OTC Drugs in Veterinary Medicine

Yıl 2021, Cilt: 10 Sayı: 2, 203 - 210, 12.12.2021

Erdem Gülersoy , Canberk Balıkçı , Mutlu Sevinç

https://doi.org/10.31196/huvfd.907363

Öz

There are many over‐the‐counter (OTC) drugs in pet medicine that are potentially toxic and their use is increasing day by day. Most OTC drugs are inexpensive and widely available in the market and can be purchased without a prescription in the absence of physician control. In veterinary medicine, when purchased by the owner without the control of the veterinarian/physician, these drugs can be used therapeutically wrong due to confusion or pronunciation errors, as well as for abuse or suicide in human medicine. In children and pet animals, OTC drug poisoning develops due to accidental ingestion or drug exposure without an attendant’s supervision. Today, the deliberate misuse of OTC drugs still maintains its
importance in both veterinary and human medicine. Therefore, necessary precautions should be taken to prevent pets’ exposure, especially cats and dogs, to intoxication with OTC drugs that may result in death. To prevent recurrence attendants, animal breeders, and owners should be informed. In this review, the toxicity of OTC drugs which are widely used and easily accessible non steroidal anti inflammatories such as aspirin, ibuprofen, acetaminophen; gastric protectants such as H2 receptor antagonists; proton pump inhibitors; emetics such as ipecac syrup; antihistamines such as diphenhydramine, loratidine; decongestants, eye drops, vitamins, laxatives along with anti tussives, and clinical consequences resulting from their misuse and environmental risk factors that may cause intoxication with these drugs, as well as treatment options that can be applied in case of exposure to these drugs, were examined.

Anahtar Kelimeler

Cat, Dog, Intoxication, Non-prescription drug, OTC drug, Symptom

Veteriner Hekimlikte OTC İlaçlar

Öz

Pet hayvanı hekimliğinde potansiyel olarak toksik olan ve kullanımı günden güne artan çok sayıda tezgah üstü (Over the counter / OTC) ilaç bulunmaktadır. OTC grubu ilaçların çoğu, piyasada yaygın olarak bulunan, ucuz ve hekim kontrolü olmadan reçetesiz satın alınabilinen ilaçlardır. Bu ilaçlar, veteriner hekimlikte hekim kontrolü dışında hasta sahibi tarafından satın alındığında kafa karışıklığına veya telaffuz hatalarına bağlı olarak yapılan terapötik yanlışlıkların yanı sıra beşeri hekimlikte suistimal veya intihar amaçlı da kullanılabilmektedir. Çocuklarda ve ev hayvanlarında OTC ilaç zehirlenmeleri, kazara yutma veya bakıcının gözetimi dışında ilaca maruz kalma sonucu gelişmektedir. Günümüzde hem veteriner hekimliğinde hem de beşeri hekimlikte OTC grubu ilaçların kasıtlı yanlış kullanımı halen önemini korumaktadır. Bu sebeple ev hayvanlarının, özellikle kedi ve köpeklerin, ölümle sonuçlanabilen OTC grubu ilaç intoksikasyonlarına maruz kalmasının önüne geçmek ve tekrar oluşumunu önlemek için gerekli önlemler alınmalı; bakıcılar, yetiştiriciler ve hayvan sahipleri bu konuda bilgilendirilmelidir. Bu derlemede yaygın kullanılan ve kolay erişilebilen aspirin, ibuprofen, asetaminofen gibi nonsteroid antienflamatuvarlar, H2 reseptör antagonistleri, proton pompa inhibitörleri gibi gastrik protektanlar, ipekak şurubu gibi emetikler, difenhidramin, loratidin gibi antihistaminikler ve dekonjestanlar, göz damlaları, vitaminler, laksatifler, antidiyaretikler ile anti tüssifler gibi OTC grubu ilaçların toksisiteleri, yanlış kullanımı sonucu ortaya çıkan klinik sonuçları ve bu ilaçlarla intoksikasyona sebep olabilen çevresel risk faktörleri ile birlikte bu ilaçlara maruz kalma durumunda uygulanabilecek tedavi seçenekleri incelenmiştir.

Anahtar Kelimeler

intoksikasyon, kedi, köpek, OTC ilaç, Reçetesiz İlaç, Semotom

Kaynakça

• Abrahm KD, 2005: Nitro-argenine methyl ester, a non selective inhibitor of nitric oxide synthase reduces ibuprofen-induced gastric mucosal injury in the rat. Dig Dis, 50 (9), 1632-1640.
• Arakelyan HS, 2020: Propylene Glycol, Food and Health. Clinical Food Toxicology.
• Baetge CL, Smith LC, Azevedo CP, 2020: Clinical Heinz Body Anemia in a Cat After Repeat Propofol Administration Case Report. Front Vet Sci, 7, 828.
• Baggot JD (2001). The pharmacokinetic basis of species variations in drug disposition In: The Physiological Basis of Veterinary Pharmacology, Baggot MVM (ed), 1-54. Blackwell Science, London.
• Barkun AN, Bardou M, Pham CQ, Martel M, 2012: Proton pump inhibitors vs. histamine 2 receptor antagonists for stress‐related mucosal bleeding prophylaxis in critically ill patients: a meta‐analysis. Am J Gastroenterol, 107, 507‐520.
• Baumer W, 2011: The use of ophthalmic drugs in the dog and cat. Kleintierpraxis, 56 (11), 604-614.
• Bergen S, Roels O, 1965: Hypervitaminosis A. Am J Clin Nutr, 16, 265-269.
• Bolfer L, Mcmichael M, Ngwenyama TR, O’Brien M, 2014: Treatment of Ibuprofen Toxicosis in a Dog with IV Lipid Emulsion. J Am Anim Hosp Assoc, 50 (2), 136-140.
• Bontempo V, 2005: Nutrition and health of dogs and cats: evolution of petfood. Vet Res Commun, 29 (2), 45-50.
• Bushra R, Aslam N, 2010: An Overview of Clinical Pharmacology of Ibuprofen. Oman Med J, 25 (3), 155-1661.
• Cadavid AP, 2017: Aspirin: The Mechanism of Action Revisited in the Context of Pregnancy Complications. Front Immunol, 15, 8, 261.
• Chavhan SG, Brar RS, Banga HS, Singh ND, 2011: Cholecalciferol toxicity in animals. Vet Clin Path, 1-4.
• Durakovic Z, Vitezic D, 2013: Pharmacodynamics and pharmacokinetics in the elderly. Period Biol, 115 (4), 517-520.
• Elwood C, Devauchelle P, Elliott J, Freiche V, German AJ, Gualtieri M, Hall E, den Hertog E, Neiger R, Peeters D, Roura X, Savary-Bataille K, 2010: Emesis in dogs: a review. J Small Anim Pract, 51 (1), 4-22.
• Febbraro S, Shea T, Cravo AS, 2020: Bioavailability of Triprolidine as a Single Agent or in Combination With Pseudoephedrine: A Randomized, Open-Label Crossover Study in Healthy Volunteers. Clin Pharmacol Drug Dev, 9 (4), 486-495.
• Fitzgerald KT, Bronstein AC, Flood AA, 2006: “Over-The-Counter” Drug Toxicities in Companion Animals. Clin Tech Small Anim Pract, 21, 215-226.
• Gerald F, O’Malley DO, 2007: Emergency Department Management of the Salicylate-Poisoned Patient. Emerg Med Clin N Am, 25, 333-346.
• Gil-Villa AM, Norling LV, Serhan CN, Cordero D, Rojas M, Cadavid A, 2012: Aspirin triggered-lipoxin A4 reduces the adhesion of human polymorphonuclear neutrophils to endothelial cells initiated by preeclamptic plasma. Prostaglandins Leukot Essent Fatty Acids, 87(4–5), 127–134.
• Glaze MB, 1991: Ocular allergy. Semin Vet Med Surg Small Anim, 6(4), 296-302.
• Goldfrank LR, Flomenbaum NE, Lewin NA, 2002: Goldfrank’s Toxicologic Emergencies. 7. ed., New York, McGraw-Hill.
• Gordon DS, Rudinsky AJ, Guillaumin J, Parker VJ, Creighton KJ, 2020: Vitamin C in health and disease: A companion animal focus. Top Companion Anim Med, 39, 1-9.
• Gülpınar G, Özçelikay G, 2015: OTC Drug Regulations in Turkey: The Opinions of Community Pharmacists and Drug Industry. Turk J Pharm Sci, 12 (3), 267-278.
• Gummin DD, Mowry JB, Spyker DA, Brooks DE, Osterthaler KM, Banner W, 2018: 2017 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 35th Annual Report. Clin Toxicol (Phila), 56 (12), 1213-1415.
• Hamilton RJ (2002). Vitamins In: Goldfrank’s Toxicologic Emergencies (ed 7), Goldfrank LR, Flomenbaum NE, Lewin NA (eds), 563-569, New York, NY, McGraw-Hill.
• Hensel P, Santoro D, Favrot C, Hill P, Griffin C, 2015: Canine atopic dermatitis: detailed guidelines for diagnosis and allergen identification. BMC Vet Res, 11, 11, 196.
• Herring IP (2013). Clinical pharmacology and therapeutics. Part 4: Mydriatics /cycloplegics, anesthetics and tear substitutes and stimulators In: Veterinary ophthalmology. 5th ed., Gelatt KN, Gilger BC and Kern TJ (eds), 423-434, Ames: Wiley-Blackwell.
• Hjelle JJ, Grauer GF, 1986: Acetaminophen-induced toxicosis in dogs and cats. J Am Vet Med Assoc, 188, 742-746.
• Hughes, CM, Mcelnay, JC, Fleming, GF, 2001: Benefits and risks of self medication, Drug Saf, 24 (14), 1027-1037.
• Hugnet C, Cadore JL, Buronfosse, Pineaux X, Mathet T, Berny PJ, 1996: Loperamide poisoning in the dog. Vet Hum Toxicol, 38(1), 31-33.
• Innes JF, O’Neill T, Lascelles BDX, 2010: Use of non-steroidal anti-inflammatory drugs for the treatment of canine osteoarthritis. In Practice, 32 (4).
• Jarolmasjed S, Kolahian S, 2013: Pretreatment of Cats with Vitamin B6 Reduces Vomiting Episodes Following Xylazine Administration. Iran J Vet Surg, 8 (1), 29-33.
• Kang MH, Park HM, 2012: Application of carvedilol in a dog with pseudoephedrine toxicosis-induced tachycardia. Can Vet J, 53 (7), 783-786.
• Kartal N, Arısoy S 2017: OTC Grubundaki ilaçların avantaj ve dezavantajlarının incelenmesi. Sag Aka Derg, 4, 4. Khan SA, McLean MK, 2012: Toxicology of frequently encountered nonsteroidal anti‐inflammatory drugs in dogs and cats. Vet Clin North Am Small Anim Pract, 42 (2), 289‐306.
• Kicera-Temple K, Londono L, Lanaux TM, Buckley GJ, 2019: Treatment of a massive naproxen overdose with therapeutic plasma exchange in a dog. Clin Case Rep, 7 (8), 1529-1533.
• Kukanich B, Papich MG, 2004: Plasma profile and pharmacokinetics of dextromethorphan after intravenous and oral administration in healthy dogs. J Vet Pharmacol Ther, 27 (5), 337-341.
• KuKanich K, KuKanich B, Guess S, Heinrich E, 2016: Effect of sucralfate on the relative bioavailability of enrofloxacin and ciprofloxacin in healthy fed dogs. J Vet Intern Med, 30, 108‐115.
• Lee JA, 2013: Emergency Management and Treatment of the Poisoned Small Animal Patient. Vet Clin Small Anim, 757–771.
• López-Jaimez G, 2016: 50 Years Ago in TheJournal ofPediatrics: Ipecac Syrup: Its Use as an Emetic in Poison Control. J Pediatr, 174, 159.
• Marks SL, Kook PH, Papich MG, Tolbert MK, Willard MD, 2018: ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats. J Vet Intern Med, 32 (6), 1823-1840.
• Marmulak T, Wiebe V, Perry M, Blythe E, 2014: Over-the-Counter Medications for Pets. America’s Pharmacist, 3, 46-54.
• Martignoni M, Groothuis GMM, Kanter R, 2007: Species differences between mouse, rat, dog, monkey and human CYP-mediated drug metabolism, inhibition and induction. Expert Opin Drug Metab Toxicol, 2 (6), 875-894.
• Martinez MN, Papich MG, 2008: Factors influencing the gastric residence of dosage forms in dogs. J Pharm Sci, 98, 3, 844-860.
• Maton PN, Burton ME, 1999: Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. Drugs, 57, 855‐870.
• Nehra AK, Alexander JA, Loftus CG, Nehra V, 2018: Proton pump inhibitors: review of emerging concerns. Mayo Clin Proc, 32, 1823‐1840.
• Niaz K, Bahadar H, Maqbool F, Abdollahi M, 2015: A review of environmental and occupational exposure to xylene and its health concerns. EXCLIJ, 14, 1167-1186.
• Niedzwecki AH, Book BP, Lewis KM, Estep S, Hagan J, 2016: Effects of oral 3% hydrogen peroxide used as an emetic on the gastroduodenal mucosa of healthy dogs. J Vet Emerg Crit Care, 27 (2), 1-7.
• Nixon SL, Rose L, Muller AT, 2019: Efficacy of an orally administered anti-diarrheal probiotic paste (Pro-Kolin Advanced) in dogs with acute diarrhea: A randomized, placebo-controlled, double-blinded clinical study. J Vet Intern Med, 33(3), 1286-1294.
• Official gazette of the republic of Turkey. Regulation on the classification of human medicinal products. Dated: 17.02.2005- Issue No: 25730.
• O'Marra SK, Delaforcade AM, Shaw SP, 2011: Treatment and predictors ofoutcome in dogs with immune-mediated thrombocytopenia. J Am VetMed Assoc, 238, 346-352.
• Othman F, Card TR, Crooks CJ, 2016: Proton pump inhibitor prescribing patterns in the UK: a primary care database study. Pharmacoepidemiol Drug Saf, 25, 1079‐1087.
• Ponnusamy P, Muthuramalingam T, Sureshkumar R, Selvakumar G, Thangapandiyan M, Rao GD, 2018: Paracetamol Poisoning In A Cat And Its Treatment. Ind J Vet & Anim Sci Res, 43 (5), 388- 389.
• Salgırlı Y, Emre B, Besgül K, Öztürk H, Sagmanlıgil V, 2012: Köpek sahiplerinin köpeklerine yaklaşımlarının değerlendiril-mesi üzerine bir pilot çalışma. Ankara Üniv Vet Fak Derg, 59, 11-15.
• Scott DW, Edginton HD, Miller WH, Clark MD, 2015: An Open Clinical Trial on the Efficacy of Loratadine for the Management of Allergic Pruritus in 27 Cats. Jpn J Vet Dermatol, 21 (1), 7-9.
• Segev G, Bandt C, Francey T, Cowgill LD, 2008: Aluminum toxicity following administration of aluminum‐based phosphate binders in 2 dogs with renal failure. J Vet Intern Med, 22, 1432‐1435.
• Shepherd AJ, 2008: Results of the 2006 AVMA survey of companion animal ownership in US pet-owning households. J Am Vet Med Assoc, 232 (5), 695-696.
• Singh BR, 2020: Guidelines for antimicrobial drug use in animals. Indian Veterinary Research Institute. Technical Report.
• Talcott PA (2006). Nonsteroidal antiinflammatories In: ): Small Animal Toxicology, Peterson ME (ed), 902-933, St. Louis, MO., Elsevier.
• Tam FM, Carr AP, Myers SL, 2011: Safety and palatability of polyethylene glycol 3350 as an oral laxative in cats. J Feline Med Surg, 13 (10), 694-697.
• Temamoğulları F 2018: Veteriner İlaçlarının Çevrede İstenmeyen Etkileri. Türkiye Klinikleri Veteriner Farmakovijilans. Sekkin S (ed), 82-85, Veteriner Farmakovijilans. Ankara: Türkiye Klinikleri.
• The US Food and Drug Administration. Outsourcing Facilities. Available online: http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/PharmacyCompounding/ucm393571.htm (accessed on 25/3/2021).
• Tolbert K, Bissett S, King A, Davidson G, Papich M, Peters E, Degernes L, 2011: Efficacy of oral famotidine and 2 omeprazole formulations for the control of intragastric pH in dogs. J Vet Intern Med, 25, 47‐54.
• Tomsa K, Steffen F, Glaus T, 2001: Life threatening metabolic disorders after application of a sodium phosphate containing enema in the dog and cat. Schweiz Arch Tierheilkd, 143(5), 257-261.
• Webb CB, Twedt DC, Fettman MJ, Mason G, 2003: S-adenyl-L-methionine (SAMe) in a feline model of oxidative injury. J Fel Med Surg, 5, 69-75.
• Zoran DL, 1999: Diet and drugs: the keys to managing feline colonic disease. Compend Contin Educ Pract Vet, 21, 731e48.