Pharm I Final Exam Flashcards
Dantrolene is a _________-receptor antagonist
Dantrolene is a ryanodine-receptor antagonist
It inhibits Ca2+ release from the sarcoplasmic reticulum, resulting in muscle relaxation
Dantrolene is the drug of choice for treatment of malignant hyperthermia
Which inhalant anesthetic has the lowest blood/gas coefficient?
What does that mean?
Desflurane
Desflurane has a blood/gas coefficient of 0.45, so at equilibrium the concentration dissolved in blood will only be 0.45 times that in the alveolus.
The more insoluble the agent (lower blood/gas coefficient), the faster it will reach equilibrium
What is the term used for the equilibrium concentration of an anesthetic in the alveolus that is required to prevent movement and response to pain in 50% of individuals?
Minimum Alveolar Concentration (MAC)
MAC will vary between differerent drugs, and between different species for the same drug
What drug reverses the effects of competitive neuromuscular blockers and treats myasthenia gravis?
Neostigmine
What is the primary clinical use for phenobarbital?
anti-epileptic drug
Occasionally it is used as a sedative
Which of the following might you use to induce anesthesia in a patient with significant cardiac disease?
- A. Thiopental
- B. Propofol
- C. Alfaxalone
- D. Ketamine
- E. Etomidate
Etomidate
Etomidate works very similarly to propofol and alfaxan but with fewer CV effects
Buprenorphine, a partial µ-agonist, is commonly administered submucosally in which animal?
Cats
Buprenorphine has a long duration (up to 8 hours) in cats. It is popular for use in cats because less dysphoria/excitement is seen compared to other opioids, and the buccal administration and less frequent dosing are convenient
Which of the following CNS depressant drugs are used to stimulate appetite in cats and dogs?
- phenothiazines
- butyrophenones
- benzodiazepines
- a2adrenergic agonists
- opioid agonists
benzodiazepines
T/F: Acepromazine may reduce catecholamine-induced cardiac arrhythmias
True
Acetaminophen is sometimes seen as a cause of poisoning, particularly in which animal species?
Cats
Acetaminophen produces toxic metabolites, particularly in cats. These toxic metabolites are usually mopped up by glutathione, but liver glutathione reserves can be quickly used up and methemoglobinemia and liver damage may result.
Why is Bromide typically avoided in cats?
Bromide is less effective in cats than it is in dogs and makes ~50% of cats cough, which can lead to irreversible lung damage and death
Loperamide is used clinically for what purpose?
Loperamide is used as an anti-diarrheal
Which inhalant anesthetic is most likely to trigger malignant hyperthermia [MH]?
What drug would you use to treat MH?
Halothane
All inhalant anesthetics can trigger malignant hyperthermia (MH), btu halothane is most likely to do so. Dantrolene is used to treat MH.
What is the mechanism of action for dissociative agents?
NMDA receptor blockade
Remember, dissociative anesthesia is characterized by catalepsy, amnesia, and anesthesia without necessarily having complete unconsciousness
T/F: Dogs are the most sensitive species to Xylazine, followed by cats, ruminants, then horses
False.
Ruminants are most susceptible to Xylazine. Then dogs/cats/horses, then swine.
What is the only inhalant anesthetic that provides analgesia?
Nitrous Oxide
Give an example of an opioid drug that is metabolized via extra-hepatic pathways
Remifentanil
You performed a necropsy on a patient. Previously the patient had been diagnosed with feline hyperthyroidism. Your patient’s heart is on the right, with the yellow arrows.
What is the condition called?
What could you have given this patient to prevent this condition from occurring?
Myocardial hypertrophy
Propanolol is used in cases of feline hyperthyroidism to prevent myocardial hypertrophy
T/F: A drug’s volume of distribution (Vd) is a good indication for the ability of drug to diffuse across membranes
True
All of the following statements about pharmacokinetics of barbiturates are true except:
- They are administered intravenously and orally
- Duration of action depends on redistribution and elimination
- They are metabolized by hydroxylation in the liver
- They are enzyme inducers
- Acidification of urine enhances renal excretion
Acidification of urine enhances renal excretion
In real life: renal excretion of barbiturates is enhanced by alkalinization of the urine.
What is Etomidate’s effect on intracranial pressure
Etomidate decreases intracranial (and intraocular) pressure
Name 2 drugs that are used to reverse the effects of Xylazine
Tolazoline and Yohimbine
Both are alpha-2 antagonists used to reverse the effects of Xylazine (alpha-2 agonist)
Why is glycopyrrolate given as a pre-anesthetic rather than atropine?
Glycopyrrolate is more specific to the heart and causes less tachyarrhythmia than atropine
Which inhalant anesthetic drug is considered the most potent cerebral vasodilator?
Halothane
Increases intracranial pressure!!
T/F: Phenothiazines can have anti-emetic effects
True!
Remember that apomorphine causes emesis by stimulating dopamine receptors in the CRTZ, so by blocking dopamine in the CRTZ, phenothiazines can have an anti-emetic effect
Which of the inhalation anesthetics that we’ve discussed has the fastest induction?
Desflurane
What is the drug of choice for treatment of malignant hyperthermia?
Dantrolene
Which species is more sensitive to dose-dependent hemolysis with Guaifenesin: horses or cattle?
Cattle are more sensitive to dose-dependent hemolysis with Guaifenesin
Concentrations higher than 5% can cause hemolysis in cattle.
Concentration higher than 10% can cause hemolysis in horses.
Phenothiazine derivatives cause CNS depression mainly by:
Blocking dopamine receptors in the CNS
Which is the best choice to treat urinary incontinence in a spayed bitch?
- Antibiotics
- Bethenachol
- Phenylpropanolamine
- Pralidoxime
- None of the above
Phenylpropanolamine
Muscarinic receptors are SLOW and involve smooth m. contraction and glandular secretions. What type of receptors are these?
- Ionotropic
- Metabotropic
- Nuclear
- Kinase-coupled
- Indirect
Metabotropic
Which inhalant anesthetic drug is considered most likely to cause catecholamine-induced cardiac arrhythmias?
Halothane
Halothane affects sensitivity of the heart to catecholamines
Morphine is popularly combined with __________ for epidurals
Morphine is popularly combined with bupivacaine for epidurals
Diazepam should not be used IM due to its pain on injection and poor IM absorption. Which other benzodiazepine could be given IM instead?
Midazolam
a2 agonist drugs are especially useful for treatment of pulmonary edema in sheep
No, that’s not right at all
Caution should be taken when using a2 agonist drugs in sheep, as you may see several effects on the lungs leading to pulmonary edema!!
Which drug that we’ve discussed in class is considered the least selective alpha-2 agonist?
Xylazine
Xylazine has a 160:1 Alpha-2:Alpha-1 ratio.
Compare this to the most selective (Dexmedetomidine) with a 1600:1 ratio
Which of the drugs that we discussed in class is the most arrythmogenic inhalant anesthetic?
Halothane
T/F: Nitrous oxide is a potent muscle relaxer
False
Nitrous oxide induces very poor muscle relaxation
____________ causes irreversible inhibition of COX by acetylating its active site
Aspirin (acetylsalicylic acid)
In an emergency: In dogs, cats, and foals, what dose of Diazepam may be given IV to effect?
5-10 mg doses
5-10 mg doses of Diazepam IV may be given to effect. This should stop the seizures for up to 20 minutes and give time for assessment. Diazepam is safe when given IV
T/F: Methohexital is a barbiturate
True, good job!
Not currently available in North America; used to be used in sighthounds in place of Thiopental
T/F: Facilitated diffusion of drugs is a carrier-mediated transport that requires energy
False
Facilitated diffusion of drugs is a carrier-mediated transport, but does not require energy
Why is Etomidate not used as a CRI?
adrenocortical suppression and **propylene glycol **
Mostly because Etomidate causes transient suppression of adrenal steroid production, which precludes CRI dosing or use in patients with hypoadrenocorticism
Which of the following drugs is the drug of choice for treatment of acute bronchial asthma?
- isoproterenol
- epinephrine
- ephedrine
- albuterol
- ipratropium
albuterol
Albuterol is a direct acting β2 agonist
The antithrombotic effect of aspirin is mainly due to:
inhibition of platelet aggregation
Which of the following is false regarding NSAIDS?
- Block cyclooxygenase enzymes
- Highly bound to plasma proteins
- Penetrates CNS, but not found in milk
- More potent anti-inflammatory drugs than corticosteroids
More potent anti-inflammatory drugs than corticosteroids
1 local anesthetic for Breyer’s Block?
Prilocaine
What is the name of the preservative associated with Halothane that can build up in vaporizers and throw off their calibration?
Thymol
Why is **Telazol® **not commonly used in small animal anesthesia?
Telazol® is a combination of tiletamine (dissociative) and zolazepam (a benzodiazepine). Dogs metabolize the zolazepam more rapidly than the tiletamine, which can lead to a rocky recovery (muscle rigidity, delerium, etc…)
In which breed of dog do we see a very prolonged effect with thiobarbiturates due to a deficiency in certain metabolic enzymes?
Greyhounds
Thiobarbiturates are typically metabolized by hydroxylation in the liver. Greyhounds are deficient in required enzymes, and we therefore observe a prolonged effect
All of the following are adverse effects associated with Acepromazine except:
- Hypothermia
- Bradycardia
- Hypertension
- Possible lowering of seizure threshold
Hypertension
T/F: Though inhalant anesthetics cross the blood-brain barrier, most of them do not cross the placenta
False
Inhalant anesthetic drugs cross the blood-brain barrier AND they cross the placenta
Which of the following anticonvulsant drugs is the most effective in the long-term treatment of hereditary siezures in dogs and cats and is relatively safe?
- phenytoin
- diazepam
- potassium bromide
- phenobarbital
- primidone
phenobarbital
Which species is considered to be most sensitive to Procaine?
Horses
Procaine is a local anesthetic that is designed to be given IM. If this drug is introduced into a blood vessel, convulsions may be seen
Which drugs are involved in the MLK Drip? What is the therapeutic use of the drip?
Morphine, Ketamine, Lidocaine
MLK drip is given as a CRI for analgesia
Which of the following is widely used as a potent anti-tussive?
- Morphine
- Codeine
- Methadone
- Hydrocodone
Hydrocodone