Applied Pharmacology Flashcards
An undesirable response to a drug by a patient. It may vary in severity from mild to fatal and is called…?
Adverse Drug Reaction
A drug that brings about a specific action by binding with the appropriate receptor is called…?
Agonist
A drug that inhibits a specific action by binding with a particular receptor is …?
Anatagonist
Any manipulation (e.g. diluting combining) performed to produce a dosage-form drug, other than the manipulations described in the directions for use on the labeling of an approved drug product is …?
Compounding
A substance used to diagnose, prevent, or treat disease is …?
Drug
The extent to which a drug causes the intended effects in a patient is …?
Efficacy
The use of a drug that is not specifically listed on the U.S. Food and Drug Administration (FDA)-approved label is …?
Extralabel Use - a vet can choose the regimen they find best for treatment based on many factors - even if that drug is not labeled for that species or disease
The amount of time (usually expressed in hours) that it takes for the quantity of a drug in the body to be reduced by 50% is …?
Half-life
The bulk production of drugs for resale outside of the veterinarian-client-patient relationship
manufacturing
The biochemical process that alters a drug from an active form to a form that is inactive or that can be eliminated from the body is …?
Metabolism (Biotransformation)
The route of administration of injectable drugs is …?
Parenteral
The ratio of the solubility of substances (e.g, gas anesthetics) between two states in which they may be found (e.g., blood and gas, gas and rubber goods) is …?
Partition Coefficent
A drug that is limited to use under the supervision of a veterinarian because of potential danger, difficulty of administration, or other considerations. The legend that designates a prescription drug states the following “Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian” is …?
Prescription (legend) drug
A program for administration of a drug that includes the route, the dose (how much), the frequency (how often), the duration (for how long) of administration is …?
Regimen
An amount of a drug still present in animal tissue or products (e.g, meat, milk, eggs) at a particular point
(slaughter or collection) is …?
Residue
The set of circumstances that must exist between the veterinarian, the client, and the patient before the dispensing of prescription drugs is appropriate is …?
Veterinarian-client-patient relationship
The length of time it takes for a drug to be eliminated from animal tissue or products after it is no longer used is…?
Withdrawal time
A vet must select a drug through the use of a method called…?
diagnostic, empirical, or syptomatic
The diagnostic method involves…?
- assessment of a patient - including a history, physical examination, laboratory tests, and other diagnostic procedures, to arrive at a specific diagnosis
The empirical method calls on the use of …?
practical experience and common sense when the drug choice is made.
True or False
Drugs may be chosen to treat the symptoms or signs of a disease if a specific diagnosis cannot be determined.
True
What is the plan (regimen) when administering a drug…?
What is the route of administration
What is the amount that will be given (dosage)
How often will the drug be given (frequency)
How long will the drug be given (duration)
When a drug has toxic effects what steps must be taken? What is the statement that the drug must be labeled with and what is this statement called?
only trained personnel can administer the drug
a veterinarian must approve the drug for use
the drug is classified as a prescription drug and must be labeled with the following statement: “Caution: Federal law restricts the use of this drug to use by or on the order of a licensed veterinarian.”
This statement is called a legend
When a drug is a controlled substance what steps need to be taken by the veterinary technician?
- careful records of the inventory and use of these drugs must be maintained, and some must be kept in a locked storage area.
- Make sure the correct drug is being administered
administer the drug by the correct route and at the correct time - carefully observe the animal’s response to the drug
- questioning any medication orders that are not clear
- creating and affixing labels to medication containers accurately
- explaining administration instructions to clients
- recording appropriate information in the medical record
What is pharmacokinetics?
the complex sequence of events that occurs after a drug is administered to a patient
What is the steady state?
the point at which drug accumulation equals drug elimination
How can drug levels be measured? What is this procedure called?
in blood, urine, cerebrospinal fluid, and other appropriate body fluids
Therapeutic drug monitoring
What are the primary factors that influence blood concentration levels of a drug and a patient’s response to it?
- rate of drug absorption
- amount of drug absorbed
- distribution of the drug throughout the body
- Drug metabolism or biotransformation
- Rate and route of excretion
The way a drug is administered to an animal is influenced by?
- available pharmaceutic form of the drug
- physical or chemical properties (irritation) of the drug
- How quickly onset of action should occur
- use of restraint or behavior characteristics of the patient
- nature of the condition being treated
What ways can a drug be administered that is considered to be orally?
drug placed directly in the mouth or may be given via a tube passed through the nasal passages (nasogastric tube) or through the mouth (orogastric tube)
Drugs that are given by injection are called…?
parenteral drugs
Drugs given by the intravenous route produce the most rapid onset of action, accompanied by the shortest duration. True or False
True
What route of administration produces the slower onset of action than the intravenous route, but provides a longer duration of action?
intramuscular route
When an injectable drug is placed in a substance that delays its absorption, it is referred to as a..?
depot preparation
The subcutaneous route produces a ______onset of action but a slightly _______ duration than the intramuscular route.
slower, longer
What does adding an enzyme, hyaluronidase do to a drug that is given subcutaneously?
may speed its absorption
Routes of drug administration are?
orally parenteral (injection), inhalation, topical
What is bioavailability?
the degree to which a drug is absorbed and reaches the general circulation
What can have an significant effect on the physical and chemical characteristics of drug molecules that influence drug bioavailability?
the manufacturing process
Drugs pass across cellular membranes through 3 common methods. What are they?
passive absorption (transport), through pores in cell membranes, active transport, pinocytosis - a third method of passive transport, cells engulf drug molecules
What is the largest absorptive surfaces in the body?
the small intestine because the efficient design of the villi maximizes the surface area
What are the 4 sources of drugs used in veterinary medicine?
- Botanial - atropine, digoxin, penicillin
- animal - hormones, heparin (insulin), old methods of harvesting
- mineral - electrolytes
- sythesized-most modern drugs are made in a lab
What conditions must be met for a valid veterinarian-client-patient relationship to occur?
relationship must be there before vet’s can administer drugs.
Vet’s are responsible for clinical assessment and ordering treatment
The client must agree to follow the plan
The vet has seen the client recently so they can make a diagnosis
The vet is available to reevaluate the patient
What is the sequence of events that a drug undergoes from administration to excretion?
drug is given -available for absorption into bloodstream - deliver to site where it will exert its action - distributed to various fluids and tissues - must accumulate in that fluid or tissue at the desired concentration - breaks down - body excretes the drug
What are some factors that influence drug absorption?
- the number of cellular membranes that drugs must cross to get to the area where they work
- bioavailability
- mechanism
- ph/ionization
- surface area
- blood-supply
- solubility
- form
- drug interaction
Most biotransformation (metabolism) of drugs occur in which of the following:
a. kidney
b. liver
c. spleen
d. pancreas
b. liver
Most drug excretion occurs via which of the following:
a. kidneys
b. liver
c. spleen
d. intestine
a. kidneys
What is the function of the binders in the medication?
Holds tablet together
What is the function of the coating in the medication?
Protects the tablet from breaking, absorbing moisturer, and early disintegration
What is the function of the coloring agents in the medication?
provide color and enhance appearance
What is the function of the disintegrants in the medication?
expand when exposed to liquid, allowing tablets and capsules to dissolve and disperse their active ingredients
What is the function of the emulsifiers in the medication?
Allow fat-soluble and water-soluble agents to mix, so they do not separate
What is the function of the fillers diluents in the medication?
increase bulk or volume
What is the function of the flavor agents in the medication?
create a desired taste or mask an undesired taste
What is the function of the flow agents in the medication?
prevent powders from sticking together
What is the function of the humectants in the medication?
hold moisture in a product
What is the function of the preservatives in the medication?
prevent degradation and extend the shelf life of a product
What is the function of the sweetening agents in the medication?
improve taste
What is the function of the thickening agents in the medication?
increase the viscosity of a product
What is pharmacotherapeutics?
Treatment using medications
Veterinarians make the prescription or order for a drug based on a diagnosis
The regimen is a plan for using the drug to treat a disease
The order or prescription should give you necessary information for the regimen
A prescription drug is given to an animal patient only…?
under the supervision and direction of a veterinarian
What is pharmacokinetics?
events that occur after a drug is administered to a patient
- outline of the possible sequence of events that a drug may follow in an anima’ls body
What is drug distribution?
how a drug gets from the absorption site to the site of action
What is biotransformation?
also called metabolism and is how the body changes the drug so it can be excreted
What is drug excretion?
How/where drugs are excreted from the body
The time required to excrete half of the present amount of drug is the half-life
Drugs that cannot be fully excreted leave ‘residue’ in the body - food animals
What is pharmoacodynamics?
mechanisms by which drugs produce physiologic changes in the body
What are cell receptors?
a drug that has a high affinity to and binds with a cell receptor is called an agonist
a drug with less affinity to but still may bind to parts of a cell receptor is a partial agonist
a drug that blocks a receptor so it cannot be bound to is an antagonist
What are agonists and antagonist?
drug molecules must combine with specific cellular receptors to exert their effects
What is meant by efficiacy?
the degree to which a drug produces its desired response in a patient
LD50 is the lowest dose that is lethal to 50% of the animals in a trial
ED 50 is the lowest dose that produces the desired effect in 50% of animals in a trial
What is a therapeutic index?
the relationship between a drug’s ability to achieve the desired effect and its tendency to produce toxic effects
LD50/ED50
a low/narrow index is more dangerous
The effect of dose amounts on the effectiveness of a drug
What is a adverse drug reaction?
an undesirable response to a drug that can range from mild to life threatening
drug characteristics, quality of drug in use, amount of drug
What is a drug interaction?
an altered pharmacologic response to a drug that can range from mild to life threatening
drug characteristics
quality of drug in use
amount of drug
What is expected in naming and labeling?
there are standards for naming and labeling set forth by the USP (United States Pharmacopoeia) and the CVM (Center for Veterinary Medicine)of the FDA (Food and Drug Administration)
Drugs are given the following type of name:
Chemical, Cod or Laboratory, Compendial, Official, Proprietary or trade, Generic
What do requirement do drug labels have to have?
drug names, concentration, quantity, name and address of the manufacturer, controlled substance status, manufacturer’s control or lot number, expiration date
What is development and approval?
when the federal government requires safety and effficacy (effectiveness) to be proved through testing
What regulatory agencies are there?
FDA - food and drug administration, CVA - center for veterinary Medicine - regulates animal drugs and feed additives
EPA - environmental protection agency - regulates animal topical pesticides
USDA - U.S. department of agriculture - regulates biologics
FARAD - Food Animal Residue Avoidance Databank - provides withholding tmes for milk and preslaughter withdrawal times for meat
AMDUCA = the animal medicinal drug use clarification acto of 1994
What book lists all animal drugs approve by the FDA?
The green book
When did Congress begin passing legislation to regulate manufacture, use, and sale of drugs?
in 1906
What is AMDUCA?
AMDUCA = the animal medicinal drug use clarification act of 1994
allows extralabel use of drugs by veterinarian prescription as long as specific requirements are met
certain drugs are prohibited from extralabel use in food animals
Rules when compounding drugs, what are they?
the FDA issued a compliance policy guideline, CPG, in 1996 to allow custom compounding under certain conditions:
- legitimate veterinary medical need
- to create an appropriate regimen for a particular species, size, gender, or condition
- lack of an available approved animal or human drug
- available approved drugs would take to long to secure
What is the Veterinary feed directive?
part of the animal drug availability act of 1996
increased FDA CVM control over use of animal feed additives so they require a veterinarian-client-patient relationship to use (no longer OTC)
What is MUMS?
The minor use and minor species animal health act of 2001
specifically allows extralabel approved drug use in less common species - sheep, goats, birds, emus, alpacas, llamas, deer, elk, rabbits, guinea pigs, reptiles, fish, shellfish,wildlife, zoo, and aquarium animals
allows extralabel approved drug use in major species for uncommon (minor) uses
Medications are a sales/revenue resource as well as a …?
treatment resource
What is the difference in a veterinary practice with dispensing vs. prescribing medications?
Most veterinary practices prescribe and dispense in- house
Some drugs are prescribed by a veterinarian and dispensed by a human or specialty pharmacy
What is the process of marketing medications?
Manufacturers - representatives Distributors Generic Companies Retail Markets Internet Pharmacies
Drug interactions can be classified as?
pharmacokinetic, pharmacodynamic, pharmaceutic
What is the term used to mean reason for using drugs?
indications
What is term used to mean reason for not using drugs?
contraindications
What is withdrawal time?
the length of time it takes for a drug to be eliminated from animal tissue or products after it is no longer used
Oil-based drugs and those with suspended particles (cloudy or thick) generally should not be given ________ because of the possibility of an embolism.
intravenously
______ medications should be administered slowly to lessen the possibility of a toxic or allergic reaction.
Intravenous
Take care to ensure that ______ drugs are injected into the vein and not around it, to avoid causing phlebitis
irritating
What is phlebitis? What is the cause of phlebitis?
- an inflammation of superficial veins (or veins close to the surface of the body)
- The main cause of phlebitis is intravenous (IV) catheter use. Poor catheter quality or care may lead to bacterial colonization of a catheter, which can then infect the dog.
When using the intramuscular route, the onset of action by this route can be relatively faster when using a _______ form. The onset of action is slower when using ______ form.
water-based (aqueous)
diluents such as oil or other forms such as microfine crystals
When an injectable drug is placed in a substance that delays its absorption, this may be referred to as a _____ preparation.
depot
Onset of action usually is inversely related to ____ of action.
duration
____ drugs should not be given by the _____ or _____ routes.
Irritating
Intramuscular, subcutaneous
Back pressure should always be applied to the syringe plunger before ________ or ______ administration of a drug to ensure the injection is not directed into a blood vessel.
intramuscular and subcutaneous
The subcutaneous route has been also called?
hypodermoclysis
Irritating or hyperosmotic solutions (those with a greater number of suspended particles than are found in body fluid) should not be given by _____ route
subcutaneous
What enzyme could be added to a drug to speed its absorption?
hyaluronidase
The intradermal route involves injecting a drug into the _____ for what purposes?
skin
- testing for tuberculosis and allergic conditions
The ______ route is used to deliver drugs into the abdominal cavity
intraperitoneal
The intraperitoneal route is used to administer what?
fluids, blood, and other medications when other routes are not available or not practical
What are some problems when using the intraperitoneal route?
adhesions and puncture of abdominal organs
