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TNG Exam 2 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

oral absorption of drugs during pregnancy is affected by progesterone. Progesterone (increases/decreases) GI motility and (increases/decreases) GI blood flow and may increase, decrease, or not affect the rate and extent of absorption of drugs.

A

decreases GI motility
increases GI blood flow

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2
Q

Giving drugs extravascularly during pregnancy may increase blood volume, cardiac output, and blood flow to some organs (muscle, SQ space, lungs, skin), what would be the effect of this?

A

increased absorption – EV parenteral, inhaled, and topical/transdermal admin

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3
Q

Giving drugs during pregnancy causes increased plasma volume and increased cardiac output / altered blood flow to organs, what effect does this have?

A

increased volume of distribution – this can affect plasma concentration and redistribute blood to different organs

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4
Q

T/F: Giving drugs during pregnancy causes decreased albumin concentration (dilution) and increased acute phase proteins (increases PPB of drugs), however, the significance of this is relatively unknown and likely minimal

A

True

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5
Q

Giving drugs during pregnancy causes increased metabolism which (increases/decreases) hepatic blood flow and (increases/decreases) protein binding.

A

increased hepatic blood flow
decreases PPB

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6
Q

elimination of drugs given during pregnancy is impacted in the sense that ….

A

increased plasma/blood volume and cardiac output –> increases renal blood flow and GFR
this could increase renal elimination of hydrophilic drugs

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7
Q

T/F: Gentamicin volume of distribution and clearance was shown to be relatively the same in mares (preg, lactating, and nonpreg), however in sheep Vd doubled and clearance increased by 150%.

A

True

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8
Q

Administering Excede / CCFA in pregnant mares will (increase/decrease) maximum concentration absorbed compared to administration to non-pregnant mare? why?

A

increase – because increased bloof flow to extravascular sites increases absoprtion of drug

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9
Q

Which drug has LOWER absorption in pregnant and post-partum mares when compared to non-pregnant mares due to the effects of progesterone decreasing GI motility?

A

firocoxib (cox-2 selective NSAID)

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10
Q

True/False: there is currently a decent amount of literature regarding dose adjustments that need to be made for pregnant mares, so there is no need to use lowest effective dose

A

FALSE – always exercise caution and use lowest effective dose

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11
Q

Name the 3 characteristics of the placenta that alter drug crossing from mother to fetus

A
  1. multiple layers of placenta
  2. different blood flow patterns
  3. tight junctions
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12
Q

Which species have the placenta with the most barriers? Least?

A

most – horses, pigs, ruminants
least – dogs, cat, humans, rodents

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13
Q

What are 3 physiologic functions of the placenta that can affect drug transfer?

A
  1. endocrine activity – producing hormones that maintain pregnancy, induce parturition, and promote mammary development
  2. metabolizing activity – might metabolize drug before it gets to fetus
  3. transporter activity – may increase drug transport or increase drug efflux (P-glycoprotein, etc.)
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14
Q

Name drug characteristics that maximize drug transfer across placenta

A
  1. smaller MW
  2. higher lipid solubility
  3. unionized
  4. lower PPB / unbound drugs
  5. higher concentration gradient
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15
Q

Which antibiotics are lipophilic and cross placenta well?

A

macrolides, fluoroquinolone

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16
Q

the pH of the fetal blood is more acidic that maternal blood. what is the significance of this?

A

weak bases diffuse across the palcenta, but then become trapped and can accumulate in fetus
ex. aminoglycosides

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17
Q

T/F: the placenta is an incomplete barrier and all drugs will cross to some degree, however gases (anesthesia) have no barriers and will affect the fetus

A

true

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18
Q

define terratogen

A

agent or factor that causes malformation of embryo

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19
Q

what 4 ways do drugs cause teratogenesis?

A
  1. alter gene expression in fetus
  2. alter apoptosis, cell migration, and cell proliferation
  3. alter synthesis and function of proteins and nucleic acids
  4. alter supply of energy source
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20
Q

what 2 things does susceptibility to teratogenesis depend on?

A
  1. genotype (differences among species)
  2. developmental stage – most susceptible in 1st trimester or period of organogenesis
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21
Q

What stage are dogs, cats, and horses most susceptible to teratogenesis?

A

dog - 14-20 days
cat - 14-26 days
horse - less than 60 days

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22
Q

What occurs when drugs are administered and exerting teratogenic effects during pregnancy?

A

very early on - dies and gets reabsorbed
1st trimester – death or obvious birth defects
2nd trimester+ – long term effects

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23
Q

True/False: teratogenic effects on fetus are dose-dependent and not linear. AKA under a certain concentration, there may be no effects, but once you reach a certain concentration, no worse effects can be found.

A

true

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24
Q

true/false: maternal susceptibility equals fetal susceptibility

A

FALSE – it is possible to give a dose of drug that is harmless to the mother and it be toxic to the fetus and vice versa

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25
Q

which drug is used to treat ringworm but is known to cause congenital anomalies in dogs, horses, but mostly cats?

A

griseofulvin

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26
Q

In which species does trimethoprim-sulfa, pyrimethamine, folic acid, and vitamin E combo cause congenital abnormalities?

A

horses

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27
Q

exogenous testosterone and estrogen causes congenital anomalies in which 2 species?

A

cats and dogs

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28
Q

What antibiotic has potential to cause congenital anomalies in dogs and cats that include decreases long bone growth and dental discoloration.

A

tetracyclines

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29
Q

trilostane and mitotane have been shown to cause congenital anomalies in _____

A

dogs

30
Q

oxfendazole, albendazole, and fenbantel cause congenital anomalies in ______

A

sheep

31
Q

which 3 antibiotics are known to be safe for use during pregnancy?

A
  1. beta lactam antibiotics**
  2. macrolides
  3. lincosamides (exc. horses)
32
Q

which endocrine drugs are safe to use during pregnancy?

A

insulin
levothyroxine

33
Q

True/False: opioids are safe to use during pregnancy

A

true

34
Q

which 2 heartworm preventatives are safe for pregnancy use?

A

heartgard and revolution

35
Q

which flea and tick prevention is safe for pregnancy?

A

frontline

36
Q

what is the advantage to systemic administration of antibiotics for uterine infection?

A

few barriers to penetrate into uterine wall

37
Q

What are the disadvantages of systemic admin of antibiotics for uterine infection?

A

cost – expensive
toxicity
frequency of admin – more

38
Q

true/false: endometrial concentration of a drug is equal to the placental concentration

A

false

39
Q

Doxycycline in horses has been shown to reach higher concentrations in the endometrium or serum?

A

endometrium

40
Q

What antibiotic is water-soluble, reaches high concentrations in uterus, and no drug in serum making it a good option to treat uterine infections in patients with kidney infections?

A

amikacin

41
Q

what are the 2 advantages of intrauterine admin of antibiotics?

A
  1. high conc of drug at the site of infection
  2. limited systemic absorption of drug
42
Q

true/false: intrauterine administration is NOT appropriate for pregnant animals d/t inducing abortion

A

true

43
Q

What local factors affect intrauterine administration of antibiotics?

A
  1. low oxygen tension
  2. presence of degradative enzymes
  3. presence of mucopurulent discharge or organic debris
  4. adverse effects on local leukocyte function
44
Q

T/F: there is decreased absorptive capability of the uterus immediately post-partum so intrauterine drug administration is not the best choice

A

true

45
Q

what are indications for intrauterine administration of antibiotics?

A

mild cases of endometritis
pre- and post-breeding – (if she has history of previous metritis or preg loss, degree of IU fluid at breeding, and routine for natural cover)

46
Q

What are the approved products for intrauterine administration?

A

chlorhexidine
gentamicin
ticarcillin sodium
amikacin

ELDU – penicillin, oxytet, and diluted iodine

47
Q

T/F: systemic absorption of an intrauterine drug is increased if disease is worse.

A

true

48
Q

IU admin of WATER-SOLUBLE oxytet in cattle has a withdrawal time for meat and milk of…

A

meat – 28-35d
milk – 72-192 hr
Depends on dose

49
Q

What should you do prior to administering intrauterine antibiotics in order to optimize their efficacy?

A

uterine lavage – antibiotics do not work if you stick them into pus.

50
Q

What factors should a drug have to be given systemically and effectively transported into milk?

A

low MW
lipid soluble / lipophilic
unionized
low PPB
high concentration gradient

51
Q

what are 2 important factors you must consider when administering systemic antibiotics with goal that they will reach the milk?

A
  1. effects on nursing animals
  2. residue (food animal) — withdrawal
52
Q

Mastitis causes vascular permeability changes. What effect does this have on systemic drug administration?

A

may increase distribution of drugs into the udder

53
Q

If a cow becomes septic and her milk production decreases, what effect does this have on drug clearance?

A

decreases drug clearance

54
Q

_____________ administration of antibiotics is common in cattle, small ruminants, and horses for the treatment and prevention of mastitis.

A

intramammary

55
Q

what are the advantages to intramammary administration?

A
  1. high conc of drug at site of infection
  2. minimal systemic absorption
  3. multiple approved products available
56
Q

what are the disadvantages to intramammary administration?

A
  1. milk residues
  2. kicked during admin (horses)
57
Q

What drugs are approved for intramammary administration in cattle?

A

betalactams (-illin), macrolides (-mycin), aminoglycodides (-mycin),

58
Q

what intramammary formulation should you use for dry cows? lactating cows?

A

dry – oil-based
lactating – water based

59
Q

T/F: you should administer drug within the teat that you want to treat so that the drug does not spread to the other teats.

A

false – drugs administered in intramammary way will spread throughout all teats and this will result in residues from all teats.

60
Q

What antibiotics should not be given to dairy animals d/t staying in the milk long-term?

A

macrolides and avermectins

61
Q

drugs used to treat ___________ can affect ability to maintain pregnancy, gestation length, lactation, and sperm quality.

A

endocrine diseases

62
Q

What drugs are used to treat hyperadrenocorticism in pregnant horses?

A

pergolide
cyproheptadine
trilostane

63
Q

what drugs are used to treat hyperadrenocorticism in pregnant dogs that will have adverse effects on the fetus?

A

mitotane, trilostane, ketoconazole, selegiline

64
Q

what is the recommendation when using pergolide during pregnancy?

A

stop treatment 2 weeks prior to foaling and restart 4 weeks after foaling

65
Q

what effect does pergolide have on sperm?

A

decreased sperm count, but it returns to normal in most horses after discontinuing the drug

66
Q

NSAIDs block prostaglandin release and therefore they have what effect on pregnancy?

A

prolongation of parturition

67
Q

NSAIDs are considered teratogens and may cause _________. Therefore you should use short duration and lowest dose possible.

A

renal agenesis

68
Q

B-2 agonists (ex. clenbuterol) cause uterine muscle relaxation. what effect does this have on pregnancy?

A

prolongs parturition

69
Q

Ca channel blockers (ex. amlodipine) block L-type Ca channels and have what effect on pregnancy?

A

prolongs parturition

70
Q

Corticosteroids, trilostane, and misoprostol can have what effect on pregnancy?

A

early induction of parturition

71
Q

Oxytocin and Dopamine type 2 receptor antagonists (metoclopramide, domperidone, acepromazine) have what effect on lactation?

A

stimulate it

72
Q

Dopamine agonists (pergolide, bromocriptine) and prolactin antagonist (cabergoline) have what effect on lactation?

A

inhibit it

TNG Exam 2 (8 decks)

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