Pharm II Exam I Material Flashcards
T/F: Fludrocortisone is a potent glucocorticoid drug with mild mineralocorticoid effects
False
Fludrocortisone (Florinel®) is a mineralocorticoid drug (more potent than DOCP), but has mild glucocorticoid effects
Drug of choice (DOC) for treatment of internal bleeding as a result of von Willebrand Disease?
Desmopressin (DDAVP)
DDAVP increases vWF level for ~2 hours in dogs, causing release from endothelial cells and macrophages.
**vWD is the most commonly inherited bleeding disorder in dogs**
Which inhaled glucocorticoid is most commonly used in practice?
Fluticasone proprionate
Used to treat pulmonary diseases such as asthma with the intention of providing a strong local (topical) effect while minimizing systemic effect
T/F: Organic iron sources are preferred over inorganic iron sources in the treatment of microcytic anemia
True
Organic iron sources are less irritating and less astringent (precipitates proteins) than inorganic iron sources
Which chelating agent is used in cases of copper toxicity?
Penicillamine
Which specific antidote is used to treat heparin toxicity?
Protamine sulfate
Drug of choice (DOC) for pheochromocytoma-induced hypertension in dogs?
Phenoxybenzamine
Pheochromocytoma is a tumor of the adrenal gland, which results in excess production of E and NE. Hypertension is caused by action on alpha receptors (phenoxybenzamine is an α-antagonist)
What is Methimazole’s basic mechanism of action?
**Methimazole **inhibits thyroid hormone synthesis
Describe the mechanism of action for streptokinase:
Converts plasminogen to plasmin
Streptokinase is a thrombolytic agent that stimulates the conversion of plasminogen to plasmin (plasmin causes fibrinolysis). It is used clinically to treat acute thromboembolic disorders.
T/F: Isophane, or Neutral Protamine Hagedorn (NPH), is a short-acting insulin commonly used for management of critical care patients
False
Isophane (NPH) insulin is an intermediate-acting insulin
T/F: Glucocorticoids will reduce inflammation in various body systems and are typically used when the cause is infectious in nature
False
T/F: Glucocorticoids will reduce inflammation in various body systems and are typically used when the cause is not infectious in nature.
They tend to be used short-term to control the inflammation while the underlying cause is dealt with
T/F: Apomorphine (Apokyn®) and Xylazine (Rompun®) are both centrally acting emetics and both have the same mechanism of action
False
Apomorphine and Xylazine are both centrally acting emetics, but they have different mechanisms of action.
Apomorphine stimulates dopamine receptors; Xylazine is an α2 agonist
T/F: Type I diabetes is caused by a relative insulin deficiency and peripheral insulin resistance
False
Type I diabetes is caused by an absolute deficiency of insulin (β cells destroyed and not producing any insulin**).
This type of diabetes mellitus can only be treated with replacement of insulin!
T/F: The antithrombotic action of aspirin is due to inhibition of platelet aggregation
True
Aspirin inhibits synthesis of TXA2 by irreversibly inhibiting COX-1 and COX-2. The result is the inhibition of platelet aggregation.
T/F: G-CSF and GM-CSF drugs are used to prevent and treat anti-cancer chemotherapy-induced neutropenia
True
Most insulin products available currently are of similar potency, so starting doses are similar between them. However, canine insulin receptors are 4 times more sensitive to one particular type of insulin than other insulins.
Name the insulin.
Detemir
Be careful when using Detemir, as its higher potency (4x) in canine patients can limit the ability to dose it accurately in small dogs
T/F: Short-acting insulins are most commonly used for management of critical care patients
True
In critical care patients, short-acting insulins are given as an IV (constant-rate infusion, NOT as a bolus injection) or intermittent IM injection
Which glucocorticoid is more potent: Prednisolone or Dexamethasone?
Dexamethasone
Dexamethasone is ~7.5x more potent than prednisolone, so a 1mg/kg dose of dexamethasone is similar to giving 7.5 mg/kg of prednisolone
T/F: Desoxycorticosterone Pivalate (DOCP) is the most commonly used mineralocorticoid and has no anti-inflammatory (glucocorticoid) effects
True
What type of diuretic has the weakest diuretic effect?
Potassium-sparing diuretics
Potassium-sparing diuretics act on the distal convoluted tubule and collecting duct (only ~2% of Na+ reabsorption occurs here)
Which insulin is available in the form of an ‘insulin pen’ that allows for accurate dosing down to 0.5U increments?
Vetsulin®
Vetsulin® recently launched an insulin pen with the capability of dosin down to 0.5U increments. This type of application would be ideal for very small dogs.
Tannic acid and Ferric chloride are each examples of _________ used as local anesthetics in the treatment of external bleeding
astringent agents
T/F: The positive inotropic effect of Digitalis is due to increased myocardial intracellular Ca2+
True
_____________ is also called ‘rebound hyperglycemia’
Somogyi Phenomenon
This occurs when the blood glucose drops too low, too quickly (usually due to an insulin overdose) and the body responds with an exaggerated defensive release of glucagon and epinephrine which cause the glucose level to shoot up and ‘overswing.’
What is the mechanism of action of Heparin?
Activation of Antithrombin III (AT3)
Heparin activates antithrombin III, resulting in inhibition of thombin (IIa) and activated coagulation factors IXa, Xa, XIa, and XIIa in the liver
Drug of choice (DOC) for treatment of myocardial hypertrophy in cats?
Diltiazam
Diltiazam inhibits the influx of extracellular Ca2+ across myocardial and smooth muscle cell membranes, inhibiting myocardial contraction and resulting in dilation of the coronary and systemic arteries
T/F: Mannitol is contraindicated in general edema, but is very effective in localized edema (cerebral or ocular)
True
Mannitol is an osmotic diuretic that pulls water from the cells into the interstitial compartment (which aggravates generalized edema). By the same mechanism it is able to pull water *away from the brain *(to treat cerebral edema) and pull aqueous humor formation from the eye (to treat ocular edema; glaucoma)
T/F: Glucocorticoids should never be used with NSAIDs
True
These two classes of drugs should never be used together due to a high risk of inducing GI ulcers with potentially fatal results
T/F: Apomorphine, a centrally acting emetic, acts by stimulating dopamine receptors. This drug is more commonly used in cats because cats possess more D2 receptors than dogs.
Noooooo!
Apomorphine is a centrally acting emetic that acts by stimulating dopamine receptors, however it is more commonly used in dogs.
Xylazine and other α2-agonists are more effective emetics in cats because cats have fewer D2 receptors, but more α2 receptors than dogs
Drug of choice (DOC) for managing hypertension in dogs?
ACE Inhibitors
(Captopril, _Enalapril_, Lisinopril, Benazepril)
Drug of choice (DOC) for complete AV block?
Epinephrine
**epinephrine is contraindicated in _in_complete AV blocks (because of tachycardia)**
T/F: Protamine Zinc Sulfate (Prozinc™) is an FDA approved insulin for cats and has a 40 IU/mL concentration
True
Prozinc™ is a long-acting insulin, but is sometimes classified as an ‘intermediate-acting’ insulin because the observed pharmacokinetics are often shorter than expected in feline patients
Macrocytic anemia is commonly seen in ruminants that are deficient in:
Cobalt
This is treated with Cobalt supplementation
T/F: Vitamin K3 (Menadione) is an effective treatment for Warfarin toxicity in horses
False
Vitamin K3 (Menadione) is not effective in treating Warfarin toxicity and should never be used in horses (causes idiopathic renal damage/renal failure)
Vitamin K1 (Phytonadione) is effective in treating Warfarin toxicity
Which loop diuretic drug is used for the treatment of exercise-induced pulomary hemorrhage in horses? What is its mechanism of action?
Furosemide (Lasix or Salix)
Furosemide inhibits Na+/K+/2Cl- symporter at the luminal membrane of the aLOH
What is the most commonly used inodilator drug and what is its mechanism of action?
Pimobendan (Vetmedin)
Pimobendan is used to treat CHF in dogs and acts by increasing sensitization of the cardiac contractile apparatus to calcium by enhancing interaction between calcium and troponin C complex
Name a glucocorticoid drug that is typically dosed by body surface area, has high first-pass metabolism, and is used to treat GI disease
Budesonide (Entocort®)
What is the most commonly used emergency therapy for hypoglycemia?
Dextrose
Boluses can be given IV. Corn syrup can be wiped on the gums as an emergency therapy until IV access is gained.
T/F: Warfarin binds extensively with albumin and binding is very weak (so it is easily displaced)
True
What is the drug of choice (DOC) for treating hypothyroidism in all species?
Levothyroxine (T4)
Which drug is given along with anti-cancer drugs to stimulate the growth of neutrophils and macrophages to prevent chemotherapy-induced neutropenia?
Sargramostim
Sargramostim is a granulocyte-macrophage colony stimulating factor (GM-CSF) drug
What is the anticoagulant agent of choice during pregnancy?
Heparin
Heparin does not cross the placenta and is not excreted in milk
Drug of choice (DOC) for tachyarrhythmias in cats?
β-blockers
**β-blockers are the DOC for both *supraventricular and ventricular *tachyarrhythmias in cats**
T/F: In a ‘typical’ Addison’s disease patient, the patient lacks glucocorticoids only
False
In ‘typical’ Addison’s disease, the patient lacks both mineralocorticoids and glucocorticoids
In ‘atypical’ Addison’s disease, the patient lacks glucocorticoids only
Drug of choice (DOC) for incomplete AV block?
Atropine
T/F: Glargine is categorized as a long-acting insulin
True
Insulin glargine has a long effect due to its acid pH which forms microprecipitates at the injection site (SC), which allows for very gradual absorption
What is the most commonly used parenteral formulation of calcium salts for treatment of hypocalcemia?
**Calcium gluconate **(borogluconate)
Parenteral calcium salts are intended for rapid correction of hypocalcemia
T/F: Metoclopramide acts by inhibiting NK1 receptors, which prevents substance P from binding, thus reducing its contribution to vomiting
False
Metoclopramide is a dopamine antagonist that (at higher doses) also blocks 5-HT3 and has effects on GI motility.
In this way, metaclopramide has both central & peripheral antiemetic effects
What is the most commonly used peripherally acting emetic?
Hydrogen peroxide (3%)
This is often recommended as first-line therapy for owners to initiate at home when toxic ingestion has occured. Keep in mind that cats are at higher risk of mucosal damage with this treatment. Use with caution or avoid in cats!
_____________ is the most commonly used drug for treating feline hyperthyroidism
Methimazole
Methimazole inhibits synthesis of thyroid hormones by inhibiting organification and coupling resulting in lower T3 and T4 production in the thyroid gland.
T/F: Glipizide is a orally-administered sulfonylurea compound that acts to stimulate basal insulin secretion
True
Glipizide is the most commonly used sulfonylurea drug, and works by directly stimulating insulin secretion by the β cells by closing the ATP sensitive K+ channels (to increase insulin release)
How is Digoxin administered normally?
Orally
It may be given by slow IV in emergencies.
T/F: Intermediate and Long-acting insulins may be given subcutaneously or intravenously
No!
Short-acting insulins may be given IV, IM, or SC
Intermediate and long-acting insulins may only be given SC! If they are given orally they will be degraded. If given IV, they may cause anaphylaxis
Diazepam is only given parenterally in cats. Why is it not administered orally?
Diazepam can cause idiosyncratic hepatotoxicity when give orally in cats!
T/F: Dextrose is used as a 50% solution for extended IV usage and is the most commonly used emergency therapy for hypoglycemia
False
Dextrose is provided as a 50% solution, but must be diluted to a 5% solution (or lower) to prevent phlebitis.
Dextrose is the most commonly used emergency therapy for hypoglycemia
What is the site of action for osmotic diuretics?
**Loop of Henle **and Early Distal Tubule