Exit Exam Flashcards
What is Pharmacokinetics?
Movement of drugs in the body
What do pharmacokinetics determine?
drug doses, dosing regimens, withdrawal times
Where does uptake of a substance occur?
from site of administration through circulation to tissues/site of action
What is bioavailability?
function of absorption and metabolism
What are some barriers to drug distribution?
drugs chemical properties, tissue blood flow, protein binding, tissue binding, anatomic barriers
What are some anatomic barriers?
blood-brain barrier, epidural barrier, blood-testis barrier
What are some chemical modifications of a drug?
active, inactive, or toxic metabolite
How are prodrugs administered?
in an inactive form; metabolized to their active form
Which systems have the role of drug metabolism?
enzyme systems
What is Phase 1 of drug metabolism?
enzymes metabolize drugs by oxidation, reduction, or hydrolysis
What is Phase 2 of drug metabolism?
enzymes add a substance to the drug to inactivate it and to facilitate its elimination
What is drug elimination?
the removal of a drug from the body
Which organ eliminates many drugs from the body?
kidneys
What is drug clearance?
rate at which drug is removed from an organ or from the body
How is drug clearance expressed?
as volume of plasma cleared of drug per unit time (ml/min)
What is a half-life?
time required for amount of drug in body to decrease by one half
What are pharmacodynamics?
study of the biochemical and physiologic effects of drugs
What are some clinically relevant PD parameters?
mechanism of action, relationship between drug concentration and effect, side effects or adverse reactions
What is mechanism of action?
biochemical effect of a drug requires that a drug either have direct physical interaction with cellular components or interact with specific target cellular proteins that result in an alteration of the cells normal physiology
What can side effects result from?
drug interacting with multiple tissue types, multiple cellular targets, alteration in patients physiology and/or drug pharmacokinetics
Adverse reactions can occur when?
at standard or inappropriate doses or as a result of altered drug PK
Adverse reactions arise when?
other drugs are given concurrently
What is the therapeutic range?
the drug concentration in the body that produces the desired effect in the animal with minimal or no signs of toxicity
What 3 major drug factors keep drugs in their therapeutic range?
route of administration, drug dose, dosage interval
Larger the therapeutic range the what?
safer the drug
What are the most common DZ that impact drug PK?
liver, kidney, and CV disease
What CV disease do?
alters the distribution of blood flow to tissues
Alterations in what impact drug?
GI, hepatic and renal blood flow
What does kidney disease do?
decreased drug elimination, increasing plasma drug concentrations, risk of adverse drug reactions, increased fluid retention, potential drug interactions
What does kidney disease risk?
adverse drug reactions or toxicity
With kidney disease, what are dose adjustment recommended for?
drugs primarily excreted by the kidney and drugs associated with increased risk of side effects
What organ is the primary site of drug metabolism?
liver
With liver disease what is difficult to predict?
need for dosage adjustments
Normal aging causes what?
a change in body composition and redistribution of blood flow to brain and heart
Redistribution of blood flow to brain and heart causes decreased what?
drug absorption, hepatic metabolism, and renal excretion
What has the most significant impact on drug disposition?
reduced kidney function
Dose dependent drug reactions affect what?
all members of a species and multiple species
Idiosyncratic drug reactions affect what?
only small portion of treated animals
Idiosyncratic drug reactions may or may not what?
affect multiple species
What is the treatment for idiosyncratic drug reactions?
drug withdrawal and drug avoidance
What is therapeutic drug monitoring?
periodic measurement of amount of drug in the blood
When is therapeutic drug monitoring recommended?
when pharmacokinetics of drug varies significantly among individuals or if the drug has narrow therapeutic range
What is the goal of therapeutic drug monitoring?
to optimize drug plasma concentrations to maximize efficacy and minimize toxicity
Is therapeutic drug monitoring reliable?
dependent on timing and number of blood samples collected
What drugs are used for immune-mediated diseases?
immunosuppressive drugs
What do immunosuppressive drugs target?
immune system
What is the goal with immunosuppressive drugs?
control diseases without significant side effects
Which immune-mediated disease drug is most commonly used?
glucocorticoids
Hydrocortisone is _____ acting?
short
Prednisone/prenisolone, methylpresnisolone and triamicinolone is _______ acting?
intermediate
Dexamethasone and betamethasone is ________ acting?
long
Glucocorticoids are eliminated from the body how fast?
very slowly
What kind of drugs are used for bacterial infection?
antimicrobials and antibacterials
Antimicrobials are used to what?
either kill or inhibit growth of microorganisms
Antibacterials are substances that do what?
kill or inhibit growth of bacteria
What is the goal of antibacterials?
assist the body’s natural defenses in elimination of bacterial pathogens while minimizing risk of toxicity
What 2 groups are antifungals divided into based on their chemistry?
polyenes and azoles
What is the duration of tx with antifungals?
weeks to months
Patient on antifungals must be monitored for what?
side effects: decreased appetite, anorexia, and vomiting
What treatment is used for GI disease?
nonspecific supportive therapies and targeted therapies, symptomatic supportive care
What drugs are used for liver disease?
hepatoprotectants, cholinergic drugs, antifibrotic therapy, metal chelation therapy
What characterizes cardiovascular disease?
structural damage or rhythm disturbances of the heart
What is cardiovascular disease a result from?
damaged cardiac muscle, valvular disease, pericardial disease, rhythm abnormalities, or altered coronary heart failure
Cardiovascular disease can progress to what?
clinical heart failure resulting in accumulation of fluid in tissues
What drugs are used for CV disease?
diuretics, inotropic agents, antihypertensives, antiarrhythmics
How are neoplastic diseases treated?
with combination of surgery chemotherapy, and radiation therapy
What are the three classes of endoparasites?
nematodes, cestodes, trematodes
What do macrolytic lactones and milbemycins treat?
nematodes and arthropods
Ectoparasiticides have a risk of what?
toxicity
New animal drugs are intended for use in what?
animals other than man
New animal drugs are approved by FDA as what?
prescription drug, over-the-counter drug, and veterinary feed directive
Controlled substances are regulated by who?
drug enforcement agency
Prescription drugs are regulated by who?
FDA
Prescription drugs are limited to use under the supervision of whom?
veterinarian or physician
Why should prescription drugs be limited to the use under a vet or physician?
because of their potential danger, toxicity concerns, administration difficulty, or other considerations
Prescription drugs are prescribed to animals once what has been established?
veterinarian/client/patient/relationship
What does the federal agency do?
assure available drugs are safe, effective, and prepared in accordance with manufacturing standards
What does the state do?
control the distribution of drugs within the state
Name four common drug preparations
oral, parenteral, inhalation, topical
Boluses are used in the treatment of _______ animals and are administered with a _________.
large, balling gun
What are 2 types of parenteral injection forms?
injections and implants
Vials may be either ______ dose or ______ dose
single, multi
All used needles should be discarded in a what?
sharps container
What are the 5 right of drug administration?
right patient, drug, dose, route, time and frequency
Oral drugs should never be administered in animals that are what?
vomiting
Intravenous administration of drugs allows the most ______ and effective drug administration?
rapid
An indwelling catheter should be replaced with a new one every how many hours?
72 hours
A simplex IV system is used to administer fluids to what kind of animals?
large
Name 6 items that should be recorded in the controlled substance log
date, owner’s name, patient’s name, drug name, amount dispensed or administered, name of the person administering drug to patient
Why should drugs given by injection not be stored in syringes for any length of time before administration?
plastic syringe may absorb the drug, causing it to be less effective
What are 4 types of syringe tips that are available for use?
luer-lok, slip-tip, eccentric, catheter-tip
A tuberculin syringe holds up to how many ml of medication?
1ml
What type of syringe is divided into units rather than milliliters?
insulin syringe
What is an agent that produces superficial irritation that is intended to relieve some other irritation?
counterirritant
What will usually separate after long periods of shell life and must be shaken well before use to provide a uniform dose?
suspension
This type of syringe is constructed in such a way that the needle screws onto the tip of the syringe
luer-lok tip
All the following are sites for IV administration in small animal except what?
jugular vein, carotid artery, lateral saphenous vein, phalic vein
carotid artery
If an IV catheter is not used continuously, it should be flushed with heparinized saline every how often?
8 to 12 hours
Cerumen is a substance that is commonly found in what anatomic part of the body?
ear
Any patient on IV fluid therapy should be monitored every how often?
15 to 30 minutes
IV tubing should be changed after how long?
24 to 48 hours
When an IM injection is given in the pelvic limb of a dog or cat, the area near what nerve should be avoided?
sciatic and ischiatic
Express 1/4 as a ratio
1:4
Express 1/4 as a decimal
.25
Express .75 as a ratio
75:100
Express .75 as a fraction
75/100
Express .004 as a ratio
4:1000
Express .004 as a fraction
4/1000
Express 1:80 as a fraction
1/80
Express 1:80 as a decimal
.0125
Express 9/1000 as a ratio
9:1000
Express 9/1000 as a decimal
.009
Express 1:32 as a fraction
1/32
1 gallon= how many quarts?
4 quart
1 gallon= how many pints?
8 pints
1 gallon= how many cups?
16 cups
1 gallon= how many ounces?
128 ounces
1 gallon= how many liters?
3.8
1 quart= how many pints?
2 pints
1 quart= how many cups?
4
1 quart= how many ounces?
32 ounces
1 quart= how many liters?
.95 liters
1 pint= how many cups?
2 cups
1 pint= how many ounces?
16 ounces
1 pint= how many ml?
480ml
1 cup= how many ounces?
8 ounces
1 cup= how many ml?
240ml
1/4 cup= how many ounces?
2 ounces
1/4 cup= how many tablespoons?
4tbsp
1/4 cup= how many ml?
60ml
1 tbsp= how many tsp?
3tsp
1 tbsp= how many ounces?
1/2 ounce
1 tbsp= how many ml?
15 ml
Define the difference between an agonist and an opioid antagonist
an agonist is a drug that combines with a receptor to bring about an action, an antagonist combines with a receptor and blocks the action
What is a neurotransmitter?
a chemical substance released by a nerve ending at the synapse. It acts on the adjacent neuron to stimulate, inhibit, or change its activity
The area of the brain that serves to relay information from the spinal cord and brainstem to the interpretation center in the cerebrum is the what?
thalamus
Most CNS drugs act by _______ or ________ the effects of neurotransmitters
interrupting the generation or conduction of nerve impulses; interfering with
What are the primary neurotransmitters for adrenergic receptors?
epinephrine or norepinephrine
What are 4 primary ways in which drugs affect the ANS?
mimicking neurotransmitters, interfering with neurotransmitters release, blocking the attachment of neurotransmitters to receptors, and interfering with the breakdown of neurotransmitters
Atropine, scopolamine, glycopyrrolate, and aminopentamide are examples of what specific drug class?
cholinergic blocking agents (anticholinergic)
What are 5 indications for the use of cholinergic agents?
to control vomiting, to treat urinary retention, to stimulate GI activity, to treat glaucoma, and to aid in the diagnosis of myasthenia gravis
What category of drug is used to treat cardiac arrest and anaphylactic shock?
adrenergic
Propanolol is an example of what category of drug?
beta blocker
What are some adverse side effects of xylazine and what drug may be used to antagonize its effects?
bradycardia and hypotension may be antagonized by using atropine; respiratory depression of excessive CNS depression may be antagonized by using yohimbine
Why would you be concerned about using a thiobarbiturate to induce anesthesia in a very thin dog?
thiobarbiturates are very soluble in fat, which acts like a sponge to take the barbiturate out of the circulation and away from the CNS. Thin animals have reduced fat levels which means that more of the thiobarbiturates remains in the bloodstream and may cause excessive depression of the CNS
What are some of the characteristics of a cat anesthetized with ketamine?
analgesia, increased muscle tone, maintenance of pharyngeal/laryngeal reflexes, muscles tremors, and loss of the blink reflex
What are some of the signs of narcotic overdose?
respiratory depression, cardiac depression, agitation, excitement, or seizures
What are 2 narcotic antagonists?
naloxone and nalorphine
Why should glyceryl guaiacolate not be mixed until just before use?
because of its tendency to precipitate out of solution when stored
You are assisting in the delivery of a litter of puppies and you deliver one that is not breathing adequately. What drug would the vet instruct to give and by what route?
doxapram may be administered on or under the tongue, into the umbilical vein, or by intramuscular injection
Why are euthanasia solutions that contain only pentobarbital classified as Class II controlled substances, whereas those that contain pentobarbital and other substances are classified as class III controlled substance?
some pentobarbital euthanasia agents have red dye added to distinguish them from pentobarbital agents that may be used for anesthesia. Because these agents are easily identified as euthanasia agents, they have less potential for abuse
All psychotherapy drugs are thought to produce their affects by altering _______ activity in the brain
neurotransmitter
Dissociative agents, such as ketamine and tiletamine, may cause what?
burning
A hypnotic known for its very short duration and its white color is what?
propofol
An inhibitory neurotransmitter that is widely distributed in the brain is what?
GABA
A benzodiazepine that is used as an anti anxiety medication and as an appetite stimulant in cats is what?
diazepam
An example of a tricyclic antidepressant used in vet med for separation anxiety in dogs is what?
clomicalm
What is used to treat old dog dementia?
anipryl
The nervous system carries out activity very rapidly by sending electric-like messages over a network of nerve fibers. What system works much more slowly by sending chemical messengers through the bloodstream to target structures?
endocrine
Which nervous system is under voluntary control?
somatic
What is the fundamental unit of the nervous system?
neuron
Axons carry electric-like messages ______ the nerve cell, and dendrites carry electric-like messages _____ the nerve cell
away from; toward
Neurotransmitters cannot be mimicked or blocked by the use of appropriate drugs, and that is why patients with nervous system disorders do not have a very good prognosis, true or false?
false
The ANS is that portion of the nervous system that controls what body activities?
unconscious
The neurotransmitter for cholinergic sites is what?
acetylcholine
Xylazine is antagonized by what?
yohimbine
