VTNE | PHARMACY & PHARMOCOLOGY

Broadly describe the function and types of immunostimulants.

Immunostimulants work to increase the body’s immunological response against unwanted viruses and cancer cells.

The animal diseases that are most commonly treated with immunostimulants include FLV, FIV, and canine lymphoma. Dogs that develop canine lymphoma can receive a boost to their immune system through the administration of canine lymphoma monoclonal antibodies medication (CL/MAb 321), produced in a laboratory.

Acemannan (trade name: Immunoregulin) is an immunostimulant that is used for treatment with FLV, FIV, and specific cancers; produced by synthesizing aloe vera and propionibacterium acnes.

Describe diabetic ketoacidosis and its common presentation

Diabetic ketoacidosis (DKA) occurs when fatty acid-derived ketone bodies become the primary cellular energy source when glucose cannot be moved into the cells for metabolism. The metabolism of fats produces an acidic state in the blood which often further complicates the diabetes, and rising levels of ketones may become toxic. Thus, animals with DKA may be very ill, vomiting, and depressed.

The condition may cause the patient to present with “fruity” smelling acetone breath as the ketone concentration rises. Blood or urine testing will definitively reveal the level of ketones. Treatment typically involves intravenous fluid replacement (to correct dehydration and dilute acids and ketones) and the administration of insulin until the blood levels are more stable.

Broadly describe the function and types of immunosuppressants

Immunosuppressant drugs can help the body to accept the organs or tissues more gradually, while holding an aggressive immune system at bay, for patients with overactive/compromised immune systems. These same drugs can also be used in patients who have received tissues or organs from donors.

Autoimmune diseases which can benefit from these drugs include autoimmune thyroiditis, autoimmune adrenalitis, immune-mediated hemolytic anemia (IMHA), myasthenia gravis, various skin autoimmune diseases, etc.

Drugs classified as immunosuppressants include glucocorticoids (ex. prednisone), azathioprine (ex. Imuran), cyclosporine (ex. Sandimmune), mycophenolate mofetil, leflunomide, and cyclophosphamide.

Describe diabetes mellitus, types 1 and 2

Diabete mellitus (DM) occurs when the body’s ability to regulate blood glucose is impaired, causing hyperglycemia and glucosuria. Type 1 diabetes (insulin-dependent DM) is caused by damage to the pancreatic beta cells, resulting in decreased insulin production; occurs most commonly in dogs. Type 2 diabetes (noninsulin-dependent DM) describes a decreased sensitivity to the amount of insulin produced; occurs most commonly in cats.

Insulin is a polypeptide hormone which is secreted by beta cells found in the Islet of Langerhans, in the pancreas. It is responsible for moving glucose out of the blood and into the cells, where it is used for energy for stored for later use.

Describe the use of insulin and insulin facilitators in the treatment of diabetes

Fast-acting insulin (ex. Vetsulin) is given to patience who require their blood sugars to be decreased rapidly.

NPH (insulin classified as an intermediate acting hormone) is used for patience who require a daily control method.

Insulin can also be blended with protamine as an extended-release product, which can also be given through injections. Animal patients with diabetes will benefit from protamine zinc insulin.

Insulin facilitators can be used to treat some diabetic patients who still produce some natural insulin. Sulfonylureas is one classification of these medications; a common sulfonylurea-based antidiabetic drug is glipizide (Glucotrol), which is given to animals with Type 1 DM. Best given twice a day during mealtimes.

Broadly describe the function and types of topical veterinary agents.

Topical medications are drugs which are applied to the skin’s surface and to the mucous membranes of the body (which line the surface of all moist body passages, and can be sensitive; ex. eyes, inner ears, nostrils, tongue, rectum, urethra, and vagina).

These medications can be applied otically as ear drops; ophthalmically as eye drops or ointments; intranasally as drops, creams, or ointments; and sublingually by placing the medication under the tongue. Cream and ointment topical medications can be applied directly to rectal and vaginal areas.

Particular caution is also required to compensate for animal biology and behaviors. Ex. Animals are known to groom/soothe injuries; some human topical products can be poisonous to the animal; topical treatments have the tendency to be poorly absorbed by animal’s system as a whole. Other drugs like nitroglycerin and certain pour-on preparations will produce a systemic effect.

Describe the function and use of antitussives, expectorants, and mucolytics

Antitussives suppress or reduce cough reflex, often administered to a patient with a dry, hacking cough. (Ex. Codeine, or dihydrocodeine phosphate)

However, they may be contraindicated, or inadvisable, for productive coughs (can be beneficial to clear mucus and other organic debris that accumulate in airways), which may respond better to expectorant medication to aid in clearing congestion. Mucus in animals can be best thinned by moistening the air they breathe through humidification rather than human medicine.

Mucolytic agents are beneficial in the improvement of bronchial airflow, by reducing the viscosity of the mucus (allows to be more readily broken up). Ex. Acetylcysteine, given by inhalation, orally, or intravenously.