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Pharmacology
Mid term
| Question | Answer | Answer | Answer | Answer |
|---|---|---|---|---|
| 4 rules for safe drug use? | #1 – All drugs are poisons | #2 – No drug is a silver bullet | #3 –All doses are guesses | #4 –Complacency Kills |
| Chemical vs nonproprietary vs proprietary (differences) | 2-(6-Chloro-9H-carbazol-2-yl)propanoic acic | generic name | trade, brand name | |
| Know FDA and DEA (no other organization abbreviations) | Food and Drug Administration | Drug Enforcement Administration | ||
| Concerns using enteric coated and extended-release drugs? | ||||
| Reasons to use a drug extra-label? Requirements to use a drug extra-label? | Many companies will discover new uses or doses with their products, but do not want to spend money on the FDA tria | If a drug is used by a different dose, route of administration, disease/condition, and/or species | ||
| What is a withdrawal period? Why do we care about it? What species does this effect? | The time between last dose and when the animal can be slaughtered | The drugs are very powerful and can harm humans | Cattle and other livestock | |
| Controlled drugs -what are they? Which class do veterinarians not have access to and why? | a federally controlled substance | C-1 | ||
| On drug inserts: difference between precaution, warning, black-box warning and contraindications | Precautions: mild ADR or expected/predictable change (may change color of urine, do not drive while taking) | Warnings: more serious side effects or ADRs that could do serious harm to the patient | Black Box Warnings: the strongest wording the FDA could require (human anti-depressants causing suicidal thoughts) | Contraindications: when the drug should not be used (allergies, juvenile patients, other diseases/conditions) |
| What details are required on a prescription? | Name of vet hospital and veterinarian with address and phone # • Date it is written • Client’s full name (first and last), address, and phone # • Animal species, name is only recommended (but should be done!) | • Rx symbol (usually already typed on paper –”take thou of”) • Drug name (usually generic is chosen), concentration/strength, number of units to be dispensed • Sig (signa –write/label) – Directions for animal | Number of refills, if allowed • Vet signature | |
| Requirements for a controlled drug log (How/where should it be kept? What should be on it? How long to keep?) | must hang onto for at least 2 years per federal law, most still require hard paper copy | |||
| Criteria to compound a drug | VPCR –compounded drug for a specific patient | Animal’s health will be threatened or suffer or die without the use of the drug | Compounded drug is made from only FDA approved human/veterinary drug | Only licensed vet or pharmacist can make |
| Therapeutic range | This is the amount of drug within the body that will produce its beneficial effect | |||
| Loading vs maintenance doses | significantly higher amount of the drug to “fill the bucket” quickly | smaller doses to maintain the therapeutic dose after a loading dose OR the initial dose used for a pet | ||
| peak/trough concentration | maximum serum concentration that a drug achieves in a specified compartment | the concentration of drug in the blood immediately before the next dose is administered | ||
| Parenteral vs non-parenteral forms -examples of each, pros/cons, speed of effect | achieve a steady state concentration con:Accidental injection outside of a vein: extravascular OR perivascular injection | IM, SQ, IV, IP | PO (per os = body opening, often used for by mouth) +Per rectum (capstar, valium/diazepam, enemas) +Topical drugs (creams, lotions, drops) +Aerosol administration (asthma inhalers, anesthetic gas) | |
| 4 mechanisms of how a drug moves within the body (diffusion types, etc) | 1. Passive Diffusion | 2. Facilitated Diffusion | 3. Active Transport | 4. Pinocytosis/Phagocytosis |
| Hydrophilic and lipophilic drugs -what areas do they absorb better? | If a drug is “water loving”, it won’t mix with fatty molecules and won’t dissolve in fats/oils | If a drug is lipophilic, and introduced into an aqueous based medium, they will clump together and not dissolve | ||
| Examples in individual patient’s that increase/decrease/change the drug’s desired effect? | ||||
| Rules for IV drugs | ONLY use if the bottle says IV! | Mix appropriately if in powder form (double and quadruple check amount) –choose appropriate diluent (Sterile H20 or NaCl) | If adding to IV fluids, make sure it’s compatible (LRS, NaCl, K, Dextrose, B- complex) | If says slow IV, it means SLOW |
| What is P-glycoprotein? Cytochrome P-450? Why do we want to know about these (or issues with them?) What is the MDR-1 mutation? | P-glycoprotein?: Active transport pump on enterocytes (GI intestinal cells) | Cytochrome P-450: a hemeprotein that plays a key role in the metabolism of drugs and other xenobiotics | the result of a genetic variant that can place dogs at risk of severe or life-threatening complications after taking particular medications at specific dose | |
| What is the first pass effect and enterohepatic circulation? Biotransformation? | a feature of hepatic metabolism that also plays a role in the elimination of multiple drugs | a metabolic process that takes place mainly in the liver and helps to facilitate the excretion of both exogenous and endogenous substances | ||
| What is the Blood Brain Barrier? What is it made up of and its job? Other parts of body with barriers? | Tight junctions + astrocytes/glial cells | maintains the right ionic balance within the brain and blocks substances that would disrupt essential neural functions | ||
| receptor | an organ or cell able to respond to light, heat, or other external stimulus and transmit a signal to a sensory nerve. | |||
| agonists | The drugs that bind and produce intrinsic activity | |||
| antagonists | The drugs that have “little” (negligible) or no effect | |||
| Reversal agents | Antagonists that bind to a receptor site and blocks agonists (exogenous source) from binding | |||
| Blockers | antagonist drugs that bind to prevent endogenous sources (hormones, neurotransmitters – something made within the body naturally) from binding | |||
| Competitive Antagonist | equal opportunity between two drugs (usually agonist and antagonist) | |||
| reversible | antagonism (surmountable) | |||
| Noncompetitive Antagonist | when the drug binds to a receptor either so tightly no other one will bind OR changes the receptor site so no other drug can bind | |||
| Biotransformation | alteration of drug structure within the body by enzymes | |||
| Prodrugs | drugs is structurally transformed by adding/removing molecules into a metabolite ->could either be less biologically active OR more active | |||
| enterohepatic circulation | the movement of bile acid molecules from the liver to the small intestine and back to the liver | |||
| Non-receptor mediated reactions -what are they? What are examples? | These drugs are often within vasculature or GI tract and act to draw things towards them in biochemical reactions or repel away | |||
| Drug excretion routes? What affects this in patients? | ||||
| What are the receptors in the emetic center vs the CRTZ? How are each of those centers “triggered” | Serotonin receptors, Acetylcholine receptors, Dopamine receptors, alpha adrenergic receptors, Substance P receptors | dopamine receptor | 1. Drugs/chemicals bind directly to them 2. Drugs/chemicals bind to receptors in the chemoreceptor trigger zone (CRTZ or CTZ) which is NEXT to the emetic center | 3. Nerve signals from distended/irritated pharynx, stomach, small intestine, peritoneum, kidney, gallbladder, or uterus 4. Nerve signals from inner ear (motion sickness) 5. Emotional stimuli from higher center in brain or intracranial trauma |
| What receptors are in the stomach? | H2 receptors | |||
| 4 types of diarrhea? | Secretory diarrhea | Exudative diarrhea | Motility diarrhea | Osmotic/Malabsorption diarrhea |
| One example of an antacid and how it works? | Proton Pump Inhibitors: stops H+ from being pumped out from cell –omeprazole. Compounded forms in pastes for horses. Human form is enteric coated –no splitting/chewing | |||
| One example of ruminant drug listed for rumen health? | Ionophores: group of antimicrobial drugs to control coccidia (protozoa) ->disrupts the electrolyte balance in the organism | |||
| One example of an antimicrobial for diarrhea use with one side effect? | Tylosin (tylan): treats gram positive, gram negative, Chlamydia and Mycoplasma organisms –inj. Approved for livestock, dogs, cats. Powder is extra-label, tylosin responsive diarrhea in middle-aged large breed dogs. | |||
| Preload vs afterload -what can affect/change this in a patient | Preload: pressure exerted by the volume of blood in ventriclesBEFORE ventricular contraction (during ventricular diastole,relaxation) –end diastolic volume | Afterload: pressure that the ventricles must exert to forceblood into arterie | ||
| What are the different categories of arrythmias? (tachy/brady, supra/ventricular) | Supraventricular tachycardia | Supraventricular bradycardia | Ventricular tachycardia | Ventricular bradycardia |
| What are the four big receptors and what happens when stimulated for the SNS and the PSNS? | Alpha -1: vasoconstriction of arteriolesin skin, abdominal organs, dilates pupil | Alpha -2: prevents further release ofnorepinephrine from nerve terminal | Beta -1: increases HR and force ofcontraction | Beta -2: increased bronchodilation,dilation of blood vessels in skeletalmuscles |
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