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Pharmacology II > Miscellaneous Therapeutics > Flashcards

Miscellaneous Therapeutics Flashcards

1
Q

What drugs are used to medically manage hydrocephalus by decreasing CSF production?

A

Omeprazole
Furosemide is also often added, but evidence for long-term benefit is conflicting
Often combined with glucocorticoids to also decrease CSF production

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2
Q

What is the antidote used for an accidental overdose/toxicity of pyrimethamine/TMS?

A

Levoleucovorin calcium (folinic acid)

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3
Q

What is the antidote used for an accidental overdose/toxicity of ivermectin, local anesthetics?

A

IV lipid emulsion therapy

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4
Q

What is the antidote used for an accidental overdose/toxicity of iron?

A

Deferoxamine

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5
Q

What is the antidote used for an accidental overdose/toxicity of doxorubicin?

A

Dexrazoxane

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6
Q

What is the antidote used for an accidental overdose/toxicity of cyclophosphamide?

A

Mensa

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7
Q

What is the antidote used for an accidental overdose/toxicity of acetaminophen?

A

Acetylcysteine

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8
Q

What is the antidote used for an accidental overdose/toxicity of heparin?

A

Protamine

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9
Q

What is the antidote used for an accidental overdose/toxicity of digoxin/cane toad poisoning?

A

Digoxin immune fab

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10
Q

What is the antidote used for an accidental overdose/toxicity of benzodiazepine?

A

Flumazenil

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11
Q

What is the antidote used for an accidental overdose/toxicity of alpha-2 sedatives?

A

Atipamezole, yohimbine

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12
Q

What is the antidote used for an accidental overdose/toxicity of opioids?

A

Naloxone, butorphanol, buprenorphine

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13
Q

Why should thiamine be given slowly if given intravenously?

A

Rapid administration can cause collapse

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14
Q

What skeletal muscle relaxant, other than a benzodiazepine, is often used to manage the muscle tremors seen in permethrin toxicity in cats?

A

Methocarbamol (Robaxin)

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15
Q

What are the physiologic conditions that IV magnesium sulfate would be warranted?

A

Replacement therapy in grass tetany

Refractory hypokalemia

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16
Q

What are the pharmacologic conditions that IV magnesium sulfate would be warranted?

A 
Skeletal muscle relaxation
Smooth muscle relaxation
---Tocolysis
---Treatment of acute asthma
Antiarrhythmic
---Ventricular arrhythmias can be combated with a high dose
Anticonvulsant (human)
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17
Q

What are the toxic conditions that IV magnesium sulfate would be warranted?

A

Inappropriately used for euthanasia in LA

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18
Q

What is the main indication in small animals for the use of anabolic steroids as an adjunctive treatment?

A

Used as an adjunctive to treat Autoimmune Hemolytic Anemia and Immune-Mediated Thrombocytopenia

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19
Q

Why are anabolic steroids injected more commonly than given orally?

A

There is a possible link between oral use and liver cancer

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20
Q

What is a hemostatic agent used for? Name the caustics used for this purpose.

A

Used in wounds to stop hemorrhage
Silver nitrate
Styptic powder/sticks; anhydrous aluminum sulfate acts as a vasoconstrictor to decrease blood flow
Formalin (diluted) infusion into bladder for severe hemorrhage

21
Q

Why is filgrastim (GCSF, Neupogen®) not routinely used for leukopenia in dogs?

A

It is very expensive, so it is usually reserved for severe neutropenia due to chemotherapy overdose

22
Q

What is the mechanism behind the adverse drug reaction of theophylline and enrofloxacin (or chloramphenicol)?

A

Enrofloxacin inhibits the CYP1A2 (I don’t know if that’s necessary but there you go) metabolism of theophylline. This leads to higher concentrations of theophylline and toxicity

23
Q

What is the mechanism behind the adverse drug reaction of Buprenorphine and other opioids?

A

Buprenorphine has a high affinity for the mu receptor and will block other opioids (it’s good in overdose situations where you will still want analgesia)

24
Q

What is the mechanism behind the adverse drug reaction of Amitraz and drugs enhancing serotonin (fluoxetine, clomipramine, tramadol, etc.)?

A

Amitraz is a MAOI and you don’t want to give it with SSRIs, TCAs, or things that increase serotonin levels

25
Q

What is the mechanism behind the adverse drug reaction of Spinosad/ketoconazole and ivermectin?

A

Spinosad is a p-glycoprotein pump inhibitor and can cause toxicity when give with drugs that are a substrate for the pump (ivermectin)

26
Q

What is astringent?

A

A topical solution the dries and toughens skin, decreasing secretions/discharge
Most work by precipitating proteins in the skin
Great for moist (insert sick/vomiting emoji) dermatitis (Hot Spots)

27
Q

What is cream; oil in water (o/w)?

A

Spread easily and no not leave the skin greasy and sticky

28
Q

What is cream; water in oil (w/o)?

A

More greasy and more emollient

29
Q

What is emollient?

A

Soften skin by preventing water from evaporating from skin

Little direct addition of lipid into the skin

30
Q

What is gel?

A

Transparent preparations containing cellulose ethers or carbromer in water or a water-alcohol mixture
Gels liquefy on contact with the skin, dry and leave thin film of active medication
Gels tend to be drying

31
Q

What is liniment?

A

A lotion, especially one made with oil, for rubbing on the body to relieve pain

32
Q

What is lotion?

A

A loosely used term that includes any liquid preparation in which medications are suspended or dissolved
An o/w emulsion with a high water content to give the preparation a liquid consistency can be considered a lotion
Most lotions are aqueous or hydroalcoholic systems; small amounts of alcohol are added to aid solubilization of the active ingredients and to hasten evaporation of the solvent from the skin surface

33
Q

What is an ointment?

A

Semi-solid preparations of hydrocarbons
Strong emollient effect makes it useful in dry skin conditions
Occlusive effect enhances penetration of active drug and improves efficacy
Provides a protective film on the skin against some irritants
Greasy, sticky, retains sweat (therefore, not suitable in moist dermatitis, skin prone to folliculitis)
Contains no water and does not require preservative

34
Q

What is paste?

A

Mixture of powder and ointment
Addition of powder improve porosity
Addition of powder to change an ointment into past also increases the consistency of the preparation so that it is more difficult to rub off. This property is useful when one does not want an irritating preparation to get onto the normal skin

35
Q

What are the primary side effects seen with methimazole in cats?

A

Bone marrow suppression and GI signs (anorexia and vomiting)

Much less common toxicity signs include skin eruptions and self-mutilation of the face.

36
Q

Methimazole is often used as a maintenance therapy for cats with hyperthyroidism. It is also nevertheless used in cats that will eventually receive radioactive iodine therapy, why?

A

It controls the signs but also checks for occult renal failure

37
Q

When might glipizide be indicated in the management of diabetes mellitus and what are its limitations?

A

Used in type II diabetes
Limitations:
Can never be used in dos because they only have type I diabetes
Has a high incidence of side effects (GI, liver damage)

38
Q

Insulins are sometimes classified based on their duration of effect as short, intermediate or longacting. Classify “regular (crystalline) insulin, Lente (Vetsulin®), and glargine insulin accordingly.

A

Regular crystalline insulin: short acting
Lente: Intermediate
Glargine insulin: Long-acting

39
Q

For dogs and cats, which source of insulin (porcine, bovine, human) most closely resembles their natural insulin? When and why might this be of significance?

A

For cats, bovine is antigenically similar
For dogs, porcine is antigenically similar
In dogs, porcine insulin is better than other insulin because dogs can develop antibodies
In cats, their insulin is more similar to cattle, but according to some experts, cats seldom develop antibodies

40
Q

Why do we typically wait about a week after a change in insulin dose to perform a glucose curve in the dog?

A

Initially after a dose change, you want to primarily monitor for hypoglycemia. About 3 to 7 days after the change, you will reach a steady-state and can do the glucose curve

41
Q

Why is corn (Karo®) syrup rubbed into the gums of an animal having a hypoglycemic seizure from an insulin overdose effective yet table sugar is not?

A

Table sugar is a disaccharide that has to be digested before absorption occurs in the intestine; whereas corn syrup is a monosaccharide that is absorbed across gums

42
Q

What drugs are used in the medical management of insulinoma and why?

A

Diazoxide: decreases insulin secretion. Mild diuretic
Glucocorticoids: Decrease glucose use by tissues and promotes glucose production

43
Q

Contrast the mechanism of action of mitotane versus trilostane in canine hyperadrenocorticism.

A

Mitotane: Selectively destroys the adrenal cortex
Trilostane: Inhibits enzyme necessary for cortisol production

44
Q

In primary hyperparathyroidism due to a tumor, what calcium disorders exist after surgical removal of the tumor and how do you manage these conditions?

A

Hypocalcemia
Supplemental calcium
Calcium gluconate given IV slowly and monitor HR
Calcium carbonate oral
Vitamin D supplementation
Calcitriol: used as “active” form in renal disease. Can be effective post-parathyroidectomy if contralateral PT gland is not completely atrophied
Dihydrotachysterol does not require PTH for activation and is the preferred form of vitamin D in hypoparathyroidism

45
Q

In primary hyperparathyroidism due to a tumor, what calcium disorders exist before surgical removal of the tumor and how do you manage these conditions?

A

Hypercalcemia (includes vitamin D rodenticide toxicity and hypercalcemia of malignancy)
Promote removal of calcium from the kidney
Saline diuresis
Furosemide
Glucocorticoids
Drive calcium back into the bone
Calcitonin im/sc
Pamidronate iv or clodronate EL iv as slow infusion

46
Q

Explain how dihydrotachysterol differs from calcitriol as a form of vitamin D and in what clinical condition may the former to preferred?

A

Calcitriol: used as “active” form in renal disease. Can be effective post-parathyroidectomy if contralateral PT gland is not completely atrophied
Dihydrotachysterol does not require PTH for activation and is the preferred form of vitamin D in hypoparathyroidism

47
Q

Identify the primary treatments to manage central versus nephrogenic diabetes insipidus.

A

Central: Demopressin
Nephrogenic: no specific therapy to reverse cause; thiazide diuretics (hydrochlorothizide or chlorothiazide) to reduce PU associated with nephrogenic DI

48
Q

Recognize the biphosphonates used in veterinary medicine and identify two indications for their use.
For those biphosphonates approved in horses, what are the primary side-effects seen?

A

Tiludronate (Tildren), clodronate (Osphos), pamidronate
Indications:
Navicular disease in horses
Management of hypercalcemia
Side-effects in horses: pain (colic) is the most frequent side-effect

Pharmacology II (18 decks)

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