Vetnuus | November 2023 14 « BACK TO CONTENTS List of essential medicines for cats and dogs <<< 13 3) Trazodone Used for the treatment of behavioural disorders related to anxiety and/or phobia. CARDIORESPIRATORY AND RENAL SYSTEMS Core List 1) Aldosterone antagonist (spironolactone) Spironolactone alleviates cardiac remodelling in chronic cardiac disease and can be combined with antihypertensive drugs for treatment of refractory systemic hypertension. It can be used judiciously alongside loop diuretics for its anti-aldosterone effect and potassium-sparing activity. 2) Angiotensin converting enzyme (ACE) inhibitors (enalapril, benazepril, captopril, lisinopril and ramipril) or angiotensin receptorblockers (ARB) (telmisartan) ACE inhibitors and ARBs are mild vasodilators and reduce systemic vascular resistance, hypertrophy and aldosterone release, especially in the treatment of dogs with dilated cardiomyopathy or myxomatous mitral valve degeneration, and as second line for the management of systemic hypertension. These drugs are also utilised for the treatment of proteinuric kidney disease. 3) Inodilator (pimobendan) It combines the effect of a vasodilator and an inotrope in dogs with heart failure. It improves long-term outcomes in preclinical stages of dilated cardiomyopathy and mitral valve disease as well as during cardiac failure. 4) Loop diuretics (furosemide or torsemide) These agents block the reabsorption of sodium (and water) in the ascending loop of Henle. They are available for iv or oral administration and are indicated for the management of acute pulmonary oedema and heart failure. They may induce electrolyte imbalances and their effect is limited by the activation of the renin-angiotensin system. 5) Vessel selective calcium channel blocker (amlodipine) Amlodipine is used for feline and canine hypertension and is titrated orally to effect. Complementary List 1) Antagonists of β-adrenergic receptors (propranolol, atenolol or esmolol) These are negative inotropes and chronotropic drugs. They can be used for treatment of tachyarrhythmias or conditions with left and right ventricular outflow obstruction. 2) Cardiac glycosides (digoxin) This drug inhibits the sodium-potassium pump and facilitates increased concentrations of calcium influx. It produces weak positive inotropism while reducing sympathetic input and improving renal blood flow. Digoxin blocks the atrioventricular node and can be used in the treatment of atrial fibrillation. The drug is used in combination with other therapies in the treatment of heart failure in some specific cases. The drug can be administered orally or iv. 3) Cardiac-selective calcium channel blockers (verapamil or diltiazem) These are used in the management of supraventricular arrhythmias (oral and injectable forms). 4) Fluticasone This is an inhaled synthetic corticosteroid with profound antiinflammatory effects that is used in several upper respiratory tract and pulmonary disorders in dogs and cats including rhinitis, bronchitis, asthma and eosinophilic pneumonia. Metered dose inhalers combined with a spacer and appropriate mask should be used for administration. 5) Salbutamol This is a selective agonist of β2-receptors that may produce bronchodilation after aerosol or oral administration with the assumption that bronchoconstriction exists, particularly in cats. 6) Sodium channel blockers (lidocaine or procainamide) They are indicated for the management of significant ventricular arrhythmias that are associated with important haemodynamic changes. ENDOCRINOLOGY Core List 1) Antithyroid agent (methimazole/thiamazole) Thyroid hormone synthesis inhibitors act by interfering with the incorporation of iodine into the tyrosyl moiety of thyroglobulin. These agents are important in the treatment of feline hyperthyroidism. These medications are for oral administration but can be compounded as transdermal preparations. 2) Glucocorticoids A class of corticosteroids that bind to the glucocorticoid receptor. Can be used for the diagnosis of hyperadrenocorticism, including the differentiation of pituitary and adrenal dependent hyperadrenocorticism. Necessary for the treatment of 24-Hour Toll-Free Helpline: 0800 21 21 21
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