2021 Exam Flashcards
Explain the relationship between half-life, plasma drug accumulation, and fluctuation. List which are variables that can affect the half-life of drugs.
Shorter half-life = more fluctuation, less drug accumulation (depends on frequency of administration)
Half-life can be affected by species, clearance, volume of distribution.
A drug is not working on a patient. You submit plasma samples for assessing the concentration.
TDM report indicates that the plasma drug concentration is within the therapeutic window. List three strategies you would implement for helping your patient.
Increase dose
Change treatment/drug
Decrease dosing interval
List the primary indication for doxapram and sildenafil.
Doxapram: stimulating the respiratory center during an emergency
Sildenafil: pulmonary hypertension
List five diseases for which loop diuretics are contraindicated.
- Anuria
- Dehydration
- Vomiting / diarrhea
- Hypotension
- Hepatic encephalopathy
Which diuretic can be used to treat nephrogenic diabetes insipidus?
Thiazide diuretics
List a contraindication of calcitriol.
Hypercalcemia
MOA: Mannitol
Osmotic diuretic at proximal tubules
Decrease water and sodium reabsorption
MOA: Furosemide
Loop diuretic descending loop of Henle
Inhibits Na-K2Cl symporter
MOA: Chlorothiazide
Thiazide diuretic - acts on distal collecting tubule
Inhibits Na/Cl transporter
MOA: hydrochlorothiazide
Thiazide diuretic - acts on distal collecting tubule
Inhibits Na/Cl transporter
MOA: trimatirene
Block Na+ channels in distal tubule
MOA: amiloride
Block Na+ channels in distal tubule
MOA: spironolactone
Inhibits aldosterone binding at distal tubule
MOA: calcitriol
Replaces activated Vitamin D
MOA: erythropoietin (EPO)
Increases RBC production
MOA: epoetin alfa, darbepoetin alfa
increases RBC production by stimulating EPO
MOA: clenbuterol
Bronchodilator, increases intracellular cAMP
MOA: prednisone
Glucocorticoid
Decreases inflammation via a variety of mechanisms
Augment beta-2 adrenergic mediated bronchial smooth muscle relaxation
Which of the factors listed influences the extent of drug accumulation in plasma?
a. fluctuation of plasma drug concentration
b. tmax
c. clearance
d. cmax
e. extent of protein binding
f. none
fluctuation of plasma drug concentration
Which of the factors listed below influences the t1/2 of drugs w/linear kinetics disposition?
a. tmax
b. clearance
c. dose
d. dose frequency
e. drug conc at steady state
f. none
Clearance
Indicate which of the following statements is INCORRECT concerning a valid VCP relationship?
a. a (licensed) vet can prescribe drugs only in the context of a valid VCPR
b. the vet has to assume the responsibility for making clinical judgements regarding the health of the animal(s) and the need for medical tx, and the client has agreed to follow the vet’s instructions
c. the vet does not need to be available for follow-up evaluation after starting the tx
d. the vet has to have sufficient knowledge of the animal(s) to initiate at least a general or preliminary dx of animal’s medical conditions
e. all above are correct
f. all above are incorrect
The vet does not need to be available for follow-up evaluation after starting the treatment.
Before prescribing any approved human or animal drug for ELDU in food production animals you must:
a. carefully diagnose and evaluate the condition for which you are prescribing the drug
b. make sure procedures are in place, so your client maintains the identify of the tx animal(s)
c. establish a substantially extended withdrawal period supported by appropriate scientific information
d. take measures to ensure that no illegal drug residues occur in the treated animal(s), your client must follow your established withdrawal period
e. all above are correct
f. all are incorrect
All are correct
Regarding compounded formulations, please indicate which statement is INCORRECT.
a. compounded formulations are preferred over generic formulations
b. vets must provide an extended withdrawal time for indicating compounded formulations in food animals
c. the score of a tablet could be considered as practicing compounding
d. the amount of product compounded should be on an individual animal basis
e. all are correct
f. all are incorrect
Compounded formulations are preferred over generic formulations
You could prescribe a compounded formulation EXCEPT:
A. when there is a valid VCPR
B. when compounding is done w/approved drugs
c. when the pharmacy is producing the compounded formulation at a commercial scale
d. when there is a restricted distribution of the drug intended to be compounded
e. when the WDT can be established by the prescribing vet
f. none of the options
When the pharmacy is producing the compounded formulations at a commercial scale
Regarding controlled substances, please indicate which of the statements below is INACCURATE:
a. all drugs used in vet practice are considered controlled substances under the controlled substances act (CSA)
b. the DEA is the federal agency that supervised the use and distribution of controlled substances
c. controlled substances are divided into 5 schedules
d. substances are placed in their respective schedules based on whether they have a currently accepted medical use in tx in the US, their relative abuse potential, and the likelihood of causing dependence when abused
e. in order to use and dispense controlled substances, you do not need to be registered with the DEA
f. none of the options are correct
All drugs used in vet practice are considered controlled substances under the Controlled Substances Act (CSA).
How many days would you need to wait until the plasma drug concentration of a drug w/a t1/2 of 30d has reached steady-state following the repeated oral administration to a dog tx 1x/day.
a. 3 days
b. 60d
c. 150d
d. 15d
e. 30d
f. none of the above
150 days
5 T1/2 = 5x30d = 150d
A long-time client, who always follows directions, calls your practice to tell you they adopted a senior, obese dog from the humane society. In your phone convo, the client asks you to prescribe carprofen because the client noticed the dog has moderate joint pain and suspects osteoarthritis. You agree that this dog could has OA and the dog may benefit from carprofen and weight loss.
Indicate which of the statements below reflects correct approach to this situation:
a. you prescribe carprofen for this patient
b. you ask your client to bring the dog into the clinic for medical evaluation of the problem
c. you tell your client that he can use the carprofen left from another perscription
d. you recommend your client set up a zoom meeting to further discuss
e. you ask your client to bring the dog to the clinic for medical evaluation of the problem, but in the meantime, you recommend your client to get some over the counter NSAIDs for tx
You ask your client to bring the dog into the clinic for medical evaluation of the problem.
Which of the drugs (or group of drugs) listed below is not included in the list of drugs prohibited to use off the label in food animals?
a. chloramphenicol
b. clenbuterol
c. furosemide
d. phenylbutazone
e. diethylstilbestrol
f. glycopeptides
g. cephalosporins
Furosemide
T/F
The FDA is responsible for the safety and efficacy of FDA-approved drugs used in extra-label manner.
False
Therapeutic drug monitoring is highly likely to be indicated for drugs associated with all the statements below EXCEPT:
a. drugs w/non-linear pharmacokinetics that may lead to rapid accumulation of drugs to toxic concentrations
b. drugs assoc w/serious toxicity
c. drugs w/a steep dose-response curve
d. drugs w/a wide therapeutic range
e. drugs w/a poorly defined or difficult detect clinical endpoint
Drugs with a wide therapeutic range
Regarding TDM, please indicate which of the statements below is INCORRECT:
a. the type of sample and the # of samples collected depend on the goal of monitoring and the amount of drug that is eliminated during a dosing interval
b. for drugs w/a long T1/2 life relative to dosing interval, a single sample collected at any time is sufficient
c. TDM is a tool to monitor plasma drug once, and it can be applied to MOST DRUGS used in vet med practice
d. for drugs w/a short T1/2 life compared to dosing interval, a sample at the peak once is preferred if safety is a concern
e. none
TDM is a tool to monitor plasma drug once, and it can be applied to MOST DRUGS used in vet med practice
Which of the following statements about drug-drug interactions (DDI) is INCORRECT:
a. induction of drug metabolism does not occur after a single administration, however, it may occur over time (2-3w) w/repeated administration of the induced
b. induction of drug metabolism can result in a faster synthesis of a toxic metabolite
c. induction of metabolism can result in a decrease in drug efficacy
d. some DDI could result in beneficial pharmacological effects
e. none
induction of metabolism can result in a decreased in drug efficacy
actually result in an increase in drug efficacy
Which of the following factors is relevant concerning the incidence and significance of drug-drug interactions:
a. order of drug admin
b. individual patient factors
c. relative doses of the interacting drugs
d. type of drug and condition being treated
e. duration of tx
f. all statements listed
All statements listed
Furosemide is indicated for treating all these conditions EXCEPT:
a. tx of edema due to cardia/hepatic causes
b. increasing urine output in renal failure
c. tx of edema due to renal causes
d. increasing urine output in anuric patients
e. exercise-induced pulmonary hemorrhage in horse
f. none of the statements listed
Increasing urine output in anuric patients
Which of the drugs listed below can exacerbate cranial hemorrhages:
a. acetazolamide
b. mannitol
c. amiloride
d. spironolactone
e. chlorothiazide
f. none
mannitol
Indicate which drug could help to tx hypoglycemia
a. acetazolamide
b. furosemide
c. amiloride
d. spironolactone
e. chlorothiazide
f. none of the options
None of the options (is this correct?)
Which of the diuretics listed below was shown to control nephrogenic diabetes insipidus?
a. acetazolamide
b. furosemide
c. amiloride
d. spironolactone
e. chlorothiazide
f. none of the options
Chlorothiazide
Erythrocyte stimulating agents are indicated in which of the following situations:
a. cat with polycythemia
b. cat with hypotension
c. cat w/a PCV of 10%
d. cat w/a PCV of 35%
e. none
Cat with a PCV of 10%
Calcitriol is indicated for treating which of the following:
a. tx of edema due to cardia/hepatic causes
b. hypocalcemia
c. hyperkalemia
d. tx of renal anemia
e. none of the options
Hypocalcemia
Indicate which of the following drugs is an antitussive approved by the FDA for treating cough in dogs:
a. tramadol
b. codeine
c. dextromethorphan
d. butorphanol
e. naloxone
f. none
Butorphanol
Indicate which of the following adverse effects is LESS LIKELY to be caused by the administration of opioids at antitussive doses in dogs:
a. sedation
b. diarrhea
c. resp depression
d. none
Diarrhea
actually causes constipation
All of the following statements regarding of treatment of reactive airway disease are true EXCEPT:
a. human pharmaceutical products indicated for asthma that are formulated as inhalers can be used in dogs, cats, horses because space devices have developed for these species
b. inhaled corticosteroids eliminate all risks of side effects
c. theophylline is an effective bronchodilator but its use in vet patients has waned b/c of the risk of adverse effects
d. corticosteroids (inhaled/systemic) are the most effective tx for reactive airway dz in vet species
e. none of the options above
Inhaled corticosteroids eliminate all risks of side effects
All of the following statements regarding bronchodilators are true EXCEPT:
a. dextromethorphan has poor oral bioavailability in dogs and a very short T1/2 such that currently available formulation of dextromethorphan are not useful
b. bronchodilators are used to tx reactive airway dz
c. cromolyn has no bronchodilator effect
d. Beta-2 receptor agnostics activates the protein G, resulting in activation of protein kinase A
e. none of the above
Beta-2 receptor agonists activates the protein G, resulting in activation of protein kinase A
Adrenergic agonist drugs (w/alpha and beta 1 and 2 agonistic activity) used as bronchodilators are expect to cause the following adverse effects EXCEPT:
a. hypertension and tachycardia
b. hypotension and bradycardia
c. muscle tremors
d. dec of pharmacological effect due to tolerance
e. none of the above
Hypotension and bradycardia
Anticholinergic drugs used as bronchodilators are assoc w/the following adverse effects except:
a. bradycardia
b. GI (ileus/constipation/dry mouth)
c. CNS-excitation followed by depression/coma
d. dec mucociliary clearnce
e. none of the options
Bradycardia
Which of the following corticosteroids is likely to be less effective/ineffective when administered orally to cats and horses:
a. dexamethasone
b. prednisone
c. prednisolone
d. none
Prednisone
List a drug that may increase the nephrotoxic potential of furosemide.
NSAIDs - i.e. carprofen in dogs
In order to establish an extended withdrawal time for a dug used in an off-label manner in a food animal, what is the best resource for you, the vet?
FARAD
List 5 characteristics of drugs to be used in patients w/renal impairment
- large therapeutic index
- not nephrotoxic
- low renal clearance
- effective w/altered tissue fxn
- effective w/dehydration/low BP
List 2 samples of antimuscarinic drugs other than atropine
Glycopyrrolate
Ipratropium bromide
List three examples of corticosteroids used in vet med
Prednisone
Prednisolone
Dexamethasone
List 3 beta-2 adrenergic receipt agonists used as bronchodilators
- clenbuterol
- epinephrine
- albuterol
also:
terbutaline, isoproteranol, metaproterenol, salmeterol
