his chapter provides an overview of the unique characteristics of various drugs used in avian species. All suggested drug CHAPTER T uses are for companion (non-food) birds only. Complete reviews of all the drugs discussed in this book are available through a variety of desk references and product information forms provided by the manufacturers. The clinician is referred to these references for a review of the general pharma- cology and specific contraindications of any drug dis- cussed. The suggestions of the manufacturer should 18 always be followed. A drug should never be used for which the clinician is not fully aware of the indica- tions, contraindications and potential side effects. Some drugs administered concurrently will potenti- ate toxicity, and the clinician should review any po- tential drug interactions before placing a bird on ORMULARY more than one drug at a time. F In this chapter, commonly used drugs and their asso- ciated doses are provided in table form for easy refer- ence. The information concerning the use of the drugs listed in the table should be reviewed before administering any therapeutic agent. If a drug is not discussed, either insufficient data is available to war- rant its use in birds, or it has been used but has little Branson W. Ritchie applicability. Greg J. Harrison The doses and material presented for each drug have been compiled from numerous reference sources, in- cluding the various chapters in this book. Some of the recommended doses are based on pharmacokinetic information, and some are based totally on observa- tion. An asterisk in the formulary table indicates that the suggested dose is based on pharmacologic data obtained in some species of birds other than poultry. Notes on any adverse drug reactions should be for- warded to the Journal of the Association of Avian Veterinarians to keep colleagues informed of any problems that occur with commonly used therapeutic agents. Representative manufacturers listed in the formulary are for reference purposes only. Other manufacturers may produce similar products of equal efficacy. 458 SECTION THREE TREATMENT REGIMENS ACETYLCYSTEINE - Mucomyst (Apothecon) ALLOPURINOL - Zyloprim (Burroughs Wellcome) Neonates treated with nebulized Mucomyst developed dyspnea, Available as a tablet (100 or 300 mg) for oral administration. Used lethargy, edema of the eyelids and tachycardia 20 minutes after for the treatment of gout. Well absorbed from the gastrointestinal therapy. tract. Functions to inhibit purine catabolism, which prevents the production of uric acid. A 100 mg tablet can be crushed and ACETYLSALICYLIC ACID - Aspirin (Butler; Vedco) dissolved in 10 ml of sterile water. Up to 1 ml of the diluted Available as tablets (5 or 60 grain) for oral administration. Also suspension may be added to 30 ml of drinking water. A fresh available as 1.25 grain orange-flavored chewable tablets. May be solution of drinking water should be provided several times per effective as an analgesic, antipyretic and anti-inflammatory agent day. A reduction in serum and urinary uric acid levels should be in some avian species. May be indicated to prevent clot formation noted within two to three days of administration. and embolisms secondary to egg-related peritonitis, granuloma- Birds being treated with allopurinol should be thoroughly hy- tous diseases and shock. Uricosuric at low doses and may be drated at all times. It has been found to cause gout in Red-tailed effective in some cases of acute and chronic gout. A five grain tablet Hawks, and may cause a skin rash, urticarial lesions or hepatitis. can be mixed in 30 ml of diluent and administered at a dose of 0.5 In birds with severe gout, the initial dose should be 25% of the ml/kg, TID (or 1 tablet per pint of drinking water). recommended dose, with a gradual increase over several days. Should be used in conjunction with colchicine in severe cases of (ACTH) ADRENAL CORTICOTROPIC HORMONE - (Vedco; Phoenix; Butler) gout. Available as an injectable solution (40 or 80 units/ml) for IM administration. Used to test stimulation of the adrenal glands in ALOE VERA - George’s Aloe Vera (Warren Laboratories) suspected cases of adrenal insufficiency. Glucocorticoid admini- Available as a lotion or for topical application on pruritic lesions or stration may falsely elevate endogenous cortisol levels. Prolonged as a liquid for oral administration. Solution for treating pruritic administration induces adrenal gland hyperplasia. skin lesions is made by mixing 0.5 oz of aloe vera oral liquid with 1 tsp of Penetran, 2 drops of Woolite and 1 pint of water. ACTIVATED CHARCOAL, KAOLIN - Toxiban (Vet-A-Mix) Available as a suspension (104 mg/ml activated charcoal and 62.5 AMIKACIN SULFATE - Amiglyde (Aveco); Amikin (Bristol Labs) mg/ml kaolin) for oral administration. Can be used to absorb some Available as injectable solutions (50 mg/ml and 250 mg/ml) for IM ingested toxins (many insecticides, pesticides, lead, mercury, inor- or SC administration. Limited activity against gram-positive or- ganic arsenic and chemotherapeutic agents) from the gastrointes- ganisms. Should be used only in birds when absolutely necessary tinal tract. High therapeutic index. Can be mixed with sodium to treat gram-negative bacteria (Pseudomonas, Klebsiella spp.) sulfate in cases of heavy metal ingestion to form lead complexes that are resistant to other, less toxic antibiotics. Very effective that are not absorbed. Sodium sulfate can cause osmotic diarrhea when used in combination with synthetic penicillins. and should be used with extreme caution in birds that weigh less Birds should be thoroughly hydrated throughout the treatment than one kg. Can be mixed with hemicellulose to function as a bulk period to decrease the possibility of nephrotoxicity. Use in conjunc- laxative and aid in the passage of ingested toxins. tion with furosemide may potentiate renal damage. Toxic effects of aminoglycosides may be potentiated when used in combination ACYCLOVIR - Zovirax (Burroughs Wellcome) with cephalosporins (see Chapter 17). Available as a soluble powder (50 mg/ml when reconstituted) for IV administration and as a capsule (200 mg), tablet (200 mg) or AMINOPENTAMIDE HYDROGEN SULFATE - Centrine (Aveco) suspension (40 mg/ml) for oral administration. Has been shown to Available as an injectable solution 0.5 mg/ml for SC or IM admini- be effective in decreasing mortality associated with flock outbreaks stration for controlling vomition. of Pacheco’s disease virus. Appears to be most effective if treat- ment is initiated in an individual bird before clinical signs occur. AMINOLOID - (Essex; Schering Corporation) Has been used to induce molt in raptors. Should induce complete Acyclovir is preferentially absorbed by herpesvirus-infected cells molt within 2 months of administration. and primarily inhibits herpesvirus DNA polymerase. Acyclovir is effective in preventing herpesvirus replication in only those AMITRIPTYLINE HCL - Elavil (Stuart); Endep (Roche) strains of herpesvirus that code for their own DNA polymerase. Available as a tablet (10, 25, 50, 75, 100, 150 mg) for oral admini- Acyclovir also has varying effects on different strains of suscepti- stration or as an injectable solution (10 mg/ml) for IM administra- ble herpesviruses. Low level of effect on uninfected host cells tion. Tricyclic antidepressant with a sedative effect that has been results in a high therapeutic index. It has been suggested for suggested for use in some cases of feather picking. Appears to be treatment of poxvirus, but there is no conclusive evidence to rarely effective. Should not be used in conjunction with support its efficacy. monoamine oxidase inhibitors. May cause depression, arrhyth- The injectable product may cause severe muscle necrosis if admin- mias, tachycardia, vomiting or muscle rigidity. istered IM and may cause phlebitis (common) and neurologic signs (rare) when administered IV. Oral administration may cause vom- AMMONIUM SOLUTION - Penetran (Trans Dermal Technologies) iting. Acyclovir has been shown to interfere with spermatogenesis Available as an ointment for topical application. Used as a topical and is mutagenic when administered at high doses in some mam- analgesic or antipuritic (see Aloe Vera). mals. AMOXICILLIN - Amoxi-drops, Amoxi-Inject (SmithKline) ALCOHOL Available as a suspension (50 mg/ml, Amoxi-drops) for oral admini- An excellent solvent for many drugs as well as a popular skin stration or as an injectable solution (250 mg/ml, Amoxi-Inject) for disinfectant. Bactericidal for most common pathogenic bacteria IM administration. Palatable and easy to administer but rarely with variable activity for viruses and fungi. Will cause a dramatic effective against the bacterial organisms that affect birds. Ab- decrease in core body temperature when applied to large areas of sorbed from the gut more effectively than ampicillin, resulting in the skin as a presurgical dressing. Consumption of alcoholic bev- higher blood levels than are achieved with oral ampicillin. Inject- erages or absorption of ethanol through open wounds can result in able solution stable one year after reconstitution if refrigerated. lethargy, incoordination and regurgitation in most avian species. Oral suspension stable for 14 days if refrigerated (see Chapter 17). 459 CHAPTER 18 FORMULARY AMPHOTERICIN B - Fungizone (Squibb) AZITHROMYCIN - Zythromax (Pfizer) Available as an injectable solution (5 mg/ml) for slow (over several Available as capsules (250 or 500 mg) for oral administration. Used hours)