Pharm II Exam I Material Flashcards
1
Q
T/F: Fludrocortisone is a potent glucocorticoid drug with mild mineralocorticoid effects
A
False
Fludrocortisone (Florinel®) is a mineralocorticoid drug (more potent than DOCP), but has mild glucocorticoid effects
1
Q
Drug of choice (DOC) for treatment of internal bleeding as a result of von Willebrand Disease?
A
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**
2
Q
Which inhaled glucocorticoid is most commonly used in practice?
A
Fluticasone proprionate
Used to treat pulmonary diseases such as asthma with the intention of providing a strong local (topical) effect while minimizing systemic effect
2
Q
T/F: Organic iron sources are preferred over inorganic iron sources in the treatment of microcytic anemia
A
True
Organic iron sources are less irritating and less astringent (precipitates proteins) than inorganic iron sources
2
Q
Which chelating agent is used in cases of copper toxicity?
A
Penicillamine
4
Q
Which specific antidote is used to treat heparin toxicity?
A
Protamine sulfate
5
Q
Drug of choice (DOC) for pheochromocytoma-induced hypertension in dogs?
A
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)
5
Q
What is Methimazole’s basic mechanism of action?
A
**Methimazole **inhibits thyroid hormone synthesis
6
Q
Describe the mechanism of action for streptokinase:
A
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.
6
Q
T/F: Isophane, or Neutral Protamine Hagedorn (NPH), is a short-acting insulin commonly used for management of critical care patients
A
False
Isophane (NPH) insulin is an intermediate-acting insulin
6
Q
T/F: Glucocorticoids will reduce inflammation in various body systems and are typically used when the cause is infectious in nature
A
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
6
Q
T/F: Apomorphine (Apokyn®) and Xylazine (Rompun®) are both centrally acting emetics and both have the same mechanism of action
A
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
8
Q
T/F: Type I diabetes is caused by a relative insulin deficiency and peripheral insulin resistance
A
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!
9
Q
T/F: The antithrombotic action of aspirin is due to inhibition of platelet aggregation
A
True
Aspirin inhibits synthesis of TXA2 by irreversibly inhibiting COX-1 and COX-2. The result is the inhibition of platelet aggregation.
10
Q
T/F: G-CSF and GM-CSF drugs are used to prevent and treat anti-cancer chemotherapy-induced neutropenia
A
True
11
Q
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.
A
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
12
Q
T/F: Short-acting insulins are most commonly used for management of critical care patients
A
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
13
Q
Which glucocorticoid is more potent: Prednisolone or Dexamethasone?
A
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
14
Q
T/F: Desoxycorticosterone Pivalate (DOCP) is the most commonly used mineralocorticoid and has no anti-inflammatory (glucocorticoid) effects
A
True
15
Q
What type of diuretic has the weakest diuretic effect?
A
Potassium-sparing diuretics
Potassium-sparing diuretics act on the distal convoluted tubule and collecting duct (only ~2% of Na+ reabsorption occurs here)
15
Q
Which insulin is available in the form of an ‘insulin pen’ that allows for accurate dosing down to 0.5U increments?
A
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.
15
Q
Tannic acid and Ferric chloride are each examples of _________ used as local anesthetics in the treatment of external bleeding
A
astringent agents
15
Q
T/F: The positive inotropic effect of Digitalis is due to increased myocardial intracellular Ca2+
A
True
16
Q
_____________ is also called ‘rebound hyperglycemia’
A
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.’
17
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
17
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
18
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)
19
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
20
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*
22
Drug of choice (DOC) for managing **hyp**_er_**tension in dogs**?
**ACE Inhibitors**
(*Captopril, **_Enalapril_**, Lisinopril, Benazepril*)
23
Drug of choice (DOC) for **complete AV block**?
**Epinephrine**
*\*\*epinephrine is contraindicated in **_in_**complete AV blocks (because of tachycardia)\*\**
24
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
25
Macrocytic anemia is commonly seen in ruminants that are deficient in:
**Cobalt**
This is treated with Cobalt supplementation
25
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*
26
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
27
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
28
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®)**
29
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.
29
T/F: Warfarin binds extensively with albumin and binding is very weak (so it is easily displaced)
**True**
31
What is the drug of choice (DOC) for treating **_hypo_**thyroidism in all species?
**Levothyroxine (T4)**
31
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
32
What is the anticoagulant agent of choice during pregnancy?
**Heparin**
Heparin does not cross the placenta and is not excreted in milk
33
Drug of choice (DOC) for **tachyarrhythmias** in cats?
**β-blockers**
\*\*β-blockers are the DOC for both *supraventricular _and_ ventricular *tachyarrhythmias in cats\*\*
34
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*
35
Drug of choice (DOC) for **incomplete AV block**?
**Atropine**
36
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
37
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*
39
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*
41
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!*
42
\_\_\_\_\_\_\_\_\_\_\_\_\_ 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.
42
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)
43
How is Digoxin administered normally?
**Orally**
It may be given by slow IV in emergencies.
44
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*
45
**Diazepam** is only given parenterally in cats. Why is it not administered orally?
**Diazepam** can cause idiosyncratic hepatotoxicity when give orally in cats!
45
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
46
What is the site of action for **osmotic diuretics**?
**Loop of Henle **and **Early Distal Tubule**
47
Which drug is frequently used to treat vestibular disease in dogs? What is its mechanism of action?
**Meclizine (Antivert®)**
Meclizine is an *H1 receptor antagonist [Antihistamine]* commonly used to treat geriatric vestibular syndrome
48
Which **dopamine agonist** is used in equine Cushing's Syndrome to treat pars intermedia dysfunction?
**Pergolide (Permax®)**
Pergolide is a dopamine agonist and acts to decrease ACTH, therefore decreasing cortisol
49
What is the most commonly used **oral calcium salt** for treatment of hypocalcemia? What is the content of elemental calcium?
**Calcium Carbonate**; *400 mg/g* of elemental calcium
This is the most elemental calcium of all the oral calcium sources. Remember, the advantage is that you have to give *fewer tablets* to your patient if there is more elemental calcium in each one
50
Which drug selectively stimulates neutrophil progenitor cells to help combat infection in cancer patients?
**Filgrastim**
Filgrastim is a granulocyte colony stimulating factor (G-CSF) drug
51
Which drug is used in treatment of hyperadrenocorticism and acts by competitive inhibition of steroid synthesis?
**Trilostane (Vetoryl®)**
Trilostane is a competitive inhibitor of steroid synthesis (3-beta hydroxysteroid dehydrogenase)
*Keep in mind that overtreatment can cause reversible oversuppression of glucocorticoid production, and (more rarely) adrenal necrosis*
53
T/F: **Amiloride** is used to treat hypokalemia
**True**
Amiloride is a potassium-sparing diuretic indicated for treatment of hypokalemia
54
What is the most ideal treatment for microcytic (hypochromic) anemia?
**Iron supplement**
55
T/F: **Tissue Plasminogen Activator (tPA)** can be used for control of bleeding
**False**
Tissue Plasminogen Activator (tPA) is a **thrombolytic agent** used to treat acute thromboembolic disorders
56
Drug of choice (DOC) for **central diabetes insipidus**?
**DDAVP** (desmopressin)
57
T/F: **Iron preparations** are commonly given intravenously
**False**
*A major side effect of iron supplementation is hypersensitivity when given IV. **Iron preparations are only administered IV in emergency situations!***
58
Drug of choice (DOC) for **ventricular tachycardia in dogs**?
**Lidocaine**
\*\*not in cats\*\*
58
What is the risk associated with using Potassium-sparing diuretics at the same time as ACE inhibitors
**Increased risk of ***_hyper_**kalemia***
60
Drug of choice (DOC) for **atrial fibrillation in horses**?
**Quinidine**
Quinidine is a Class 1A anti-arrhythmic that is administered PO, IM, or IV.
*Caution: Quinidine has a wide distribution and crosses the BBB*
60
T/F: Glipizide may be a good option for a dog that is hypoglycemic, but whose owner is 'afraid of needles'
**False**
**Glipizide** is the most commonly used oral hypoglycemic drug and is usually given in the case that the owner is afraid to give injections or is otherwise unable to give injections.
*However, oral hypoglycemic drugs are not effective in dogs!!*
61
T/F: **Chlorothiazide** and **Hydrochlorothiazide** can be used to treat hypercalcemia
**False**
Both drugs are thiazide diuretics, and both drugs ***increase reabsorption of Ca2+***
63
Protamine sulfate is a specific antidote for:
**Heparin**
64
T/F: Central diabetes insipidus (CDI) is caused by an ADH deficiency, whereas nephrogenic diabetes insipidus (NDI) is caused by impaired responsiveness of the kidney to ADH
**True**
65
\_\_\_\_\_\_\_\_\_\_\_\_ is an injectable somatostatin analog sometimes used as an adjunct treatment for insulinoma in dogs and ferrets
**Octrotide** (Sandostatin®)
66
T/F: **Desmopressin (DDAVP)** is the drug of choice for treatment of nephrogenic diabetes insipidus
**False**
Desmopressin (DDAVP) is the drug of choice for treatment of **_central diabetes insipidus (CDI)_**, not nephrogenic diabetes insipidus (NDI)
*Thiazide diuretics are the drug of choice for treatment of nephrogenic diabetes insipidus*
68
T/F: **Isoproterenol** is the strongest β1 agonist and the drug of choice to treat cardiogenic shock
**False**
Isoproterenol *is* the strongest β1 agonist, but it is a non-selective β agonist (so it also affects β2), which causes skeletal muscle vasodilation, leading to hypotension. *Don't ever use hypotensive drugs in a hypotensive patient*
68
What is the mechanism of action for **Cyproheptidine**?
**inhibiting the satiety center by blocking serotonin (5-HT1)**
Cyproheptidine (Periactin®) is a long term appetite stimulant and is generally more effective in cats than in dogs
69
What is the primary effect of **Digoxin** in the treatment of CHF?
**Inhibition of Na+/K+ ATPase in the myocardial cell membrane**
The result is an *increase in intracellular calcium*, resulting in ***increased myocardial contractility***
70
**Azathioprine** and **Cyclosporin A** are both cytotoxic drugs useful for treatment of:
**Immune-mediated Hemolytic Anemia [IMHA]**
71
Name the most common disease causing clinically significant hyperglycemia that requires therapy:
**Diabetes Mellitus**
Diabetes mellitus is a chronic metabolic disorder that is characterized by high blood glucose caused by insulin deficiency and/or resistance.
72
T/F: **Spironolactone** may exhibit adverse effects on reproduction
**True**
Spironolactone, a potassium-sparing diuretic, *acts on progesterone and androgen receptors and inhibits testosterone*, exhibiting an adverse effect on reproduction
74
Drug of choice (DOC) for managing **hyp**_er_**tension in cats**?
**Amlodipine**
Amlodipine is a Ca2+ channel blocker. The decrease in intracellular Ca2+ inhibits myocardial contraction and results in direct vasodilation
75
T/F: **Lente** insulin is an intermediate-acting insulin
**True**
77
What type of diuretic is Mannitol?
**Osmotic diuretic**
78
T/F: **Dorzolamide** is a potassium-sparing diuretic indicated for treatment of primary and secondary hyperaldosteronism
**False**
**Dorzolamide** is a carbonic anhydrase inhibitor used to treat glaucoma by inhibiting aqueous humor formation and decreasing IOP.
*(**Spironolactone** is a potassium-sparing diuretic indicated for treatment of primary and secondary hyperaldosteronism)*
79
Which local hemostatic acts as an α1-agonist to reduce hemorrhage or bleeding via vasoconstriction?
**Epinephrine**
80
Which drug can be used to rapidly remove competitive neuromuscular blockers (such as Ruconurium) by chelation?
**Sugammadex**
Sugammadex is an agent for reversal of neuromuscular blockade by the agent rocuronium in general anaesthesia.
81
T/F: **Thiazide diuretics** are useful in cases of diabetes insipidus, prevention of calcium oxalate uroliths in dogs, hypercalcemia, and hypertension
**False**
Thiazide diuretics are useful in cases of diabetes insipidus, prevention of calcium oxalate uroliths in dogs, and hypertension.
***_Thiazide diuretics are contraindicated in hypercalcemia!_***
82
Name a drug used to treat hyp**_er_**adrenocorticism that is cytotoxic to the adrenal gland, targets the zona fasciculata and reticularis, and has a narrow therapeutic index
**Mitotane (o,p-DDD, Lysodren®)**
This oral medication is supplied as 500mg tablets. *Absorption is greatly increased by giving with oil or crushing the tablets (it is not recommended that owners do this!!!)*
84
In a 'typical' Addison's patient, which glucocorticoid drug is most often used short term?
**Dexamethasone **is most often used in the short term (IV) followed by **prednisone **for maintenance (PO)
85
T/F: VItamins K1 and K3 are effective for treatment of Warfarin poisoning
**False**
Vitamin K3 is *not effective* for treatment of Warfarin toxicity
85
Which **β1-agonist** drug is the least likely to cause tachycardia, and is used in cardiogenic shock especially when there is a lack of renal perfusion?
**Dopamine**
86
What is **Maropitant citrate (Cerenia®)**'s mechanism of action?
**NK1 receptor antagonist [Neurokinin inhibitor]**
Blocking NK1 receptors prevents substance P from binding thus reducing its contribution to vomiting
*\*\*This is the most common antiemetic used currently\*\**
87
\_\_\_\_\_\_\_\_\_\_\_\_\_\_ is administered IM or IV over 1 hour in LRS or 5% dextrose for **diagnosis of diabetes insipidus**
**Natural ADH (Pitressin)**
If the patient responds, it is central diabetes insipidus (CDI)
*If they do not respond, it is nephrogenic diabetes insipidus (NDI)*
88
A dog presented through ER obtunded, had a blood glucose of 864mg/dL, and a serum osmolality of 360mOsm/kg. Which hypoglycemic agent would be most appropriate?
**Regular insulin (Humulin-R)**
Short-acting insulins would be best in this situation
89
**Diazepam **is not recommended for oral use in cats. Why not?
***Oral use of Diazepam in cats can cause idiosyncratic hepatotoxicity***
In cats, Diazepam shoud only be given parenterally!
90
T/F: **Loop diuretics** are the drugs of choice for the treatment of acute pulmonary edema
**True**
91
Name two short-term appetite stimulants that act by stimulating GABA and inhibiting the satiety center:
**Diazepam **and **Midazolam**
Diazepam is typically given IV; Midazolam is given IM
*Both of these drugs are benzodiazepines*
92
T/F: **Phytonadione** is commonly used as a warfarin reversal agent
**True**
Phytonadione is Vitamin K1 and is used to treat warfarin toxicity
93
T/F: **Lidocaine** is effective in the treatment of ventricular tachyarrhythmias by intravenous or oral administration
**False**
Lidocaine is the DOC to treat ventricular tachycardia and tachyarrhythmia in dogs, but is not given orally (due to extensive 1st pass metabolism)
94
How is heparin administered?
**IV **or **SC**
## Footnote
*It is not absorbed orally and should not be given IM*
95
The immunosuppressive dose of prednisone in canines is:
**2-4 mg/kg/day**
96
If you have a diabetic ketoacidosis (DKA) patient, which category of insulin would be most appropriate for immediate use?
**Short-acing insulin (crystalline/regular/neutral)**
*Usually **regular** insulin is started either as IV CRI or intermittent IM injections*
98
Thyrotoxicosis occurs most commonly in *which species*?
**Cats**
Thyrotoxicosis is a multi-systemic disorder arising from chronic excess of thyroid hormones (T3 and T4). It occurs most commonly in cats and is usually due to adenomatous hyperplasia
99
Which category of insulins are most commonly used for management of critical care patients (DKA, hyperosmolar, etc.)?
**Short-acting insulins**
*Examples: Lispro, aspart, glulisine, and soluble insulin (crystalline/neutral/regular) such as Humulin-R*
101
T/F: **Spironolactone** causes diuresis via competitive antagonism of antidiuretic hormone (ADH) receptors
**False**
Spironolactone causes diuresis via competitive antagonism of **_aldosterone receptors_**
102
Drug of choice (DOC) for **nephrogenic diabetes insipidus**?
**Thiazide Diuretics**
Hydrohloro**_thiazide_**, Chloro**_thiazide_**
104
Why are insoluble esters often combined with steroids?
Insoluble esters are added to steroids *to make it take longer to absorb and delay onset of action, as well as prolong the duration of action. **THESE ARE NOT FOR IV USE***
105
Which agent is used to treat hemorrhage due to systemic hyperfibrinolysis?
**Aminocaproic acid**
Aminocaproic acid inhibits the conversion of plasminogen to plasmin
106
T/F: **Warfarin** acts by activating antithrombin III
**No!**
**Warfarin** is an oral anticoagulant that acts by *inhibiting Vitamin K epoxide reductase*
107
Which corticosteroid is considered the most potent mineralocorticoid and is given orally for the treatment of hypoadrenocorticism?
**Fludrocortisone**
108
Which **vasodilator** would be the best choice for long-term treatment of congestive heart failure (CHF)?
**Enalapril**
109
T/F: **Warfarin** and **heparin** both cross the placenta, resulting in fetal hemorrhage
**False**
Warfarin crosses the placenta and may result in fetal bleeding.
*Heparin does not cross the placenta*
110
Drug of choice (DOC) for treatment of supraventricular tachyarrhythmias in dogs?
**Digoxin**
111
What is the antidote used to treat **Warfarin toxicity**?
**Vitamin K**
*\*\*Keep in mind, Vitamin K takes at least 1 day to take effect, so it will only be used in cases where the animal will be able to survive for the next 24 hours\*\**
112
**Aminocaproic acid** is used in the treatment of bleeding due to thrombolytic agents. What is its mechanism of action?
inhibits conversion of plasminogen to plasmin
113
Which **potassium-sparing diuretic** is administered orally, and competitively blocks aldosterone to treat 1° and 2° hyperaldosteronism?
**Spironolactone (Aldactone®)**
114
T/F: **Thiazide diuretics** are the drugs of choice for the treatment of acute pulmonary edema
**False**
***Loop diuretics*** are the drugs of choice for the treatment of acute pulmonary edema
116
Adverse effects associated with Colony Stimulating Factors (Filgrastim and Sargramostim)?
**Bone pain**
*Sargramostim may also cause fever and **cardiopulmonary toxicity***
118
The main mechanism of action of aspirin in preventing thrombosis is:
**inhibition of thromboxane A2 (TXA2**)
119
Which hypoglycemic agent would be ideal for a fat cat with PU/PD/PP that has an uncomplicated diabetes mellitus? The owner is "terrified of needles."
**Glipizide**
Glipizide is an oral hypoglycemic drug and works by direct stimulation of insulin secretion by the β-cells by closing the ATP sensitive K+ channels (to increase insulin release)
120
What is the drug of choice (DOC) for Digitalis-induced arrhythmias in dogs that don't respond to Lidocaine?
**Phenytoin**
Phenytoin is a Class IB anti-arrhythmic
121
What is the drug of choice [DOC] for treatment of drug-induced sinus bradycardia?
**Atropine**
123
A dog showing neurologic signs caused by hypoglycemia (glucose = 40 mg/dl) associated with elevated insulin concentration in blood. Which of the following drugs may be effective orally in elevating blood glucose levels *mainly* by inhibiting pancreatic insulin secretion?
1. glucagon
2. epinephrine
3. diazoxide
4. prednisone
**Diazoxide**
Diazoxide opens K+ channels in β cells, which switches off voltage-gated Ca2+ channels and results in inhibition of insulin release
124
What is the preferred drug to treat **iron toxicity**?
**Deferoxamine (Desferal)**
Deferoxamine is a chelating agent that binds iron to form a more easily excreted chelate product
125
Which **antithyroid drug** would be useful in cats who are difficult to medicate orally or who have GI disease leading to poor absorption?
**Methimazole (Felimazole®)**
Methimazole can be made into a transdermal formulation and applied to the ear pinna.
*Note: use of transdermal methimazole does not always prevent GI upset and it does not prevent any of the idiosyncratic drug reactions*
126
Which systemic hemostatic stimulates the formation of prothrombin (Factor II) and factors VII, IX, and X in the liver?
**Vitamin K**
127
Drugs that are used to control hemorrhage and bleeding are known as:
**Hemostatics**
128
What is the site of action for **loop, or high ceiling diuretics**?
**Ascending loop of Henle (aLOH)**
*Loop diuretics are the _most effective_ because ~25% of the filtered Na+ is reabsorbed in the aLOH*
129
Which drug is most commonly used for supportive care of 'atypical' Addison's disease patients?
**Prednisone**
Prednisone is most often used (PO - short term *and* long term)
*\*\*Keep in mind that some patients can progress from 'atypical' to 'typical' Addison's disease\*\**
130
T/F: **NIDDM** can be treated with oral hypoglycemic agents or injectable insulin
**True**
Type II diabetes, or Non-insulin dependent diabetes mellitus (NIDDM), is caused by a relative insulin deficiency and peripheral insulin resistance. *This form can be treated with oral hypoglycemic agents or injectable insulin.*
131
The primary endogenous mineralocorticoid is:
**aldosterone**
132
The most commonly inherited bleeding disorder in dogs is:
**von Willebrand Disease**
134
T/F: **Warfarin** is contraindicated during pregnancy because it can cause fetal bleeding
**True**
Warfarin *crosses the placenta* (can cause fetal bleeding), is excreted in milk, and is teratogenic
135
T/F: **Erythropoeitin [EPO]** is effective in the treatment of anemia due to chronic renal failure
**True**
136
T/F: Administering **Vitamin K1** to an animal can immediately reverse the action of Warfarin
**False**
Vitamin K1 takes at least 1 day to take effect in cases of warfarin toxicity
137
Which drug is commonly used to perform a T3 suppression test?
**Liothyronine sodium (T3)**
138
Which would be more effective as an astringent agent: Ferric chloride or Ferrous chloride?
**Ferric chloride**
*(ferric is more astringent than ferrous)*
139
T/F: **Dihydrotachysterol (DHT)** is useful for treatment of hypercalcemia
**False**
Dihydrotachysterol (DHT) is useful for treatment of **_hypo_**calcemia. It is less potent than Calcitriol but more potent than ergocalciferol
140
Which **MAO inhibitor** may be used in the treatment of hyperadrenocorticism?
**L-Deprenyl (Anipryl®)**
L-Deprenyl is uncommonly used for PDH, but may be useful for tumors of the pars intermedia.
*It inhibits MAO, resulting in increased dopamine, which suppresses ACTH, which in turn decreases cortisol*
141
The less soluble an ester is, the longer it takes to absorb (delayed onset of action) and the longer the duration. **Which of the following is not an insoluble ester?**
* Diproprionate
* Pivalate
* Succinate
* Acetonide
* Acetate
**Succinate**
Sodium succinate is a salt ester. Salt esters are combined with alcohol steroids to make them soluble, which allows for IV injections or larger volumes of steroid
142
Which of the following treatments for primary **_hypo_**parathyroidism has the fastest onset of action and fastest resolution of overdose after discontinuation?
* Dihydrotachysterol (DHT)
* Calcitriol
* Ergocalciferol
* Calcitonin
**Calcitriol**
Ergocalciferol will have the slowest onset/longest duration of hypercalcemia if overdosed. DHT would be next and *Calcitriol will have the shortest, thus giving you the most control over the calcium levels*
Calcitonin is used to treat **_hyper_**calcemia, not **_hypo_**calcemia (as you would see with hypoparathyroidism)
