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VTT Pharmacology 6

Locals,Antimicrobials, Chemo

QuestionAnswer
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
Created by: Adeprey4311