Module A - Pharmacy Basics Flashcards

1
Q

5 Patients “rights”

A

Right Drug
Right Time
Right Route
Right Amount
Right Patient

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2
Q

4 General Rules for Drugs

A
  1. All drugs are poisons
  2. No drug is a silver bullet
  3. All doses are a guess
  4. Complacency Kills
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3
Q

4 main things to know for administration of drugs

A

Why - Reason for needing
What - Effect on the animal
How - Drug function
What - Negative or adverse effects

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4
Q

What is VCPR?

A

Vet-Client-Patient-Relationship

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5
Q

True or False - VCPR is not required to prescribe/sell medications

A

False

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6
Q

Two requirements to maintain VCPR

A
  1. DVM has assumed responsibility for clinical assessments and recommendations regarding the health of the animal.
  2. DVM has sufficient knowledge of animal to base the assessment, dx, and tx of patient
  3. Client has agreed to follow DVM recommendations
  4. DVM is available for follow up if needed
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7
Q

What is Pharmacology?

A

Study of effect of drugs on the structure and its metabolism in tissue. Both good and bad effects

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8
Q

What is Pharmacokinetics?

A

What the body does to the drug

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9
Q

What are the 4 movements of Pharmacokinetics?

A

Absorption
Distribution
Metabolism
Excretion

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10
Q

What is Toxicology?

A

Study of adverse effects of chemicals

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11
Q

What is a patent?

A

Originator given exclusive rights for set period of time (legal)

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12
Q

What is the withdrawal period?

A

Time required for drug to be eliminated from body
(Relates to food producing animals)

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13
Q

What is the Chemical Name for a drug?

A

Describes molecular structure (not what we as RVTs need to know in detail)

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14
Q

What is a drug?

A

Substance used to diagnose, treat, & prevent disease

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15
Q

What is the Generic Name of a drug?

A

Official name given to chemical name

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16
Q

What is the Trade Name of a drug?

A

Company chooses once manufacturing begins

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17
Q

What is another term for Trade Name?

A

Brand Name

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18
Q

How do companies consider marketing when determining Trade Name?

A

May have drug name in it, or created as easy to remember/sounds good

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19
Q

What is an Unapproved Drug (in relation to Canada)?

A

No DIN number
Not approved by Canadian Regulatory Body

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20
Q

What is a Banned Drug?

A

Health Canada disallows use in animals that are consumed by people

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21
Q

What is a compound?

A

When you mix ingredients. One must be a drug
Can be done in clinic or human pharmacy

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22
Q

What is a Nutraceutical?

A

“Nutrition” + “Pharmacuetical”
Often claims to provide physiological benefit or protection against chronic disease
No DIN
Not evidence based

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23
Q

What are the 7 sources for drugs?

A
  1. Plants
  2. Minerals
  3. Bacteria/Molds
  4. Animals
  5. Semi-Synthetic
  6. Synthetic
  7. Recombinant DNA Technology
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24
Q

4 groups of drugs based on physical state

A

Liquids
Semi-solids
Solids
Gases

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25
Q

True or False - Drugs are designed for convenient administration

A

True

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26
Q

True or False - Drugs are only available in one form

A

False (ie. Baytril = liquid, injectable, and tablets)

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27
Q

What are the 6 types of liquids?

A

Solution
Suspensions
Lotions
Liniment
Drench
Syrups

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28
Q

What is a solution?

A

Solute is completely dissolved in the solvent
Solute = dissolved substance
Solvent = dissolving substance

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29
Q

What type of solution uses alcohol as the solvent?

A

Tincture

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30
Q

What are the typical solvents?

A

Water or sterile water

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31
Q

Do solvents settle out?

A

No

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32
Q

What is a suspension?

A

Mixture where solute particles are large and suspended but not dissolved in the solvent

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33
Q

Do suspensions settle out?

A

Yes. Must be shaken well prior to use

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34
Q

What is a lotion?

A

Used for topical or mucous membrane application
(Fur must be parted or shaved for topical use)

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35
Q

Is a lotion soothing?

A

Yes

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36
Q

What is a liniment?

A

Topical application to counter irritation (superficial irritation to relieve pain deeper)

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37
Q

Is a liniment warm or cool?

A

It is either or depending on if alcohol part of the mixture (cool if added)

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38
Q

What is a drench?

A

Liquid administered orally with dropper or syringe

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39
Q

What is a drench typically used for?

A

Large animals

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40
Q

What is a syrup?

A

Contains the drug plus a flavoring liquid for oral use

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41
Q

What are the 5 types of semi-solids?

A

Ointments
Creams
Suppositories
Pastes
Gels

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42
Q

What is an ointment?

A

Usually water in oil emulsions with oil being the greater component

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43
Q

Is an ointment water-miscible?

A

No

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44
Q

What is an ointment usually used for?

A

Dry lesions

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45
Q

What is a cream?

A

Oil in water, with water being the greater component

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46
Q

Is a cream water-miscible?

A

Yes

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47
Q

What are creams used for?

A

Moist lesions

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48
Q

What is a suppository?

A

Used for insertion into the vagina, uterus, or recturm

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49
Q

What is a paste?

A

Common form of oral medication

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50
Q

What is a gel?

A

Transparent or translucent semi-solid

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51
Q

What are the 6 types of solids?

A

Tablet (tab) or caplet
Bolus
Capsule (cap)
Implants (imp)
Granules (gran)
Powder (pwr)

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52
Q

What is a tablet or caplet?

A

Firm, powder mixtures that are compressed, usually with a stabilizer, color, or lubricants

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53
Q

Can you break tablets/caplets apart?

A

Yes but only if scored and if scored, only in half

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54
Q

What is a bolus?

A

Large tablet
(In SA it is a large amount of fluid)

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55
Q

What is a capsule?

A

Powder within a gelatin case

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56
Q

What is an implant?

A

Hard pellets designed to be inserted SQ (ie. Microchip)

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57
Q

What is a granule?

A

Small ball of compressed powder

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58
Q

What is a powder?

A

The simplest form. Is usually a mixture of the drug and a diluent

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59
Q

What are the two main categories of administration route?

A

Parenteral (injections)
Non-Parenteral

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60
Q

What are the 4 things to consider for route to be effective?

A

Must be absorbed
Transported to the appropriate tissue or organ
Penetrate to the subcellular level
Elicit a response or alter an ongoing process

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61
Q

Route depends on what 4 things?

A

Chemical/physical properties of drug
Form available
Condition being treated
Characteristics of patient

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62
Q

What are the 2 main non-parenteral methods of administration?

A

Oral and Topical

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63
Q

What are the common routes for oral administration?

A

Feed, water, drench, pastes, nasogastric tubes, pills, or boluses

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64
Q

Are oral medications absorbed slowly or quickly?

A

Slowly. Absorption affected by many factors

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65
Q

Where are topical medications applied?

A

At site where it is needed (ie. on skin or other membranes)

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66
Q

What alternative can work for topical drug application?

A

Absorbed from its application site and work systemically (ie. Otic, Rectal, Vaginal, Nasal)

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67
Q

What is SQ/SC injection?

A

Subcutaneous (under the skin)

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68
Q

Is SQ absorption quick or slow?

A

Slower (~20 mins)

69
Q

Can you administer irritating substances?

A

No

70
Q

What is IM injection?

A

Intramuscular (into the muscle)

71
Q

What is the absorption for IM Injection?

A

Slightly faster ~5-10 mins

72
Q

Are IM injections painful?

A

Yes-can be

73
Q

Where can you do IM injections on horses/food animals?

A

Cervical neck (triangle)

74
Q

What are the site volume restrictions for IM injections?

A

Small dogs/cats = 2-3 mL per site
Large Dogs = <5mL per site
LA = 10-15 mL per site

75
Q

What is IV injection?

A

Intravenous (into a vein)

76
Q

What is absorption rate for IV Injection?

A

Immediate drug availability

77
Q

What benefits are there to IV Injections?

A

Preferred for large volumes of fluid
Can be used for irritating drugs

78
Q

Can you do any rate for IV Injections?

A

No - rate is important. Rapid rate can induce toxic/allergic reaction

79
Q

What are the preferred sites for IV injections?

A

SA = cephalic, saphenous, jugular
Horses = Jugular
LA = Jugular, Tail

80
Q

What is IA injection?

A

Intra-articular (into a joint)

81
Q

What is important to remember for IA injection?

A

Absolute sterility is a must

82
Q

What is IP Injection?

A

Intra-Peritoneal (into the abdominal cavity)

83
Q

What can you use IP injection for?

A

Used for fluids or euthanasia solutions in pocket pets and small birds

84
Q

What is IC injection?

A

Intracardiac (into the heart)

85
Q

What are IC injections used for?

A

Euthanasia and perhaps for cardiac resuscitation of dying animals

86
Q

What is ID injection?

A

Intradermal (into the skin)

87
Q

What are ID injections used for?

A

Allergy testing
TB testing

88
Q

What are subconjunctival injections used for?

A

To treat certain eye conditions

89
Q

Where is an intra-arterial injection given?

A

Into an artery

90
Q

When is an intra-arterial injection given?

A

Rarely used intentionally. Used with a tourniquet for injection of antibiotic into an artery leading to an infected bone area

91
Q

What is an IO injection?

A

Intraosseous/Intramedullary (into the marrow cavity of bone)

92
Q

When is an IO injection used?

A

Can be used as an emergency procedure to deliver blood and or fluids to small, severely dehydrated animals

93
Q

When is an epidural used?

A

Injection into the epidural space between caudal vertebrae/used for anesthetic purposes

94
Q

What is inhalation?

A

Drugs in a gaseous form delivered to the patient in inspired air

95
Q

What are Pharmacodynamics?

A

What the drug does to the body

96
Q

What are the 3 factors of pharmacodynamics?

A
  1. Involves receptor binding, post receptor effects, and chemical reactions
  2. Response depends on the drug binding to its target
  3. Concentration of the drug at the receptor site influences the drugs effect
97
Q

What will pharmacokinetics knowledge aid in?

A

Understanding which drug is chosen
The best route is used
Side effects to watch for

98
Q

What is Absorption?

A

Process when a drug crosses various barriers to reach the blood stream

99
Q

Which route is not a factor for absorption?

A

IV injections

100
Q

What is bioavailability?

A

Degree to which a drug is absorbed and becomes available by the general circulation

101
Q

What are the two main methods for crossing cellular membranes

A

Passive process
Active Process

102
Q

Is energy required for passive or active process?

A

Yes for active

103
Q

What are the two types of passive process?

A

Simple diffusion
Facilitated diffusion

104
Q

What is the most common method of diffusion?

A

Simple

105
Q

What is simple diffusion?

A

Down a concentration gradient (higher concentration across a barrier to lower concentration site)

106
Q

What is facilitated diffusion?

A

Water-soluble drugs cross membranes through pores or channels from high to low concentration
Lipid soluble drugs cross cell membranes by dissolving in them

107
Q

What are the two types of active process?

A

Active transport
Pinocytosis/Phagocytosis

108
Q

What is active transport?

A

Drugs can be transported by this method, if close in structure to endogenous substrate

109
Q

What is Pinocytosis/Phagocytosis?

A

Less common mechanisms
Particles or droplets are engulfed
Immunoglobins are absorbed into neonate animals by this method

110
Q

What 7 factors affect absorption?

A

Route of administration (including natural barriers within the body)
Drug Solubility (Fat vs H20)
Size of drug molecule
Ionization of the drug molecule
Formulation of the drug
Concentration of the drug
Blood supply to the absorptive area

111
Q

How are oral drugs absorbed?

A

Absorption first occurs through GI mucosa. Occurs entire length of GI tract so large absorptive area, rich in blood supply

112
Q

What can prevent or slow oral drug absorption?

A

Gut fill and Pyloric emptying rate = delay movement of drugs to intestines for absorption
Some may bind to gut contents

113
Q

How can the GI tract affect oral drug absorption?

A

Low gastric pH may destroy or inactivate some drugs
Presence of GI disease is an important factor in altering the absorption of drugs

114
Q

How are oral drugs absorbed in ruminants?

A

Large capacity of rumen dilutes drugs
pH 5.5-6.5 tends to cause ion trapping of basic drugs
Microbial activity affects the stability of many drugs
Rate of passage of feed out of the rumen depends on amount of feed taken in

115
Q

How are IV and IA medications absorbed?

A

Eliminates need to diffuse into the circulatory system

116
Q

What increases IM and SC medications absorption?

A

Multiple injection sites increase absorption by increasing the absorptive surface

117
Q

What needs to be considered for injection medications for absorption?

A

Must be formulated to be:
- Pyrogen-free (not causing a fever)
- Sterile
- Adjusted to body pH
- Adjusted to body osmolality

118
Q

What affects lipid soluble topical drugs absorption?

A

Sebaceous secretions of skin and the keratinized epithelium limit absorption
Topical medications usually formulated in fats or fat solvents

119
Q

What factors increase topical drugs absorption?

A

When skin is broken
With increased circulation
When using a ‘vehicle’ ie. DMSO

120
Q

Are inhaled drugs absorbed quickly or slowly?

A

Rapid absorption due to large surface area with right blood supply

121
Q

Which drug solubility is faster absorbed?

A

Lipid-Soluble

122
Q

Does size of drug matter for absorption?

A

Yes - the smaller the molecule, the easier it can be absorbed

123
Q

What happens to large molecules during absorption?

A

Excluded from endothelial pores and gain access to circulation via the lymphatics instead so slowed

124
Q

Does an Ion charge affect absorption?

A

Yes - non-ionized drugs diffuse easier

125
Q

Where do basic drugs do better for absorption?

A

basic environment

126
Q

Where do acidic drugs do better for absorption?

A

acidic environment

127
Q

Drugs can have ___________ __________ which control the rate at which the drug is dissolved

A

Protective coating

128
Q

True or false - many drugs are combined with carriers

A

True

129
Q

The higher the drug concentration at a site the ____________ the absorption & why

A

faster - larger difference in concentration at site

130
Q

The __________ the blood supply, the faster the absorption

A

greater
(skeletal muscle, liver, kidney)

131
Q

True or False - Massage & Heat increase absorption by increasing blood flow to area

A

True

132
Q

What is distribution?

A

Dispersion from site of absorption to site of action (circulatory system)

133
Q

Distribution: Absorption site into __________, then into ______________ ___________ and finally into cells

A

Plasma, extracellular fluid (ECF)

134
Q

True or False - Equilibrium between drug sites equals concentration

A

False

135
Q

What is distribution affected by?

A

Concentration gradient (high -> low)
Protein Binding
Storage in various tissues
Dilution in luminal fluids
Specialized Barriers:
- Blood-brain Barrier
- Placenta
- Eye
- Joint Synovia
Disease Processes

136
Q

True or False - Lower plasma proteins = more binding

A

False (less binding so smaller dosage required)

137
Q

Where can drug go once leaves plasma compartment?

A

Can be stored in tissues or site of action

138
Q

What tissues can drugs be stored in?

A

Fat, Liver, Kidney, and Bone

139
Q

Drugs can enter and become trapped in _______

A

Luminal fluids (dilution)

140
Q

What is blood-brain barrier?

A

Barrier between plasma & ECF of brain

141
Q

_____________ cells of capillaries have _______ junctions instead of pores

A

Endothelial, tight

142
Q

How to nutrients enter to BBB?

A

active transport (carrier mediated systems)

143
Q

True or False - Neonates have less efficient BBB

A

True

144
Q

True or False - Placenta is as effective as BBB to many drugs

A

False

145
Q

_________-Soluble drugs diffuse across placenta barrier easily

A

Lipid

146
Q

Where do tight capillary endothelium junctions limit absorption and distribution exist?

A

The eye, joint synovia, BBB

147
Q

True or False - Purulent & Necrotic debris may bind and inactivate some antibiotics

A

True

148
Q

True or False - Renal & Hepatic diseases can affect protein binding

A

True

149
Q

What is biotransformation also known as?

A

Metabolism

150
Q

What is metabolism/biotransformation?

A

Body’s ability to change a drug’s chemical form from when it was administered to a form that can be eliminated by the body

151
Q

A drug that has undergone a chemical change is said to be _______________

A

Metabolized

152
Q

A drug that is altered is called a ___________

A

Metabolite

153
Q

True or False - All drugs can be metabolized

A

False - Some circulate and are excreted in an unchanged form from that which they were administered

154
Q

What 3 things can drug metabolism use?

A
  1. Reduce activity/toxicity (most common)
  2. Increase activity/toxicity (not common)
  3. Change it to a form that is readily excreted
155
Q

True or False - Some drugs require metabolism to be active

A

True

156
Q

Where does metabolism mainly occur?

A

Liver

157
Q

Amount of enzymes available for metabolism depends on?

A

Species (cats have limited ability for select drugs)
Age (young have underdeveloped systems)
Sex (male anabolic steroids increase production) Stress (decreased in increased stressed)
Nutritional status (malnourished VV production)
Disease (especially liver disease)
Enzyme Induction (from repeated use)

158
Q

What is first pass effect?

A

Absorbed from gut, enter hepatic portal circulation, filtered by liver, enter systemic circulation
Some of drug may be metabolized before it reaches systemic circulation and target site

159
Q

Does first pass effect increase or decrease bioavailabilty?

A

Decrease (to point ineffective)

160
Q

True or False - First Pass Effect is used on IV and Oral drugs

A

False - Oral drugs only

161
Q

What is the major route for drug excretion?

A

Kidney (renal)

162
Q

Renal excretion requires drug to be _________ soluble

A

Water

163
Q

What other system needs to be functioning normally for renal excretion?

A

Lower Urinary Tract

164
Q

Where does biliary excretion occur?

A

Liver - through bile into GIT, excreted through feces

165
Q

What is Intestinal Excretion?

A

Secreted across GIT mucosa by active transport, eliminated through feces

166
Q

True or False - Some drugs can be secreted unchanged, especially basic, fat-soluble drugs

A

True

167
Q

Quantities of drug found in milk or meat are called what?

A

Residues

168
Q

Gas anesthetics eliminated through?

A

Expired air/Exhalation

169
Q

What is half life?

A

Estimation of rate of drug loss from the body / Time required for blood concentration of a drug to decrease/eliminated by 50%