Boots Material Flashcards
When treating large dogs over 50 pounds with Levothyroxine, dosing should be done by _____ to prevent oversupplementation
Surface area (meter squared)
*Have a much higher chance of excess if we dose on body weight for larger dogs
The most common disease causing clinically significant Hyperglycemia that requires therapy
Diabetes Mellitus
Preferred drug for treating Hypothyroidism in all species
Levothyroxine Sodium (T4)
Most effective Emetic in cats to induce vomiting
Xylazine
Vitamin D formulation that must be hydroxylated in the liver and in the kidney to the primary active form
Ergocalciferol
*Least desirable to use
True/False: Most animals with Diabetes Mellitus will require Insulin injections
True
Substance formulated alongside the active ingredient in a drug
Excipient
Replacement dosing of _____ can be used for the treatment of Hypoadrenocorticism (Addisons disease)
Glucocorticoids
What are the two types of Hyperadrenocorticism that we will be treating?
Pituitary dependent
Adrenal dependent
True/False: Liothyronine (T3) has a faster onset, shorter duration, and greater potency than Levothryoxine (T4)
True
*Not typically used to treat hypothyroidism
Phenomenon characterized by rebound hyperglycemia in which the patients is overdosed on Insulin and the body responds by causing the glucose level to shoot up and overswing
Somogyi Phemenon
Long term Apetite stimulant mainly used in dogs that increases norepinephrine as well as antagonizing Serotonin
Mirtazapine
Anti-emetic that works as a dopamine antagonist and blocks seretonin to decrease vomiting
Metoclopamide
Currently the most commonly used form of Vitamin D for lifelong therapy of hypoparathyroidism
Calcitriol
When starting treatment for Levothyroxine (T4), what is the recommended daily dosage?
Twice daily (BID)
*0.02 mg/kg PO
Common to see increase in _____ on the serum chemistry with excess Glucocorticoid use
ALP
*Alkaline phosphatase
True/False: Glucocorticoids will reduce inflammation in various body systems
True
Two parenteral formulations used for in the short term for rapid correction of Hypocalcemia
Calcium Gluconate- most common
Calcium Chloride
Most commonly used Oral Formulation to treat Hypocalcemia at 400mg/g
Calcium Carbonate
Vitamin D formulation that is least desirable to use because effects are not seen until 5-21 days of treatment and after toxic dose exposure it can take up to 18 weeks for resolution
Ergocalciferol
Drug used in the long term treatment of Hypercalcemia that “tones down” serum calcium by reducing osteoclast activity
Calcitonin
*clinical usefulness if questionable
Drug that is cytotoxic to the adrenal gland used to treat Hyperadrenocorticism
Mitotane
*Narrow therapeutic index
Oral use of _____ in cats can cause Idiosyncratic Hepatotoxicity
Diazepam
*Do not give orally to cats
True/False: Radioactive Iodine treatment for hyperthyroidism can be performed without anesthesia and is very safe
True
After which Hyperthyroid treatment must patients be hospitalized in isolation for several weeks after treatment due to radioactive substances excreted in the urine
Radioactive Iodine
Corticoids whose predominate effect is on Sodium Retention and Potassiume excretion
Mineralcorticoids
Glipizide is only used in Type ____ diabetes in cats
II
How is Levothyroxine generally administered?
Oral BID
True/False: We should treat the patient, not the disease
True
What Long acting Insulin is FDA approved insulin for cats that has a 40 IU/mL concentration?
Prozinc
Patients lack both Mineralcorticoids and Glucocorticoids, most commonly treated with DOCP plus Prednisone
Typical Addisons
Oral Hypoglycemic drug that stimulates insulin secretion by the Beta cells, and therefore requires functioning Beta cells to work
Glipizide
Drug used to treat Hyperadrenocorticism that is started with a higher induction dose followed by maintenance dosing in which you need to closely monitor adrenal function
Mitotane
Emetic that is commonly instilled into the conjunctival sac
Apomorphine
Which Insulin drug are canine receptors 4x more sensitive to than other insulins
Detemir
Drugs that will commonly inhibit Fibroblasts in dogs leading to Cruciate injuries
Glucocorticoids
Oral Hypoglycemic agents or injectable insulin are used for the treatment of what type of Diabetes Mellitus
Type II
Used by owners at home during the acute phase of Hypoglycemia, that is drizzled on the gums as emergency therapy
Karo Syrup
What short acting Insulin product is the Go to in cases of Hyperglycemia in emergency situations?
Regular Insulin
Drug used to mainly treat Pituitary dependent Hyperadrenocorticism where you start at lower doses then increase gradually with daily oral doses for the life of the patient
Trilostane
In a canine patient, will we treat Hyperglycemia with injectable insulin or oral Glipizide?
Injectable Insulin
*Glipizide is only used in cats with type II diabetes
Vitamin D formulation that has a fast onset and fast resolution after over supplementation
Calcitriol
*Clinical effect within 1-3 days
Patient lack Glucocorticoids only and is treated with Prednisone
Atypical Addisons
Apetite Stimulate used for long term use that inhibits the satiety center by blocking Serotonin (5-HT1)
Cyproheptidine
Oral hypoglycemic drug used in the treatment of Type II diabetes
that does not require functional Beta cells and does not affect insulin secretion
Metformin
*Inhibits hepatic glycogenolysis
True/False: For dogs we tend to reach for Intermediate acting insulin dosed twice daily and for cats we tend to use Long-acting insulins dosed once daily
False
*Dogs on Intermediate insulins and Cats on Long insulins are usually both dosed BID
If there is an underlying disease process causing Hypocalcemia, such as hypoparathyroidism, then calcium replacement therapy is usually done short term, while _____ replacement is initiated for long term managment
Vitamin D
Two Longer acting Glucocorticoids where the duration is over 48 hours
Betamethasone
Dexamethasone
What two Insulin injections are approved for Veterinary use by the FDA in animals with Diabetes Mellitus?
Prozinc
Vetsulin
Radioactive iodine is an ______treatment
Irreversible
What is the endogenous Mineralcorticoid
Aldosterone
Oversupplementing Levothyroxine chronically can lead to _____
Thyrotoxicosis
True/False: Mitotane used to treat hyperadrenocortisim in animals can be cytotoxic to humans, particularly pregnant clients, and gloves should be used when handling
True
Specifically formulated diet for the treatment of feline Hyperthyroidism
Hilld Y/D diet
When measuring the efficacy of anti-thyroid drugs, we measure ____
T4
True/False: Calcium Gluconate is more caustic than Calcium Chloride and should never be given SC or IM
False
*Calcium Chloride is more caustic and should never be given SC or IM
Lifelong therapy for Primary Hypoparathyroidism
Vitamin D
True/False: Calcitriol does not require parathyroid hormone activation
True
Long term treatment for Hypercalcemia that reduces bone resorption, decreases GI aborption and increases renal excretion of calcium
Prednisone or Prednisolone
*Glucocorticoids
What is the most common disease that leads to long term treatment for Hypoglycemia?
Non surgical Insulinoma
*Insulin secreting neoplasias
For extended IV usage of Dextrose, it must be diluted to a ___% solution
5
*Don’t want to exceed 5% Dextrose
What Long Acting insulin forms microprecipitates at the injection site which allows very gradual absorption
Glargine
Most commonly used drug to treat both Pituitary or Adrenal dependent Hyperadrenocorticism
Mitotane
Repeated dosing of _____ in cats can cause oxidative RBC injury and Heinz body anemia when used for more than 5 days
Propofol
Disease in which the patient will be sick and not eating considered a medical emergency, which is treated by giving 0.9%NaCl Fluid followed by Regular Insulin with added Dextrose
Diabetes Ketoacidosis (DKA)
*Regular insulin via CRI and Dextrose if patient is not eating
Most commonly used Anti-emetic that blocks Neurokinin receptors for prevention and treatment of vomiting in dogs and cats
Maropitant Citrate
What are the two Mineralcorticoids used in the treatment of Hypoadrenocorticism?
Desoxycorticosterone Pivalate (DOCP)
Fludrocortisone
The “Go To” Emetic that stimulates dopamine receptors generally used in dogs to cause vomiting
Apomorphine
*Only 10% efficacy in cats
Single injection treatment for Hyperthyroidism that has a half life of about 8 days
Radioactive Iodine
Prednisolone has a relative anti-inflammatory potency of 4, compared to ______ that has a relative potency of 30. Making ______ 7.5 x more potent than Prednisolone
Dexamethasone
*Glucocorticoids
When monitoring the treatment for Hypothyroidism, we are measuring the serum ____ levels
T4
True/False: Clinical duration of Insulin products is often shorter acting in dogs than cats
False
*Shorter acting in cats
True/False: Vitamin D is important in the parathyroid response to decreased Calcium in the serum
True
Treatment for Hypoparathyroidism by increasing calcium absorption in the gut, mobilization from bone, and decreased urinary excretion of calcium
Vitamin D Formulations
Between Levothyroxine Sodium (T4) and Liothyronine Sodium (T3), which one will have the fastest onset, shorter duration, and greater potency?
Liothyronine (T3)
100% of the body’s ____ comes from the thyroid
T4
Hills Y/D diet must be fed _____ for treatment of hyperthyroidism and therefore may not be feasible for indoor/outdoor cats
Exclusively
Most common Drug used for Replacement therapy in cases of dangerously low Glucose levels
Dextrose
True/False: Intermediate acting insulins are the first choice in cats
False
*The first choice in cats are Long acting Insulins
True/False: Short-acting insulins are usually administered as a bolus injection in the ICU
False
*Should not be given as a bolus injection. Only give as constant rate infusion
True/False: If you give Methimazole to a cat and they develop a side effect, you can give the drug at a lower dose
False
*Side effects are not dose dependent- If a cat develops any clinical side effects- STOP TREATMENT
Which one of these is not an Oral drug used in the treatment of Hyperglycemia?
Glipizide
Acarbose
Metformin
Rosiglitazone
Acarbose
Most commonly used oral Hypoglycemic agent used in veterinary medicine for the treatment of type II Diabetes Mellitus in cats
Glipizide
*Sulfonylreas
_______ and frequent small meals should be your First Line medical therapy for long term Hypoglycemia treatment due to insulin-secreting neoplasia
Glucocorticoids
*Prednisone or Prednisolone
Most commonly used emergency therapy for Hypoglycemia
Dextrose
Most common long term treatment for Hypercalcemia
Glucocorticoids
*Prednisone or Predisolone
Anti-Emetic used mainly for vestibular vomiting in dogs
Meclizine
If you have a patient on Glucocorticoids (Prednisolone), Sulfonamides, Mitotane, Phenobarbital, Zonisamide, Anesthetic drugs, or Phenylbutazone, you should not be testing their ____
Thyroid
*Drugs that interfere with thyroid hormones- need to be off these drugs for at least 4-6 weeks
Drug given in a single bolus that is given intravenously diluted 1:4 to prevent phlebitis in cases of acute Hypoglycemia
Dextrose
Most commonly used drug for treating Hyperthyroidism in cats in North America
Methimazole
Which short term acting insulin is used in emergency situations where the patient is not eating and you need fine tune control of their glucose levels
Regular Insulin
In managment of critical care patients with diabetic ketoacidosis, it is best to use ____ acting Insulins
Short
Treatment for Hyperthyroidism that is a singe injection that will be taken up by the thyroid and will selectively destroy active thyroid tissue
Radioactive Iodine
True/False: For long term management of Hyperglycemia it is best to use Short acting insulins such as Regular Insulin
False
*Regular is only used in the hospital and ICU
Drugs that are used in cats with Type II diabetes for owners that fear to give insulin injections
Oral Hypoglycemic drugs
*Usually Glipizide
Apetitie stimulant used in the hospital that provides short term increase in appetite when given IV
Propofol
Treatment of Hyperthyroidism that is not as aggresive and T4 levels don’t get dramatically low and is great alternative for a patient that had a bad reaction to Methimazole
Hills Y/D diet
What type of drugs commonly lead to Gatrointestinal ulcers
Glucocorticoids
Top two drugs given short term in the hospital to get animals to eat
Benzodiazepines
Propofol
True/False: Short acting insulins, such as Regular, have immediate onsets and short durations lasting around 1-10 hours
True
*Duration is longer if given IM or SC
If serum Calcium x serum Phosphorus is greater than ___ there is a higher risk for soft tissue damage and more aggressive management should be considered
70
*Kidney Failure may occur at this level
What Treatment for Hypothyroidism should be used in patients who have a reduced ability to convert T4 to T3?
Liothyronine (T3)
Long term Apetite stimulant that is more effective in cats than dogs
Cyproheptidine
Diet that has restricted level of iodine which reduces that amount of T4/T3 produced
Hills Y/D diet
True/False: Liothyronine (T3) is commonly used for treatment of Hypothyroidism
False
*Clinically it is used to perform T3 suppression test to diagnose hyperthyrodism in cats
Which Minteralcorticoid has mild Glucocorticoid
(anti-inflammatory) effects
Fludocortisone
*DOCP has no anti-inflammatory effect.
Drug used in the long term treatment of Hypoglycemia that increases gluconeogenesis, decreases glucose uptake into tissues, and stimulates glucagon secretion
Prednisone or Prednisolone
What Mineralcorticoid is given orally BID and has mild glucocorticoid effects
Fludrocortisone
Long acting insulins are mainly used in what species?
Cats
Which Long-acting Insulin is more commonly used in dogs, but can be limited in the ability to dose accurately in small dogs due to its higher potency (4x) in canines
Detemir
T3 is the biologically ____ form
Active
