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Pharmacology Drugs 6
SA antimicrobials-Antifungals
| Question | Answer |
|---|---|
| characteristics of metronidazole | used largely on anaerobic, gram- microbes; can be used on some gram+; has tissue penetration; is a bacteriocidal; shows toxicities in GI and brain |
| T/F: the more life-threatening a disease is, the more you'll see antimicrobials used in combination. | True |
| when/why would you use a high dose and long duration of therapy of an antimicrobial? | Life threatening infection Intracellular pathogen Immunocompromised host Chronic or recurrent infection Hard to reach site |
| what are some possible choices for treating a female with a simple urinary tract infection? | amoxicillin, clavomox, cephalexin, TMS, Enrofloxacin |
| What are some choices of antimicrobials to use in a male intact dog presenting with infertility and prostatitis? | fluoroquinolone--> enrofloxacin, TMS, Chloramphenicol |
| Why wouldn't you elect to use TMS in a doberman pinscher with prostatitis, even though it's a good choice? | causes polyarthropathy |
| An animal presents with a foreign body in it's nasal sinus. What antimicrobial would you choose to use? | none; remove foreign body and only treat if infection occurs after removal |
| what are some antimicrobial choices for a male castrated mixed breed dog with a cough after boarding in a kennel? | depends, if the dog is otherwise healthy treat with: doxycycline, azithromycin, enrofloxacin, TMS |
| what is your top diagnosis on a dog with actue polyarthropathy and PMN inclusion bodies? | Ricketsial disease |
| what would you use to treat a dog with acute polyarthropathy and PMN inclusion? | Doxycycline |
| A female intact dog presents with ciliary dyskinesia and severe pneumonia. What would you treat with? | Enrofloxacin and ampicillin; Imipenem/meropenem; Amikacin and ampicillin; Ticarcillin and Enrofloxacin; Ticarcillin and gentamycin |
| you are presented with a MC DSH with a fever, anorexia, and a fluctuant subcutaneous mass. what do you do first before beginning antimicrobial treatment. | confirm it is an abcess and drain the abcess |
| what would you use to treat an abcess in a cat? | Amoxicillin; Clavamox; Cefazolin; Simplicef; Convenia |
| what would you use to treat a shar pei with pyoderma? | Convenia; Cefpodoxime; Cephalexin; Clavamox; TMS; Enrofloxacin |
| A female lab presents at your clinic with sudden onset severe depression, findings of sepsis. She is being treated for lymphoma with chemotherapy. What do you use to treat? | Enrofloxacin and ampicillin; Imipenem/meropenem; Amikacin and ampicillin |
| what would you use to treat periodontal disease in a cat? | Clindamycin; Clavamox; Doxycycline |
| a calf presents with diptheria. What is your first choice of the infectious agent? | Fusobacterium necrophorum |
| a calf presents with pneumonia. What is your first choice of the infections agent? | Mannheimia hemolytica |
| a calf presents with septicemia. What is your first choice of the infections agent? | E. coli |
| a calf presents with blackleg. What is your first choice of the infections agent? | Clostridium chauvei |
| A pig presents with Enzootic pneumonia. What is your first diagnosis of the infectious agent? | mycoplasma pneumonia |
| In reference to economics iin LA medicine, why would you use one drug over another, even if the one you decide on is more expensive? | Drug cost is of little importance. The most important thing to think about is THE WITHHOLD TIME of the animal. A more expensive drug, may be cheaper in the long run b/c of a short withdraw time. |
| what else should you consider when prescribing a drug for LA if drug cost is relatively minor? | efficacy of the drug; dosing interval of the drug |
| Which of these would you choose to treat a cow after a DA surgery? No other complications to worry about. Oxytetracycline SID 3 days, $9 Penicillin G BID 3 days, $18 Ceftiofur SID 3 days, $24 | ceftiofur b/c no withdraw time |
| if a cow is really sick, should you worry more about withdraw times or cost of the drug? | cost of drug; really sick= drop in production anyway |
| If a producer decides to cull the cow should you give antibiotics? | if you have to give antibiotics, give one with lowest withdraw period. If the animal doesn't need drugs, don't give |
| define extra label drug use. | use of a drug in a fashion other than specified on the product label |
| what is ELDU regulated under? | AMDUCA= Animal Medicinal Drug Use Clarification Act |
| what are the three classes of drugs used on a farm? | Over the counter (OTC) drugs; Prescription drugs; OTC or prescription drugs used in a manner other than described on the label |
| what are the categories of drug use? | lable use, legal extra label drug use, illegal |
| what are the requirements of ELDU? | no approved animal drug labeled for intended useage; drug muse FDA approved animal or human drug; valid Veterinary-Client-Patient relationship |
| When can an drug be used legally in an extra-label fashion? | Prescribed by a licensed veterinarian in your state; Diagnosis based on examination, history or laboratory data; No illegal drugs used; Appropriate withdrawal times set and followed; Appropriate and complete labeling and record keeping |
| when is a human drug not allowed for use in veterinary medicine? | When a drug meant for use in veterinary medicine is available |
| what is required in the records to prescribe out an extra-label drug? | Client name; Animals being treated; Disease being treated; Drug name and active component; Keep records for a min of 2 years; Veterinarian’s name and address; Name of drug; Dosing information; Cautionary statements; withdrawal |
| what are the animals defined as food animals? | cattle, pigs, sheep, goats, and includes those kept for breeding purposes and as pets |
| which drugs have a voluntary restricted use? | aminoglycosides, phenylbutazone, DMSO |
| what is the most commonly used drug in equine medicine? | penicillin G |
| the use of antibiotics in equine medicine carries an increased risk of? | diarrhea |
| what pathogen is most commonly associated with diarrhea in equine? | salmonella |
| what factors interfere with bacterial conolizaition resistance of the gut of equids? | stress, energy dense diets, antibiotics |
| if a foal is sick, what should you assume it is sick with? | septicemia |
| newborn foals will become infected with what type of bacteria? | pathogens from normal horse environment; NOT SUPERANTIGENS |
| If you see a mare that has just foaled with a distended udder, what should you assume? | foal is sick and not nursing (not, the mare is producing a lot of milk) |
| If you seen enophthalmia in a foal, what does that indicate? | dehydration |
| uveitis in a foal is highly indicative of?? | sepsis |
| If you see jaundice in a foal what is it a result of? | newborn= Neonatoal Isoerythrolysis; young foal= sepsis |
| T/F: you don't have to use different enrichment medias to test the blood of a foal for sepsis if it has already had antibacterial treatment. | False |
| when doing a bacterial culture for sepsis, should you be concerned if you see a growth of staph. epidermititis? What does it mean? | No; your culture is contaminated, you must re-do |
| in foals, should you use antibiotics that are metabolized by the kidneys or liver? | more so by kidneys; liver not fully functional and will retain drugs for up to 14d |
| when giving drugs to neonates, what do you have to keep in mind when the drug is given orally? | higher chance of toxicosis |
| when giving a CNS depressent, what do you have to keep in mind? | BBB of foal not as well developed as adult, so will have large effects |
| what is the preferred route of administration of a drug for neonatal foals? | parenteral route |
| which drugs are excreted unchanged in urine? | penicillin G, aminoglycosides, cephalosporins |
| you should avoid using drugs that are metabolized by the liver in foals. what are those drugs? | chloramphenicol, erythromycin |
| aminoglycosides and beta lactams are often paired together to treat infections. what should you pay attention to when giving this mixture? why? | renal function. if renal status changes due to onset of renal disease, stop use of this b/c aminoglycosides causing the disease |
| what does Therapeutic drug monitoring (TDM) ENSURE? | dosing intervals and quantities that are safe and effective |
| respiratory infection "rattles" caused by?? | rhodococcus equi |
| what would you use to treat rhodococcus equi? | Erythromycin + rifampin; Azithromycin + rifampin; Clarithromycin + rifampin |
| if you have brick red gums and a prolonged CRT in a horse, what should you suspect? | endotoxemia due to typhlocolitis |
| what antimicrobial would you use to treat potomac horse fever? | oxytetracyline |
| what antimicrobial would you use to treat clostridium difficile | metranidazole |
| what antimicrobial would you use to treat lawsonia intracellularis? | erythromycin, chloramphenicol, tetracyclin |
| what is one of the most common topical fungal diseases in small animals? | dermatophytosis |
| what are some common systemic fungal diseases of small animals? | blastomycocsis, histoplasmosis, coccidiomycosis, cryptococcosis |
| which fungal disease can be either systemic or topical? | aspergillus |
| which fungal disease has no treatment and why? | phthyosis b/c it's casued by an algae |
| why is it difficult to treat a fungal disease? | there are few drug options, treatment takes months, diseases are usually challenging and expensive |
| how are systemic fungal diseases commonly acquired? | inhalation |
| characteristics of blastomycosis? | infects mainly dogs; will attack lungs, bone, skin, eyes, LN, and CNS; blue broad-based budding organism; found from minnesota to louisiana and east to virginias and NC |
| characteristics of histoplasmosis? | infects dogs or cats; will attack the GI (mainly), liver/spleen, LN, lungs, eyes, bone marrow; small multiple intracellular organism; found in midwest (minnesota to louisiana) to Georgia Michigan and upper northeast |
| characteristics of cryptococcosis? | found in cats more than dogs, but will cause CNS signs in dogs; infects the nasal cavity, brain and lungs; see budding, large capsule with variable sized daughter cells; found worldwide |
| Characteristics of coccidiomycosis? | dogs>cats; infects lungs, heart, CNS, bone, and eyes; large and thick-walled with few cells; found in SW US |
| T/F: the antibody test for coccidiomycosis is not useful in identifying the organism. | false |
| why is pthyosis so hard to treat? | it doesn't have ergoterol in its cell wall |
| what clinical signs will you see with pthyosis? | cutaneous or GI granulomas |
| what is the nasal form of aspergillus? | A. fumigatas |
| what is the systemic form of aspergillus? | A. terries |
| in which breed will you commonly see the nasal form of aspergillus? the systemic form of asperfillus? | dolichocephalic dogs; German Shepherds |
| what are the two most clinically used antifungals? | polyene antibiotics; azole derivatives |
| Amphotericin B is used to treat which types of fungal disease? | systemic (except cryptococcosis) |
| dose limitations of amphotericin B? | yes; nephrotoxic |
| how does amphotericin B work? | binds ergosterol |
| what are the azole drug derivatives? | ketaconazole, itraconazole, fluconazole |
| which azole drug derivative is most hepatotoxic? | ketaconazole |
| which azole derivative has better CNS penetration and is okay to use on an empty stomach? | fluconazole |
| of the newer azole drugs, which is an itraconazole analog? | posaconazole |
| of the newer azole drugs, which are fluconazole derivatives? | voriconazole, ravuconazole |
| what can be used to treat nasal aspergillus? | topical clotimazole |
| what is griseofulvin used to treat? | ringworm |
| which antifungal is used in combo with amphoteracin B to inhibit DNA/protein synthesis? | 5-Fluorocytosine |
| t/f: supportive care is not necessary during fungal infections which involve the lungs or GI tract. | False |
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