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VTT Pharmacology 6
Locals,Antimicrobials, Chemo
| Question | Answer |
|---|---|
| How do local anesthetics work? | By preventing the generation and conduction of nerve impulses in the peripheral nerves |
| What order are nerve functions lost after local anesthetics are administered? | pain,, warmth, touch, deep pressure, motor function |
| What are the uses for local anesthetics? | Topical (skin, eye, ear, larynx)/ Infiltration/ IV (Bier Block (distal extremity)/regional (epidurals,etc...) |
| Are local anesthetics absorbed systemically? | yes |
| When calculating the dose of local anesthetic, Do you calculate the drug amount for each area of the body that needs to be anesthetized? Why or Why not? | NO, the dose calculated is for the entire patient. The calculated does must be divided amongst the areas needing the local anesthetic |
| Most potentially harmful side effects occur when? | After accidental intravenous administration |
| How can we prevent accidental intravenous administration? | Always aspirate before administration |
| What are the potential adverse effects of local anesthetics? | CNS excitement followed by depression, Cardiovascular: Arrhythmias, Allergies: rash/hives/anaphylaxis, Paresthesia ( the pins and needles feeling as local anesthetic wears off) |
| Why is epinephrine added to local anesthetics? | To cause vasoconstriction in the area, reducing perfusion, thereby reducing the absorption of the local anesthetic, essentially prolonging the effect of the local anesthetic. It also reduces bleeding |
| What is proparicaine used for? | Ophthalmic procedures ex. tonometry, FB removal, swab for culture or cytology, minor procedures |
| How is proparicaine administered? | topically to the eye |
| Proparicaine anesthetizes what part of the eye? | Cornea |
| How long do the anesthetic effects of proparicaine last? | 5-10 minutes |
| What are 2 things to remember when storing proparicaine? | it must be refrigerated and protected from light |
| What is the onset and duration of lidocane? | immediate onset, short duration of effect (60-120 minutes) |
| Why does lidocane burn? | Due to low PH |
| What can be added to lidocane to neutralize the "burn"? | Sodium Bicarbonate |
| What concentrations is lidocane supplied in? | 1%, 2% |
| How does Bupivacaine compare to Lidocane? | Bupivacaine is 4 times more potent than lidocane |
| What is the duration and onset of bupivacaine? | onset 20 minutes, duration of effect is 4-6 hours |
| What are the most common uses for bupivacaine? | regional and epidural nerve blocks |
| _____&______ result from lower doses and blood levels than reported with lidocane | CNS and Cardiac toxicity |
| Due to bupivacaine's potential for CNS and cardiac toxicity it is not used for what? | The Bier Block |
| What [ ]'s is bupivacaine supplied in? | 0.25%, 0.50%, 0.75% |
| When giving an IT block, how is the calculated does administered? | between the 2 testicles and the incision site |
| What drug has dual action? | Tramadol |
| How does tramadol work? | it is an agonist at MU receptors and a monoamine reuptake inhibitor |
| The analgesic effect of tramadol has been compared to what? | Merperidine or codeine |
| What drug class does tramadol fall into? | Schedule/class 4 |
| Is tramadol considered an opioid? | yes |
| How is tramadol supplied? | 50mg tablets |
| What is the MOA of Amantadine? | Oral nmda receptor inhibitor |
| What is amantadine used to treat in humans? | Parkinson's |
| What is the trade name for gabapentin? | Neurontin |
| What is gabapentin used for? | many forms of chronic pain, However its best application is for NEUROPATHIC pain |
| What are the side effects of gabapentin? | sedation, weight gain |
| What is the MOA of gabapentin? | unclear |
| What type of drug is amitriptyline? | Tricyclic antidepressant TCA |
| What is the MOA of amitriptyline? | inhibits serotonin and norepinephrine reuptake, though it may have other analgesic effects |
| What are the side effects of amitriptyline? | sedation, anticholinergic effects |
| What is multimodal pain management? | The use of multiple pharmaceutical agents, from different classes simultaneously for pain management |
| What are the benefits of multimodal pain management? | can reduce amount of medications necessary to relieve pain, minimize side effects, using pre-surgical, surgical, and post surgical technique allows for better pain control |
| What are the different ways to classify antimicrobials? | spectrum of activity (what type of microorganisms they fight, virus, bacteria, fungi, protozoa) |
| What does a -static antimicrobial agent do? | prevents replication |
| What does a -cidal antimicrobial agent do? | kills outright |
| What do -static antimicrobial agents depend on? | a functional immune system |
| What are the goals of antimicrobial therapy?? | To kill or disable pathogens without killing the host |
| What is required to obtain the goal of antimicrobial therapy? | Pathogens must be susceptible to the drug, The drug must be able to reach the site of infection in high enough [ ]'s to kill or disable the pathogens, patient must tolerate high [ ]'s of the drug, other factors |
| What are 2 other factors that contribute to how effective antimicrobial therapy is? | client compliance and cost |
| How can we determine whether or not a pathogen is susceptible to a drug? | Culture and sensitivity |
| What is MIC? | Minimum inhibitory concentration |
| What does MIC mean? | lowest [ ] of drug which will inhibit growth |
| What does it mean if a pathogen is sensitive? | MIC is low enough not to produce significant side effects in the patient |
| What does it mean if a pathogen is resistant? | MIC is so high, that swignificant side effects are seen in the patient |
| Antimicrobials must reach the site of infection in _____ [ ]'s to ______ MIC. | High enough, exceed |
| What is used when performing Kirby-Bauer antibiotic testing? | Mueller-Hinton medium, antibiotic impregnated discs |
| What is resistance? | genetic changes, mutations of chromosomes |
| What is an R-plasmid? | an addition piece of DNA responsible for antibiotic resistance |
| What does the R in R-plasmid stand for? | resistance |
| What is a plasmid/ | a circle of double stranded DNA that is separate from the chromosomes, which are found in bacteria and protozoa. |
| What does a plasmid contain? | genes normally not essential for cell growth/survival |
| How can resistance occur? | Inappropriate antimicrobial use |
| How can resistance be prevented? | by administering the right amount at the correct intervals for the correct amount of time, in the appropriate manner, EDUCATE clients on the importance of following instructions exactly including, giving for the entire length of time prescribed |
| What is a residue? | The presence of a drug or chemical in animal tissue or food products |
| How do residues occur? | administration of drug or chemical to food animals, contamination of food products |
| Can antimicrobial agents be degraded by cooking or pasteurization? | NO |
| What are the 2 effects of residues can cause in humans? | Hypersensitivity, and the killing off of susceptible (beneficial) GIT bacteria, leaving resistant (pathogenic) bacteria to proliferate |
| What is a withdrawal time? | a specific # of days in which a drug must be withheld from any animal intended for food prior to slaughter or sale |
| What are 5 ways antimicrobials work? | 1.cell wall (drugs work while cell wall is forming during bacterial division, bacteria are lysed as they drawn in H20 during osmosis) 2.cell membrane 3.inhibit protein synthesis 4.interfere with critical enzymes 5.impair production of bacterial DNA/RNA |
| What is the MOA of penicillin's? | block enzymes essential for cell wall assembly 9different enzymes are involved, different penicillin drugs affect different enzymes |
| Are penicillin drugs bactericidal or bacteriostatic? | bactericidal |
| What are penicillin drugs effective against? | Most gram (+) and some gram (-) bacteria |
| penicillin drugs are excreted ______ by kidneys, also _____ _____ into urine | unchanged, actively transported |
| Due to the active transport of penicillin into the urine penicillin drugs can attain much ______ [ ]'s in urine than in _____ | higher, blood |
| Do not use penicillin drugs with what other antimicrobial agents? | bacteriostatic |
| What is cross resistance? | if bacteria become resistant to one type of penicillin, it is also resistant to most other types of penicillin |
| Are penicillin's hydrophilic or lipophilic? | Hydrophilic, meaning they cannot reach therapeutic levels in the brain, globe of the eye, or prostate |
| Penicillin is dependent on what? | actively dividing bacteria |
| Some bacteria acquire resistance by producing what enzyme? | beta- lactamase |
| What part of the penicillin molecule does beta-lactamase attack? | The beta-lactam ring |
| What compound can sometimes be added to penicillin drugs to produce a modified penicillin which is resistant to beta-lactamase? | Clavulanic acid |
| What common veterinary drug is a penicillin with Clavulanic acid? | Clavamox |
| Why is Clavamox supplied as individually foil wrapped tablets? | because they absorb moisture from the air and quickly turn to mush |
| What is Clavamox called in human medicine/ | Augmentin |
| What is the most common adverse reaction to penicillin? | hypersensitivity |
| What is cross reactivity? | If a patient is allergic (hypersensitive) to one, they are likely allergic to all others of the same type as well |
| When does super infection occur? | When agent (in this case penicillin) destroys beneficial bacterial in the GIT allowing pathogenic bacteria to proliferate |
| What can super infection result in? | severe diarrhea and death in some species |
| What species have a predisposition for super infection? | guinea pigs, ferrets, hamsters, rabbits, snakes, birds, turtles, chinchillas |
| What does metastasis mean? | the spread of cancer from its primary site to other areas of the body |
| What is the difference between benign and malignant tumors? | malignant tumors can spread by invasion and metastasis, Benign tumors cannot, they only grow locally |
| What is the definition of cancer? | Malignant and invasive growth of a tumor |
| Give an example of a 'bad' benign tumor | brain tumor, this situation requires treatment as aggressive as that used with malignant tumors |
| Chemotherapeutic drugs are divided into what 2 groups? | cell cycle non-specific and cell cycle specific |
| How do cell cycle non specific agents work? | They are able to act upon all phases of the cell cycle except the resting phase G0 |
| How do cell cycle specific agents work? | these drugs act selectively at a certain phase of the cell cycle (usually S or M) |
| Why are there so many side effects of chemotherapy? | because the chemotherapeutic agent cannot tell the difference between a cancer cell and a normal, much needed cell |
| list 5 side effects of chemotherapy | Anaphylactic reaction, immunosuppression, cardiomyopathy, vomiting/diarrhea, hair loss (poodles/old English sheep dogs), cystitis, tissue damage due to extravasation, pain with admonistration |
| What is extravasation? | Drugs outside the vein |
| How can extravasation be prevented? | Always aspirate before administration/ check and double check |
| list 5 safety protocols to be used when handling chemotherapeutic agents | designate a specific location for drug handling, use an absorbent, disposable, plastic backed sheet to cover work area, Always wear latex gloves when handling (even while vet administers drug, always wear protective lab coat, gowns, plastic eyewear etc |
| What does meters squared represent? | BSA body surface area of the patient |
| Most antineoplastic drug dosages are based on what? | BSA measured in meters squared |
| Why do doses of chemotherapeutic agents need to be calculated so carefully? | because these agents have a narrow therapeutic index, and potentially life threatening side effects |
| List 5 categories of anti-neoplastic drugs | Alkylating agents, antimetabolite agents, vinca Alkaloid agents. antibiotic anti-neoplastic agents, platinum drugs |
| Give 1 example of an Alkylating agent | cyclophosphamide or CYTOXAN |
| Give 1 example of an antimetabolite agent | methotrexate |
| Give 1 example of a vinca alkyloid agent | Vincristine |
| Give 1 example of an antibiotic anti-neoplastic agent | doxorubicin |
| give 1 example of a platinum drug | cistplatin |
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Adeprey4311
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