87 terms

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)