Transcript Common Equine Medications and Their Effects

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
• NSAIDs
(Non-steroidal Antiinflammatories)
• Antibiotics
• Gastroprotectants
• Topicals
• Miscellaneous
Talking Points
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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
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PO = Per Os = Orally
IV = Intravascularly
IM = Intramuscularly
PR = Per rectum = enough said
Sedatives
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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)
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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)
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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)
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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)
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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
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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
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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
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“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
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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)
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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?