Small Animal Dermatology, 3rd edition

APPENDIX B DRUG FORMULARY 795

Metoclopramide(Reglan, Maxolon)

Prokinetic drug. Centrallyacting antiemetic.Stimulates motility ofupper GI tract. Action isto inhibit dopaminereceptors and enhanceaction of acetylcholine inGI tract. Used primarily forgastroparesis andtreatment of vomiting. Itis not effective for dogswith gastric dilation.

Adverse effects areprimarily related toblockade of centraldopaminergic receptors.Adverse effects similar tophenothiazines (e.g.,acepromazine) have beenreported, in addition tobehavioral changes. Donot use in epilepticpatients or with diseasescaused by GI obstruction.

Results of clinical studies inanimals have not beenreported. Use in animals (anddoses) based on experiencein people or anecdotalexperience in animals. Mostuse is for general antiemeticpurposes, but doses as highas 2 mg/kg have been usedto prevent vomiting duringcancer chemotherapy.

10, 5 mg tablet;1 mg/mL oralsolution; 5 mg/mLinjection.

0.2–0.5 mg/kg q6–8h IV,IM, po; CRI: loading doseof 0.4 mg/kg IV, followedby 0.3 mg/kg/h IV. Inrefractory patients, ratesup to 1.0 mg/kg/h havebeen used.

Metronidazole(Flagyl and generic)and Metronidazolebenzoate

Antibacterial andantiprotozoal drug.Disrupts DNA in organismvia reaction withintracellular metabolite.Action is specific foranaerobic bacteria.Resistance is rare. Activeagainst some protozoa,including

Giardia

;

however, other drugs,such as fenbendazole,have been used forGiardia

.

Most severe adverse effectis caused by toxicity toCNS. High doses havecaused lethargy, CNSdepression, ataxia,vomiting, and weakness.Metronidazole may bemutagenic. Fetalabnormalities have notbeen demonstrated inanimals withrecommended doses, butuse cautiously duringpregnancy. Cat may findbroken tabletsunpalatable.

Metronidazole is one of themost commonly used drugsfor anaerobic infections.Although it is effective forgiardiasis, other drugs usedfor giardiasis includealbendazole, fenbendazole,and quinacrine. CNS toxicityis dose related. Maximumdose that should beadministered is50–65 mg/kg/day in anyspecies. Although tabletshave been broken or crushedfor oral administration tocats, they find theseunpalatable. Whenpalatability is a problem incats, consider metronidazolebenzoate.

250, 500 mg tablet;50 mg/mLsuspension;5 mg/mL injection;the benzoate formis not availablecommercially andmust be obtainedfrom compoundingpharmacies. 20 mgof metronidazolebenzoate

=

12.4 mg

metronidazole.

For anaerobes – dog:15 mg/kg q12h, or12 mg/kg q8h po; cat:10–25 mg/kg q24h po.For

Giardia

• dog:

12–15 mg/kg q12h for 8days po; cat: 17 mg/kg(1/3 tablet per cat) q24hfor 8 days.

(continued

)