Basic Pharma Drugs

Phenobarbital

Elevates seizure threshold and produces e>ect

at lower doses and with no sedation.

Phenobarbital

DOC for long-term seizures.

Phenobarbital

It should be used first in all cases of seizures but not for

ongoing seizures.

Phenobarbital

DOC for treating epilepsy in cats.

Phenobarbital

Occasionally used as an oral sedative agent in

small animals.

Phenobarbital

Adverse effect: increases cytochrome P450 activity and may decrease thyroid hormone levels.

Pentobarbital

Used to stop seizures but causes anesthesia

at therapeutic doses.

Pentobarbital

Used to treat seizures caused by strychnine

poisoning and tetanus

Pentobarbital

Anticonvulsant that is a major active ingredient in euthanasia solutions

Pentobarbital

Adverse e>ects include respiratory depression and hypothermia.

Pentobarbital

It is very irritating when given subcutaneously or perivascularly

Diazepam

Most widely used anticonvulsant, also has sedative, hypnotic, and tranquilizing e>ects.

Diazepam

Used for tx/mgt of seizures of any origin, behavioral problems, and restlessness.

Diazepam

Used as maintenance anticonvulsant, appetite stimulant, urine marking control, and anxiolytic for cats but not in dogs.

Midazolam

More potent than diazepam but has shorter DOA.

Midazolam

Used the same way as diazepam and also as premedication for general anesthesia

Midazolam

May cause respiratory depression in animals and produce agitation and ataxia in horses.

Lorazepam

Very long acting with slow onset of action.

Lorazepam

4x more potent than diazepam and is not painful during injection

Lorazepam

Safely used in individuals with compromised liver function as it does not produce active metabolites.

Lorazepam

Also used for treating chemotherapy-induced nausea and vomiting, alcohol withdrawal, and akathisia secondary to antipsychotic medications.

Flumazenil

Reversal agent for benzodiazepine overdose.

Levetiracetam

MOA: Inhibits spread of seizure activity by binding to synaptic vesicle protein-2A (SV2A).

Levetiracetam

Used orally as an adjunctive therapy for canine refractory epilepsy.

Levetiracetam

Adverse effects: minimal side effects and always taper dose to prevent withdrawal symptoms.

Levetiracetam

It is not metabolized in the liver.

Zonisamide

MOA: Inhibits voltage-gated Na+ and Ca2+ channels of neurons to induce hyperpolarization and decreased Ca2+ influx.

Zonisamide

Sulfonamide-based anticonvulsant used solely or adjunctively to control refractory epilepsy in dogs with high safety margin

Gabapentin

MOA: Prevents excitatory neurotransmitter release by inhibiting voltage-gated Ca2+ channels.

Gabapentin

Used as adjunctive therapy for refractory or complex partial seizures.

Gabapentin

Used for chronic pain in small animals and as an anxiolytic for cats.

Gabapentin

Caution in animals with liver/kidney disease.

Felbamate

MOA: Inhibits NMDA receptor-mediated neuronal excitation and blocks voltage-gated Na+ and Ca2+ channels, while enhancing GABA-mediated neuronal inhibition.

Felbamate

A dicarbamate drug used orally in dogs to treat refractory epilepsy and in patients with focal and generalized seizures.

Felbamate

Used to control obtunded mental status in patients with brain tumors or cerebral infarcts.

Potassium Bromide

MOA: Br- enters neurons via Cl- channels, resulting in hyperpolarization of the neuronal membrane.

Potassium Bromide

Used orally to treat refractory seizures in dogs but not in cats.

Potassium Bromide

Adverse effects include sedation (+ with phenobarbital), polyphagia with weight gain, PU/PD, electrolyte imbalance, and vomiting.

Potassium Bromide

It has very long half-life and is eliminated by the kidneys exclusively.

Morphine

A μ-agonist and a less potent κ- and δ-agonist.

Morphine

Used for the treatment of acute pain in dogs, cats (low doses), and horses (in combination with xylazine/diazepam)

Morphine

Induces vomiting in dogs via D2-mediated stimulation of the CRTZ.

Morphine

Induces transient defecation before reducing GI motility.

Morphine

Induces miosis in dogs and primates, and mydriasis in cats

Hydromorphone

A synthetic μ-agonist that is 5-7x more potent than morphine but has shorter DOA

Hydromorphone

Used preoperatively because it produces more sedation and less vomiting than morphine.

Hydromorphone

Adverse effects: Constipation can occur in long-term therapy in all species and may cause hyperthermia in cats.

Oxymorphone

A dihydroxy derivative of morphine that is 10x more potent than morphine but is more expensive than hydromorphone

Oxymorphone

Used as an analgesic in dogs and cats.

Oxymorphone

Used as preanesthetic in dogs to induce neuroleptanalgesia

Oxymorphone

Used for IV anesthesia in swine.

Methadone

A synthetic μ-opioid agonist and NMDA receptor antagonist

Methadone

Used as a morphine alternative in dogs and cats.

Methadone

Used for treatment of colic in horses and perioperatively to control pain in dogs and cats.

Methadone

In cats, it can be administered orally via the transmucosal route by placing it in the buccal pouch.

Meperidine

a.k.a. Pethidine

Meperidine

a μ-opioid agonist with similar chemical structure with atropine and has short DOA.

Meperidine

Suitable for treating moderate to severe pain.

Only administered IM or SC.

Meperidine administration

Fentanyl

A synthetic μ-opioid agonist that is 100x more potent than morphine with faster onset but shorter DOA.

Fentanyl

Used in dogs and cats as part of an anesthetic induction regimen or a potent analgesic to control postoperative and chronic pain.

Fentanyl

Available in transdermal patches, used to control chronic pain.

Fentanyl

Not approved for use in food-producing animals.

Remifentanyl

An ultrashort acting opioid similar to fentany

Remifentanyl

used as an analgesic during the perioperative or postoperative period

Remifentanyl

Can be used in patients with hepatic and renal diseases.

Remifentanyl

Administered as CRI.

Alfentanil

A μ-opioid agonist fentanyl derivative that is 4x less potent than fentanyl but is 30-40x more potent than morphine.

Alfentanil

Used as an analgesic and sedative, and is used for adjunctive anesthesia, particularly in cats.

Sufentanil

A u μ-opioid agonist fentanyl derivative that is 5-10x more potent than fentanyl in analgesic activity.

Sufentanil

Useful for adjunctive anesthesia, epidural anesthesia, or postoperative analgesic.

Sufentanil

Dose-related CNS and respiratory depression is the principal adverse effect.

Sufentanil

Has a rapid onset of action and a faster recovery time than fentanyl

Carfentanil

An ultrapotent fentanyl analogue (100x more potent than fentanyl, 10000x more potent than morphine).

Carfentanil

Used only in veterinary medicine for immobilizing very large wild animals.

Carfentanil

Used to immobilize wild horses but not domestic horses.

Carfentanil

It can disrupt temperature regulation which can be fatal in the field.

Butorphanol

A partial agonist for μ-receptors, but a full agonist for κ-receptors.

Butorphanol

Can be used as an opioid reversal agent.

Butorphanol

Has an analgesic potency 4-7x more than morphine with rapid onset and shorter DOA.

Butorphanol

Has an antitussive and antiemetic effect in dogs.

Butorphanol

Can be used as a pre-anesthetic in dogs and cats.

Butorphanol

In birds and horses, provides equal or better analgesia than full μ-agonists.

Buprenorphine

A partial agonist for μ-receptors, and an antagonist for κ-receptors

Buprenorphine

30x more potent as an analgesic than morphine with

longer DOA than most opioids.

Buprenorphine

Used as an analgesic in small animals and horses.

Buprenorphine

It is highly protein bound but it undergoes significant first pass effect and is resistant to antagonism by naloxone

Nalbuphine

An antagonist at the μ-receptor and an agonist at the κ-receptor, with equal potency to morphine.

Nalbuphine

Used to control mild to moderate pain only

Nalbuphine

Used topically to control pain associated with corneal ulcers in dogs and cats.

Nalbuphine

Not commercially available for ophthalmic use but may be prepared through compounding.

Tramadol

A synthetic μ-receptor opiate agonist that also inhibits reuptake of serotonin and norepinephrine

Tramadol

A prodrug which is metabolized by the liver into O-desmethyltramadol.

Tramadol

Can be used as an analgesic or antitussive in dogs and cats and control chronic cancer pain or osteoarthritis pain

Atypical opioids

DO NOT GIVE concurrently with other drugs that increase serotonin levels.

Tapentadol

A synthetic opioid whose parent compound is a μ-receptor agonist and norepinephrine reuptake inhibitor.

Tapentadol

More effective as analgesic for dogs and patients with liver impairments

Naloxone

Has a high affinity for μ-receptors and lower a>inity for κ- and δ-receptors

Naloxone

Short-acting opioid used to reverse the respiratory depression caused by μ-receptor opioids after surgery and in neonates after cesarean delivery.

Naloxone

Beneficial in the treatment of septic, hypovolemic, and cardiogenic shock.