drug index.docx

VPHM 142
Drug Index
Anne Simonne R. Gayongan
ANTI-INFLAMMATORY DRUGS
1st generation Antihistamines
MOA: act as inverse agonists of histamine, resulting to reversible, competitive inhibition of H1 action; with cholinergic and CNS activity
Drug Indication Precaution Possible side effects Contraindication
Chlorpheniramine
maleate
allergic reactions,
pruritus
Use with caution in patients with narrow
angle glaucoma, hypertension, GI or
urinary obstruction, hypertension,
hyperthyroidism, cardiovascular disease
Moderate sedation, GI effects,
paradoxical excitement (cats)
Hypersensitivity to
other antihistamines
Diphenhydramine
HCl
allergic reactions,
motion sickness,
sedation, vomiting,
aseptic laminitis
(cattle),
pancreatitis (cats,
adjunctive
treatment)
Use with caution in patients with angle
closure glaucoma, prostatic hypertrophy,
pyloroduodenal or bladder neck
obstruction, and COPD
Marked sedation,
anticholinergic effects (dry
mouth, urinary retention), GI
effects, paradoxical excitement
(cats)
Hypersensitivity to
Dimenhydrinate allergic reactions,
motion sickness,
pancreatitis (cats,
adjunctive
treatment)
caution in patients with angle closure
glaucoma, GI or urinary obstruction,
COPD, hyperthyroidism, seizure disorders,
cardiovascular disease or hypertension;
may mask clinical signs of ototoxicity
CNS depression, anticholinergic
effects, GI effects
Hypersensitivity to it
and other
antihistamines
Clemastine allergic reactions caution in patients with prostatic
hypertrophy, bladder neck obstruction,
severe cardiac failure, angle-closure
glaucoma, or pyeloduodenal obstruction
dogs: sedation
paradoxical hyperactivity, and
anticholinergic effects
cats: diarrhea
Hypersensitivity
Hydroxyzine allergic reactions,
pruritus, sedation /
tranquilization
Sedation most likely; Dogs
(rarely): Tremors,
seizures; Cats: Polydipsia,
depression, or behavioral
Hypersensitivity

VPHM 142
changes, teratogenic in lab
animals
Meclizine motion sickness
(primary use),
sedation, vomiting
Sedation; anticholinergic effects,
contradictory CNS stimulation
possible
Hypersensitivity
Pyrilamine
maleate
(Primarily used in
horses;
injectable)
Hypersensitivity
reactions,
histamine
mediated adverse
effects
Horses: CNS stimulation
(nervousness, insomnia,
convulsions, tremors, ataxia),
palpitation, GI disturbances, CNS
depression (sedation), muscular
weakness, anorexia, lassitude &
incoordination
n/a
Trimeprazine pruritus caution in patients with hepatic
dysfunction, cardiac disease, active
bacterial or viral infections, peptic ulcer,
acute psychoses, corneal ulcer, Cushingoid
syndrome, diabetes, osteoporosis, chronic
psychotic reactions, predisposition to
thrombophlebitis, hypertension, CHF,
renal insufficiency, general debilitation,
very young animals
Sedation, may cause significant
hypotension, cardiac rate
abnormalities, hypo- or hyper-
thermia,
“Cushingoid” effects with
sustained use
Relatively
Contraindicated:
Systemic fungal
infections,
hypovolemia,
or shock & in
patients with tetanus
or strychnine
intoxication
Tripelennamine histamine
mediated adverse
effects, a CNS
stimulant in
“Downer cows”
Do not administer IV to horses. CNS stimulation (if given IV to
horses), sedation,
depression, ataxia, GI effects
(oral use)
IV administration in
horses
Cyproheptadine appetite
stimulation in dogs
and cats, pruritus,
feline asthma,
serotonin
syndrome
(adjunctive
treatment, dogs or
caution in patients with urinary or GI
obstruction, severe CHF, narrow angle
glaucoma
Effects: Sedation (cats may
demonstrate paradoxical
hyperexcitability) &
anticholinergic effects; some
reports of hemolytic anemia in
cats
Hypersensitivity

VPHM 142
cats), PPID in
horses
2nd
generation Antihistamines
MOA: act as inverse agonists of histamine, resulting to reversible, competitive inhibition of H1 action; limited the BBB penetration due to Pgp
mediated efflux
Drug Indication Precaution Possible side effects Contraindication Notes
Cetirizine Allergic
reactions,
pruritus
The combination product containing
pseudoephedrine is not appropriate for use in
dogs or cats.
vomiting,
hypersalivation, or
somnolence in small
animals
Fexofenadine Allergies, itching
due to mast cell
tumors
Glaucoma. Older patients. Working dogs
Nursing mothers. Patients with problems
urinating, prostate enlargement, thyroid
problems, or heart disease. Obstructions in
the gastrointestinal tract. Severe kidney or
liver problems
drowsiness hypersensitivity
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Aspirin
(acetylsalicylic
acid, ASA)
Osteoarthritis
degenerative joint
disease
Fever
Pain
Cardiomyopathy in cats
Endotoxic shock
Use with caution in cats, avoid in
pregnant animals
don’t use with drugs that alkalinize the
urine, with aminoglycosides, GCCs,
digoxin, furosemide, oral anticoagulants,
NSAIDs, phenobarbital, tetracyclines,
spironolactone
GI effects, severe blood loss,
anemia, hypoproteinemia,
acidosis (cats), possible
teratogenic effect and delay
parturition
Hypersensitivity;
patients with
hemorrhagic disorders,
asthma, or renal
insufficiency
Phenylbutazone
(Nonselective
COX inhibitor)
For musculoskeletal
pain and inflammation
in horses and dogs,
lameness and pain
Use with caution in foals or ponies,
preexisting renal disease, CHF, other
drug allergies
GI erosions and ulcers in horses,
destruction of bone and joint,
hypoalbuminemia, diarrhea,
anorexia, & renal effects. Dogs:
hypersensitivity, history
or preexisting

VPHM 142
relief from colic in
horses
Do not give IM or SC; IA injections may
cause seizures
GI ulceration, sodium & water
retention, diminished renal blood
flow, blood dyscrasia
hematologic or bone
marrow abnormalities,
preexisting GI
ulcers, food producing
animals
Flunixin
meglumine
(Nonselective
COX inhibitor)
Musculoskeletal pain
Visceral pain
Endotoxic shock
Surgical pain
Caution in patients with preexisting GI
ulcers, renal, hepatic, or
hematologic diseases
Sweating and swelling at
injection site (horse), vomiting,
diarrhea, nephrotoxicity, gastric
ulceration (if chronically used in
dogs)
hypersensitivity
Carprofen
(COX 2
inhibitor)
Osteoarthritis
(inflammation and pain)
in dogs
Post operative pain
Caution in Geriatric patients or those
with preexisting chronic diseases
Liver toxicities in Labrador
retriever, GI effects
dogs with bleeding
disorders (e.g., Von
Willebrand’s), history of
serious reactions to it or
other propionicclass
NSAIDs
Ketoprofen
(Nonselective
COX inhibitor)
musculoskeletal pain
and inflammation in
horses
Postoperative and
chronic pain in dogs
and cats
Cautions: GI ulceration or bleeding,
hypoproteinemia, breeding animals
Do not administer intra-arterially &
avoid SC injections
Horses: Potentially, gastric
mucosal damage & GI ulceration,
renal crest necrosis, & mild
hepatitis may occur. Dogs:
Vomiting, anorexia, & GI ulcers
Naproxen
(Nonselective
COX inhibitor)
musculoskeletal pain
and
inflammation in horses
Caution: History of gastric ulcers, heart
failure
GIT ulcers and renal effects in
dogs and horses, hematologic,
and CNS effects in horses
Active GI ulcers or
history of
hypersensitivity to
the drug.
Piroxicam
(Nonselective
COX inhibitor)
Osteoarthritis in
dogs
Musculoskeletal
conditions
Extreme Caution: Active, or a history of
GI ulcer
disease or bleeding disorders.
Caution: Severely compromised cardiac
function
Use with special caution in cats
GI ulceration & bleeding, renal
papillary necrosis, & peritonitis
Hypersensitivity or
severely allergic to
aspirin or
other NSAIDs
Tepoxalin For the control of pain
and
caution in patients with impaired
hepatic, cardiovascular or renal
vomiting & diarrhea GI and renal
problems

VPHM 142
(COX and LOX
inhibition)
inflammation
associated with
osteoarthritis in dogs
function, or at risk for developing
nephrotoxic affects associated with
NSAIDs
do not use in patients with GI ulcers
Deracoxib
(Selective COX
2 inhibitors)
for post operative pain
& inflammation due to
orthopedic
surgery in dogs > 4 lb
control of pain and
inflammation
associated with
osteoarthritis
in dogs > 14 lb
caution in patients with concurrent GI
ulcerative diseases, renal or hepatic
dysfunction, those in hypoproteinemic
states, or with conditions that may
predispose them to hypercoagulability
Associated with GI, urinary,
hematologic, hepatis, neurologic,
dermatologic effects
Hypersensitivity,
elevated kidney and
liver values
Firocoxib
(Selective COX
2 inhibitors)
for treatment of pain
and
inflammation
associated with
osteoarthritis in dogs
caution and enhanced monitoring in
patients with preexisting renal, hepatic
or cardiovascular dysfunction
GI effects, facial skin lesions
and/or excitation (horses)
Hypersensitivity to it
and other NSAIDs,
active GI ulcerative
conditions
Robenacoxib
(Selective COX
2 inhibitors)
relief of pain and
inflammation
in dogs and cats
caution in dogs or cats with impaired
cardiac or renal function or that are
dehydrated, hypovolemic or
hypotensive and in cats with hepatic
dysfunction
vomiting or diarrhea Hypersensitivity, active
GI ulcerative conditions,
hepatic disease in dogs
Tolfenamic acid
(COX 2
inhibitor)
pain and inflammation
(cattle mastitis, pigs,
dogs), febrile syndrome
in cats
caution in patients with decreased renal
or hepatic function
vomiting or diarrhea Hypersensitivity to it
and other NSAIDs,
active GI ulcerative
conditions
Meloxicam Pain associated with
surgical procedures,
arthritis and other
causes in dogs; Used in
cats for SC injection for
GI effects Hypersensitivity to it
and other NSAIDs active
GI ulcerative conditions,
hepatic cardiac or renal
function and

VPHM 142
surgical pain; Acute
respiratory infection in
cattle in combination
with antibiotic; Mastitis
in dairy cattle
hemorrhagic disorders
(dogs)
Glucocorticoids
Drug Indication Mode of action Precaution Possible side
effects
Contraindication Notes
Short-acting Suppression of
immune cells
and
inflammation,
including
histamine
synthesis
Cortisone alternative to
predniso(lo)ne for
the oral treatment of
hypoadrenocorticism
in dogs
Prednisone Inflammatory
diseases / reactions
Caution: Active
bacterial infections,
corneal ulcer,
Cushingoid
syndrome,
diabetes,
osteoporosis,
chronic psychotic
reactions,
predisposition to
thrombophlebitis,
hypertension, CHF,
renal insufficiency
Dogs: polydipsia
(PD), polyphagia
(PP), and polyuria
(PU), Systemic
steroid effects
Systemic fungal
infections
Should be
tapered off
when
withdrawing
Prednisolone
Hydrocortisone
Methylprednisolone
Intermediate-acting
Triamcinolone

VPHM 142
Long-acting
Flumethasone
Dexamethasone
Betamethasone
Other antiinflammatory agents
Drug Indication Mode of action Precaution Possible side effects Contraindication
Dimethylsulfoxide
(DMSO)
As an adjunct to intestinal
surgery, Treatment of
cerebral edema or spinal
cord injury, Topical
treatment of perivascular
injection of irritating
substances,
A carrier of drugs across the
skin
inactivates the
superoxide
radicals
produced
during
inflammation
Wear rubber gloves
when applying topically;
apply only to clean, dry
areas
Use with extreme caution
in animals with
mastocytomas,
dehydration, shock
Minimal adverse side
effects; garlic taste after
topical
application; skin irritation,
teratogenic effects in
some species
Polysulfated
glycosaminoglycans
Control symptoms
associated
with noninfectious
degenerative or traumatic
arthritis in dogs and horses
Should not be used in
place of other treatments
when
infection suspected or
present, or when surgery
or joint immobilization
required
Intra-articular use: Post-
injection inflammation
possible. Dogs: Dose-
related inhibition of
coagulation/hemostasis
possible.
Intra-articular
injection if
patient
hypersensitive
to PSGAG.
GASTROINTESTINAL DRUGS
Emetics
A. Centrally acting emetics
MOA: stimulate the CRTZ, which in turn excites the vomiting center

VPHM 142
Apomorphine emetic in dogs Do not use in
contraindicated animals
CNS stimulation in
cats, protracted vomiting
Contraindicated in certain
species (e.g., rodents, rabbits)
& when vomiting may be
deleterious (e.g., impending
coma, aspiration)
Dopamine
receptor
agonist
Xylazine emetic in cats Monitor the animal
for sedation &
hypotension
Extreme caution:
preexisting cardiac
dysfunction,
hypotension or shock,
respiratory dysfunction,
severe
hepatic or renal
insufficiency, preexisting
seizure disorders, or if
severely debilitated
Muscle tremors,
bradycardia, reduced RR,
etc.
Animals receiving epinephrine
or having active ventricular
arrhythmias
a2-adrenergic
agonist
B. Locally acting emetics
MOA: Stimulate directly the pharynx that triggers the vomiting center via CN IX, or the visceral afferent nerves of the stomach & intestines by
causing irritation, inflammation or distension
3% Hydrogen
peroxide
Induces
vomiting in
dogs, cats, pigs
and ferrets
Administer cautiously as
it may cause severe
aspiration pneumonia
Aspiration of hydrogen
peroxide solution during
administration or stomach
contents after inducing
emesis; vasovagal response
in animals with
cardiovascular conditions,
Animals that are already
vomiting, severely lethargic,
comatose, debilitated,
seizuring, have had recent
abdominal surgery
Antiemetics
Drug Indication Precaution Possible side
effects

VPHM 142
A. Antihistamines (block H 1 receptors)
MOA: Block H1 receptors in the vestibular apparatus & CRTZ
Diphenhydramine vomiting in dogs
and cats due to
motion sickness or
inner ear
abnormalities
Use in caution in patients with angle
closure glaucoma, prostatic
hypertrophy, pyloroduodenal or
bladder neck obstruction, and COPD
sedation Hypersensitivity to other
antihistamines
Dimenhydrinate caution in patients with angle
closure glaucoma, GI or urinary
obstruction, COPD, hyperthyroidism,
seizure disorders, cardiovascular
disease or hypertension; may mask
clinical signs of ototoxicity
Hypersensitivity to it and
Promethazine Cautious use and smaller doses of
phenothiazines should be given to
animals with hepatic dysfunction,
cardiac disease, or general
debilitation
hypovolemia or shock
Meclizine Cautious use in patients with
prostatic hypertrophy, bladder neck
obstruction, severe cardiac failure,
angle-closure glaucoma, or
pyeloduodenal obstruction
Hypersensitivity extralabel use
in dogs
2. Phenothiazine tranquilizers (block D 2 receptors)
MOA: Block the D2 receptors in the CRTZ & inhibit the vomiting center
Chlorpromazine, prevent motion
sickness in dogs and
cats
Reduced dosage in
debilitated/geriatric animals, those
with hepatic or cardiac disease or
when combined with other agents;
Use with caution in dehydrated
patients
hypotension and
sedation
Prochlorperazine caution in patients with hepatic
dysfunction, cardiac disease, general
debilitation, or very young animals
Hypovolemia/dehydration
or shock & in patients

VPHM 142
with tetanus or
strychnine intoxication
3. Serotonin (5 HT3) receptor antagonists
MOA: Inhibit 5HT3 receptors in the CRTZ
Ondansetron Intractable vomiting
(in chemotherapy)
not effective for emesis
caused by motion
sickness, hypersensitivity
recommended
in dogs
receiving
chemotherapy
Dolasetron, severe nausea and
vomiting in dogs
and cats,
particularly if
caused by cancer
chemotherapy drug
Use with caution in patients with
developing prolongation of cardiac
conduction intervals.
Hypersensitivity, patients
with atrioventricular
block II to III, or with
markedly prolonged QT
Granisteron Severe vomiting or
prophylaxis before
chemotherapy
n/a n/a n/a
4.
Metoclopramide
relief of nausea &
vomiting associated
with chemotherapy,
parvoviral enteritis,
and gastric motility
disorders
should be avoided in dogs with
pseudopregnancy
Horse: changes
in behavior,
constipation,
dogs and cats:
constipation
may be antagonized by
atropine and opioids
GI hemorrhage,
obstruction or
perforation,
hypersensitivity
D2 receptor
antagonist
5. Neurokinin 1
(NK 1) receptor
antagonists e.g.
Maropitant
citrate
prevention and
treatment of acute
vomiting in dog
caution in dogs with hepatic
dysfunction, in puppies less than 11
week old, with highly protein bound
medications
diarrhea,
bloody stool,
endoctoxic
shock, otitis
NK-1 receptor
antagonist
that
blocks
receptors
found in the
emetic center,
CRTZ and in

VPHM 142
peripheral
afferent
nerves
Antiulcers
effects
Antacids
MOA: Reduce HCl levels in the stomach
Locally acting: Neutralize
stomach acid,
lower pepsin
activity
Interfere with GI
absorption of
concurrently
administered
weak acid drug
Al hydroxide constipation
Mg hydroxide
(milk of
magnesia)
Laxative effect
Ca carbonate
2. H 2 receptor
antagonists (or H
2 blockers)
treatment of NSAID-
induced ulcers
Suppresses HCl
production
Cimetidine treats and prevents
gastric, abomasal,
duodenal ulcers,
hypersecretory
conditions of
stomach,
esophagitis, gastric
reflux
rare but may
inhibit hepatic
microsomal
enzymes
Ranitidine promotes gastric
emptying

VPHM 142
Famotidine
Nizatidine prokinetic
agent in small animal
medicine for the
treatment of
constipation and
delayed
gastric emptying
3. Proton pump
inhibitors
irreversibly binds
to the proton
pump at the
luminal surface of
the parietal cell
that pumps H ions
into the gastric
lumen
constipation,
sedation, ileus,
pancreatitis, CNS
effects
Omeprazole
Lansoprazole
Pantoprazole
Rabeprazole
4. Synthetic
prostaglandins
(PGE 1
analogues) e.g.
Misoprostol
NSAID-induced
ulceration
Inhibits HCl acid
secretion from the
parietal cell into
the stomach;
Stimulates gastric
mucus secretion
5. Gastromucosal
protectants
(Sucralfate)
Forms a paste-like
substance
that binds to the
ulcer →
back diffusion of
H+ ions is
prevented and
ulcer healing

VPHM 142
is promoted
Antidiarrheals
Drug Indication Precaution Possible side
effects
A. Narcotic analgesics (opiates)
MOA: Increase segmental contractions, Decrease intestinal secretions
Diphenoxylate Control of
diarrhea
– available in combination with
atropine sulfate
Loperamide Control of
diarrhea
ileus,
constipation
sedation and CNS
excitement
(horses and cats)
infectious diarrhea acceptable in cats because of
poor CNS penetration
2. Anticholinergics (antispasmodics, motility modifiers)
Decrease intestinal motility & peristalsis; also reduce gastric secretions
MOA: Decrease intestinal motility & peristalsis; also reduce gastric secretions
Relief of pain & tenesmus associated with large bowel inflammatory disease, Relief of spasm in gut spasms
Aminopentamide
Hyoscine
Propantheline
Clidinium
N butyl
scopolammonium
bromide
Pain; treatment of
colic in horses; CI
in horses with
impaction or ileus
3. Adsorbents/Protectants
MOA: coat the intestines to prevent further irritation or erosion; bind bacteria and/or toxins
Kaolin/pectin
(protectants)
May adsorb or
bind other
administered drugs

VPHM 142
Bismuth subsalicylate anti-inflammatory
effect & inhibit PG
production
Activated charcoal Poisoning from
diarrhea-causing
bacterial toxins
Laxatives
effects
1. Osmotic agents
MOA: soften the stool and stimulate stretch receptors to enhance peristalsis
MgOH (Milk of
Magnesia)
Cramping, nausea
Lactulose
2. Irritants/Stimulants
MOA: Irritate the mucosal lining of GIT
Emodin
Castor oil
Bisacodyl
3. Bulk forming laxatives
MOA: increase the bulk & fluidity of intestinal content
Psyllium constipation and
sand impaction
(horses)
Bran
Methylcellulose
Metamucil
4. Lubricants
MOA: soften stool for easier passage
Mineral oil constipation, colic
and impaction in
horses

VPHM 142
Petrolatum passage of hairballs
in cats
incorporated in
oral laxatives
5. Stool softeners
MOA: reduce surface tension and allow water to penetrate GI contents
Docusate Na (
dioctyl sodium
sulfoccinate )
hard, dry feces
(small animals),
impaction (horses),
digestive upset
(cattle)
Docusate Ca (
dioctyl calcium
sulfoccinate )
Prokinetics
MOA: Increase the movement of ingested material through the GIT; induce coordinated motility patterns in the GIT
effects
1 .Dopaminergic antagonists
Metoclopramide • gastroesophageal
reflux • delayed
gastric emptying •
GIT motility
disorders in dogs
and cats • GIT
stimulation in foals
Domperidone regulate GIT
motility
2. Serotonergic antagonists
Cisapride gastroesophageal
reflux, GIT stasis in
horse, dogs and
cats
• Enhance ACh
release from the
nerve endings of
the myenteric
plexus

VPHM 142
Other GIT drugs
effects
Carminatives/antifoaming
agents
-poloxalene
frothy bloat in
ruminants
act as
surfactants
(reduce surface
tension) thus
causing bubbles
to break down →
gas is expelled
via eructation
Antibiotics
-Metronidazole
-Amoxicillin
-Clavamox
-Tylosin
bloody diarrhea,
signs of sepsis
antibiotics could
destroy the
normal intestinal
microflora and
allow the growth
of bacterial
pathogens
Probiotics
-Plain yogurt with active
culture
Repopulate the
GIT with
beneficial bacteria
Digestive enzymes
-Pancrelipase
exocrine
pancreatic
insufficiency
Pancrelipase –
contains
pancreatic
enzymes that
facilitate fat,
protein and
carbohydrate
digestion
diarrhea,
nausea,
cramping
Appetite stimulants
-Cyproheptadine (cats)

VPHM 142
-Mirtazapine (dogs and
cats)
-Diazepam (transient
appetite stimulation)
-Oxazepam
Drugs for treating
inflammatory bowel
disease (IBD)
-Sulfasalazine
-Glucocorticoids
(prednisone/prednisolone)
-Azathioprine
DRUGS OF THE CARDIOVASCULAR SYSTEM
DRUGS USED TO TREAT HEART FAILURE
Positive inotropes
effects
A. Digitalis/cardiac
glycosides
Chronic heart
failure, atrial
arrhythmias
especially atrial
fibrillation
Inhibition of Na-K
ATPase increases
intracellular Na+
, leading to stronger
myocardial
contraction
Reduces blood
pressure, small
direct diuretic effect
Caution: Severe
pulmonary
disease, hypoxia,
acute myocarditis,
myxedema, or
acute MI,
frequent VPC’s V-
tach, chronic
constrictive
pericarditis or
incomplete AV
block
Cardiac
arrhythmia, mild
GIT disturbances
Hypokalemia
(greater chance of
toxicity), circulatory
shock renal failure,
liver failure,
ventricular
tachycardia, heart
block, ventricular
premature
contraction
administered
according to
body surface
area
B. Bipyridine compounds

VPHM 142
Amrinone or
Inamrinone
short-term
inotropic support
in small animal
patients with
heart failure
Inhibition of
phosphodiesterase
3, leading to
increased cardiac
inotropy and
vasodilatory
response in blood
vessels
Incompatible with
dextrose and
furosemide;
extreme caution
with hypertrophic
cardiomyopathy
Arrhythmias,
thrombocytopenia,
hepatotoxicity,
hypersensitivity
severe aortic or
pulmonic valve
disease
Very
expensive
Milrinone Incompatible with
furosemide
C. Beta-adrenergic agonists / Sympathomimetics
Dopamine Increase the force
of myocardial
contraction
Activate adenylyl
cyclase that
catalyzes the
conversion of ATP to
cAMP, increasing
cardiac inotropy
Do not use for
more than 2-3
days for inotropic
support.
Avoid
extravasation
injuries.
(dopamine)
Nausea/vomiting,
ectopic beats,
tachycardia,
hypotension,
hypertension,
dyspnea, headache
& vasoconstriction
Pheochromocytoma,
ventricular
fibrillation, &
uncorrected
tachyarrhythmia
Dobutamine facial twitching in
dogs, tachycardia;
higher doses can
cause CNS effects
(especially in cats)
Known
hypersensitivity to
the drug or the
preservative (sodium
bisulfite); or patients
with IHSS
Animals with
atrial
fibrillation
should be
digitalized
prior to
receiving
dobutamine
D. Inodilators
Pimobendan CHF secondary to
Dilated
Cardiomyopathy
(DCM) or chronic
degenerative
valvular disease
(CVD) or
endocardiosis
inhibition of
phosphodiesterase
III (PDE-III)
increasing
intracellular calcium
sensitivity in the
Give on an empty
stomach
caution in patients
with uncontrolled
cardiac
arrhythmias
GI effects Hypersensitivity,
hypertrophic
cardiomyopathy,
aortic stenosis, any
condition with
functionally /
anatomically

VPHM 142
cardiac contractility
apparatus
abnormal cardiac
output
Vasodilators
effects
1. Angiotensin-converting enzyme (ACE) inhibitors
Captopril
CHF,
hypertension
Blocks the
production of
angiotensin II, a
potent
vasoconstrictor
used with caution and under
close supervision in patients
with renal insufficiency;
caution in patients with
hyponatremia, coronary or
cerebrovascular insufficiency,
preexisting hematologic
abnormalities or a collagen
vascular disease
hypotension, renal
failure,
hyperkalemia,
vomiting and
diarrhea
hypersensitivity
with ACE inhibitors
Enalapril
maleate
converted
to
enalaprat,
its active
form;
crosses the
placenta
(caution in
pregnant
patients)
Benazepril Mildly
fetotoxic at
high
dosages
2. Angiotensin II Receptor Blockers (ARB)
losartan CHF,
hypertension,
diabetic
nephropathy
Block angiotensin II
receptors
irbesartan Not safe during pregnancy;
correct volume or Na
depletion before using; do
not use in hypotensive
patients. I
Not known Very limited
experience
in
veterinary
medicine
3. Calcium
channel
blockers
mild, moderate,
or severe heart
failure,
Block Ca2+ influx
into the cardiac
cell; inhibit Ca2+

VPHM 142
hypertrophic
cardiomyopathy,
hypertension in
cats, circulatory
shock & trauma
release from the
SR
4. Veno-Arteriodilators
Prazosin adjunctive
treatment of
CHF, systemic
hypertension, or
pulmonary
hypertension in
dogs
block a1
adrenergic
receptors
Caution in chronic renal
failure or preexisting
hypotensive conditions; in
dog breeds with ABCB1
mutation
Potentially
hypotension, CNS
effects (lethargy,
dizziness, etc.), &
GI effects
nitroglycerin
(topical)
CHF,
hypertension
relaxes vascular
smooth muscle
Caution in cerebral
hemorrhage or head trauma,
diuretic-induced
hypovolemia, or other
hypotensive conditions
rashes at the
application sites &
orthostatic
hypotension
anemia or
hypersensitivity to
nitrates
Rotate
application
sites; wear
gloves
when
applying
Nitroprusside in combination
with dopamine
for refractory
CHF,
acute/severe
hypertension;
acute heart
failure
secondary to
mitral
regurgitation
immediate acting
intravenous
hypotensive agent
that
directly causes
peripheral
vasodilation
Caution in geriatric patients,
hepatic insufficiency, severe
renal impairment,
hyponatremia, or
hypothyroidism; avoid
extravasation; continued use
may lead to potential
thiocyanate & cyanide
toxicity
Hypotensive
effects, nausea,
retching,
restlessness,
apprehension,
muscle twitching,
dizziness
Compensatory
hypertension,
inadequate
cerebral
circulation, or
during emergency
surgery in patients
near death
5. Arteriodilators
Hydralazine Hypertension,
adjunctive
reduce cardiac
afterload by
reducing systemic
Caution in severe renal
disease, intracerebral
Hypotension, reflex
tachycardia,
sodium/water
Known
hypersensitivity,
coronary artery

VPHM 142
treatment of
heart failure
arteriolar
resistance
bleeding, preexisting
autoimmune diseases
retention (if not
given concurrently
with a diuretic), or
GI distress
disease,
hypovolemia or
preexisting
hypotension
6. Phosphodiesterase inhibitor
Sildenafil pulmonary
hypertension
inhibits cyclic
guanosine
monophosphate
(cGMP) specific
phosphodiesterase
type-5 (PDE5)
should not be used
concurrently with nitrates or
in patients documented
hypersensitive to it; extreme
resting hypotension, fluid
depletion, severe left
ventricular outflow
obstruction, or autonomic
dysfunction.
not well-known;
inguinal flushing,
possible GI effects
patients receiving
organic nitrates
Very
expensive
7. Beta blocker
• Carvedilol adjunctive
therapy in the
treatment of
heart failure
(dilated
cardiomyopathy)
Non-selective
Beta-adrenergic
blocker with
selective alpha1 -
adrenergic
blocking activity
Caution in patients with
hepatic insufficiency
Too rapid beta
blockade can cause
decompensation in
patients with heart
failure
class IV
decompensated
heart failure,
bronchial asthma,
2nd or 3rd degree
AV block, sick sinus
syndrome (unless
artificially paced),
severe bradycardia,
cardiogenic shock
or hypersensitivity
to the drug
ANTIARRHYTHMIC DRUGS
Class I (A,B,C)- Local anesthetic agents (Membrane stabilizers)
MOA: Impede depolarization by blocking the fast Na+ channels in the myocardial cell membrane

VPHM 142
IA
depress conduction of electrical impulses and lengthen refractory period thereby slowing down repolarization
Quinidine atrial fibrillation,
flutter;
supraventricular
& ventricular
tachyarrhythmias
Extreme caution in any form
of AV block or if any clinical
signs of digoxin toxicity are
exhibited;
Caution in uncorrected
hypokalemia, hypoxia, &
disorders or acid base
balance; hepatic or renal
insufficiency
cardiac depression, low
cardiac output, hypotension,
Extra-cardiac effects in the
GIT (vomiting, diarrhea) &
CNS
Hypersensitivity, myasthenia
gravis; complete AV block with an
AV junctional or idioventricular
pacemaker; intraventricular
conduction defects; digitalis
intoxication with associated
arrhythmias or AV conduction
disorders; aberrant ectopic
impulses; or abnormal rhythms
secondary to escape mechanisms
Large
animals
Procainamide intravenous
control of atrial
arrhythmia
Extreme Caution: Cardiac
glycoside intoxication,
systemic lupus; Caution:
Significant hepatic, renal
disease or CHF
Dogs: Blood level related: GI
effects, weakness,
hypotension, negative
inotropism, widened QRS
complex & QT intervals, AV
block, multiform ventricular
tachycardias. Possible:
fevers & leukopenias
Myasthenia gravis; hypersensitive
to drug, procaine or other
chemically related drugs; torsade
de pointes; or 2nd or 3rd degree
heart block (unless artificially
paced)
less GIT
effects;
small
animals
Disopyramide arrhythmia Caution: Sick sinus
syndrome, bundle branch
block, or Wolff Parkinson-
White (WPW) syndrome,
hepatic or renal disease
Anticholinergic effects,
cardiovascular effects
(edema, hypotension,
dyspnea, syncope, &
conduction disturbances (AV
block), can reduce serum
glucose
Hypersensitivity to the drug, 2nd or
3rd degree AV block, cardiogenic
shock, severe uncompensated or
poorly compensated cardiac failure
or hypotension, glaucoma (closed-
angle), urinary retention, or
myasthenia gravis
IB
block fast sodium channels thereby suppress automaticity, slow conduction and prolong refractory period in Purkinje fibers and diseased
myocardial cells

VPHM 142
lidocaine arrhythmia, local
anesthesia
Cats appear more sensitive to
cardiodepressant and CNS effects of
lidocaine; use with caution in patients
with liver disease, congestive heart failure,
shock, hypovolemia, severe respiratory
depression, marked hypoxia, bradycardia,
or incomplete heart block having VPC’s,
unless the heart rate is first accelerated
CNS signs include drowsiness,
depression, ataxia, muscle
tremors, etc.; nausea &
vomiting (usually transient).
Known hypersensitivity to the
amide-class local anesthetics,
severe degree of SA, AV, or
intraventricular heart block (if
not being artificially paced), or
Adams-Stokes syndrome
phenytoin ventricular
dysrhythmias in
horses or
digoxin-induced
arrhythmias in
dogs or horse
additive hepatotoxicity may result if
phenytoin is used with either primidone or
phenobarbital
Dogs: Anorexia & vomiting,
ataxia, sedation, gingival
hyperplasia, hepatotoxicity.
Cats: Ataxia, sedation,
anorexia, dermal atrophy
syndrome,
thrombocytopenia
Hypersensitivity; IV use
contraindicated for 2nd or 3rd
degree heart block, sinoatrial
block, Adams-Stokes syndrome,
or sinus bradycardia.
mexiletine Ventricular
arrhythmia
Extreme caution: Pre-existing 2nd or 3rd
degree AV block (without pacemaker), or
in patients with cardiogenic shock
Caution: Severe congestive heart failure or
acute myocardial infarction, hepatic
function impairment, hypotension,
intraventricular conduction abnormalities,
sinus node function impairment, seizure
disorder, or sensitivity to the drug
GI distress, CNS effects
(trembling, unsteadiness,
dizziness, depression),
shortness of breath, PVC’s &
chest pain
IC
Slow conduction and have little effect on AP duration
Encainide supraventricular
and ventricular
tachyarrhythmias
(SVT and VT)
Felacainide
Class II- Beta-adrenergic blockers
MOA: block b-adrenergic receptors, thus preventing the binding of NE and EP to these receptors

VPHM 142
nonselective
propranolol Hypertrophic
cardiomyopathy,
Ventricular arrhythmias
Caution: Significant renal
or hepatic insufficiency,
sinus node dysfunction,
labile diabetic patients,
digitalized or digitalis
intoxicated patient
bradycardia, lethargy
& depression
Heart failure,
hypersensitivity to this
class of agents,
greater than 1st
degree heart block, or
sinus bradycardia
gradual
withdrawal when
discontinuing
Cardioselective / β1 selective
atenolol hypertension &
tachyarrhythmias in small
animals
lethargy, hypotension,
or diarrhea
bradycardic
arrhythmias,
hypersensitivity, heart
failure
gradual
withdrawal when
discontinuing
metoprolol supraventricular
tachyarrhythmias,
premature ventricular
contractions (PVC’s, VPC’s),
systemic hypertension, &
treatment in cats with
hypertrophic
cardiomyopathy
Caution: Significant
hepatic insufficiency,
bronchospastic lung
disease, CHF,
hyperthyroidism, labile
diabetics, & sinus node
dysfunction
bradycardia, lethargy
& depression,
impaired AV
conduction, CHF or
worsening of heart
failure, hypotension,
hypoglycemia,
bronchoconstriction,
syncope, & diarrhea
Overt or unstable
heart failure,
hypersensitivity beta-
blockers, greater than
first-degree heart
block, or sinus
bradycardia
Side effects
common in
geriatric patients
esmolol short-term treatment of
SVT; determining if
effectiveness of b-blockers
for controlling arrhythmias
Caution: Patients with
CHF, bronchoconstrictive
lung disease, or diabetes
mellitus
Hypotension &
bradycardia a
Patients with overt
cardiac failure, 2nd or
3rd degree AV block,
sinus bradycardia, or
in cardiogenic shock
Class III- Potassium channel blockers
MOA: blockade of K channels delays repolarization and lengthens the time between action potentials, increasing the effective refractory period
Bretylium

VPHM 142
Amiodarone emergency tx of
ventricular tachycardia
and fibrillation;
tachyarrhythmias
Consider use only when
other less toxic and
more commonly used
drugs are ineffective
vomiting and
hypotension; Hind
limb weakness,
increased bilirubin
(amidarone on horses)
2nd, 3rd degree heart
block,
bradyarrhythmias
Sotalol use with caution in
patients with diabetes
mellitus, or
hyperthyroidism
asthma, sinus
bradycardia, 2nd or
3rd degree heart block
(unless artificially
paced), long QT
syndromes,
cardiogenic shock or
uncontrolled CHF
Class IV- Calcium entry blockers
MOA: blocks Ca2+ entry into the myocardial cells, slowing the conduction rate and frequency via the AV node (targets phase 2)
Verapamil supraventricular
tachycardia and
atrial flutter
Caution: Heart failure,
hypertrophic
cardiomyopathy, & hepatic
or renal impairment. Use
very cautiously in patients
with atrial fibrillation &
Wolff-Parkinson-White
(WPW) syndrome.
Hypotension, bradycardia,
tachycardia, exacerbation
of CHF, peripheral edema,
AV block, pulmonary
edema, nausea,
constipation, dizziness,
headache, or fatigue
Cardiogenic shock or severe
CHF (unless secondary to a
supraventricular
tachycardia), hypotension,
sick sinus syndrome, 2nd or
3rd degree AV block,
digoxin intoxication, or
hypersensitive to verapamil.
Oral and IV
Nifedipine atrial fibrillation
and
supraventricular
tachycardia
edema, hypotension,
Potential teratogen (high
doses of diltiazem)
Oral
administration
Diltiazem Caution: Geriatric patients
or those with heart failure
(particularly if also receiving
beta blockers), or hepatic or
renal impairment
Severe hypotension, sick
sinus syndrome or 2nd or
3rd degree AV block, acute
MI, radiographically
documented pulmonary
congestion, hypersensitivity
Amlodipine hypertension caution in patients with
heart disease, hepatic
may cause anorexia &
hypotension in cats early in

VPHM 142
RESPIRATORY SYSTEM DRUGS
Drugs that alter respiratory secretions
Drug Mode of action Precaution Possible side
effects
Expectorants
Indication: productive cough
Ethylenediamine
dihydroiodide
(EDDI)
stimulate bronchial mucus secretions via
a vagal-mediated reflex action on the
gastric mucosa
mild respiratory
disease in
horses and
cattle
Hypertonic saline Attracts fluid into the airway lumen via
osmosis thus liquefying content
Aerosolized
form
Guaifenesin
(glyceryl
guaiacolate)
Has a reflex irritant action on the vagus
nerve that stimulates bronchial
secretion
Mild hypotensive
effect & increase
in cardiac rate,
thrombophlebitis
possible
None noted except
concurrent use
with physostigmine
Mucolytics
Acetylcysteine Indication:
respiratory ds. with
tenacious mucus,
paracetamol/
acetaminophen
poisoning in cats
MOA: Improve
the mobility of
mucus by
decreasing its
viscosity or
thickness
GI effects (nausea,
vomiting) and
rarely, urticaria
hypersensitivity
dysfunction; hypertension
may rapidly reoccur if
dosages are missed
therapy; gingival
hyperplasia seen in some
dogs

VPHM 142
Decongestants
MOA: stimulates the a-adrenergic receptors in mucus membranes leading to local vasoconstriction
Topical
Phenylephrine, reduce nasal congestion Caution: Geriatric
patients, patients with
hyperthyroidism,
bradycardia, partial
heart block, or other
heart disease
Monitor BP
Reflex bradycardia,
CNS effects
(excitement,
restlessness,
headache), & rarely,
arrhythmias
Severe hypertension,
ventricular
tachycardia,
hypersensitivity
Nasal sprays
Oxymetazoline
Xylometazoline
Systemic
Pseudoephedrine, reduce nasal congestion Caution: Glaucoma,
prostatic hypertrophy,
hyperthyroidism,
diabetes mellitus,
cardiovascular
disorders, or
hypertension
Restlessness,
irritability,
hypertension, &
anorexia
phenylpropanolamine reduce nasal congestion in
small animals
Treatment of
incontinence in
female dogs
Antitussives
Indication: persistent and unproductive cough that interferes with sleep and rest, or causes muscle fatigue and exhaustion
Contraindication: excessive respiratory secretions
Drug Indication Mode of action Precaution Possible
side effects
• Locally-acting
MOA: Soothe irritated respiratory mucous membranes

VPHM 142
Menthol Act as a
counterirritant
may cause local irritation
and should not be used
around, or in eye
should not be used in cats
irritation
Tincture of
benzoin
Benzonatate
• Centrally acting
*Narcotic antitussives
codeine harsh,
nonproductive
cough
hypothyroidism, severe
renal insufficiency,
adrenocortical
insufficiency (Addison’s
disease),
and in geriatric or severely
debilitated patients
sedation
and
constipation
Hypersensitivity to
narcotic analgesics,
intake of MAOIs,
diarrhea due to
toxic ingestion,
venom from
scorpion
morphine primary activity
at the mu
receptors, with
some activity
possible at the
delta receptor
Extreme Caution:
Respiratory disease or
from acute respiratory
dysfunction Caution:
Hypothyroidism, severe
renal insufficiency,
adrenocortical
insufficiency, geriatric or
severely debilitated
patients, head injuries or
increased intracranial
pressure, & acute
abdominal conditions (e.g.,
colic)
Hypersensitivity to
morphine,
diarrhea caused by
a toxic ingestion

VPHM 142
hydrocodone
(controlled
opiates)
direct
suppression of
the cough reflex
on the cough
center in the
medulla.
extreme caution in
patients suffering from
respiratory diseases
when respiratory
secretions are increased or
when liquids are
nebulized into the
respiratory tract
Hypersensitivity to
narcotic analgesic,
patients receiving
monoamine
oxidase inhibitors
(MAOIs;
Selegiline),
diarrhea caused by
a toxic ingestion
Any
combination
product
containing
acetaminophen
must NOT be
used in cats
*Nonnarcotic antitussives
Dextromethorphan nonproductive
cough
Suppress the
cough center but
nonaddicting
Butorphanol
tartrate
Bronchodilators
effects
A. B receptor
agonists:
bronchoconstriction direct stimulation
of b2 adrenergic
receptors
tachycardia,
hypertension
Albuterol
stimulating
production
of cyclic AMP
through activation
of adenyl cyclase.
caution in patients
with cardiac
dysrhythmias or
dysfunction,
seizure disorders,
hypertension or
hyperthyroidism
May be teratogenic
(high doses) or
delay labor
Clenbuterol management of
airway obstruction
(RAO) in horses,
uterine relaxant
tachycardia, muscle
tremors, sweating,
restlessness, &
urticaria
contraindicated
in food
producing
animals
Salmeterol

VPHM 142
Epinephrine Anaphylaxis Stimulates alpha
and beta
adrenergic
receptors, leading
to relaxation of
bronchial smooth
muscles
extreme caution
in patients with a
prefibrillatory
cardiac rhythm
Anxiety, tremor,
excitability,
vomiting,
hypertension
(overdosage),
arrhythmias,
hyperuricemia, &
lactic acidosis
(prolonged use or
overdosage)
Narrow-angle
glaucoma,
hypersensitivity
to epinephrine,
shock due to
non-
anaphylactoid
causes, labor,
potent
bronchodilator
for life-
threatening
situations
Pseudoephedrine urethral sphincter
hypotonus, oral
decongestant
Indirect
stimulation of a
and b receptors by
causing the
release of
norepinephrine
Caution:
Glaucoma,
prostatic
hypertrophy,
hyperthyroidism,
diabetes mellitus,
cardiovascular
disorders, or
hypertension
Restlessness,
irritability,
hypertension, &
anorexia
Isoproterenol acute bronchial
constriction, cardiac
arrhythmias
Nonspecific beta
agonism
Caution: Coronary
insufficiency,
hyperthyroidism,
renal disease,
hypertension, or
diabetes
Tachycardia,
anxiety, tremors,
excitability,
headache,
weakness, &
vomiting; more
arrhythmogenic
than dopamine or
dobutamine
Tachycardias or
AV block caused
by cardiac
glycoside
intoxication,
ventricular
arrhythmias that
do not require
increased
inotropic activity
Short duration of
activity
B. Methylxanthines
Theophylline bronchospasm &
cardiogenic
pulmonary edema
Inhibit the enzyme
phosphodiesterase
(PDE) in smooth
mm. cells
Not given on
patients
hypersensitive to
ethylenediamine
CNS stimulation
and gastrointestinal
irritation
Hypersensitivity
to xanthines and
ethylenediamine
Bronchodilator
drug with
diuretic activity

VPHM 142
caution in patients
with severe
cardiac disease,
seizure disorders,
gastric ulcers,
hyperthyroidism,
renal or hepatic
disease, severe
hypoxia, or severe
hypertension
caffeine respiratory and
cardiac ds. that
would benefit from
BD; myocardial
stimulation
Theobromine
c. Antihistamines
Drug Indication MOA Precaution Side effects Contraindication
Pyrilamine
Allergic and
respiratory
conditions like
heaves in horses,
pneumonia in
cattle, feline
asthma, insect bites
H1 receptor
inverse agonist
Horses: CNS stimulation
palpitation, GI disturbances,
CNS depression muscular
weakness, anorexia, lassitude
& incoordination
Tripelennamine Do not administer IV to
horses.
CNS stimulation (if given IV to
horses), sedation,
depression, ataxia, GI effects
(oral use)
Diphenhydramine
Doxylamine
sedation
Clemastine caution in patients with
prostatic hypertrophy,
bladder neck obstruction,
severe cardiac failure, angle-
dogs: sedation
paradoxical hyperactivity,
and anticholinergic effects
cats: diarrhea
Hypersensitivity

VPHM 142
closure glaucoma, or
pyeloduodenal obstruction
Cetirizine combination product
containing pseudoephedrine
is not appropriate for use in
dogs or cats
vomiting, hypersalivation, or
somnolence in small animals
Cyproheptadine caution in patients with
urinary or GI obstruction,
severe CHF, narrow angle
glaucoma
Sedation (cats may
demonstrate paradoxical
hyperexcitability) &
anticholinergic effects; some
reports of hemolytic anemia
in cats
hypersensitivity
D. Anticholinergics
Ipratropium
bromide
Bronchospasm in
RAO (horse)
Counteracts BC
caused by
acetylcholine by
blocking the
receptors
Drugs for allergic & inflammatory disorders
effects
*Corticosteroids
Fluticasone
propionate
feline asthma,
recurrent airway
obstruction (RAO,
heaves) or
inflammatory
airway disease
(IAD) in horses, and
Suppression of
immune cells and
inflammation,
including
histamine
synthesis
n/a Hypersensitivity,
acute
bronchospasm
Inhaled
preparation
with less
steroidal
systemic
effects

VPHM 142
dogs with chronic
tracheobronchial
disease
Beclomethasone
diproprionate
Respiratory airway
inflammation
Prednisone Caution: Active
bacterial infections,
corneal ulcer,
Cushingoid
syndrome, diabetes,
osteoporosis,
chronic psychotic
reactions,
predisposition to
thrombophlebitis,
hypertension, CHF,
renal insufficiency
Dogs: polydipsia
(PD), polyphagia
(PP), and polyuria
(PU)
Systemic steroid
effects e.g.
Cushingoid effects
Systemic fungal
infections
Prednisolone is
preferred over
prednisone in
cats and
horses.
Should be
tapered off
when
withdrawing
Prednisolone
Triamcinolone Same with
prednisone + active
tuberculosis
Cushingoid effects
Respiratory stimulants (analeptics)
effects
Doxapram respiratory
depression caused
by general
anesthesia,
sedatives or
hypnotics, apneic
neonates and
preterm animals •
treatment of
direct stimulation
of the medullary
respiratory
centers and,
possibly, through
the reflex
activation of
carotid and aortic
chemoreceptors
Caution: History of
asthma, arrhythmias,
or tachycardias. Use
extreme caution in
patients with
cerebral edema or
increased CSF
pressure,
Hypertension,
arrhythmias,
seizures, &
hyperventilation
leading to
respiratory
alkalosis
Receiving mechanical
ventilation,
hypersensitivity, seizure
disorders, head
trauma/CVA,
uncompensated heart
failure, severe
hypertension,
respiratory failure
Avoid IV
extravasation
or using a
single
injection site
for a
prolonged
period

VPHM 142
hypercapnia
associated with
hypoxic-ischemic
encephalopathy in
foals
pheochromocytoma,
or hyperthyroidism
secondary to
neuromuscular
disorders, airway
obstruction
Methylxanthines stimulate
respiration by
altering the
sensitivity of
respiratory
center to CO2
URINARY SYSTEM DRUGS
Diuretics
effects
A. Cardiovascular
diuretics or Xanthine
derivatives
- Theophylline
- Aminophylline
Conditions that
are characterized
by fluid retention
- Heart failure
- Inflammation or
trauma
-
Hypoproteinemia
- Renal failure (to
induce urine
flow)
- High blood
pressure
increases
renal blood flow
that increases the
rate of urine
production
Not given on
patients
hypersensitive to
ethylenediamine
caution in patients
with severe cardiac
disease, seizure
disorders, gastric
ulcers,
hyperthyroidism,
renal or hepatic
disease, severe
hypoxia, or severe
hypertension
CNS stimulation
and
gastrointestinal
irritation
Hypersensitivity
to xanthines and
ethylenediamine
diuretic effect is
usually
enhanced
by simultaneous
administration
of
another diuretic
mild diuresis
B. Osmotic diuretics

VPHM 142
Mannitol Cerebral edema,
Actual or
anticipated renal
Shutdown, Acute
renal failure
Osmotically
attracts large
volumes of H2O
at the renal
tubules,
increasing urine
volume
CHF,
cardiovascular
shock
Urea
C. Natriuretic agents
Thiazides:
-Chlorothiazide
-Hydrochlorothiazide
-Bendrofluazide
edema of most
types,
nephrogenic
diabetes
insipidus &
hypertension in
dogs
inhibit Na+ & Cl-
reabsorption in
the proximal and
distal tubule
Severe renal
disease, preexisting
electrolyte/water
balance
abnormalities,
impaired hepatic
function,
hyperuricemia, SLE,
diabetes mellitus
Electrolyte
imbalance,
hyperglycemia,
Systemic acidosis
Hypersensitivity,
pregnancy
May be given
concurrently
with K- sparing
diuretics
because of
hypokalemic
effect
Carbonic anhydrase
inhibitors:
-Acetazolamide
-Dichlorphenamide
-Methazolide
-Ethoxolamide
metabolic
alkalosis or
glaucoma in
small animals;
HYPP in horses
(acetol)
noncompetitive,
reversible
inhibition of the
enzyme carbonic
anhydrase,
reducing the
formation of H+
and bicarbonate
ions
Electrolytes &
acid/base status
should be
monitored with
chronic or high
dose therapy
GI disturbances,
CNS effects,
hematologic
effects, renal
effects,
hypokalemia,
hyperglycemia,
hyponatremia
significant
hepatic, renal,
pulmonary or
adrenocortical
insufficiency,
hyponatremia,
hypokalemia,
hyperchloremic
acidosis or
electrolyte
imbalance
Give oral doses
with food if GI
upset occurs
D. Potassium sparing diuretics
Spironolactone Ascites,
congestive heart
failure
aldosterone
antagonist in the
collecting duct;
prevents
reabsorption of
Caution: Any renal
impairment or
hepatic disease
Facial dermatitis
in cats.
Hyperkalemia,
hyponatremia, &
Hyperkalemia,
Addison’s
disease, anuria,
acute renal
failure or
May be used in
combination
with

VPHM 142
Na+ and
excretion of K+
dehydration,
increased BUN &
mild acidosis in
patients with
renal impairment.
significant renal
impairment
thiazides &
other more
potent
diuretics
Triamterene alternative to
spironolactone
for the
adjunctive
treatment of
congestive heart
failure in dogs
Reduce the entry
of Na+ into the
distal tubule
(collecting duct)
must monitor
serum K+
Hyperkalemia Anuria, severe
or progressive
renal disease,
severe hepatic
disease,
hypersensitivity
to triamterene,
preexisting
hyperkalemia,
concurrent
therapy with
another K-
sparing agent
E. Loop diuretics
Furosemide/Frusemide most edematous
conditions
inhibits Na+ & Cl+
reabsorption
especially in the
ascending loop of
Henle where
most of the Na+
is reabsorbed
Avoid concurrent
use of furosemide
with
aminoglycosides
(antibacterials with
ototoxic side
effects)
Volume &
electrolyte
disturbances,
Dehydration,
weakness, shock,
Ototoxicity
extremely
potent diuretic
action
Others:
Bumetanide
Ethacrynic acid
Muzolimine

VPHM 142
Drugs for Urolith Treatment
Drug Indication Mode of action Contraindication Possible side effects
A. Urinary acidifiers
-Methionine Dissolves and helps prevent
formation of struvite uroliths
Renal failure, pancreatic disease, hepatic
insufficiency, preexisting acidosis,
oxalate or urate calculi; not
recommended for kittens
Gastrointestinal distress (food may
alleviate), Heinz-body hemolytic
anemia (cats)
-Ammonium Cl hepatic failure or uremia GI distress; IV use may lead to
metabolic acidosis
B. Urinary alkalinizers
-Potassium citrate
Treatment of calcium oxalate,
cystine and ammonium urate
crystals
heart failure, severe renal impairment,
UTI with calcium or struvite stones,
hyperkalemia, ulcer disease
GI distress, hyperkalemia, fluid
retention, metabolic alkalosis
C. Xanthine oxidase
inhibitors
(preventive)
-Allopurinol
Decrease the production of
uric acid, thus helping
decrease the formation of
ammonium urate uroliths
red-tailed hawks & should be used with
caution, if at all, in other raptors
GI effects, hypersensitivity,
hepatic and renal effects
DRUGS AFFECTING BLOOD COAGULATION
Systemic Hemostatic drugs (coagulants or procoagulants)
Drug Indication Mode of action Precaution Possible side effects
Vitamin K1 treatment of anticoagulant
rodenticide toxicity, Vit K
deficiency, sulfaquinoxaline
toxicity, & in bleeding disorders
co-factor in the formation of
clotting factors II, VII IX & X
avoid administering the drug
IV, do not give on animals
with hypersensitivity to it
Anaphylactic reactions,
Bleeding from injection site
Desmopressin
acetate
von Willebrand’s disease Causes the release of von
Willebrand
factor (VWF)
Use caution in patients
susceptible to thrombosi
Eye irritation after
conjunctival

VPHM 142
administration;
hypersensitivity possible
Protamine sulfate heparin-induced
hemorrhage, bracken fern
poisoning
combines
with acidic heparin to form a
stable salt that prevents
anticoagulant
activity of heparin
Monitor for heparin
“rebound effect”; inject
slowly (IV)
bradycardia, hypotension
Local Hemostatic drugs (coagulants or procoagulants)
Drug Indication Mode of action Notes
Clotting factors:
Thromboplastin, a local hemostatic in surgery promotes conversion of
prothrombin to thrombin thus
accelerating the coagulation
process
Thrombin, bleeding from parenchymatous tissues,
cancellous bone, dental socket, laryngeal &
nasal surgery
Converts fibrinogen to fibrin; white
sterile powder of bovine origin
*Must NOT be injected otherwise
may lead to intravascular
clotting
Fibrinogen
Fibrin Foam Applied directly onto
hemorrhagic areas
absorbable gelatin sponge USP for
capillary or venous bleeding
Artificial matrices:
Absorbable gelatin
sponge,
capillary and venous
bleeding
sterile, water-insoluble, gelatin-base
sponge that is absorbable
Oxidized
cellulose
Matrix for clot formation is achieved
by the reaction between
hemoglobin and cellulosic acid
Microcrystalline
collagen
surface hemostatic agent during
surgery
adheres to wet surfaces

VPHM 142
Anti-hemostatic agents
effects
Anticoagulants
Heparin anticoagulant for
blood transfusion;
pulmonary
embolism &
venous thrombosis
Inactivates thrombin
by activating
antithrombin III
Vitamin K
antagonists
long-term
treatment of
thromboembolisms
Inhibit the utilization
of vitamin K for
synthesis of clotting
factors
Anticoagulant
rodenticides
1st
gen:
Warfarin,
Indanedione
Pest control Block Vitamin K-
dependent synthesis
of clotting factors II,
VII, IX and X; inhibits
epoxide reductase, an
enzyme that
reduces vitamin K
Anticoagulant
rodenticides
2nd
gen:
bromadiolone,
brodifacoum
Pest control
Antithrombotics
Aspirin anticlotting effect
in the treatment of
laminitis in horses
Irreversible inhibition
of platelet
cyclo-oxygenase (COX-
1), reduces TXA
synthesis.
GIT
bleeding, vomiting

VPHM 142
Clopidogrel cats with
cardiomyopathy;
dogs with
underlying
hypercoagulability
reduces platelet
activation and
aggregation by
irreversibly inhibiting
the
binding of ADP to its
platelet
receptor
alternative
medication in
animals that
are unable to
tolerate aspirin
ANTINEOPLASTIC DRUGS
Drug Indication Mode of action Route Toxicities or adverse side effects
1. Alkylating agents
Chlorambucil Lymphoma, chronic, lymphocytic
leukemia, mast cell tumor, IgM
myeloma. Also used as an
immunosuppressant
Prolong the S phase, Inhibit
replication of DNA through
cross-linking of DNA strands
PO Potential teratogen,
myelosuppression & GI toxicity,
Mild marrow toxicity
Cyclophosphamide Lymphoma,
carcinoma, sarcoma
PO or IV Marrow, GIT, Hemorrhagic cystitis
2. Anthracyclines
Doxorubicin Lymphoproliferative neoplasms,
various
carcinomas and
sarcomas
Bind with DNA and interfere
with RNA and protein
synthesis; cell cycle specific
IV (slow
infusion)
Myelosuppression, GI upset,
hypersensitivity, myocardial
toxicity, nephrotoxicity(cats),
perivascular damage
with extravasation
3. Antimetabolites
Methotrexate Lymphoma analogues of purines and
pyrimidines that may be
incorporated into the DNA
molecule to inhibit protein and
enzyme synthesis; affect S phase
PO or IV Mild myelosuppression and GIT
upset
Cytosine
arabinoside
Myeloproliferative Lymphoma SQ, IM
or IV
4. Antitubulin agents

VPHM 142
Vincristine Lymphoma, mast cell tumor,
transmissible
venereal tumor,
immune-mediated
thrombocytopenia
stabilize or destabilize
microtubules, affecting mitosis
and causing cell death
IV Myelosuppression
perivascular vesicant, peripheral
neuropathy, constipation in cats
Vinblastine Mast cell tumor IV Myelosuppression
perivascular vesicant
5. Miscellaneous agents
Platinum drugs
-Cisplatin
-Carboplatin
solid tumors (osteosarcomas and
carcinomas)
interrupt the S phase in tumor
cells
IV renal toxicity, GI effects
L-Asparaginase lymphoproliferative
neoplasms
Catalyzes breakdown of
asparagine, an amino acid
required by cancer cells
Hypersensitivity and GI
disturbances
Glucocorticoids lymphoid neoplasms, management
of complications of neoplastic
diseases, increase appetite
has a lympholytic action, Cell
cycle nonspecific
NSAIDs
-Piroxicam transitional cell carcinoma
of the bladder and squamous cell
carcinoma in the dog inhibit frequently overexpressed
COX-2 enzyme activity present
in many tumor types
GI effects
-Newer COX-2
inhibitors (e.g.
deracoxib or
meloxicam)
canine transitional cell
carcinoma, squamous cell
carcinoma, and other tumor types
in dogs and cats.

VPHM 142
ANTIBACTERIAL AGENTS
INHIBITORS OF CELL WALL/CELL MEMBRANE SYNTHESIS
Beta lactams
MOA: bind to penicillin-binding proteins (PBPs), which are transpeptidases (responsible for synthesis of peptidoglycan) along the bacterial cell
wall; results to weakening of bacterial cell wall
Contraindicated in gerbils, guinea pigs, hamsters, rabbits
A. Penicillins
B. Cephalosporins
C. Carbapenems
D. Monobactams
A. Penicillins
Drug Activity Possible side
effects
Contraindication and/or
precaution
Notes
1. Natural PCNs
Penicillin G some G+ (Staphylococcus sp.
and Streptococcus sp. and
selected G- (Arcanobacterium,
L. monocytogenes, and P.
multocida)
Hypersensitivity
possible. Very high
doses may
cause CNS effects Known hypersensitivity
Degraded by stomach acid
Penicillin V GI effects or
hypersensitivity
More stable in
stomach acid (can be
orally administered)
2. Aminopenicillins
Amoxicillin Penetrates through G- bacilli
better than PCN, which
increases the spectrum to
include some
Enterobacteriaceae, including
GI effects Do not administer
systemic antibiotics orally
in patients with
septicemia, shock, or
other grave illnesses as
absorption of the
Combined with β-lactamase
inhibitors to overcome
resistance
and to increase the spectrum
Ampicillin GI effects

VPHM 142
strains of E. coli, Proteus
mirabilis, and Salmonella sp.
medication from the GI
tract may be significantly
delayed or diminished.
3. Beta-lactamase inhibitors
clavulanic acid little antibacterial effect but
can inhibit beta-lactamase
enzyme
sulbactam
Amoxicillin with
Clavulanic acid
(Co-amoxiclav)
GI effects,
hypersensitivity
treatment of urinary tract,
skin and soft tissue infections
caused by susceptible
organisms
4. Antistaphylococcal PCNs or β-lactamase stable/resistant penicillins
Oxacillin
Have some activity against
other G+ and with minimal
activity against G- bacteria
GI effects treatment of bone, skin, and
other soft tissue infections in
small animals
cloxacillin Hypersensitivity to
penicillins
via intramammary infusion in
dry and lactating dairy cattle
dicloxacillin GI effects hypersensitivity to
penicillins; do not use oral
medications in critically ill
patients
oral
Synthetic PCNs –
methicillin,
nafcillin
5. Extended-spectrum PCNs /Anti-pseudomonal PCNs
Piperacillin most activity against
G-aerobic and anaerobic
bacteria of all of the PCNs; this
includes Pseudomonas strains,
other G-
(many Enterobacteriaceae,
Proteus & Bacteroides sp.)
Ticarcillin
Carbenicillin

VPHM 142
B- Cephalosporins and Cephamycins
Group Activity Indication Drugs side effects Special species considerations
1st
gen greater activity against G+
bacteria, moderate G- activity (E.
coli., Shigella, enterobacter,
Klebsiella, Pasteurella, Proteus &
Salmonella)
Respiratory, skin
and soft
tissue infections,
and urinary
tract infections,
osteomyelitis
and pre-and post-
surgical use
in dogs, cats,
horse, cows, pigs,
sheep and goats
Cephalexin
Cefadroxil
Cephalothin
Cefazolin
Cephapirin
hypersensitivity
allergic reactions
in
small animals
Cross-sensitivity
with PCNs
GIT: Vomiting
after oral
cephalosporin
administration,
diarrhea and loss
of appetite
Reptiles: slow excretion, must have
long dosing interval
Avians: rapid elimination and poor
GIT absorption, must have high dose
and frequent administration
Rabbits and small rodents:
disruption of normal intestinal
mucosa
can cross the placenta and enter the
milk
2nd
gen Generally active against both G+
and G- bacteria
Cefaclor
Cefoxitin
Cefuroxime
Cefonicid
Cefprozil
Cefmetazole
Cefotetan
Cefamandole
Ceforanide
3rd
gen more active against G- bacteria
esp. enteric organisms
Ceftiofur
Cefotaxime
Ceftazidime
Cefoperazone
Moxalactam
Ceftriaxone
Cefixime
Cefpodoxime
Cefovecin
4th
gen broadest spectrum
(includes G+ cocci, G- bacilli, P.
aeruginosa, B-lactamase resistant
E. coli)
Cefepime
Cefquinome
5th
gen
Ceftaroline
broad-spectrum: active against
Enterobacteriaceae,
staphylococci (including MRSA) &
enterococci

VPHM 142
C- Carbapenems (PENEMS)
Drug Indication Activity Possible side effects Notes
Imipenem/cilastatin Serious, resistant
infections that
would otherwise
require multiple
Drugs; Bacterial
infections resistant
to other ATBs
Active against G+, G-,
anaerobes & many
bacteria resistant to
other drugs
- Penetration of
porin channels
Seizures, risk of
renal injury
Contraindications/Cautions: Patients
hypersensitive to it or other beta-
lactams, patients with renal
impairment (dosages adjustment may
be required), CNS disorders (e.g.,
seizures, head trauma)
Meropenem Lower incidence of
seizures
Doripenem
Ertapenem considered investigational; not
effective against Pseudomonas or
Acinetobacter
D- Monobactams
Drug Indication Activity Possible side effects Notes
Aztreonam serious bacterial infections that
are resistant to aminoglycosides
or fluoroquinolones
- Has activity against a wide range of
aerobic G- bacteria, with little G+ effect
- Effective in the treatment of G- bacterial
meningitis
Associated with epileptogenic
effects in experimental animals
or to humans
PEPTIDE ANTIBIOTICS
Drug Indication Activity MOA Possible side effects Route Notes

VPHM 142
A.
Glycopeptide
antibiotics
Vancomycin Infections of MRSA,
multidrug resistant
Enterococcus spp.,
pseudomembranous
colitis caused by
Clostridia dificile
MRSA, etc. binds to the
pentapeptides of the
peptidoglycan
monomers & inhibit
peptidoglycan
polymerization along
the bacterial cell wall
Nephrotoxicity, ototoxicity IV (poor
oral
absorption,
pain and
irritation
when IM)
“last resort”
antibiotic in
human medicine,
banned for use
on food-
producing
animals
Teicoplanin hypersensitivity skin
reactions (rash, pruritus,
urticaria), pain (IM) or
phlebitis (IV) at injection
sites, and rarely
nephrotoxicity or
ototoxicity (usually in
patients also receiving
aminoglycosides)
Rapid IV
injection
Avoparcin Was an antibiotic
growth promoter in
poultry and swine in
Europe but
B. Bacitracin necrotic enteritis in
poultry, prophylaxis
and therapy for
corneal and ocular
surface infection
similar
spectrum of
activity as PCN
G
(G+ and few G-,
some
spirochetes)
Interfere with cell wall
synthesis through
inhibition of a
peptidoglycan
precursor
Topical
-poor oral
absorption
C. Fosfomycin Dogs with UTI,
systemic infections
Multidrug
resistant E.
coli, G+ and G-
irreversibly inhibits
phosphoenol pyruvate
transferase, interfering
Nephrotoxic in cats

VPHM 142
with peptidoglycan
synthesis
D. Polymyxins for skin, mucous
membrane, eye &
ear infections
(topical); intestinal
infections (PO)
G- except for
Proteus spp
and Serratia sp.
cationic surfactant
(detergent) that
disrupts cell membrane
integrity through
interaction with cell
phospholipid
Systemic use leads to
nephrotoxicity,
neurotoxicity &
neuromuscular blocking
effects; Pus decreases
antibacterial activity
Topical, PO combined with
neomycin &
bacitracin in
topical
preparations for
a broader
activity
INHIBITORS OF PROTEIN SYNTHESIS
30S ribosome subunit- Aminoglycosides and Spectinomycin, Tetracyclines
Aminoglycosides
Drug Indication Mode of action Activity side effects Contraindication Notes
Streptomycin Septicemias,
Digestive,
Respiratory &
Urinary diseases
bind to the 30s
ribosomal sub-unit &
cause a
misreading of the
genetic code, leading
to cell death
Aerobic G- bacteria
(e.g. Klebsiella sp.,
P. aeruginosa,
E. coli), some G+
(e.g. S. aureus),
some
mycobacteria,
some mycoplasma
strains, some
spirochetes
Nephrotoxicity (least
nephrotoxic among
aminoglycosides),
ototoxicity,
neuromuscular
blockade
Dihydro
streptomycin
Kanamycin Nephrotoxicity
ototoxicity,
neuromuscular
blockade
Neomycin topical formulations
for skin, eyes, and
ears, oral treatment
of enteric infection
Nephrotoxicity (most
nephrotoxic),
ototoxicity,
neuromuscular
blockade
Apramycin bacterial enteritis,
colibacillosis,
salmonellosis, etc.
Nephrotoxicity Cats and patients
with myasthenia
gravis

VPHM 142
in pigs, calves and
poultry
ototoxicity,
neuromuscular
blockade
Tobramycin Septicemias,
Digestive,
Respiratory &
Urinary diseases
Framycetin
Paromomycin
Gentamicin reserved for
serious
infections when
given
systemically
Amikacin used with
extreme caution
in patients with
preexisting renal
disease
Spectinomycin
Indication Mode of action Activity side effects Contraindication Notes
Susceptible
(respiratory or enteric)
infections in food
producing animals
bind to 30s bacterial
ribosome
subunit & inhibit
CHON synthesis
Active against aerobic G+
& G- bacteria, Mycoplasma
sp.; Ineffective against
obligate G- anaerobes
Minimal compared to
aminoglycosides, May cause
anaphylactic reactions &
neuromuscular blockade
hypersensitivity
Tetracyclines
Drug Indication Mode of action Activity side effects Contraindication
and precaution
Notes
• Chlortetracycline
(CTC)
GIT, respiratory,
skin bacterial
infections, genito-
urinary tract
systemic
reversibly bind
and subsequently
distort the 30S
bacterial
ribosomal
subunit,
• G+ & G- bacteria
with little activity
against E. coli,
Salmonella, Proteus
or Pseudomonas
• Mycoplasma
Irritating when
given IM, Rapid IV
injection in cattle
may lead to
cardiovascular
collapse
Avoid milk,
antacids, iron salts
3 hrs before &
after oral
administration of
tetracyclines
• Oxytetracycline
(OTC)
• Tetracycline

VPHM 142
infections, sepsis,
infectious diseases
of locomotive
organs
interfering with
the translation
process
• Some
Mycobacteria
• Chlamydia (e.g.
Chlamydia psittaci)
• Rickettsia (e.g.
Anaplasma,
Ehrlichia)
(except
doxycycline &
minocycline)
• Doxycycline (DC) Can cause colitis
in horses
Less affected
by milk &
calcium salts
• Minocycline (MC)
General contraindications: pregnant animals & in neonates up to 4 weeks of age, may cause bone deformation
General side effect: tetracycline teeth (yellowish discoloration), colitis, photodermatitis
50S ribosome subunit- Macrolides, Lincosamides Pleuromutilins, Chloramphenicols, Streptogamins, Linezolid
Macrolides
Drug Indication Mode of
action
Activity Possible side
effects
Erythromycin infections caused by
susceptible organisms in
swine, sheep, and cattle
Bind to 50s
ribosomal
subunit
broad spectrum
(Strep, S. aureus,
penicillin resistant
strains, G-,
obligate anaerobes)
Gastric irritation,
vomiting
rabbits, gerbils,
guinea pigs, &
hamsters
Tylosin livestock diseases
caused by Mycoplasma, S.
hyodysenteriae & G+ aerobes
Fatal diarrheas in
horses
Tilmicosin - bovine and ovine sp.
for the treatment of
respiratory ds. caused by
Mannheimia haemolytica and
Pasteurella sp.
- For ovine mastitis due to S.
aureus and M. agalactiae
- For A. pleuropneumoniae,
M. hyopneumoniae, P.
multocida in pigs
tachycardia,
swelling at
injection site,
death (IV in
primates, goats,
swine, horses)

VPHM 142
- Mycoplasma in poultry
Azithromycin
&
clarithromycin
• Mycoplasma infections in
pig and poultry
• Hemorrhagic digestive
disease in pigs
• Liver abscesses
(Fusobacterium
necrophorum) in cattle
• Respiratory infections in
cattle
produced for
human
medicine
Spiramycin has activity
against
T. gondii &
Isospora sp.
Josamycin
Kitasamycin
General indications: borreliosis, brucellosis (usually in combination with rifampin or streptomycin), chlamydiosis, ehrlichiosis, leptospirosis,
listeriosis, rickettsiosis, and tularemia
Lincosamides
Drug Indication Mode of
action
Activity side effects Contraindication Notes
Lincomycin -Swine: for dysentery,
mycoplasma infections,
erysipelas and
streptococcal Infections
-Ruminants:
intramammary infusion
for mastitis
-Dogs and cats: abscesses
Bind to 50s
bacterial
ribosomal
subunit
moderate spectrum
- G+ aerobic bacteria
- anaerobic bacteria
-some Mycoplasma
serious GIT problems
(fatal enterocolitis in
horses and other
herbivores, rabbits,
rodents)
Horses, Rodents,
Ruminants,
Lagomorph
Clindamycin
Lincomycin-
Spectinomycin
enteric, respiratory
and other infections of
cattle, sheep, pigs &
poultry; mycoplasmal air
sacculitis, complicated
CRD, and E. coli,
necrotic enteritis
(C. perfringens)

VPHM 142
Pleuromutilins
Drug Indication Mode of action Activity side effects
Tiamulin Mycoplasma pneumonia, swine
dysentery, and proliferative ileitis
(swine), leptospirosis, bacterial
pneumonia
Bind to 50s
bacterial ribosomal
subunit
broad spectrum (G+, G-,
anaerobes) and
mycoplasma
Mycotoxicity and growth
depression in chickens, calves,
pigs (with ionophores),
enterocolitis (horses)
Valnemulin
Phenicols
Drug Indication MOA Activity side effects Contraindication
and precaution
Notes
Chloramphenicol Corneal infections,
cats with
Mycoplasma or
chlamydial
conjunctivitis,
systemic and local
infections
(Salmonellosis and
Bacteroides sp.)
Inhibits
bacterial
protein
synthesis
by binding
to 50s
ribosomal
subunit
Staph spp. and
Strep spp. are
susceptible;
Pseudomonas spp.
are resistant
Irreversible aplastic
anemia in chronic use
Avoid contact
with the drops
(fatal aplastic
anemia in
exposed
humans)
Can cross the
corneal barrier and
enter the anterior
chamber; banned in
food-producing
animals
because of dose-
dependent bone
marrow
suppression
Thiamphenicol Susceptible
respiratory and GI
infections in calves,
pigs, poultry
Most G+, G-,
Rickettsia spp.,
Chlamydia spp.,
Enterobacteriaceae
Less toxic than
chloramphenicol
Florfenicol bovine
respiratory disease
Diarrhea, inappetence,
reduced water
consumption
fluorine
improves its
efficacy, reduces
toxicity, reduces
bacterial resistance
Streptogamins
Drug Indication Mode of action Activity Possible side
effects

VPHM 142
Group A:
Virginiamycin
M
Dalfopristin vancomycin-resistant
staphylococcus and
Enterococcus faecium
(humans) infections
Group B:
Virginiamycin
S
growth promotant in
chickens, turkeys, swine
and cattle; necrotic
enteritis and coccidiosis
in chickens, swine
dysentery
Quinupristin vancomycin-resistant
staphylococcus and
Enterococcus faecium
(humans) infections
Linezolid
Indication Mode of action Precaution side effects Contraindication Notes
certain G+ infections
including certain drug-
resistant enterococcus,
staphylococcus, and
pneumococcus strains,
Disrupt bacterial
growth by inhibiting
the initiation process
of protein synthesis
INHIBITORS OF NUCLEIC ACID SYNTHESIS
DNA- quinolones and fluoroquinolones
RNA- Rifampins

VPHM 142
Quinolones
Drug Indication Mode of action Activity Possible side
effects
-Flumequine Local and systemic
infections including
those caused by
intracellular
pathogens
Inactivates
bacterial DNA
gyrase which is
important in DNA
replication
(supercoiling of
DNA).
Broad spectrum of
activity
used in
livestock
intestinal
infections
-Nalidixic acid
Fluoroquinolones
Enrofloxacin Susceptible infections (mostly cats) Inhibit bacterial DNA
synthesis:
1. Blocks ATP-dependent
enzyme DNA gyrase
2. Relaxation of
supercoiled DNA is
inhibited
3. double-stranded DNA
becomes more
susceptible to breakage
good activity against most
G- bacteria, especially
Enterobacteriaceae
1. Hypersensitivity
2. Crystalluria
3. GIT reactions, dizziness,
diarrhea
4. Embryotoxic, Maternotoxic
5. Arthropathies and cartilage
erosion in young animals
Difloxacin
Susceptible infections
Marbofloxacin
Danofloxacin
Ciprofloxacin
Rifamycin
Drug Indication Mode of action Activity side effects Contraindication Notes
Rifampin Rhodococcus equi
infections,
proliferative
enteropathy caused
disrupts RNA
synthesis by
binding to
subunits of
G+, some
mycobacteria, a few
G- (mostly cocci),
some anaerobes,
Uncommon;
potentially rashes,
GI distress, &
Hypersensitivity to
it or other
rifamycins
combined with
erythromycin
for the
treatment of R.

VPHM 142
by Lawsonia
intracellularis in
young horses
sensitive DNA-
dependent RNA
polymerase
and chlamydiae,
fungi, intracellular
organisms
increases in liver
enzymes
equi infections
in foals
Rifamycin Susceptible
infections in horses,
dogs, cats
ANTIMETABOLITES- sulfonamides, trimethoprim
Sulfonamides
Sulfachlorpyridazine • Coccidiosis
• Infectious coryza
• Bacterial cystitis
• Diptheria
• Fowl cholera
• Fowl typhoid
• Bacterial
enteritis
• Bacterial
pneumonia
• Pododermatitis
• Pullorum disease
• Bacterial
respiratory
infections
• Skin & soft tissue
infections
interfere with
the synthesis of
bacterial folic
acid needed for
bacterial DNA
and RNA
synthesis
Inhibit G+ & G- bacteria,
Chlamydia & some
protozoa (e.g. coccidia,
toxoplasma)
Ineffective against most
obligate anaerobes (not
for treating serious
anaerobic infections)
Crystalluria (all species)
Dogs: Keratoconjunctivitis sicca, idiosyncratic
toxicosis (esp. in Doberman
Pinschers), inhibition of
thyroid hormone synthesis
Horses: Severe cardiac arrhythmia & collapse may
result from concurrent administration of
sulfonamides with sedatives or anesthetics
Poultry:
• Hemorrhagic syndrome, vit K deficiency causing
agranulocytosis & hemolytic anemia
• Several sulfonamides can lead to decreased egg
production and growth.
Sulfadimethoxine
Sulfamerazine
Sulfamethazine
Sulfaquinoxaline
Sulfanilamide
Sulfathiazole
Sulfadiazine
Sulfadimidine
(Sulfamethazine)
Sulfadimerazine
Sulfadoxine
Sulfafurazole
Sulfaguanidine
Sulfadimethoxazole
Potentiated sulfonamides

VPHM 142
Diaminopyrimidines
-Ormetoprim
-Trimethoprim
-Baquiloprim
• Bacterial arthritis in pigs
• Prevention & treatment
of coccidiosis in poultry
• Colibacillosis in poultry &
livestock
• Enteric septicemia in
catfish
• Bacterial enteritis
• Equine protozoal
myeloencephalitis
• Fowl cholera
• Furunculosis (salmon and
trout)
• Bacterial GIT infections
• Infectious coryza
• Mastitis
• Perioperative infections
• Bacterial pneumonia
• Pododermatitis
• Respiratory tract
infections
• UTIs
• strangles
• skin and soft tissue
infections
The combination
(sulfonamide-
diaminopyrimidine)
block sequential stages in
the synthesis of bacterial
folic acid (tetrahydrofolate
Broad spectrum
• G+ and G- bacteria,
Chlamydophila
• Nocardia sp.
• Some protozoa
(Toxoplasma sp.)
• Some anaerobes
- similar as with
sulfonamides alone
-blood dyscrasias
Crystallization in the
urinary tract
-Hypersensitivity,
specifically anaphylaxis in
all species
-Dogs: idiosyncratic
toxicosis,
keratoconjunctivitis sicca,
neurologic disorders
(ataxia, aggression,
behavioral changes),
polyarthritis etc.
Combinations
-trimethoprim/ sulfadiazine
-trimethoprim/ sulfadoxine
-trimethoprim/ sulfamethoxazole
(co- trimoxazole)
-trimethoprim/ sulfaquinoxaline
-trimethoprim/ sulfadiazine
sulfonamides(bacteriostatic)
+
trimethoprim(bactericidal) =
bactericidal potentiated
sulfas
The sulfonamide blocks the
conversion of para-
aminobenzoic acid (PABA)
to dihydrofolic acid (DFA),
and trimethoprim blocks
the conversion of DFA to
tetrahydrofolic acid by
inhibiting dihydrofolate
reductase
Other Antibacterial Agents
Drug Indication Mode of action Activity Possible side effects Notes
A. Nitrofurans
Nitrofurazone For UTI, wound
infections
Banned in food-
producing animals
due to potentially

VPHM 142
Inhibit bacterial enzyme
systems
Broad spectrum GIT and hepatic
disturbances
carcinogenic
residues
Nitrofurantoin urinary tract infections
Furazolidone For topical and ocular
infections
B. Nitroimidazoles antibacterial and
antiprotozoal
effects (Giardia sp.,
Trichomonas,
amoebiasis, anaerobic
bacteria)
disrupt DNA & nucleic acid
synthesis
anorexia, vomiting,
diarrhea,
neurologic signs
Use with care in
pregnant animals
C. Aminocoumarins
Novobiocin Susceptible infections inhibition of DNA synthesis,
RNA synthesis also cell wall
and
protein synthesis
mainly G+ Systemic use: Fever, GI
(nausea, vomiting,
diarrhea), rashes, &
blood dyscrasia
Used in
combination with
other agents for
the treatment of
bovine mastitis
Clorobiocin
ANTIFUNGAL DRUGS
Drug Indication Mode of action Dosage
form
side effects Notes
1. Polyenes
Nystatin oral or GIT C. albicans
infection in
dogs, cats and birds
disrupt the fungal cell
membrane by binding to
ergosterol
Fungistatic at low conc,
fungicidal at high conc
Oral or
tropical
GI upset and hypersensitivity
Amphotericin B progressive or
disseminated deep
mycosis
Parenteral
(IV and
topical)
nephrotoxicity Lower doses are
recommended in
cats

VPHM 142
Used in combination
with other antifungal
drugs:
2. Imidazoles or azoles
Ketoconazole Broad-spectrum antifungal
Trichophyton verrucosum,
T equinum, T
mentagrophytes,
Microsporum canis, and M.
nanum; and yeast:
Malassezia
pachydermatis and
Cryptococcus neoformans
Cause leakage of fungal
cell membrane; mostly
fungistatic
Ketoconazole: inhibits
ergosterol synthesis
Oral and
topical
Hepatotoxic (chronic use),
teratogenic (possible),
Dogs: inappetence, vomiting,
pruritus, alopecia, reversible
lightening of the hair coat
Cats: (more sensitive to
ketoconazole), anorexia, fever.
depression, diarrhea, increased
liver enzymes, hepatotoxicity
Fewer side effects
than amphotericin B
Miconazole fungal keratitis in the
horse
Topical same MOA as
ketoconazole but has
a greater potency,
decreased toxicity,
and a wider
spectrum of activity
Itraconazole Systemic mycoses,
blastomycosis
Oral and
IV
Clotrimazole localized lesions associated
with Malassezia
topical
Fluconazole CNS mycoses Oral, IV,
topical
3. Fluorinated
pyrimidine
(flucytosine)
Active against yeasts
(Candida spp, C.
neoformans, M.
pachydermitis) and some
Aspergillus sp.
interfere with RNA &
protein synthesis
Oral, IV bone marrow depression
4. Superficials
e.g.
Griseofulvin
For topical/superficial
mycoses (targets
dermatophytes)
disrupt fungal cell
division
Oral,
topical
-Teratogenic in all species
-dogs: vomiting, diarrhea and
increased liver enzymes

VPHM 142
-cats: anemia, leukopenia,
vomiting, diarrhea, depression,
pruritus, ataxia, fever, bone
marrow suppression (FIV+)
5. Others:
Terbinafine
Interferes with fungal
sterol biosynthesis at an
early stage, causing
deficiency of ergosterol,
intracellular
accumulation of
squalene, and
fungal cell death
Oral,
topical
ANTHELMINTIC DRUGS
ANTINEMATODAL DRUGS
Benzimidazoles
Drug Indication Mode of action Dosage form side effects notes
• Albendazole •Horses: strongyles, pinworms,
ascarids
• Cattle: ascarids, several strongyle
species, liver fluke
& tapeworms (albendazole);
lungworm (fenbendazole)
• Sheep and goats: ascarids, several
strongyle sp, stomach worms,
lungworm (fenbendazole)
• Dogs: hookworms, roundworms,
pinworms, some
are effective against Taenia
pisiformis but not D.
interfere with the
energy
metabolism of
worm on a cellular
basis
-Oral liquid: cattle,
sheep, goats
-tablets, pills, oral
suspension: dogs
and cats
-oral paste: horses
Lethargy, vomiting,
diarrhea,
Hepatotoxicity
(mebendazole),
Teratogenicity
(albendazole,
netobimin,
• Thiabendazole
• Oxibendazole
• Mebendazole
• Cambendazole
• Oxfendazole
• Fenbendazole
• Probenzimidazoles More water-
soluble

VPHM 142
caninum
• Swine: strongyles and lungworms
Organophosphates
Drug Indication Mode of action Dosage form Possible side effects Notes
Dichlorvos • Horse: bots, strongyles,
roundworms, pinworms
• Cattle: strongyles
• Dogs & cats: hookworms,
roundworms, whipworms
• Swine: ascarids, whipworms,
nodule worms, strongyles
acetylcholinesterase
inhibition resulting to
worm paralysis
Muscle tremors,
miosis;
overdose could lead
to muscarinic &
nicotinic
signs in the worm
host (SLUDGE),
Trichlorfon
Coumaphos
Haloxon
Tetrahydropyrimidines
Drug Indication Mode of action Dosage form
• Pyrantel
pamoate/embonate
• Horses: ascarids, strongyles, pinworms
• Cattle, sheep, goats: strongyles
• Dogs, cats: hookworms, roundworms
• Swine: roundworms, strongyles
depolarizing neuromuscular
blocking agent
Oral formulations
• Pyrantel tartrate
• Morantel tartrate
Imidazothiazoles
Drug Indication Mode of action Precaution Possible side effects Dosage form Notes
• Levamisole Ascarids,
whipworms,
hookworms,
lungworms,
strongyles
mimic the action
of acetylcholine
(cholinergic
agonists),
resulting to worm
paralysis
With
immunostimulant
and anti-
inflammatory
effects
Salivation, ataxia, muscle
tremors
oral (pellets,
powder, paste,
suspension)
• Tetramisole

VPHM 142
Piperazine compounds
Drug Indication Mode of action Dosage form
• Piperazine dihydrochloride Nematodes specifically dog and cat
roundworms
Cause muscle hyperpolarization,
thus blocking neuromuscular
transmission in the parasite
Oral formulation
• Piperazine sulfate
Avermectins
Drug Indication Mode of action side effects Contraindication
Abamectins Broad-spectrum anti-nematode of ruminants,
horses, pigs & dogs, heartworm larvae,
ectoparasites
bind to glutamate-
gated Cl- channels in
neurons & myocytes
(potentiators of
GABA), resulting to
worm paralysis and
death
• Eprinomectin
• Moxidectin
• Doramectin
• Selamectin
• Ivermectin • Horses: strongyles, pinworms, ascarids,
hairworms, stomach worms, threadworms,
bots, lungworms
• Cattle: GIT roundworms, lungworms, grubs,
lice, mange mites
• Dogs and cats: preventive for D. immitis,
hookworms (cats)
• Birds and snakes: endoparasites
CNS depression, ataxia
and possible
death may occur after
ivermectin
administration in
dogs with mdr1 gene
mutation
Collies and collie
mixes (genetic
mutation), Murray
Grey cattle,
animals with
ABCB1/mdr1
mutation
Milbemycins
• Milbemycin oxime
• Moxidectin
Broad-spectrum anti-nematode of ruminants,
horses, pigs & dogs, heartworm larvae,
ectoparasites

VPHM 142
ANTICESTODES
Pyrazine derivatives
Drug Indication Mode of action side effects
Praziquantel effective against all cestodes increases the permeability of the
worm’s cell membrane
lethargy, vomiting, diarrhea,
anorexia
Epsiprantel for Taenia and Dipylidium sp.
ANTITREMATODAL DRUGS
Antitrematodal Drugs
Drug Indication Mode of action Precaution
Clorsulon Effective against
adult and immature
forms of F. hepatica
in cattle
inhibits the
worm’s enzyme
systems for energy
production
Albendazole Effective against adult
forms of F.
hepatica in cattle
interferes w/ the worm’s
energy metabolism
Not approved for use in
lactating
animals
Praziquantel For lung
trematodes in cats
and dogs
Triclabendazole For all stages of
liver fluke
ANTHELMINTICS FOR HEARTWORM INFECTION
Drug Indication Route side effects Notes
• Adulticide

VPHM 142
Thiacetarsamide Adult D. immitis IV nephrotoxicity,
hepatoxicity, coughing,
gagging,
lethargy
Not recommended
anymore by the
American Heartworm
Society
Melarsomine Adult D. immitis IM nephrotoxic & hepatotoxic
but safer & more effective
than
thiacetarsamide
coughing, gagging.
Depression, lethargy,
anorexia, fever, vomiting
• Microfilaricide
Ivermectin ataxia,
depression, salivation
Not recommended for
puppies <6 weeks of
age, collies & collie
mixes, dogs with mdr1
mutation
Milbemycin also used as a heartworm preventative
in cats; also for hookworms, ascarids,
whipworms
Selamectin • Used for fleas, ear mites, sarcoptic
mange in dogs
• Also or cat nematodes & hookworms
Moxidectin GIT signs, neurologic signs
Diethylcarbamazine (DEC) Also for ascarids, hookworms,
whipworms
vomiting

drug index.docx

Recommended

Recommended

More Related Content

Similar to drug index.docx

Similar to drug index.docx (20)

Recently uploaded

Recently uploaded (20)

drug index.docx