Exam 2 Pharm II Flashcards

Question

A two-year-old bitch received estrogen for pregnancy termination. She developed signs of pyometra (a purulent vaginal discharge, anorexia, fever, depression, polyuria and polydipsia). Systemic bactericidal antibiotic therapy should be combined with a. megesterol acetate b. estradiol c. hCG d. PGF2a e. eCG

Answer 1

1. **_Cholinergics_** - SQ to prevent systemic effect * **Bthanechol ($$$), Neostigmine SQ** 2. **_Bitters_**- stimulates salivation to indirectly stimulate rumen motility * **Ginger, capsicum, methyl salicylate** 3. **_Magnesium hydroxide_** = antacid, laxative and adsorbent * Mg is not absorbed and thus osmotically pulls water into the rumen. The increase water will sitimulate movement

Answer 2

b. ovarian follicular cysts in cattle which drug does this?

Answer 3

Leuteolysis --\> decrease serum progesterone ------------ also stimulates uterine contraction secondary\* to luteolysis

Answer 4

**Clindamycin** ORAL

Answer 5

MOA: **5-HT₄/Serotonin agonist** in enteric neurons Use: **prokinetic** with no secretion for the entire GIT (including Colon and esophagus)

Answer 6

Praziquantel - acts on tegument

Answer 7

**uterine prolapse and decrease appetite** ---- progestins decrease uterine contractions and increase appetite

Answer 8

**Choleretic (increase bile flow**) and may have **immune-modulating** properties - use in chronic inflammatory liver disease in small animals (Cholangiohepatitis) **Contraindicated in bilary obstruction** and may interfere with bile acid tests

Answer 9

1. Peptic ulcer 2. Gastric erosive disease 3. Gastroesophageal reflux disease 4. Duodenal ulcer 5. Cimetidine is used in the treatment of equine melanoma (as immunomodulator) 6. Ranitidine or nizatidine can be used as GI prokinetic

Answer 10

Periparturient (peak lactiation ketosis does not respond)

Answer 11

Androgens and Anabolic Steroids

Answer 12

**Pyometra/Cystic Endometrial Hyperplasia (CEH)** Also: mammary gland enlargement and tumors, increased appetite, weight gain, letharfy, temperament changes, coat changes, hyperglycemia, and inhibition of the adrenal cortex, acromegly, delay parturition, masculinization of female fetuses

Answer 13

Continuous release from the lung, skin, GI mucosa and the CNS (hypothalamus) ------------------------------------------ Mast cell pool = mast cells and basophils

Answer 14

c. glucocorticoids

Answer 15

b. ivermectin

Answer 16

rumen acidosis

Answer 17

dinoprost tromethamine (Lutalyse, Prostamate) (also approved in cattle and mares)

Answer 18

**b. metoclopramide** ---------------------------- At high doses it has anti-emetic effects by acting as a 5-HT3 receptor antagonist

Answer 19

* TCA such as imipramine * Alpha2‐agonists such as xylazine * PGF2α

Answer 20

PGF2à (dinoprost tromethamine)

Answer 21

Penicillin G procaine (mostly from the procaine)

Answer 22

**Macrocyclic lactones (MLs/MCLs)** = * **Avermectins** (Ivermectin, Eprinomectin, Doramectin, Selamectin) * **Milbemycins** (Milbemycin oxime, Moxidectin) --------- also inhibit egg production of parasites

Answer 23

Aminoglycosides

Answer 24

* Abortifiacient in cattle from day 7-150 of gestation * Induction of parturition in swine and cattle * Expulsion of mummified fetuses * treatment of pyometra * Synchronization of estus in cattle * Controlling estrus time in mares * Treatment of silent estrus and pyometra due to persistent CL in cattle

Answer 25

horses Procaine can enhance

Answer 26

e. inhibits 5 a-reductase

Answer 27

c. milbemycin oxime

Answer 28

e. metoclopramide

Answer 29

testosterone‐estradiol, trenbolone

Answer 30

* **Ovarian suppression** followed by **follicular cysts** * **Vaginal or uterine prolapse** or **abortion** * **Aplastic anemia and leukopenia (bone marrow suppression**) in small animals * Bone **fractures** (too much or too little) * Feminization in the male * **Pyometra** if used in mismating in small animals

Answer 31

**Metronidazole (Flagyl)** MOA: **inhibit nucleuic acid synthesi**s - requires anaerobic conditions --------------- Second line of defense= Benzimidazoles (Albendazole, Fenbendazole) Also can use: Quinacrine & Furazolidone

Answer 32

d. liver flukes (Fasciola hepatica)

Answer 33

Second generation does not cross the BBB (=non-drowsy) and are longer lasting

Answer 34

Uterine infections Mismating in bitch

Answer 35

Simple bulk laxatives Gently Absorb water and swell, reflexively stimulate GI movement

Answer 36

**Fluoxetine (Prozac)** --------------- Also used for other behavior disorders (aggression, OCD, anxiety, urine marking) SIDE EFFECTS: Nausea, anorexia, anxiety, irritability, sleep disturbances

Answer 37

1. Metronidazole **(dogs, horses)**- mitogenic and carcninogenic so due not use in food cattle due to residues 2. Clioquinol- Used for diarrhea in **horses** due to Trichomonas, bacteria and yeasts 3. Carnidazole- Used against Trichomonas columbae (pigeon canker) in **pigeons not intended for human consumption**

Answer 38

MOA: PG agonists that **increase uveoscleral outflow** by stimulating FP receptors in the eye Use: topically on the eye in the treatment of **open-angle glaucoma or ocular hypertension**

Answer 39

Usually Topical -------------------------- Polymyxin distrupts the cell membrane It a narrow therapeutic index

Answer 40

* _Metaphylaxis_ * Full doses to kill/inhibit pathogens in groups of healthy animals **exposed to a pathogen** (e.g. BRD) * _Prophylaxis_ * **Full or Low** doses to healthy animals **to prevent disease**

Answer 41

Cell Membrane inhibitors = Cationic detergent Topical!

Answer 42

* –No treatment (DO NOTdo OVH when CS present) * –Sedatives (not dopamine antagonists) * –Water deprivation or furosemide * –Androgens or estrogens (Testosterone cypionate, Mibolerone, DES) * –Dopamine agonists (Bromocriptine, Cabergoline)

Answer 43

c. poloxalene

Answer 44

Androgens (testosterone, trenbolone, mibolerone)

Answer 45

Ionophores - lasalocid

Answer 46

**Aluminum, magnesium and calcium salts** * MOA: Chemically neutralize hydrochloric acid * Aluminum hydroxide inactivates pepsin and binds to bile salts and may stimulate PG * Also binds phosphorus

Answer 47

**Mismating** in the bitch and queen (inhibition of prolactin results in decrease in progesterone and abortion) – **Pseudopregnancy** in the bitch or queen ---------- Cabergoline is more effective and has fewer side effects than bromocriptine Both are PROLACTIN INHIBITORS (ERGOLINE DERIVATIVES)

Answer 48

d. cyproheptadine

Answer 49

Bacteri**ostatic** **------------------------------------------** **Includes:** Aminoglycosides, tetracyclines, macrolides, lincomycin, chloramphenicol

Answer 50

False- E induces estrus WITHOUT ovulation

Answer 51

d. poloxalene (therabloat) ----- Can also use docusate sodium (DOSS), veg oil, mineral oil

Answer 52

1. **Clorsulon** - late larvae and adult fluke 2. **Albendazole**- adult fluke, as well as monezia and GI & lung nematodes

Answer 53

Concentration dependent ---------------------------------- The concentration does not need to be maintained for any certain duration. May have a Post-Antibiotic Effect Focus on peak concentration: Cmax / MIC \> 8-12 Ex. Aminoglycosides

Answer 54

**Morantel(Nematel)** ---------------- other drugs approved in goats= **Lasolocid** (ionophore anticoccidials) other drugs approved in lactating cow= **Eprinomectin & Fenbendazole**

Answer 55

b. misoprostol

Answer 56

1. **Contraction of the smooth muscles of the GI, bronchioles, uterus and large blood vessels** 2. **Vasodilation of capillaries, arterioles and venules then contraction leading to increased permeability, edema, hypotension and hypovolemic shock** 3. Stimulates exocrine secretions 4. Positive inotropic effect 5. CNS stimulation

Answer 57

Causes of **drug resistance**

Answer 58

* LA- increase mastitis * SA- diabetes m & hypersensitivity

Answer 59

Morphine, polymyxin, & castor oil ------------------------------------------- Avoid IV

Answer 60

d. inhibiting urease and decreasing absorption of ammonia from the rumen

Answer 61

FSH w/ PGF_2a

Answer 62

horses= sweating and colic cows= NONE!!!!!

Answer 63

Multiresistant human infection "Big gun"

Answer 64

Conversion of NEFA to **keotne bodies** (acetone, acetoacetate, Beta‐ hydroxybutyrate)

Answer 65

dinoprost tromethamine Cloprostenol Fenprostalene

Answer 66

**Metronidazole** - DO NOT USE IN PREGNANCY Use **Furazolidone** in pregnant animals

Answer 67

– Paromomycin (Humatin) – Azithromycin (Zithromax) – Nitazoxanide (Navigator)

Answer 68

* **MDR1/ABCB1 mutants** (unable to keep drug out of BBB**)** * diarrhea caused by **bacterial infections** (high risk of the bacteria going systemic)

Answer 69

Hydroxyprogesterone caproate Medroxyprogesterone acetate

Answer 70

H₂Blockers

Answer 71

False!- They both _**treat** and prevent_ cocidioss

Answer 72

TRUE- REMEBER THIS!!!!! ------------------------------------------- Polmyxins, tetracycin and sulfonamides are also rare causes of nephrotoxicity.

Answer 73

**Emollient** Act as mechanical surfactants or lubricants/stool softeners

Answer 74

sodium bicarbonate IV

Answer 75

have cholinergic activity by inhibiting acetylcholinesterase (AChE) and thus **stimulating gastrointestinal motility** in canines

Answer 76

Pour on in beef and **lactating dairy cattle**

Answer 77

FALSE: narrow spectrum drug will exert **less** selection pressure on non-target organisms

Answer 78

Equines - it is a dopamine antagonist with lower CNS penetration (compared to metoclopramide)

Answer 79

Mibolerone, testosterone

Answer 80

* **Glucose 50% IV bolus** (or other sugar = fructose, sorbitol) * **Parenteral Glucocorticoids- dexamethasone, isoflupredone** * **Insulin & glucocorticoids** * **Oral Glucose precursors** - * propylene glycol, ammonium lactate * sodium proprionate in ration

Answer 81

propably not

Answer 82

deslorelin acetate (ovuplant - GnRH)

Answer 83

**Colon and esophagus -**-- **as well as all parts on the GIT** only available through compounding, better to use metoclopramide, unless you want to specifically target the colon or esophagus

Answer 84

1. **Sulfonamides & dihydrofolate reductase inhibitors** 2. **Fluoroquinolones** 3. **Nitroimidazoles- Metronidazole** 4. **Nitrofurans** 5. **Rifampin** 6. **Novobiocin**

Answer 85

* Binds to the ulcer site and protects it against acid, pepsin and bile * Requires an acidic environment to bind to mucosa! * May also stimulate protective PGs and antioxidants and increase mucosal blood flow.

Answer 86

* *Copper sulfate** (5% in calves and **2% in lambs**) * *Sodium bicarbonate 10%** in calves (100‐250 mL) ------- Both **oral** **short duration** (seconds to minutes) copper sulfate is a heavy metal and **lambs are sensitive to toxicity** Used to ensure that drugs bypass the rumen in order to increase rate of absorption and prevent altering of/by rumen micorbes

Answer 87

**Rumen Bloat** MOA: **surfactants that reduce surface tension** to cause the release of gas from the rumen fluid ---------------------------- Can also use vegetable oil and mineral oil Bloat can be lethal due to cardiovascular collapse

Answer 88

* Cow- Glucocorticoids (dexamethosone) and maybe PGF2a * Mare- oxytocin- cervix must be open * open cervix via DES or estrodiol cypionate 12-24 hours before oxytocin * Sow- PGF2a and oxytocin * Small Animals- oxytocin

Answer 89

Levamisole, pyrantel, morantel

Answer 90

**Irreversible Cholinesterase inhibitors** ----- Organophosphate approved in **swine, dogs and cats** Used mainly as a **anti-nematodes** ``` Swine= GI nematodes dogs = Roundworms, hookworms and whipworms ``` Cats = Roundworms and hookworms (Ancylostoma tubaeforme, Uncinaria stenocephala)

Answer 91

Coat the GI mucosa or physically bind to toxic compouds in lumen ------------------------------------ Include: * Mg trisilicate (Gaviscon®) * Hydrated Al silicate (Kaolin) and Pectin * Bismuth subsalicylate (Pepto-bismol®) -turn stool dark/black * Activated charcoal (+/- sorbitol cathartic) * Cholestyramine * Calcium carbonate (binds bile acids and endotoxins)

Answer 92

**Osmotic Cathartics** Nonabsorbed particles that attract water into the GI lumen Can cause electrolyte imbalances

Answer 93

Melarsomine (Immiticide) - IM

Answer 94

Time Dependent ----------------------------- T \> MIC is greater than 40-50% of the dose interval To be effective the recommended dosing interval MUST be followed. Ex. Penicillins and amphenicols

Answer 95

c. sodium bicarbonate solution (or copper sulfate 5%) --------------- lambs= 2% copper sulfate short duration of action oral

Answer 96

Praziquantel and epsiprantel = Anti-cestode

Answer 97

e. propylene glycol

Answer 98

* **Castration** * **Megesterol acetate** (not more than 32 days) - Inhibits gonadotropins (feedback) * **Finasteride-** Inhibits the enzyme 5 a‐reductase in the prostate which converts testosterone to dihydrotestosterone (responsible for prostate hypertrophy) * **GnRH antagonists** * **Large doses of GnRH agonists -** feedback

Answer 99

Oxytocin ---also used to induce parturition in mares and bitch and for milk let down

Answer 100

Gastric distention ---------------------- Systemic antacids with short duration and causes sytemic alkalosis and liberates CO2

Answer 101

c. ondansetron (Zofran)

Answer 102

Dopamine antagonists such as phenothiazines, metoclopramide, and domperidone stimulate prolactin secretion and milk production

Answer 103

d. finasteride

Answer 104

Cimetidine

Answer 105

c. deslorelin acetate (ovuplant) - GnRH ...or LH

Answer 106

Interstitial/Leydig cells Horses= seminiferous tubules and epidiymis

Answer 107

* _Febantel_ - probenzimidazole, wide safety margin * approved in horses, dogs, and cats * broad spectum * _Levamisole_- narrow safety margin * approved in cattle, sheep and swine * acts agains GI roundworms and lung worms * Administered orally, Sub-Q and TOPICALLY

Answer 108

Anti-emetic Prokinetic - gastric molitity, peristalsis, improve transit time Increase LES pressure Relaces pyloric sphincter ---------------------------------------------------------------- Contraindicated in GI obstruction or bleeding

Answer 109

Large animals- increase milk production & enhancing growth Small animals- pituitary dwarfism in dogs & GH‐responsive dermatosis

Answer 110

**Irritant cathartics** Irritate the GI mucosa to stimulate motility and secretion

Answer 111

Inhibition of protein synthesis

Answer 112

**Competative antagonist of H2 receptor** **Has immunomodulatory effects, including suppressor T cells and enhancing cell-mediated immunity** Has been looked at as a anti-neoplastic in equine melanoma treatment

Answer 113

e. decreased libido in male dogs and cats

Answer 114

Cimetidine & Famotidine

Answer 115

bovine somatotropin (BST)

Answer 116

**(1) Give large dose of Aminoglycosides SID** Aminoglycosides are considered dose dependent One large dose also lead to LESS nephrotoxicity

Answer 117

ovarian follicular cysts

Answer 118

Aminoglycosides, polymyxins, tetracyclines

Answer 119

estrogens --\> causes bone marrow suppresion

Answer 120

d. diethylstilbestrol (DES)

Answer 121

Competative NM blocker ---------------------- Treats large ROUNDWORMS only Approved in chickens and turkeys, swine, horses, dogs and cats ---------------------- swine – Nodular worms Horses – Large roundworms, strongyles and pinworms Dogs and cats – Large roundworms

Answer 122

Meclizine- H1 Antagonist

Answer 123

e. cattle grubs (Hypoderma bovis)

Answer 124

a. estrogen ---\> pyometra

Answer 125

Use: **Hepatic encephalopathy** management in liver Dz MOA: **Ion traps ammonia** in the colonic lumen and enhances the removal from the body

Answer 126

Block muscarinic receptors in the GIT to inhibit motility and secretions. Usually labeled as antispasmodics or spasmolytics. ------------------------------------------- Contraindicated in horses &inhibiting motility may worsen some cases

Answer 127

1. **Catecholamines -** Epinephrine 2. **Cromolyn sodium-** Intal® a mast cell stabilizer 3. **Phosphodiesterase inhibitors-** Methylxanthines --\> Aminophylline 4. **Glucocorticoids**- Reduce IgE mediated histamine release from mast cells

Answer 128

FALSE Drugs that inhibit cell wall synthesis may be **antagonized** by antibiotic drugs that inhibit protein synthesis Drugs that inhibit cell wall synthesis require actively dividing bacteria in order to work

Answer 129

**d. cisapride** ---------- MOA: 5-HT₄/Serotonin agonist in enteric neurons ---\> prokinetic with no secretion Autocoid

Answer 130

* _Fluids_- correct **dehydration** * _Glucocorticoids_ (dexamethosome) **- shock** * _Activated Charcoal_- **inactivate endotoxins** * _Oral Antibiotics_- **inhibit lactic acid production** by *lactobacillus* * _Antihistamines_- **prevent laminitis** (induced by glucocorticoids) * _Thiamine/ Brewers Yeast_= promote **lactic acid metabolism**

Answer 131

False! They are **time** dependent T \> MIC is greater than 40-50% of the dose interval

Answer 132

FALSE- LH/hGC surgery is more common and effective

Answer 133

Ivermectin Milbemycin- OK in collies

Answer 134

Approved in dogs, horses, swine and cattle including **lactating dairy cattle** **NOT** cats * Dogs= Ascarids, Hookworms, Whipworm and Taenia cestodes * Horses= anti-nematodal * Cattle= GI roundworms, lungworms, Moniezia

Answer 135

* Used as pour‐on (Cydectin) for internal and external parasite control in cattle (Including lactating dairy) * Used orally in horses (Quest) for broad‐spectrum antinematodal activity * Used orally and parenterally in dogs for prevention of heartworm disease (Dirofilaria immitis) = Proheart

Answer 136

Inhibits conversion of urea --\> ammonia by * **Changing the pH-** prevents enzyme activity (enzyme prefers alkaline environment) and makes ammonia ionized (will not be absorbed) * **Lowers rumen temperature** - inhibits enzyme activity * **Dilute ammonia**

Answer 137

A combination of PGF2a and dexamethasone

Answer 138

1. **_β-lactam antibiotics-_** bacterialcidal * **Penicillins** (e.g. Ampicillin) * **Cephalosporins** (e.g. Cephalexin) * **Carbapenems** and monobactams (e.g. Imipenem, Meropenem) * **β-lactamase inhibitors -** Clavulanic acid, Sulbactam, Tazobactam * combined with B-lactams 2. **_Glycopeptides-_** **vancomycin** 3. **_Bacitracin_**

Answer 139

Erythromycin

Answer 140

–Ivermectin (heartgaurd) –Milbemycin oxime (interceptor) –Moxidectin –Selamectin

Answer 141

Viokase® \>\>Pancreazyme® \>\> raw pancreas In order of efficacy and cost, virokase being the highest -------------------------------- Can use H2 blockers (Famotidine) to improve efficacy in patients that tend to break down the enzymes in the gut

Answer 142

Prostaglandin E1 analog – **Misoprostol** (Cytotec®) - oral Inhibit cAMP resulting in decreased protein kinase activity and hydrogen ion concentration less potent than H2 blockers or PPI **Increases mucus and sodium bicarbonate secretion, stimulates epithelialization of the mucosa and mucosal blood flow resulting in ulcer healing (COX-1).**

Answer 143

Misoprostol (Cytotec) ---------------------- A synthetic prostaglandin E1 that causes GI cytoprotection and decreases acid secretion

Answer 144

**Benzimidazoles**

Answer 145

e. boldenone

Answer 146

* Follicular cyst (also in bitches) * Boosting luteal formation * Deslorelin acetate (ovuplant) is used to induce ovulation in mares and cattle

Answer 147

* ACE inhibitors (Captopril, enalapril, lisinopril, benazepril) * Angiotensin II ‐receptor antagonists (Losartan

Answer 148

c. Equine protozoal myeloencephalistis (EPM) caused by Sarcocystic nuerona

Answer 149

Antibiotic that inhibit DNA synthesis/functions Includes: **Potentiated sulfonamides,** fluoroquinolones, nitrofurans, nitromidazoles, griseofulvin

Answer 150

d. ponazuril

Answer 151

FALSE- it is not recommended due to pyometra and other side effects

Answer 152

c. stimulating sharp increase in estrogen and decrease in progesterone by the placenta

Answer 153

Fluprostenol

Answer 154

canine Risk of infecting immunocompromised patient ------------------------- S. aureus are normal commensals of humans

Answer 155

**c. cyproheptadine (Periactin)** --------------------- Blocks serotonin receptors Also used as antihistamine (block H1-receptors) and treatment of serotonin syndrome in dogs and cats CROSSES BBB --\> sedative effects

Answer 156

Proton Pumps Inhibitors (PPI) - Irreversibly inhibit H+/K+/ATPase proton pump resulting in decreased hydrochloric acid production --------------------------------- ``` More potent than the H2-blocker class Raise gastric pH ``` Omeprazole (prilisec/Gastrogard)- oral only, equine Pantoprazole (Protonix) and Lansoprazole (Prevacid)- injectable

Answer 157

1. **Gastric acid secretion** 2. Positive inotropic effect and increased heart rate(?)

Answer 158

Drugs that **inhibit cell wall synthesis**

Answer 159

Bovine Ketoisis

Answer 160

Tocolytics- ß2‐agonists (e.g., terbutaline, ritodrine), Magnesium sulfate & Inhalation anesthetics

Answer 161

c. blocking 5-HT3 receptors -------------------- Use: Prevention and treatment of anticancer chemotherapyinduced nausea and vomiting

Answer 162

c. aspirin

Answer 163

e. praziquantel

Answer 164

Decoquinate

Answer 165

Parenteral- they are small proteins

Answer 166

–Gastrointestinal roundworms –Lungworms (Metastrongylus spp.) –Lice –Mange mites (Sarcoptes scabiei var.suis) ORAL or INJECTION

Answer 167

d. praziquantel

Answer 168

progesterone CIDR & norgestomet for cattle Altrenogest in mares

Answer 169

Progesterone‐estradiol benzoate Melengesterol

Answer 170

Both have the same clincal effects BUT... GnRH is smaller/shorter- thus less antigenic GnRH has a shorter duration

Answer 171

5‐HT3 receptor antagonist at HIGH doses = anti-emetic D1 and D2 receptor antagonist at LOW doses = prokinetic

Answer 172

– Gastrointestinal roundworms – Lungworms (Dictyocaulus arnfieldi) – Bots (Gasterophilus spp.) ORAL ONLY

Answer 173

* Improving **athletic performance** in horses * **Cachexia** and debilitating diseases * During **tissue repair** * Nonspecific adjunctive therapy in the treatment of **anemia in small animals (now use EPO)** * **Appetite stimulants** (indirect via metabolism)

Answer 174

NOPE- distrupts normal flors and can be life threatening

Answer 175

c. albendazole

Answer 176

Zinc gluconate neutralized by arginine (Neutersol)

Answer 177

Emodepside ---- CATS ONLY A **cyclic depsipeptide** Used to treat **round worms** (Toxocara cati, Toxascaris leonina) & **hookworms** (Ancylostoma tubaeformae) in CATS ONLY Combined **with prziquantel (Profender)** as a spot‐on solution for cat

Answer 178

Anti-histamines/ H₁ Antagonist