Pharmaceutical Toxins

Question 1

major toxicities associated with NSAIDs (ibuprofen, carprofen, naproxine, aspirin)

Answer 1

GI toxicity - vomiting, diarrhea, anorexia, gastric ulcers, abdominal pain
Renal damage
CNS effects (seizures, ataxia, coma)
platelet aggregation inhibition (blood thinners)
hepatoxicosis uncommon

Question 2

Phase II metabolizing enzyme cats are deficient in

Answer 2

UGTs (UDP-glucuronosyltransferases)

Question 3

predominant effects of acetaminophen in dogs

Answer 3

hepatotoxicosis, vomiting, tachycardia, tachypnea, anorexia
high doses lead to methemoglobinemia

Question 4

predominant effects of acetaminophen in cats

Answer 4

methemooglobinemia

high doses & males get hepatotoxicosis

Question 5

specific treatment for acetaminophen toxicosis

Answer 5

NAC to be a source of thiol to increase GSH levels

Question 6

cats are more interested in which drug than dogs

Answer 6

venlafaxine

Question 7

amphetamine toxicity clinical signs and drugs to treat them

Answer 7

seizures & tremors (barbiturates, not diazepam)
agitation (acepromazine or chlorpromazine)
tachycardia (propanolol)
cyproheptadine

Question 8

venlafaxine MOA & clinical signs

Answer 8

inhibits serotonin-NE reuptake
vomiting, tachypnea, tachycardia

Question 9

venlafaxine treatment

Answer 9

emesis, activated charcoal
cyproheptadine (serotonin antagonist)
acepromazine or chlorpromazine for agitation

Question 10

thyroid hormone toxicity MOA, clinical signs & treatment

Answer 10

MOA: excess levothyroxine (soloxine, synthroid) –> relates to hyperthyroidism
Clinical Signs: tachypnea, tachycardia, vomiting
treatment: propanolol, emetics, activated charcoal, supportive care

Question 11

psuedoephedrine toxicity MOA & clinical signs + treatment

Answer 11

MOA: sympathomimetics
clinical signs: seizures, tremors, tachycardia, hallucinogenic, agitation, vocalization, hypertension, head bobbing
treatment: emesis, activated charcoal, acepromazine or chlorpromazine for agitation, barbiturates like phenobarbital for seizures not diazepam, propanolol for tachycardia

Question 12

effects of psuedophedrine can be enhanced by

Answer 12

caffeine & ephedrine
pre-existing disease

Question 13

treatment for NSAIDs toxicity

Answer 13

stabilization - diazepam can be used for seizures
activated charcoal (repeated due to enterohepatic recirculation)
prevent renal failure with dobutamine
gastric protection with misoprostol and sucralfate

Question 14

drug to prevent renal failure

Answer 14

dobutamine

Question 15

drugs for gastric protection

Answer 15

misoprostol (inhibts gastric acid secretion and mucous/bicarb secretion)
sucralfate (protectant)

Question 16

why is carprofen safer for dogs than ibuprofen

Answer 16

stereochemistry!
less toxic S form accumulates in GI
equal R and S forms
S form undergoes selective enteroheptatic recycling