A Case Based Approach to Equine Neuropharmacology

Presentation Description / Summary: Neurologic diseases in horses, whether primary or secondary to other body systems derangements, are common. Neuropathic pain, nerve impingement, trigeminal-mediated headshaking, epilepsy, sleep disorders, and meningitis are neurological conditions that require pharmacological intervention. However, there are not many drugs available to alleviate the signs. Therefore, understanding the absorption, distribution, metabolism, elimination, and overall pharmacokinetic parameters of the most commonly used drugs for neurological conditions will provide clinicians with the tools to improve treatment of these conditions. In this presentation, clinical cases will be presented, where the pathophysiology will be explained in depth to enable a proper understanding of the mode of action of the drugs indicated for each condition. The mode of action and pharmacokinetic parameters will be discussed for the drugs indicated for the cases previously presented, as well as potential drug-drug interactions. Gabapentin, pregabalin, potassium bromide, phenytoin, phenobarbital, and levetiracetam will be discussed for the long-term management of epilepsy. For seizures, diazepam and midazolam will be put into context. For neuropathic pain, acetaminophen, gabapentin, and pregabalin will be discussed. For headshaking, cyproheptadine, carbamazepine, and licorice will be covered. The most common antimicrobials with potential efficacy in treating bacterial meningitis will be presented. Finally, potential medications for treating different neurological conditions will be discussed.

Learner Outcomes: 1. To associate the pathophysiology of the most common neurological conditions in horses with the mechanisms of action of the primary drugs used to treat disease. 2. To understand the key pharmacokinetic parameters that influence the efficacy of the main drugs used to treat neurological conditions. 3. To identify potential neurotrophic drugs that could be used to treat various neurological conditions.