Small Animal Dermatology, 3rd edition

APPENDIX B DRUG FORMULARY 763

Corticotropin (ACTH)(Acthar)

Used for diagnosticpurposes to evaluateadrenal gland function.Stimulates normalsynthesis of cortisol fromadrenal gland.

Adverse effects unlikelywhen used as singleinjection for diagnosticpurposes.

Doses established bymeasuring normal adrenalresponse in animals.

80 U/mL gel.

Response test: collectpre-ACTH sample andinject 2.2 IU/kg IM. Collectpost-ACTH sample at 2hin dogs and at 1 and 2h incats.

Cosyntropin(Cortrosyn)

Cosyntropin is a syntheticform of corticotropin(ACTH) used fordiagnostic purposes only.In humans, it is preferredover corticotropin becauseit is less allergenic.

Same as for corticotropin. Use for diagnostic

purposes only; notintended for treatment ofhypoadrenocorticism.Maximum dosage fordogs should be 250

μg.

250

μg per vial.

ACTH response test:collect pre-ACTH sampleand inject 5

μg/kg IV or IM

(dog) or 125

μg

(0.125 mg) IM (cat). Cat:collect sample at 60 and90 min after IVadministration and 30 and60 min after IMadministration. Collectpost sample at 30 and60 min.

Cyclophosphamide(Cytoxan, Neosar)

Cytotoxic agent.Bifunctional alkylatingagent. Disruptsbase-pairing and inhibitsDNA and RNA synthesis.Cytotoxic for tumor cellsand other rapidly dividingcells. Used primarily asadjunct for cancerchemotherapy and asimmunosuppressivetherapy.

Bone marrow suppressionis most common adverseeffect. Can producesevere neutropenia (thatusually is reversible).Vomiting and diarrheamay occur in somepatients. Dogs aresusceptible to bladdertoxicity (sterilehemorrhagic cystitis). Maycause hair loss when usedin somechemotherapeuticprotocols.

Cyclophosphamide isusually administered withother drugs (other cancerdrugs in cancer protocolsor corticosteroids) whenused forimmunosuppressivetherapy. Consult specificanticancer protocols forspecific regimens.

25 mg/mL injection;25, 50 mg tablet.

Dog: anticancer:50 mg/m

2

once daily 4

days/week po, or150–300 mg/m

2

IV, and

repeat in 21 daysImmunosuppressivetherapy: 50 mg/m

2

(approx. 2.2 mg/kg) q48hpo, or 2.2 mg/kg oncedaily for 4 days/week.Cat: 6.25–12.5 mg/catonce daily 4 days/week.

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