Exotics Final L30 Pharmacotherapeutics

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T/F there are lots of pharmacokinetic studies in small mammals.

False (dosages based on empiracle data, observations, and experience.

Drug uptake depends on 6:

age
sex
physiology
diet
disease status
etc

T/F Most drugs in small mammals are extra label.

True (very few approved by FDA)

What permits drugs to be used on animals other than those approved?

AMDUCA

What should you obtain before administering drugs?

accurate body weight

What is the preferred way to administer most medications, especially by clients?

Per Os

What may be preferable to pills?

-crushing pills in palatable food (bananas etc)
-liquid form

T/F Liquid form is suitable for all drugs.

False (not for many abx --> dysbiosis)

Use and drawback of meds in drinking water?

use: commercially kept large populations
drawback: undesirable taste or sick animals adipsic

What is the preferred perenteral route of drugs?

Subcutaneous (easy, minimal stress, use interscapular area)

Which drugs should you be careful with subcutaneously?

Necrotizing drugs eg enrofloxacin that may cause skin slough (dilute with saline to help)

What is the intramuscular site preferred? Why?

Deep in quadriceps or lumbar
-caudal thigh injection may result in nerve paralysis

Enro - subcutaneous injection, what should you consider?

necotizing --> may cause skin slough. dilute with saline

Should you inject in the caudal thigh muscles?

no, may result in nerve paralysis

What limits the intramuscular sites?

small mass of the animal

Compounding is useful for trying to medicate via which route?

PO

Is compounding easy? what must be considered?

No, challenging
Very few approved meds
Legal & ehtical issues

Compounding must be in compliance with established ____. Done by order of a ___ ___ within a valid ____ and from approved ____ or ____ drugs.

laws
licenced vet
vcpr
human or animal drugs

Does compounding require a prescription?

Yes!

When compounding one should be aware of incompatibilities between ____ and ____ ingredients.

active & inactive

Which weird flavors do rabbits like?

carrot, banana creme, vanilla butternut, lettuce, pineapple, strawberry.

What are the most commonly used meds in small mammal medicine?

Antibiotics

Are there lots of pharmacokinetic studies? how are dosages based?

no, lack pharmacokinetic studies
dosages are impircal

Rodents are _____ (omnivores, carnivores, herbivores) and have gram ____ (+/-) and _____ (aerobic/anaerobic) intestinal micorflora.

herbivores
gram +
anaerobic

What do antibiotics cause in rodents?

dysbiosis
suppress healthy gi flora

What does PLACE stand for rodent drugs? T? G?

Penicillin
lincomycin
amoxy/+/- clavamox, ampicillin
cephalasporins, clindamycin
erythromycin
(maybe also tms, tet, tylosin, gent)

What route of abx is often contraindicated in rodents?

oral - dysbiosis

What abx can be used in rodents?

penicillin, occasionally

What should you look for when giving abx to rodents?

signs of dysbiosis

Which abx are safe for rodents?

CFMs
chloramphenicol
fluroquinolones
metronidazole
sulfonamides

T/F Many abx have been evaluated for effictiveness.

False (unfortunately need to rely on empiric data)

Factors to consider for appropriate abx:
Patients ___/____ condition
____ ____ involved
Patients ___ & _____ status

clinical/pathologic condition
organ system involved
nutritional & hydrastion status

What bacterial and ab properties should be considered when selecting an appropriate abx?

culture & sensitivity
bacteriostatic vs cidal
MIC of pathogen

Further considerations in choosing an abx
Administraiton ___ and____
Potential ___ ____
Owner ____.

Dose & rate administration
Potential advese effects
Owner compliance

Which 5 drugs did we get dosages for that we don't have to know?

MET-2C
Metronidazole
Enrofloxacin
TMS
chloramphenicol/ciprofloxacin

What unique disgusting ability do rabbits have?

can produce granulomatous abscesses

Are rabbit abscesses treatable with antibiotics alone?

No, require excision and antimicrobial therapy.

Which antibiotics are inappropriate in rodents (gram what)? what do they cause?

Gram pos
enteritis and abx associated clostridial enterotoxemia

Which route is worst for inappropriate abx? which species most susceptible?

PO
chinchillas, gpigs, hamsters

Streptomycin is toxic to which?

gerbils, gpigs, hamsters, mice

Who is procaine toxic to?

mice & gpigs

High doses of chloramphenicol and aminoglycosides ar toxic to?

gpigs
chinchillas

What should you not give chinchillas?

high dose chloramphicol or aminoglycoside
gram pos abx per os

What should you not give g pigs

high dose chloramphenicol or aminoglycoside
procine
streptomycin
po gram pos abx

what should you not give to mice

procaine
streptomycin

What should you not give to hamsters?

streptomycin
po gram pos abx

Which abx can cause clostridial enterotoxemia? SPEL Ct

streptomycin
pens (incl ampicillin, amoxycillin)
erythromycin
lincomycin
cephalosplorins, clindamycin
tylosin
(others)

Why do small mammals now need pain relief?

they are considered part of the family unit

What are indications for analgesia in small mammals?

-post surgical/post-trauma/chronic pain
-reduce stress & promote healing
-results in smoother recoveries
-pre-emptive analgesia may reduce need for analgesics post-op

Is pain assessment of small mammals easy?

No, requires knowledge of behavior

What are signs of pain?

-subtle changes in activity level
-shift body position
-vocalizing
-bruxism
-hypersalivation
-dec appetitie
-lack of grooming

Which animals are at the bottom of the food chain? how does this affect their pain?

rabbits & rodents
-pain signs are subtle

What 2 groups of analgesics are used together or alone for pain?

opiates
NSAIDs

Which opioids are used in small mammals?

buprenorphine & butorphanol
(meperidine, morphine oxymorphone)

What nsaids are used in small mammals?

carprofen, ketoprofen, meloxicam

T/F Opioids only affect central pain alleviation.

False (central & peripheral)

What are 3 properties that make opioids desirable?

efficacious, safe, reversible

Which is the most important opioid receptor for pain control?

mu

What are 2 major side effects for opioids?

sedation
respiratory depression

T/F the effects on bp are consistent.

False (hypotension in ferrets & rats, hypertension in rabbits and mice)

What might opioids cause in all animals, hint GI?

ileus

Which opiods are most commonly used in small mammals? why?

butorphanol and buprenorphine
-synthetic opiate partial antagnoists
-minimal resp effects, no cns depression

Why are butorphanol and buprenorphine frequently used in small animal medicine?

minimal resp effects and no significant CNS depression

Which receptors does buptorphanol work on?

kappa and sigma

T/F butorphanol is less potent than morphine.

False (more)

In comparison to buprenorphine, butorphanol has a ____ onset and ____ duration. (fast/slow, long/short)

faster onset
shorter duration
(butorphanol = fast quick high)

What side effect does butorphanol have in ferrets? What can help?

profound sedation (use lower doses)

Buprenorphine action on which receptors?

mu

Is buprenorphine long or short acting? why?

long
lots of mu receptors in body

Buprenorphine is ___ potent than morphine.

More

T/F buprenorphine has several adverse effects.

False (few, rarely resp depression)

Buprenorphine is a partial ___ agonist and a ___antagonist, does it have the same action or different as opiate agnostis?

partial mu
kappa antagnoist
Same

T/F Nsaids are increasingly used in exotic small mammals.

True

What can NSAIDs help with in small mammals?

pain from inflammation eg arthritis, dental dz

Are nsaids safe? labeled for small mammals?

little info on safety
off-label use

What side effects do NSAIDs have?

gastric ulcers
-vomiting, anorexia, depression, diarrhea
-less common: gi ulcers, renal failure, hepatic failure, death

What can sucralfate be used for with NSAIDs

gastric ulcers

What should you do to prevent NSAIDs s/e?

-history, PE
-serum biochem
-Avoid use of other nsaids or steroids
-ensure hydration

What are 2 things you can do to prevent NSAID s/e

-ensure hydration
do not dose multiple nsaids or nsaids w/steroids

T/F It is ok to give nsaids and steroids together.

FALSE (not 2 nsaids either)

What 4 nsaids are used in small mammals?

meloxicam (metacam)
carprofen (rimadyl)
ketoprofen
flunixin meglumine (no more than 3 days) (banamine)

T/F Rabbits are ok with corticosteroids.

False (sensitivity to them - immune suppresion and liver toxicity)

T/F it is ok to give rabbits corticosteroids once.

False (even 1-time doses, topicla or opthalmic can cause GI ulceration and immunosuppresion.)

What hepatic changes are seen with rabbits on steroids?

lipid deposits, glycogen deposition

Can you ever give corticosteroids to a rabbit?

yes, with extremem caution and concurrent gastric protectant.

Do you give steroids to rabbits for derm issues?

no (only head trauma or shock)

T/F it is generally ok to use corticosteroids for head trauma and shock in small mammals.

False (controversial)

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