Page 2822 - Cote clinical veterinary advisor dogs and cats 4th

Imipenem-cilastatin (Primaxin) Insulin, detemir (Levemir) 1485

Generic Name (Brand Administration/
Name, Synonyms) Canine Dosages Feline Dosages Adverse Effects/Warnings Availability
VetBooks.ir Imipenem-cilastatin Susceptible infections: Susceptible infections: Use with caution in renal impairment Powder for injection;
5-10 mg/kg IV q 6-8h
5-10 mg/kg IV q 6-8h
(dosage adjustment may be
reconstituted imipenem
(Primaxin)
solution should be further
required) and in CNS disorders
(e.g., seizures, head trauma).
solution and infused over
Adverse effects include GI upset, diluted in a compatible IV
CNS toxicity (seizures, tremors), 20-60 minutes.
hypersensitivity, and infusion
reactions (thrombophlebitis). Too
rapid IV infusions may cause GI
or CNS toxicity, or other untoward
effects. Rarely, increases in serum
creatinine, BUN, hepatic enzymes,
hypotension, and tachycardia have
been reported.
Imipramine (Tofranil) Narcolepsy/cataplexy: Behavioral modification: Anticholinergic side effects are Tablets, capsules
0.5-1 mg/kg PO q 8-12h 0.5-1 mg/kg PO q 12-24h common. Do not use with MAO
Behavioral disorders: Urethral incompetence: inhibitors (e.g., amitraz). May
2.2-4.4 mg/kg PO q 24h 2.5-5 mg/CAT PO q 12h lower seizure threshold. Use with
Urethral incompetence: caution in patients with thyroid
5-15 mg/DOG PO q 12h disorders, urinary retention,
hepatic disorders, KCS, glaucoma,
cardiac rhythm disorders,
DM, or adrenal tumors due to
anticholinergic adverse effects.
Immunoglobulin (IGIV, IVIG, Immune-mediated blood Dosing in cats is not described. Adverse effects are often associated Injection; infused over a
hIVIG) disorder: 0.5-1.5 g/kg IV with too rapid IV administration 6- to 12-hour period. Very
over 6-12 hours (administer over 6-12 hours). expensive.
Can cause anaphylaxis, perhaps
associated with trace amounts
of human albumin. Can cause
increased blood pressure or
local reactions at or near the
injection site. Volume overload
is possible. IVIG may promote
hypercoagulability and an
inflammatory state.
Insulin, regular (Humulin-R, DKA or hyperosmolar DKA: Prepare in saline Hypoglycemia is most important Injection. To prepare CRI,
Novolin-R) syndrome: 0.2 units/ as described (see adverse effect. Other adverse add 1.1 units/kg (cat) or
kg/h IV CRI, or prepare in administration), and begin effects include insulin-induced 2.2 units/kg (dog) to bag of
saline as described (see infusion at 10 mL/h IV CRI, hyperglycemia (Somogyi effect), 0.9% saline then run diluted
administration) and begin adjusting prn based on insulin antagonism/resistance, insulin solution through
infusion at 10 mL/h IV CRI, frequent glucose assessment rapid insulin metabolism, and IV tubing and discard the
adjusting prn based on (see Diabetic Ketoacidosis). local hypersensitivity reactions. first 50 mL of fluid (due
frequent glucose assessment Dextrose supplementation to adsorption onto plastic
(see Diabetic Ketoacidosis). begun when glucose is <250; tubing) before attaching to
Dextrose supplementation or intermittent IM dosing the patient.
begun when glucose as for dog starting with
is <250. Alternative 0.1 units/kg
intermittent IM dosing: Hyperkalemia: 1 4 units/kg IV
0.1-0.2 units/kg IM bolus, or 1 units/CAT with
into muscles of the rear dextrose supplementation (2 g
legs; repeat IM doses of dextrose per unit of insulin,
0.1 units/kg q 1h until 1 2 by bolus and 1 2 in IV
glucose <250 mg/dL, then fluids)
IM q 4-6h or SQ q 6-8h
until ready to switch to
longer-acting insulin upon
return of appetite
Insulin, detemir (Levemir) DM: 0.1 units/kg SQ q 12h, DM: 0.25 units/kg SQ q 12h, Hypoglycemia is most important Injection; use U100 syringes
adjusted prn. Rarely used adjusted prn. Rarely used adverse effect. More potent in for injection. Vial should be
in dogs. in cats. dogs than other commonly used rolled to mix and not shaken.
insulin types. Other adverse Also available as insulin pen.
effects include insulin-induced
hyperglycemia (Somogyi effect),
Drug Compendium
insulin antagonism/resistance,
rapid insulin metabolism, and
local hypersensitivity reactions.

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