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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?