Common Equine Common Equine Medications and Their Medications and Their Effects Effects Matt Kornatowski, DVM Matt Kornatowski, DVM
Jan 15, 2016
Common Equine Medications Common Equine Medications and Their Effectsand Their Effects
Matt Kornatowski, DVMMatt Kornatowski, DVM
My PerspectiveMy Perspective
• Many questions about drugs
• Misconceptions
• Reasons for choosing
certain drugs
• Safety for you and your horse
OutlineOutline
• Sedatives• NSAIDs
(Non-steroidal Anti-inflammatories)
• Antibiotics• Gastroprotectants
• Topicals• Miscellaneous
Talking PointsTalking Points
• Appearance
• Uses
• Administration routes
• Side Effects
Non-Talking PointsNon-Talking Points
• Doses• Steroids (Too much)• Reproduction drugs
– Dr. Stanford’s talks
• Dewormers– A whole different talk!
• Supplements • Controlled drugs
AbbreviationsAbbreviations
• PO = Per Os = Orally
• IV = Intravascularly
• IM = Intramuscularly
• PR = Per rectum = enough said
SedativesSedatives
• Acepromazine
• Detomidine
• Romifidine
• Xylazine
• Use caution!
AcepromazineAcepromazine(Ace)(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)
DetomidineDetomidine(Dormosedan, Dorm)(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
RomifidineRomifidine(Sedivet)(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
XylazineXylazine(Rompun)(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
NSAIDsNSAIDs(Non-Steroidal Anti-Inflammatories)(Non-Steroidal Anti-Inflammatories)
• Phenylbutazone
• Banamine
• Firocoxib
• Aspirin
• Piroxicam
• Meloxicam
NSAIDsNSAIDs(Non-Steroidal Anti-Inflammatories)(Non-Steroidal Anti-Inflammatories)
PhenylbutazonePhenylbutazone(Bute)(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 MeglumineFlunixin Meglumine(Banamine)(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 MyositisClostridial MyositisResult of IM injections
AspirinAspirin
• White powder
• Used for hypercoagulable states, Equine Recurrent Uveitis
• Given PO
• Side Effects: Same as above (less common), platelet inhibition,
tinnitus (overdose)
FirocoxibFirocoxib(Equioxx, Previcox)(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
PiroxicamPiroxicam
• Cox 1
• Used for Squamous Cell Carcinoma
• Given PO, IV (less common)
• Side effects: Same as above
Meloxicam (Metacam)Meloxicam (Metacam)
• Cox 2 specific, considered quite safe
• Used in Europe
• Coming soon??
AntibioticsAntibiotics
• SMZs• Penicillin G• Gentamicin• Ceftiofur• Doxycycline• Metronidazole• Enrofloxacin• Chloramphenicol
ResistanceResistance
• 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)
SMZsSMZs
• Trimethaprim Sulfadiazine (Veterinary)– SMZs, Uniprim, Tucoprim
• Trimethoprim Sulfamethoxazole (Human)– Tribrissen
• 160 mg Trimethoprim• 800 mg Sulfa• Main difference:
– Urine concentration– Metabolization
SMZsSMZs
• Paste, powder, white tablets
• Given PO, IV (Rare)
• Used for variety of infections– Mainly skin, uterine, urinary
• Side effects: Colitis,
Anemia (long term)
Penicillin GPenicillin 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)
GentamicinGentamicin(Gentocin)(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
CeftiofurCeftiofur(Naxcel, Excede)(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)
DoxycyclineDoxycycline
• Small, orange tablets
• Used for various issues– Penetrates tissues very well
• Given PO– Oxytetracycline given IV
• Side effects: Congenital malformations
• GI disruption• Relatively safe
MetronidazoleMetronidazole(Flagyl)(Flagyl)
• Oblong white tablets
• Used for diarrhea, thrush,
canker (anaerobic infections)
• Given PO, PR, topically
• Side effects:– Neurotoxicity (rare)– Disruption of GI protozoa
EnrofloxacinEnrofloxacin(Baytril)(Baytril)
• Liquid or oral paste • Used for variety of infections
– Less resistance
• Given PO, IV• Side effects: Colitis
NeurotoxicityTissue irritation (Oral lesions) Cartilage damage in young
ChloramphenicolChloramphenicol
• 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!
GastroprotectantsGastroprotectants
• Gastrogard
• Ulcergard
• Ranitidine
OmeprazoleOmeprazole(Gastrogard/Ulcergard)(Gastrogard/Ulcergard)
• Oral, white paste• Treat/prevent
gastric ulcers• Proton pump inhibitor
– Decreases acid secretion
• Given PO• Side Effects:
– No adverse effects listed
RanitidineRanitidine(Zantac)(Zantac)
• Small, circular yellow or white tablets
• Treat gastric ulcers
• Inhibits H2 receptors– Decreases acid secretion
• Given PO, IV
• Side effects: Very rare
TopicalsTopicals
• Triple Antibiotic Ointment
• Silver Sulfadiazine
• Furazone
• Surpass
• DMSO
Triple Antibiotic OintmentTriple Antibiotic Ointment(Neomycin, Polymyxin, Bacitracin)(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 SulfadiazineSilver Sulfadiazine(SSD)(SSD)
• Thick, white cream
• Anti-bacterial, anti-fungal
• Used for burns, eye ulcers,
wounds
• Side Effects: Skin irritation
NitrofurazoneNitrofurazone(Furazone)(Furazone)
• Yellow gel– Can be mixed with DMSO
• Antibacterial
• Good for burns, skin infections– Scratches
• Side effects:– Contact dermatitis– Renal impairment
Diclofenac Diclofenac (Surpass)(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
DMSODMSO((DDi-i-MMethyl ethyl SSulf-ulf-OOxide)xide)
• 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 MedsMiscellaneus Meds
• Pergolide
• Isoxsuprine
• Marquis
PergolidePergolide
• 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
IsoxsuprineIsoxsuprine
• White tablets
• Used for laminitis & navicular– Dilates blood vessels– Questionable efficacy
• Given PO
• Side effects: Unlikely– Tachycardia, hypotension – Hyperexcitability
PonazurilPonazuril(Marquis)(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 PointsKey Points
• Sedatives – Ataxia, sweating, urination
• NSAIDs– Gastric ulcers, kidney problems
• Antibiotics– Resistance– Potentially cause colitis
• Call your vet before administering any drugs!
Questions?Questions?