K
Kanamycin Sulfate
Pharmacology and Mechanism of Action
Aminoglycoside antibiotic. Bactericidal. Like other aminoglycosides, kanamycin acts to inhibit bacteria protein synthesis via binding to 30S ribosome. Kanamycin has a broad spectrum of activity that includes Staphylococcus spp. and gram-negative bacilli. It has weak activity against streptococci and anaerobic bacteria. Kanamycin is not as active against most bacteria as gentamicin or amikacin.
Indications and Clinical Uses
Kanamycin is a broad-spectrum antibiotic used to treat gram-negative infections. It is less active than gentamicin, amikacin, or tobramycin. Therefore, there is little advantage for using kanamycin over the other drugs in this class.
Precautionary Information
Adverse Reactions and Side Effects
Nephrotoxicity is the most dose-limiting toxicity. Ensure that patients have adequate fluid and electrolyte balance during therapy. Ototoxicity and vestibulotoxicity also are possible.
Contraindications and Precautions
Do not use in animals with renal disease. Do not use in dehydrated animals.
Instructions for Use
Kanamycin is not as active as other aminoglycosides. For serious infections consider gentamicin or amikacin.
Patient Monitoring and Laboratory Tests
Susceptibility testing: CLSI minimum inhibitory concentration (MIC) value break point for susceptibility is less than or equal to 16 mcg/mL. Monitor BUN, creatinine, and urine for evidence of renal toxicity.
Stability and Storage
Store in a tightly sealed container, protected from light, and at room temperature. It is soluble in water but is not stable in compounded formulations. Do not mix with other drugs. Do not freeze.
Kaolin + Pectin
Pharmacology and Mechanism of Action
Antidiarrheal compound. Kaolin is a form of aluminum silicate and pectin is a carbohydrate that is extracted from the rinds of citrus fruits. This product has a claim to act as a demulcent and adsorbent in the treatment of diarrhea. The action of kaolin-pectin is believed to be related to binding of bacterial toxins (endotoxins and enterotoxins) in the GI tract. However, experimental studies have shown that kaolin-pectin has been an ineffective binder of E. coli enterotoxin and clinical studies have failed to show a benefit from the administration of kaolin-pectin. This product may change the consistency of stools, but it will not decrease fluid or electrolyte loss, nor will it shorten the duration of illness. Kao-Pectate formulations contain salicylate as one of the active ingredients.
Indications and Clinical Uses
Kaolin and pectin combinations are used for the symptomatic treatment of acute diarrhea. Despite the lack of clinical evidence of efficacy, some veterinarians administer this drug for short-term treatment. Commercial forms that contain salicylate (8.68 mg/mL) may have anti-inflammatory effects to decrease secretory diarrhea caused by bacteria.
Precautionary Information
Adverse Reactions and Side Effects
Side effects are uncommon. There is 8.7-mg/mL salicylate in the regular strength and 16 mg/mL in the extra-strength formulation. Because some animals may be sensitive to salicylates, this ingredient in the formulation should be considered before administering to animals.
Instructions for Use
Kaolin-pectin may not change the course of diarrhea but may change the character of the feces.
Formulations
Ketamine Hydrochloride
Pharmacology and Mechanism of Action
Anesthetic agent. Exact mechanism of action is not known, but most evidence supports its action as a centrally acting dissociative agent. Ketamine produces mild analgesia and modulates pain via its ability to act as a noncompetitive antagonist for n-methyl D-aspartate (NMDA) receptors. Ketamine is an equal concentration of two isomers (R-ketamine and S-ketamine). S-ketamine is more active and eliminated faster. Ketamine is rapidly metabolized in most animals (60-90 minute half-life in dogs); however, metabolite (norketamine) may produce more prolonged NMDA antagonistic effects.
Indications and Clinical Uses
Ketamine is used for short-term anesthetic procedures. Duration of action is generally 30 minutes or less. Ketamine has some analgesic properties via its effects on NMDA receptors and has been administered as an adjunct to other analgesic medications, usually with opiates, sometimes as a slow continuous rate infusion (CRI). Ketamine is often combined in use with other anesthetics and sedatives such as benzodiazepines (diazepam) or alpha2 agonists (medetomidine, dexmedetomidine, and xylazine). Such combinations have been synergistic and allowed lower doses of each individual component. One example of a combination is MLK, which is morphine (or fentanyl), lidocaine, and ketamine.
Although ordinarily contraindicated in patients with epilepsy, it has been used to treat cases of refractory status epilepticus through its NMDA receptor effects.
Precautionary Information
Adverse Reactions and Side Effects
Ketamine causes pain with intramuscular injection (pH of solution is 3.5). Tremors, muscle spasticity, and convulsive seizures have been reported. Spontaneous movements, salivation, and increased body temperature are more common in dogs when high doses are used. Ketamine will increase heart rate and blood pressure as a result of an increase in sympathetic tone. It will produce an increased cardiac output compared to other anesthetic agents. Salivation, mydriasis, and regurgitation are increased in animals that receive ketamine, which may be reduced by premedication within atropine. Apnea may develop in some animals, and oxygen supplementation should be provided.
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