inhibitory or excitatory
2.receptor
3.drug example
1.excitatory
2.AMPA,NMDA, Kainate
3.ketamine
GABA
1.inhibitory or excitatory
2.receptor
3.drug example
1.inhibitory
2.GABA-A
3.barbiturates, propofol, etomidate, isoflurane, sevoflurane
morphine
1.receptor
2.potency
1.full mu agonist
2.1
methadone
1.receptor
2.potency
1.full mu agonist
2.1-1.5
hydromorphone
1.receptor
2.potency
1.full mu agonist
2.5-10
oxymorphone
1.receptor
2.potency
1.full mu agonist
2.10
fentanyl
1.receptor
2.potency
1.full mu agonist
2.100
buprenorphine
1.receptor
2.potency
1.partial mu agonist
2.30
butorphanol
1.receptor
2.potency
1.kappa agonist and mu antagonist
2.5-10
nalbuphine
1.receptor
2.potency
1.kapp agonist and mu antagonist
2.1
naloxone
1.receptor
2.potency
1.mu antagonist
2.0
tramadol
1.receptor
2.potency
1.weak mu antagonist
2.0.1

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