Pharmacology II Final Flashcards by Jennifer Kintz

Which cell types in the body are the most common innocent by-standers affected by chemotherapy? Two most common side effects?

Rapidly-Dividing Cells

Gastrointestinal disturbances (V/D)
Bone marrow suppression

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How do we monitor the negative side effects of chemotherapy usage on bone marrow? Which cells do we decrease and in what order generally?

Rechecking CBC’s

Neutropenia > Thrombocytopenia > Anemia

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Term for the important number we are monitoring for when rechecking CBC’s on chemotherapy patients?

Nadir

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Which alkylating chemotherapeutic agent can cause sterile hemorrhagic cystitis?

Cyclophosphamide
Admin: IV or PO
Requires hepatic bioactivation

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Which alkylating chemotherapeutic agent is commonly used as an immunosuppressant?

Chlorambucil
Admin: PO
Requires hepatic bioactivation

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Which alkylating chemotherapeutic agent is the treatment of choice for multiple myeloma?

Melphalan
Admin: PO
Does NOT require hepatic activation

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What are your four alkylating (nitrogen mustard and nitrosurea) chemotherapeutic agents?

Cyclophosphamide
Chlorambucil
Melphalan
Lomustine

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Which alkylating chemotherapeutic agent has major side effects of thrombocytopenia and irreversible chronic hepatotoxicity? Mainly used for?

Lomustine
Admin: PO
CNS disease due to wide distribution

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T/F: Alkylating chemotherapeutic drugs are considered cell-cycle specific.

FALSE; they are cell-cycle NON-specific

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T/F: Platinum containing chemotherapeutic drugs are considered cell-cycle non-specific.

True; MOA similar to alkylating agents

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Which “big gun” chemotherapeutic agent is absolutely contraindicated for use in CATS? Other side effects?

Cisplatin
“Splats Cats”
Nephrotoxicity
Myelosuppression

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Which platinum containing chemotherapeutic agent does NOT require saline diuresis and CAN be used in cats? Drawback?

Carboplatin; may not be as effective in some cancers but is considered “less toxic”

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What is the most commonly used cytotoxic antibiotic? Major risk?

Doxorubicin

Potent vesicant!

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Breeds predisposed to cardiotoxicity associated with doxorubicin administration?

Dobies, Rotties, other giant breeds

POSSIBLY MDR1 mutants

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Which category of chemotherapeutics is S-phase specific? Outcome?

Anti-metabolites

Interferes w/DNA synthesis

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Main difference between anti-metabolite chemotherapeutic drugs methotrexate and cytosine arabinoside?

Methotrexate DOES NOT enter CNS while cytosine arabinoside does

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Which category of chemotherapeutics is M-phase specific? Outcome?

Microtubule inhibitors

Prevents mitosis

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What are two commonly used chemotherapeutics that are potent vesicants?

Doxorubicin (anti-metabolite)

Vincristine (microtubule inhibitor)

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Name the two commonly used microtubule inhibitors of chemotherapeutic drugs.

Vincristine
VESICANT
Vinblastine

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Which category of chemotherapeutics is mainly G-phase specific? Outcome? Common use?

Tyrosine kinase inhibitors
Inhibits transcellular membrane protein
MAST CELL TUMORS!

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Pros and cons of the melanoma vaccine?

Highly effective
VERY expensive
Available only through veterinary oncologist

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Three commonly used non-chemo, anti-cancer drugs commonly used?

Peroxicam
Bisphosphonates
Prednisone/Prednisolone

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Peroxicam commonly used as adjunct or sole treatment for what condition?

Transitional Cell Carcinoma of the bladder!

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Many cancers express COX-2. In which one specifically is it most common to see?

Carcinomas

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Main neoplasia pathology that calls for the use of bisphosphonates?

Neoplasias with osteoclastic activity

Which group of animals generally should not receive oral penicillins? Antibiotic of choice?

Guinea pigs; enrofloxacin!

If you cannot do a full culture, what other helpful diagnostic can you perform?

Gram stain

Broad spectrum antibiotic that induces microsomal enzymes and to which resistance develops rapidly? Which pharmacologic agent used as an adjunct to chemotherapy also induces rapid resistance?

Rimfampin | Prednisone/Prednisolone

Macrolide antibiotic that is also used as a GI prokinetic?

Erythromycin

Carbapenem antibiotic that is used SQ?

Meropenem

Fluoroquinolones inhibit function of what enzyme?

DNA gyrase

Acts on the 30S ribosomal subunit and can cause yellow discoloration of teeth in young animals?

Tetracycline

Antibiotics that act as cationic detergents to disrupt cell membranes?

Polymyxin

Antimicrobial resistance due to mutation within the microbe?

Chromosomal

The two major toxicities seen with aminoglycosides?

NEPHROTOXICITY | Ototoxicity

Resistance that is due to normal lack of the antimicrobial target in the bacteria?

Intrinsic

Class of antibiotics that are good against gram (-) as well as mycoplasma?

Fluoroquinolones

Pus is so rich in this that it can overcome the action of sulfonamides.

PABA; it takes thousands of molecules of sulfa to compete with one molecule of PABA

Which natural penicillin should not be given IV?

Pen-G

What pharmacologic is banned in food animal due to risk of aplastic anemia in humans?

Chloramphenicol

One of the most common adverse effects seen with sulfonamide use in dogs. Which breed is particularly sensitive?

KCS; Dobies!

What is a major consideration with the use of oral sulfonamides in large animal?

Alteration of GI flora! | Major caution with oral use

Which class is synergistic with penicillins IN VIVO but incompatible IN VITRO?

Aminoglycosides

Streptogramins work on what subunit of the ribosome?

50s

Clindamycin is a member of what subclass of antibiotics that has good anaerobic activity?

Lincosamides

Specific treatment for tritrichomonas n felines?

Ronidazole

What is the last resort antibiotic for MRSA in humans that prevents attachment of the ribosome to mRNA?

Linezolid

What is the cell wall disrupting antibiotic that is often used topically to avoid toxicity?

Bacitracin

Azithromycin and some other macrolides have extended effects due to accumulation in what?

phagocytes

Trimethoprim is an example of a drug that inhibits what?

Dihydrofolatereductase (DHFR) Pyrimethamine also

What other specific diagnostic test do sulfa's interfere with in felines?

Thyroid testing!

Which antibiotic is often used with other antibiotics for anaerobic infections and which also has imunomodulatory effects?

Metronidazole

Term for the lowest antimicrobial concentration at which point bacterial replication is halted.

MIC

What is a beta-lactamase inhibitor commonly combined with amoxicillin?

Clavulanic acid

What is the first-gen cephalosporin that is used intra-mammary to treat mastitis in cattle?

cephapirin

What is the 3rd generation cephalosporin that is a pro-drug ester converted to the active ingredient after absorption?

Cefpodoxime

T/F: For a time-dependent antibiotic, you would administer the medication once daily.

FALSE; time-dependent antibiotics require MORE frequent dosing schedules

What tetracycline is used orally but can cause esophageal irritation?

doxycycline

Which macrolide is particularly prone to causing cardiac issues (cardiotoxicity) if given IV?

Tilmcosin! | Doxorubicin is the chemotherapeutic agent that also causes cardiotoxicity in large breed dogs

Commensal bacteria can act as what for resistance genes?

Reservoir

The kidney, liver, nervous system, bone marrow and GI tract are common sites for what with regard to antimicrobials?

Toxicity

A nonselective toxic chemical applied topically to kill microorganisms is called what?

Antiseptic

Activated charcoal products may or may not contain what cathartic?

Sorbitol

What is a cathartic?

Product that encourages defecation.

Name for substances secreted by microorganisms to inhibit other microorganisms?

Antibiotics

Stimulation of H2 receptors in the stomach increases production of what?

Acid

Transferable drug resistance involves what three mechanisms?

Conjugation Transduction Transformation

Pepto bismol (bismuth subsalicylate) often turns feces what color?

Black

Stimulation of H1 receptors often causes lungs to do what?

constrict

Term for when a group of susceptible animals are treated with antibiotics after exposure to a pathogen to prevent disease.

Metaphylaxis

Which opioid anti-diarrheal agent is kept out of the CNS by the P-glycoprotein efflux pump?

Loperamide | Immodium

The minimum antibiotic concentration to induce death of bacterium is termed what?

Minimum Bactericidal Concentration (MBC)

Nephrotoxicity of some drugs can be potentiated by concurrent use of what other drugs?

Diuretics

What is the H2 blocker used to treat equine melanoma?

Cimetidine

T/F: Antibiotics that target cell membranes tend to be less toxic.

FALSE; they tend to be MORE toxic

Name the two H2-blockers that exhibit pro-kinetic actions in the dog.

Ranitidine | Nizatidine

What dopamine antagonist has less CNS penetration than metoclopromaide and is used more often in equines? Clinical use?

Domperidone; PPID

Chromosomal mutation and transferable drug resistance represent what type of resistance?

Acquired

Antibiotics that work best when a high level of drug is reached are called what? Good example?

Concentration-dependent These drugs often exhibit a Post-Antibiotic Effect (PAE) Aminoglycosides

Antibiotics that work best by inhibiting protein synthesis commonly fall into what category?

Bacteriostatic

Term for the lowest concentration of an antibiotic that will stop a microorganism from reproducing is termed what?

MIC

Metamucil, wheat bran and prunes are all examples of what kind of laxative?

Bulk

What anti-histamine is used to treat old dog vestibular disease?

Meclizine

Which dopamine antagonist improves gastric emptying and improves intestinal transit time?

Metoclopromide; blocks dopamine receptors

Sorbitol, polyethylene glycol and lactulose are all examples of what type of cathartic?

Osmotic

What drug demonstrates more prokinetic activity in the colon and is sometimes used to treat megacolon in cats?

Cisapride

T/F: Concentration-dependent antibiotics often work best with multiple daily dosings.

FALSE; they work best as SID

In which animals do you avoid cephalosporins?

Guinea pigs Hamsters Gerbils Rabbits

Which antibiotic is given as a slow, IV infusion only?

Vancomycin; MRSA!

Alternative use for Neomycin?

Gut sterility in hepatic encephalopathy cases

Stimulation of dopamine receptors causes what two main things to occur?

1. Emesis | 2. Stimulates appetite

Drug of choice for cryptococcal meningitis in cats?

Fluconazole

Of the 3 -azole antifungals, which one has the most side effects?

#1 KETOCONAZOLE 2. Fluconazole 3. Itraconazole

Possible complication of newer broad-spectrum terbinafine?

May elevated ALT in cats

Difference in production of ergosterol that makes a product fungicidal?

Fungicidal: prevents conversion of squalene to squalene epoxide ==> accumulation and DEATH Main product = terbinafine (NEW)

Why are polyenes (i.e. amphotericin B) preferred over the azoles in immunocompromised individuals?

Polyenes are fungiCIDAL

Amphotericin B is ineffective against what?

many Aspergillus

Main toxicity concern with large doses of ketoconazole?

Hepatotoxicity

Drug that is highly effective against systemic blasto, histo, aspergillosis and sporotrichosis?

Itraconazole | PREFERRED for basto/histo

Medication used for treatment of ocular keratitis 2ndry (equine) and nasal (K9) aspergillosis?

Clotrimazole

Only time when epinephrine is the drug of choice for use as a bronchodilator?

ACUTE anaphylactic shock

What are the main two indications for use of terbutaline? Admin how?

Preventing an asthma attack or DURING SA: injection or oral Eq: injection ONLY

Beta-adrenergic agonist that is prohibited for use in food animals? Why?

Clenbuterol (ventipulmin) | Anabolic steroid!

Albuterol is administered how and to which two species?

Via inhalation | Cats and horses

Unique property of methylxanthine derivatives? Ex?

Stimulate skeletal muscle which improves breathing EX: aminophylline theophylline

Drug used in the reversal of respiratory depression 2ndry to inhalation/barbiturate anesthesia? Good ex for use?

Doxapram | C-section, use on puppies!

Medication used in the treatment of insulinomas when diet and steroids are no longer effective?

Diazoxide

Selective chemotherapeutic drug for the treatment of insulinomas?

Streptozocin | NARROW therapeutic index

Medication of choice used to stimulate insulin secretion?

Glipizide REQUIRES functioning hepatic cells Opposite of diazoxide!

Insulin of choice for cats tpically?

Glargine | It is the longest acting

Most insulins have similar potency. What is the exception?

Detemir! | 4X more potent in K9s

What is an alternative to glucose monitoring for diabetes patients? Advantage?

Fructosamine levels | Gives an idea of the last few weeks of tx