Isoxsuprine Controlled Release Formulation

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Isoxsuprine Controlled Release Formulation Powered By Docstoc
					Common Equine Medications
    and Their Effects
     Matt Kornatowski, DVM
           My Perspective
• Many questions about drugs
• Misconceptions
• Reasons for choosing
  certain drugs
• Safety for you and your horse
                         Outline
• Sedatives                  • Topicals
• NSAIDs                     • Miscellaneous
  (Non-steroidal Anti-
  inflammatories)
• Antibiotics
• Gastroprotectants
              Talking Points

•   Appearance
•   Uses
•   Administration routes
•   Side Effects
          Non-Talking Points
• Doses
• Steroids (Too much)
• Reproduction drugs
  – Dr. Stanford’s talks
• Dewormers
  – A whole different talk!
• Supplements
• Controlled drugs
              Abbreviations
•   PO = Per Os = Orally
•   IV = Intravascularly
•   IM = Intramuscularly
•   PR = Per rectum = enough said
               Sedatives
•   Acepromazine
•   Detomidine
•   Romifidine
•   Xylazine
•   Use caution!
                Acepromazine
                   (Ace)
• Affects dopamine receptors
• Light yellow appearance
  Oral tablets/paste
• Used for mild calming effect
  – Not strong analgesic/sedative
• Given PO, IM, IV
• Lasts 3-4 hrs
• Side effects: Sedation, ataxia, hypotension,
  – persistent penile prolapse (paraphimosis)
              Detomidine
          (Dormosedan, Dorm)
• Alpha 2 agonist
• Clear in appearance
• Used for heavy sedation, mild
  analgesia
  – Dentals, wound repair, etc
• Given IM, IV
• Lasts 45 min – 1 hr
• Side effects: Ataxia, swaying, diuresis
  – Occasional hyperresponsiveness
  – Rarely recumbency
     • Reversal agents
                Romifidine
                (Sedivet)
• Alpha 2 agonist
• Clear in appearance
• Used for moderate sedation
  – Wound repairs, oral exams
• Given IM, IV
• Lasts 1 – 1 ½ hrs
• Side effects: Ataxia, sweating
  – Rarely facial edema
                   Xylazine
                  (Rompun)
•   Alpha 2 agonist
•   Clear in color, shortest acting
•   Used for mild sedation, mild analgesia
•   Given IM, IV
•   Lasts app. 30 min
•   Effects: Sedation, mild analgesia
    – Occasional hyper-responsiveness
             NSAIDs
(Non-Steroidal Anti-Inflammatories)
•   Phenylbutazone
•   Banamine
•   Firocoxib
•   Aspirin
•   Piroxicam
•   Meloxicam
             NSAIDs
(Non-Steroidal Anti-Inflammatories)
               Phenylbutazone
                   (Bute)
• Large white tablets, white paste, flavored powder
• Used for musculoskeletal pain
  – Mild anti-pyretic effect
• Given PO, IV
• Lasts 12-24 hrs
• Side effects: GI ulceration (high dose)
  – Renal papillary necrosis (dehydration)
  – Bone marrow suppression (anemia)
     • Long term use
  – IM injections cause tissue necrosis (death)
  – Use caution in pregnant mares
     • “Bute Babies”
            Flunixin Meglumine
                (Banamine)
•   White paste, clear liquid
•   Used for GI pain, fever reduction
•   Given PO, IV, (IM??)
•   Lasts 12 hrs
•   Side effects: GI ulceration
    – Renal ischemia (papillary necrosis)
                      AND….
Clostridial Myositis
 Result of IM injections
                Aspirin
• White powder
• Used for hypercoagulable states, Equine
  Recurrent Uveitis
• Given PO
• Side Effects: Same as above (less
  common), platelet inhibition,
  tinnitus (overdose)
                  Firocoxib
             (Equioxx, Previcox)
•   Cox 2 specific
•   Used for musculoskeletal pain
•   Given PO
•   Lasts 24 hrs
•   Side effects: Less common but similar to
    other NSAIDS
    – GI ulceration, renal injury, oral erosions
                Piroxicam
•   Cox 1
•   Used for Squamous Cell Carcinoma
•   Given PO, IV (less common)
•   Side effects: Same as above
       Meloxicam (Metacam)
• Cox 2 specific, considered quite safe
• Used in Europe
• Coming soon??
                 Antibiotics
•   SMZs
•   Penicillin G
•   Gentamicin
•   Ceftiofur
•   Doxycycline
•   Metronidazole
•   Enrofloxacin
•   Chloramphenicol
                   Resistance
• When a microorganism has
  the ability of withstanding the
  effects of antibiotics
   – Genetic mutation within the
     bacteria
• Due to overuse or improper use
   – underdosing
• Multi-drug resistant superbugs
   – MRSA (Methicillin Resistant Staph. Aureus)
                      SMZs
• Trimethaprim Sulfadiazine (Veterinary)
  – SMZs, Uniprim, Tucoprim
• Trimethoprim Sulfamethoxazole (Human)
  – Tribrissen
• 160 mg Trimethoprim
• 800 mg Sulfa
• Main difference:
  – Urine concentration
  – Metabolization
                     SMZs
• Paste, powder, white tablets
• Given PO, IV (Rare)
• Used for variety of infections
  – Mainly skin, uterine, urinary
• Side effects: Colitis,
  Anemia (long term)
                       Penicillin G
• “G” = Gold Standard
• White liquid
• Limited spectrum of activity
• Used commonly for
  Staphylococcus/Streptococcus
  - Skin, “strangles”
• Given IM only!
    – Other forms of penicillin can be given IV
• Side effects: Soft tissue reaction, Allergic reaction,
  anemia (long term use)
                    Gentamicin
                    (Gentocin)
• Clear liquid, ophthalmic
  ointment
• Synergistic with penicillin
   – Gentomicin is poor against
     Streptococcus
• Given IV, IM, Ocular
• Side effects: Nephrotoxic (Kidneys)
   – Rare ototoxicity (ears)
   – Neurotoxicity
                 Ceftiofur
             (Naxcel, Excede)
• White powder reconstituted
  to yellow liquid
• Excede is brown, thick liquid
• Used for respiratory infections,
   internal disease, surgery
• Given IV, IM (Excede IM ONLY)
• Side effects: Colitis & anemia (high doses)
               Doxycycline
• Small, orange tablets
• Used for various issues
  – Penetrates tissues very well
• Given PO
  – Oxytetracycline given IV
• Side effects: Congenital malformations
     • GI disruption
     • Relatively safe
              Metronidazole
                (Flagyl)
• Oblong white tablets
• Used for diarrhea, thrush,
  canker (anaerobic infections)
• Given PO, PR, topically
• Side effects:
  – Neurotoxicity (rare)
  – Disruption of GI protozoa
               Enrofloxacin
                 (Baytril)
• Liquid or oral paste
• Used for variety of infections
  – Less resistance
• Given PO, IV
• Side effects: Colitis
  Neurotoxicity
  Tissue irritation (Oral lesions)
  Cartilage damage in young
              Chloramphenicol
• Yellow pills, oral liquid, eye ointment
• Used for variety of infections
   – “Big gun” antibiotic
• Given PO, IV, Ocular
• Side effects: Diarrhea, inappetance
  bone marrow suppression
  Relatively safe
• Aplastic anemia in humans
   – Wear gloves!
         Gastroprotectants

• Gastrogard
• Ulcergard
• Ranitidine
              Omeprazole
         (Gastrogard/Ulcergard)
• Oral, white paste
• Treat/prevent
  gastric ulcers
• Proton pump inhibitor
  – Decreases acid secretion
• Given PO
• Side Effects:
  – No adverse effects listed
                 Ranitidine
                 (Zantac)
• Small, circular yellow or white tablets
• Treat gastric ulcers
• Inhibits H2 receptors
  – Decreases acid secretion
• Given PO, IV
• Side effects: Very rare
                   Topicals
•   Triple Antibiotic Ointment
•   Silver Sulfadiazine
•   Furazone
•   Surpass
•   DMSO
    Triple Antibiotic Ointment
(Neomycin, Polymyxin, Bacitracin)
• Clear gel comprised of 3 antibiotics
• Topical antibiotic
• Used for variety of issues
  – Eye ulcers (Ophthalmic),
    wounds, mild to moderate
    skin infections
• Side effects: Contact dermatitis
           Silver Sulfadiazine
                  (SSD)

• Thick, white cream
• Anti-bacterial, anti-fungal
• Used for burns, eye ulcers,
  wounds
• Side Effects: Skin irritation
                Nitrofurazone
                 (Furazone)
• Yellow gel
  – Can be mixed with DMSO
• Antibacterial
• Good for burns, skin infections
  – Scratches
• Side effects:
  – Contact dermatitis
  – Renal impairment
                   Diclofenac
                   (Surpass)
•   White gel
•   Topical NSAID (Non-specific Cox 1 & 2)
•   Control of joint pain & inflammation
•   Side effects:
    – Well tolerated
    – Dermatitis (Let dry)
    – Possible weight loss,
      gastric ulcers, diarrhea
                 DMSO
          (Di-Methyl Sulf-Oxide)
• Clear gel
• “Topical application to reduce
  acute swelling due to trauma”
   – Used in many other ways
• Topical carrier agent
  – Some anti-inflammatory
    properties
• Side effects: “Burning” (erythema)
  – Garlic odor
  – Relatively safe
  – Teratogenic properties in humans (Gloves!)
        Miscellaneus Meds

• Pergolide
• Isoxsuprine
• Marquis
                Pergolide
• Dopamine agonist
  – Decreases release of
    certain proteins
• Used to treat
  Cushing’s Disease
• Side effects: Few (Well tolerated)
  – In humans: Neuroses (hallucinations),
    nausea, vomiting, rhinitis
               Isoxsuprine
• White tablets
• Used for laminitis & navicular
  – Dilates blood vessels
  – Questionable efficacy
• Given PO
• Side effects: Unlikely
  – Tachycardia, hypotension
  – Hyperexcitability
                     Ponazuril
                     (Marquis)
• Paste formulation
• EPM treatment ONLY
  – Equine Protozoal Myelitis
  – Anti-protozoal
  – Affects organelle specific to
    protozoa!
• Given PO
• Side effects:
  – At 10x the dose, some soft manure
  – Very safe!
                 Key Points
• Sedatives
  – Ataxia, sweating, urination
• NSAIDs
  – Gastric ulcers, kidney problems
• Antibiotics
  – Resistance
  – Potentially cause colitis
• Call your vet before administering any
  drugs!
Questions?

				
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posted:2/23/2011
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