Pharm Exam Ii

Front 1

most potent to least potent alpha adrenergic receptors

Back 1

alpha: epi>norepi>isoproterenol

Front 2

most potent to least potent beta adrenergic receptors

Back 2

beta: isoproterenol>norepi=epi

Front 3

Drug of choice for the treatment of urethral hyperreflexia and functional urethral obstruction

Back 3

phenoxybenzamine

Front 4

tolazoline

Back 4

reversal agent of xylazine

Front 5

alpha 2 adrenergic agonist-for hypertension

Back 5

clonidine

Front 6

natural catecholamines

Back 6

norepi
epi
dopamine

Front 7

synthetic catecholamines

Back 7

isoproterenol
dobutamine

Front 8

noncatecholamines

Back 8

ephedrine
amphetamine
metaraminol
phenylephrine
phenylpropanolamine

Front 9

epi mostly stimulates what receptors?

Back 9

alpha and beta

Front 10

norepi mostly stimulates what receptors?

Back 10

alpha and beta, but mostly alpha

Front 11

isoproterenol stimulates what receptors?

Back 11

pure beta

Front 12

Alpha 1 receptors located where?

Back 12

postsynaptic
smooth muscle
cause vasoconstriction

Front 13

phenylephrine?

Back 13

nephrosplenic entrapment

Front 14

epinephrine #1 drug for?

Back 14

CPR-vasoconstriction

Front 15

Alpha 1 adrenergic receptors stimulate what kind of G coupled proteins?

Back 15

Gq=decrease IP3 and DAG

Front 16

Alpha 2 adrenergic agonist receptors located where?

Back 16

presynaptically
postsynaptically

Front 17

presynaptic alpha 2 adrenergic receptors do what when stimulated?

Back 17

cause vasodilation-negative feedback on NE release=vasodilation

Front 18

postsynaptic alpha 2 adrenergic receptors do what?

Back 18

vasoconstriction

Front 19

Beta receptors activate what kinds of G coupled proteins?

Back 19

Gs=increased adenylyl cyclase, increased cAMP=increased cell activity

Front 20

Beta 1 receptors work on?

Back 20

cardiac stimulation
release rennin

Front 21

Beta 2 receptors do what?

Back 21

Vasodilate:
increase aq humor (contra for glaucoma)
bronchodilation
decrease release of glucagon in response to low blood glucose so you become hypoglycemic

Front 22

In general stimulation of D1 and D2 receptors causes dilation or constriction of vessels?

Back 22

vasodilate

Front 23

Dopamine? Know it all.

Back 23

Dose dependent pharmacologic effect
2mg/kg/min: diuresis
2-10mg/kg/min: positive inotropic effect=hypotension and show
above 10mg/kg/min: vasoconstriction=hypotension and shock

Front 24

Three things you should know about catecholamines?

Back 24

ineffective orally
slow when applied SQ (vasoconstriction)
Do not cross the BBB

Front 25

Epi in glaucoma?

Back 25

decreases intraocular pressure in OPEN angle glaucoma, might be contraindicated in other types of glaucoma

Front 26

What are the two goals of giving drugs during shock?

Back 26

maintain normal bp
bronchodilation

Front 27

dobutamine half life?

Back 27

short half life

Front 28

For renal failure patients, what drug can you use to increase peeing?

Back 28

dopamine increases diuresis at 2mg/kg/min. dose dependent pharm effect!

Front 29

Adrenergic drug's effect on the GIT?

Back 29

inhibit GI activity, but we don't use them for this, we still use atropine (re: block SLUD)

Front 30

If you give epi after you give acepromazine?

Back 30

BAD! hypovolemic shock

Front 31

If epi becomes extravascular when you give it what happens?

Back 31

local necrosis, sloughing of the skin at injection site bc of vasoconstriction and ischemia

Front 32

what was the handout on that he gave us? why should we know that?

Back 32

epinephrine reversal...it has to do with using acepromazine then epi...it can be hard to reverse

Front 33

Ephedrine: directly or indirectly acting noncatecholamine?

Back 33

indirectly acting noncatecholamine

Front 34

Any advantage to using ephedrine over epi?

Back 34

longer duration of action
given orally
we dont really use it though

Front 35

why would you use ephedrine on an eye?

Back 35

mydriatic agent

Front 36

Can you develop tachyphylaxis with ephedrine?

Back 36

yes

Front 37

Amphetamine sulfate?

Back 37

not used in vet med
noncatecholamine

Front 38

What drug has an advantage over epi because it can treat hypotension without causing vasoconstriction and stimulating the heart?

Back 38

phenylephrine

Front 39

phenylpropanolamine: indirect or direct acting noncatecholamine?

Back 39

indirect acting noncatecholamine

Front 40

Beta adrenergic antagonists can only block directly acting or indirectly acting agonists?

Back 40

indirectly acting agonists

Front 41

Example of a beta 2 agonist?

Back 41

clenbuterol

Front 42

Best way to give beta 2 agonists?

Back 42

through inhalation

Front 43

Why would you want to give beta 2 agonists via inhalation?

Back 43

bc they act on the bronchioles. so this way you can give a lower dose than if you were to give it orally, meaning you have less chance of side effects

Front 44

How do adrenergic antagonists work?

Back 44

they sit in the receptor sit and block agonists from accessing the site (aka receptor antagonism, takes an agonist and an antagonist)

Front 45

Nonselective beta blocker?

Back 45

propanalol

Front 46

Selective beta blocker that has some use in glaucoma patients?

Back 46

timolol

Front 47

selective beta blocker that has some use in cardio protection bc it can scavenge free radicals?

Back 47

carvedilol

Front 48

prototype drug for beta blockers

Back 48

atenolol: can be give 1x/day

Front 49

what is the beta blocker used on cats with hypertrophic cardiomyopathy?

Back 49

atenolol

Front 50

Why should you not use nonselective beta blockers in vet med?

Back 50

bronchoconstriction

Front 51

On what patients should you not use beta blockers at all?

Back 51

1. heart failure
2. hepatic disease
3. diabetes mellitus (hypoglycemic...remember Beta 2?)

Front 52

Nonselective beta 2 blockers should not be used in animals about to undergo glycemic tests bc?

Back 52

beta 2 blockers block the effect of hypoglycemia (beta 2)

Front 53

If you give beta 2 blocker, will you see an increase, decrease or no change in the amount of glucagon in your patient?

Back 53

see a decrease in glucagon, bc it is normally released in response to low blood glucose, but blockers block this effect and decrease glucagon release.

Front 54

Would alpha 1 dilate pupil or constrict?

Back 54

dilate pupil bc causes vasoconstriction, constricts the radial muscles=dilation of pupil

Front 55

How does alpha 2 have the effect to cause vasodilation?

Back 55

supresses sympathetic output...remember alpha 2 presynaptic have a negative feedback on Norepi release...causes vasodilation

Front 56

what do alpha 2's do on to beta cells in the pancreas? Which does what to insulin?

Back 56

stimulates them which inhibits insulin release

Front 57

Drugs that stimulate alpha 2 cause vasodilation and hypotension, why?

Back 57

stimulate alpha 2 adrenergic receptors in the CNS, if you do this, you will suppress the outflow of sympathetic neurtransmitters from the braine. why they are used in humans for hypertension

Front 58

first alpha antagonists id'ed?

Back 58

ergot alkaloids

Front 59

What kind of tranquilizer is acepromazine?

Back 59

phenothiazine tranquilizer

Front 60

In general, which agonists (alpha or beta) do you want to use for glaucoma?

Back 60

beta

Front 61

most drugs are competitive or noncompetitive antagonists?

Back 61

competitive antagonists

Front 62

phenoxybenzamine increases or decreases sympathetic outflow?

Back 62

increase sympathetic outflow

Front 63

phenoxybenzamine is competitive or noncompetitive?

Back 63

competitive (covalently binds=irreversible)

Front 64

phenoxybenzamine is more competitive against alpha 1 or alpha 2

Back 64

alpha 1

Front 65

What is the drug of choice for functional urethral obstruction caused by internal urethral spincter tone increased in cats and dogs?

Back 65

phenoxybenzamine

Front 66

Drug(s) of choice for external urethral sphincter tone being excessive?

Back 66

dandrolene or diazepam

Front 67

What drug do you use for pheochromocytoma?

Back 67

phenoxybenzamine

Front 68

You would want to use phenoxybenzamine with what drugs before surgery to prevent what?

Back 68

phenoxybenzamine with beta blockers to prevent tachycardia during surgery

Front 69

Do you want to use phenoxybenzamine in glaucoma patients?

Back 69

no. it increases aq humor production by causing vasodilation bc of blocking alpha receptors.

Front 70

tolazoline?

Back 70

competitive alpha 1 and 2 antagonist
reversal agent for xylazine

Front 71

prazosin?

Back 71

competitive
selective alpha 1 antagonist
vasodilation and hypotension

Front 72

Does prazosin cause an increase, decrease or no change in NE release?

Back 72

exerts less reflex sympathomimetic response than nonselective alpha 1 and 2 antagonists, so it DOES NOT cuase an increase in NE release, so it only causes a little tachycardia bc alpha 2 receptors are not being blocked

Front 73

Prazosin can decrease sympathetic tone to treat?

Back 73

functional urethral obstruction aka urethral hyperreflexia (like phenoxybenzamine)

Front 74

What is the bummer about prazosin use?

Back 74

tachyphylaxis

Front 75

What are the three alpha 2 receptor antagonists that we should know everything about?

Back 75

yohimbine, tolazine, atipamezole

Front 76

Alpha 2 agonists are given for the treatment of?

Back 76

systemic hypertension

Front 77

alpha 2 agonists are used for what three things we must know! ***

Back 77

For dose dependent:
1. sedation
2. analgesia
3. muscle relaxation

Front 78

What is the order of most potent sedative to least potent sedative?

Back 78

metadomidine>detomidine>romifidine>xylazine

Front 79

Can alpha 2 receptors stimulate alpha 1 receptors?

Back 79

yes they can even though they are called alpha 2 receptors

Front 80

xylazine has its highest activity on alpha 1 or alpha 2 receptors?

Back 80

alpha 1 receptors

Front 81

detomidine acts mostly on alpha 1 or alpha 2?

Back 81

detomidine middle activity on alpha 1

Front 82

metadomidine mostly works on what receptors?

Back 82

very selective for alpha 2 receptors, has very little activity on alpha 1

Front 83

What species are least sensitive to the effects of alpha antagonists and which are most sensitive to antagonists?

Back 83

pigs-least sensitive
ruminants-most sensitive (give them 1/10 the dose of xylazine)

Front 84

alpha 2 agonists have their effect by?

Back 84

in general by stimulating alpha 2 receptors in the brain stem they cause sedation

Front 85

which has longer duration of sedation, detomidine or xylazine?

Back 85

detomidine

Front 86

Duration of analgesia depends on?

Back 86

dose. it is dose depedent

Front 87

xylazine?

Back 87

alpha 2 AGONIST
use in horse with colic
short duration of action

Front 88

what do you have to remember when you give xylazine to a horse?

Back 88

sedation lasts much longer than analgesia! So be careful. they might be sedated, but after 15 min or so they can feel everything again!

Front 89

xylazine should be used with what drugs to increase analgesia?

Back 89

opioids

Front 90

How do alpha 2 agonists cause skm relaxation?

Back 90

by interupting the intraneuronal impulse transmission to muscle

Front 91

Can you give xylazine IV to sheep?

Back 91

causes hypoxia

Front 92

Alpha 2 agonists should not be used in animals with?

Back 92

1. unstable cardio activity (they decrease CO by 30-50%)!!! this is significant
2. exercise tolerance (they already have very low HR)

Front 93

Alpha 2 agonists intitially cause what kind of tension, followed by what kind of tension?

Back 93

Alpha 2 agonists initially: hypertension
followed by: hypotension

Front 94

If you experience bradycardia when you give xylazine, what can you give the animal?

Back 94

atropine or glycopyrrolate

Front 95

If you experience bradycardia when you give detomidine or demetadomidine, what can you give?

Back 95

atipamezole, don't give atropine or glycopyrrolate bc you will cause more severe arrhythmias

Front 96

What species are most likely to develop bradycardia when you give alpha 2 agonists?

Back 96

cats and dogs, humans and primates are least likely to get bradycardia

Front 97

If an owner tells you that her horse has been on sulfonamides, right before you reach for detomidine to sedate it, what should you do?

Back 97

Think otherwise. Never give detomidine to an animal that has been on sulfonamides=fatal cardiac dysrhythmias!

Front 98

Alpha 2 agonists are commonly used as preanesthetics, what must you keep in mind when you are doing this though?

Back 98

animal vomit 3-5 minutes after they are given alpha 2 agonists, so you should wait for this time to pass before you induce general anesthesia

Front 99

What is the emetic drug of choice in cats?

Back 99

xylazine

Front 100

You shouldn't give beta 2 agonist when you are doing a glucagon test, but what other agonists shouldn't you give either and why?

Back 100

no Alpha 2 agonists=stimulate beta cells in pancrea=hyperglycemia transiently=can throw off your glucose tolerance test
-also decreases cortisol levels (which can be bad bc surgery is stressful and you have a lot of cortisol then)

Front 101

Alpha 2 agonists increase, decrease or do not change urine output. why?

Back 101

increase urine output bc they decrease ADH

Front 102

xylazine is an alpha 2 agonists, so why do I have to be careful when I use it on pregnant animals?

Back 102

can still stimulate alpha 1 receptors that are present on uterus=causes oxytocin like effect=dont use in late pregnancy cows!

Front 103

Xylazine is closely related to?

Back 103

clonidine

Front 104

If you have already given ketamine, can you give xylazine?

Back 104

no! you will cause cardiopulmonary dysfunction w/ the two.

Front 105

If you cause a seizure when you give xylazine, what should you reach for?

Back 105

IV diazepam=cannot block with an alpha 2 antagonist, bc the seizure is being caused by alpha 1, so you have to give diazepam, not yohimbine

Front 106

Detomidine mostly used in what species?

Back 106

horses
not used in small animals at all

Front 107

Most potent alpha 2 agonist in vet med?

Back 107

medetomidine: had develop atipamezole just to reverse it

Front 108

Why should you never use potent alpha 2 agonists in horses or ruminants?

Back 108

not dexmetadomidine or metadomidine in horses or ruminants bc it causes severe ataxia

Front 109

Can you use xylazine with other tranquilizers?

Back 109

no! it causes significant hypotension (dont use with acepromazine...so far no using ace with epi or xylazine with ace or keta...only with yohimbine, tolazine....)

Front 110

who is most sensitive to xylazine?

Back 110

ruminants

Front 111

what is the advantage of using alpha 2 agonists?

Back 111

reversible

Front 112

What are some potent inducers of p450s?

Back 112

barbituates (phenobarbital)

Front 113

yohimbine?

Back 113

reverses xylazine
-cannot reverse metadomidine or dexmetadomidine (that is what atipamezole is for)

Front 114

What is a good alpha 2 antagonists for ruminants?

Back 114

tolazine (reverses xylazine better in ruminants than yohimbine)

Front 115

What is a drawback of atipamezole?

Back 115

it is expensive

Front 116

what alpha 2 antagonists causes piloerection in horses?

Back 116

tolazine

Front 117

When you are treating an epileptic patient, what should you keep in mind?

Back 117

you need to figure out the underlying cause of the seizures and try to treat that

Front 118

what is excessive discharge of neurons in the brain, characertized by loss of consciousness, increase muscle tone or movement, altered sensation and other neuro changes?

Back 118

-seizure

Front 119

What are seizures characterized by spastic movement?

Back 119

convulsions

Front 120

recurrent seizures are called?

Back 120

epilepsy

Front 121

What is the difference between primary and secondary epilepsy?

Back 121

primary: inherited, aka idopathic
secondary: acquired, caused by various conditions

Front 122

Seizures can be classified as?

Back 122

general or focal
(general can become focal and focal can become general)

Front 123

What are the three phases of a seizure?

Back 123

1. preictal phase
2. ictus
3. postictal phase

Front 124

Status epilepticus is what?

Back 124

seizure lasting 30 minutes or more or a seizure representing multiple short seizures with no consciousness

Front 125

what are the four mechanisms by which seizures can begin?

Back 125

1. altered neuronal membrane function
2. decrease inhibitory neurotransmitter (GABA)
3. increased excitatory neurotransmitter (glutamate)
4. altered extracellular K and Ca concentration

Front 126

Because it is hard to control seizures what should you always remember to practice?

Back 126

therapeutic monitoring

Front 127

Three most common seizure controlling drugs?

Back 127

phenobarbital, primidone and diazepam

Front 128

Can anticonvulsants cross the bbb?

Back 128

yes

Front 129

what is the most lipid soluble anticonvulsant?

Back 129

diazepam

Front 130

emergency drug of choice for status epilepticus?

Back 130

IV diazepam

Front 131

where are a majority of anticonvulsants metabolized?

Back 131

liver

Front 132

what is half life?

Back 132

time to eliminate 50% of the drug from the body
helps you determine dosing interval

Front 133

Diazepam: long or short half life?

Back 133

short: why we give it IV

Front 134

If a patient misses a dose of what drug, it is likely to have a seizure?

Back 134

diazepam, short half life, so big difference between peak and trough=seizure with missed dose

Front 135

when you trying to monitor diazepam in the body, how many blood samples should you take and when? Why?

Back 135

take two blood samples:
1. at peak (which would be 4-6 hours after you gave the initial dose)
2. at trough (right before you are getting ready to give the second dose)
you do this bc it has such a short half life

Front 136

phenobarb: long or short half life?

Back 136

long half life

Front 137

if you are monitoring a dog to see how it will do with phenobarbital, how many blood samples should you take, when should you take them and why?

Back 137

take one blood sample
take it at trough (right before you are going to give another dose)
you do this bc it has such a long half life

Front 138

With what anticonvulsant, should you not be too worried if the client forgets to give a dose?

Back 138

phenobarbital: it has a long half life so if the patient misses a dose it probably will not seizure

Front 139

With what anticonvulsant can you give an extra dose in the middle of the seizure and stop it?

Back 139

diazepam: bc of its short half life

Front 140

Does giving an extra dose of phenobarbital do any good in a seizuring patient?

Back 140

no, just give IV diazepam

Front 141

which anticonvulsant induces its effect at doses lower than those required to induce profound CNS depression?

Back 141

phenobarbital

Front 142

which anticonvulsant has the widest spectrum of activity?

Back 142

phenobarbital

Front 143

How do anticonvulsants have there effect?

Back 143

allosteric modifiers of GABA so that it stays attached to its buddy longer and increases the time the Cl channels are open which increases the seizure threshold by causing hyperpolarization

Front 144

which anticonvulsant has good oral bioavailability? is inexpensive and lasts a long time?

Back 144

phenobarbital

Front 145

since phenobarbital doesn't start having its effect on the body until 8-15 days after you give it, what should you do?

Back 145

Give a loading dose
-use volume of distritbution X conc steady state to get loading dose

Front 146

If you are giving phenobarbital at 3 to 40 mg/ml, what should you monitor for?

Back 146

liver failure, it is hepatotoxic

Front 147

If you are giving phenobarbital with other drugs, what should you keep in mind?

Back 147

it is a potent inducer of p450 which means it will also increase the metabolism of other drugs that are in the system

Front 148

The fact that phenobarb stimulates p450 means that it causes?

Back 148

autoinduction: it increases its own metabolism

Front 149

what is the only other anticonvulsant you can combine phenobarb with?

Back 149

bromide

Front 150

If you are monitoring liver function in a patient on phenobarbital and you find elevated serum alkaline phosphate enzymes, what should you think?

Back 150

-elevated serum alkaline phosphate enzymes in a patient on phenobarb is not indicative of liver disease-with phenobarbital administration

Front 151

Since phenobarb can be hepatoxic what other anticonvulsant that isn't hepatotoxic can you give it with?

Back 151

bromide

Front 152

which anticonvulsant is not hepatotoxic?

Back 152

bromide

Front 153

If a client accidentally gives too much phenobarbital to a dog, what can you do to try to avoid hepatotoxicity?

Back 153

-give bicarb, since it is a weak acid it will increase the urine excretion of phenobarbital

Front 154

which drug has some anticonvulsant activity but most of its anticonvulsant activity is coming from it being metabolized to phenobarbital?

Back 154

primidone: it might work ok in dogs that don't repsond well to phenobarbital though

Front 155

What is the most potent hepatotoxic anticonvulsant?

Back 155

primidone

Front 156

You should never use primidone with what?

Back 156

phenobarbital or phenytoin

Front 157

How should you give phenytoin?

Back 157

oral, rectal
IV: severe hypotension
IM: tissue necrosis

Front 158

What is a disadvantage of phenytoin?

Back 158

saturaton kinetics: difficult to maintain plasma conc in dogs, doses necessary to have its effect affect the enzyme system to eliminate it and become saturated.

Front 159

By what order elimination process is phenytoin eliminated?

Back 159

zero order elimination process, nonlinear kinetics (makes it a pain bc you can't just double the dose and double the concentration in the blood like with first order kinetics)

Front 160

What is the drug of choice for alkaloid induced ventricular dysrythmias in dogs?

Back 160

phenytoin

Front 161

Why should you never ever use phenytoin with primidone or phenobarbital?

Back 161

enhanced hepatotoxicity

Front 162

when you run for diazepam when a patient is seizuring, what should be careful of when you get the IV set and start giving it?...if you can get an IV started...

Back 162

dont give an rapid IV bolus=cardiotoxic
give slowly

Front 163

Can diazepam cause increase or decrease appetite?

Back 163

appetite stimulant

Front 164

Diazepam is rapidly metabolized which means?

Back 164

it cant be used long term=tachyphylaxis

Front 165

Can you give bromide to cats?

Back 165

no. bronchial asthma like symptoms

Front 166

what is flumazenil?

Back 166

reverses diazepam
but! its carrier is ethylene glycol=hepatotoxic

Front 167

What are the two metabolites of diazepam?

Back 167

nordiazepam
oxazepam
-both are less active than diazepam,but are still active

Front 168

How many blood samples of diazepam when you are monitoring?

Back 168

2: short half life!

Front 169

What is one drawback to using diazepam in cats?

Back 169

hepatoxicity can happen at any time, it is unpredictable

Front 170

what is a drug that dogs do not develop tolerance to, commonly used with phenobarbital or bromide for long term control of seizures and is a prodrug?

Back 170

clorazepate

Front 171

If you use clorazepate with phenobarbital what should you do?

Back 171

decrease the dose of phenobarbital given with it

Front 172

which drug is hepatotoxic to cats like diazepam?

Back 172

clorazepate

Front 173

which anticonvulsant is more potent and better absorbed orally than diazepam, can't be used long term in dogs, but can be used long term in cats, but is still hepatotoxic in cats?

Back 173

clonazepam

Front 174

what anticonvulsant can be used as an alternative to diazepam in status epilepticus, has minimal hepatoxocity in cats, dosen't have to metabolized in the body to work, can be used in geriatric patients?

Back 174

lorazepam

Front 175

If you give a cat bromide and it develops bronchial asthma like symptoms, what should you give it?

Back 175

treat with glucocorticosteroids

Front 176

Is bromide toxic?

Back 176

yes! very potent

Front 177

Is bromide toxic to the liver?

Back 177

no. not hepatotoxic, but in general it is toxic.

Front 178

what is the treatment of choice for bromide toxicity?

Back 178

NaCl (salt)
-or give diuretics like furosemide

Front 179

why can bromide be given orally?

Back 179

high osmolality

Front 180

gabapentin?

Back 180

neuropatic pain control

Front 181

Drug of choice of REFRACTORY status epilepticus?

Back 181

pentobarbital sodium

Front 182

what are drugs that stimulate the CNS called?

Back 182

Analeptics

Front 183

What do respirotary analeptics work on?

Back 183

stimulate depressed respiratory centers

Front 184

what is respiratory analeptic that can be used to stimulate respiration after surgery or in new borns, can be given sublingually or in the umbilical vein in pups, causes medulla oblongata stimulation, safe drug to be used in vet med, can cause acidosis bc of its preparation

Back 184

doxapram

Front 185

What are the four methylxanthine derivatives?

Back 185

Caffeine
theophylline
theobrimide
aminophylline

Front 186

what do methylxanthines do in the CNS?

Back 186

stimulate the CNS

Front 187

what do methylxanthines do to the coronary blood vessels

Back 187

dilate coronary bvs

Front 188

Liver disease will increase, decrease or not change the length of pharm action with methylxanthines?

Back 188

increase pharmacological action

Front 189

what are the four barbituates we talked about in class?

Back 189

1. phenobarbital
2. pentobarbital
3. methohexital
4. thiopental

Front 190

what is an example of a substituted phenol?

Back 190

propofol

Front 191

what are the two cyclohexylamines aka dissociative anesthetics?

Back 191

1. ketamine
2. tiletamine (telazol)

Front 192

Imidazole derivatives? (2 of them)

Back 192

1. etomidate
2. metomidate

Front 193

What the four GROUPS of barbituates?

Back 193

1. thiobarbituates
2. ultrashort acting oxybarbituates
3. short acting oxybarbituates
4. long acting oxybarbituates (oral anti-epilepsy barbituates=phenobarbital)

Front 194

Barbituates are weak acids or weak bases?

Back 194

weak acids

Front 195

why is significant that barbituates are formulated as sodium salts?

Back 195

no perivascular leakage

Front 196

Based on chemical structure barbituates are organized into what two groups?

Back 196

1. oxybarbituates
2. thiobarbituates

Front 197

what is the difference in structure bt oxybarbituates and thiobarbituates?

Back 197

1. oxybarbituates: have o2 at C2
2. thiobarbituates: have sulfur at C2

Front 198

The R1 and R2 of oxybarbituates is aryl or alkyl?

Back 198

both

Front 199

The R1 and R2 of thiobarbituates is aryl or alkyl?

Back 199

both are aryl groups

Front 200

By what routes are barbituates absorbed?

Back 200

absorbed by all routes

Front 201

How should ultra short acting barbituates be given?

Back 201

only by IV

Front 202

Do barbituates have a low or high volume of distribution?

Back 202

high volume of distribution

Front 203

what form do barbituates have to be in to cross the BBB?

Back 203

unionized

Front 204

If you an acidotic cat and you want to give it thiopental to induce anesthesia should you increase or decrease the dose of anesthesia, why?

Back 204

decrease the dose bc:
acidosis: increase cellular penetration by anesthetics=deeper anesthesia

Front 205

If you have a cat with a lot of bicarb in its system and you want to induce anesthesia should you increase or decrease the dose, why?

Back 205

increase the dose bc:
alkalosis: decreases cellular penetration by anesthetics=lighter anesthesia

Front 206

If you have a dog that is hyproteinemic and you are going to give a barbituates, what should you note?

Back 206

barbituates are not active when they are protein bound
hypoproteinemic=less protein to bind barbituate=more active drug floating around=deeper anesthesia

Front 207

which structural group of barbituates is more lipid soluble?

Back 207

thiobarbituates are more lipid soluble

Front 208

Termination of barbituate anesthesia is by what three methods?

Back 208

1. physical redistribution
2. metabolic degradation
3. renal excretion

Front 209

Do the kidneys affect long acting barbituates?

Back 209

nope

Front 210

What are examples of:
1. a long acting barbituate
2. a short acting barbituate
3. an ultra short acting barbituate

Back 210

1. long=phenobarbital
2. short=pentobarbital
3. ultra short=thiopental

Front 211

How does recovery from thiopental occur?

Back 211

by redistribution

Front 212

Recovery from methohexital is primarily due to?

Back 212

biodegradation in liver and plasma

Front 213

How do barbituates induce skeletal muscle relaxation peripherally?

Back 213

cause skeletal muscle relaxation peripherally by decreasing binding and sensitivity of Ach to postsynaptic membranes

Front 214

The pharmacologic effect of barbituates ultimately is to?

Back 214

cause dose dependent depression of all organ systems and functions

Front 215

If you overdose an animal on barbituates and the heart continues to beat, what can you do?

Back 215

artificially respirate for several minutes

Front 216

when you give an IV injection of a barbituate you get transient__________and sustained_________.

Back 216

transient hypotension
sustained tachycardia

Front 217

40% of dogs develop bigeminy when they are given this drug?

Back 217

thiopental

Front 218

The affects on the CNS by barbituates at:
1. subtherapeutic doses
2. anesthetic doses
3. high doses
4. overdose
are....

Back 218

1. subtherapeutic: sedation w/o analgesia
2. anesthetic: general anesthesia, poor analgesia, good muscle relaxation
3. high dose: deep anesthesia w/ depression of medullary centers and motor function
4. overdose: respiratory arrest, then cardioarrest, then death

Front 219

what drug is given IV to treat strychnine poisoning?

Back 219

phenobarbital sodium

Front 220

Which drug is more potent than thiobarbituates, may cause excitement during recovery, and IS SAFE for sight hounds?

Back 220

methohexital

Front 221

Which drug has reconstituted solution that is unstable, cumulates after multiple doses, causes ventricular bigeminy in some dogs, IS NOT safe to use in sight hounds, causes poor muscle relaxation and analgesia?

Back 221

Thiopental

Front 222

What is the cheapest drug in vet med for short term anesthesia?

Back 222

thiopental

Front 223

why should you never give thiopental alone to a horse? What should you do instead?

Back 223

excitement and ataxia-premedicate with xyalzine or opioids first

Front 224

Dissociative anesthetics are characterized by?

Back 224

1. sensory loss
2. analgesia
3. amnesia
**But without actual loss of consciousness

Front 225

Dissociative anesthesia is characterized by?

Back 225

1. CNS excitement
2. analgesia
3. skm rigidity
4. amnesia with superficial sleep
5. dissociation from the environment
6. intact protective reflexes

Front 226

Large doses of dissociative anesthetics do what to the heart?

Back 226

depress the cardio system by directly depressing myocardium

Front 227

What drugs cause an apneustic breathing patter in cats?

Back 227

Dissociative anesthetics (ketamine and telazol)

Front 228

where is ketamine metabolized?

Back 228

In the liver

Front 229

If you give ketamine alone to cats, what will recovery be like?

Back 229

-smooth
-can have "tennis match" cats

Front 230

If you give ketamine alone to dogs, what will recovery be like?

Back 230

-stormy recovery

Front 231

Which drug causes skeletal muscle rigidity instead of relaxation and as a result should not be used for abdominal or thoracic surgery alone?

Back 231

-ketamine

Front 232

why should you use caution when you give dissociate anesthetics to animals with renal function that is compromise?

Back 232

-more than 50% of the drug is excreted in the urine unchanged

Front 233

what is in triple drip?

Back 233

xylazine + ketamine + guaifenesin
or
alpha 2 agonist, dissociative anesthetic and guaifenesin

Front 234

which dissociative anesthetic an you use for a c-section?

Back 234

ketamine

Front 235

which anesthetics should you never use alone in horses and why?

Back 235

dissociative anesthetics (ketamine and telazol) cause prolonged ataxia

Front 236

Telazol works better in cats or dogs?

Back 236

cats

Front 237

What is the prototype phenol drug?

Back 237

propofol

Front 238

What is a huge negative of propofol?

Back 238

microbial growth

Front 239

which drug do you have to throw away after 6 hours because it supports microbial growth?

Back 239

propofol

Front 240

what is an advantage of propofol over thiopental?

Back 240

maintains short term anesthesia with a smooth, short recovery

Front 241

What is another disadvantage of propofol besides its supporting microbial growth?

Back 241

-expensive $$$

Front 242

Which drug causes heinz body anemia in cats?

Back 242

propofol

Front 243

Which phenol can be given IV for control of status epilepticus?

Back 243

propofol

Front 244

What is one imidazole derivative?

Back 244

etomidate

Front 245

which drug inhibits adrenal steroidogenesis?

Back 245

etomidate

Front 246

What is neuroleptalgesia?

Back 246

neurolpetis: lack of anxiety
analgesia: lack of pain
so anesthetics with a lack of pain and anxiety

Front 247

What is the prototype opioid?

Back 247

morphine

Front 248

Benzodiazepam antagonist?

Back 248

flumazenil

Front 249

You should remember to combine opioids with other two types of drugs?

Back 249

1. sedatives
2. tranquilizers

Front 250

what drugs cause a loss of sensation in a body part w/o loss of consciousness and sensation?

Back 250

local anesthetics

Front 251

These are advantages of what group of drugs?
1. Avoid physio abnormalities of general anesthesia
2. neurophysiological responses to pain and stress can be modified beneficially

Back 251

local anesthetics

Front 252

In local anesthetics, addition of carbon to the aromatic ring or the amine group of the molecule increase, decrease or do nothing to its lipid solubility?

Back 252

addition of carbon increase the lipid solubility

Front 253

why can benzocaine be used topically?

Back 253

it has a hydrophilic domain

Front 254

These are idea characteristics of what type of drugs:
1. reversible nerve block
2. non-irritating to tissue
3. low systemic toxicity
4. effective whether injected or applied topically
5. rapid onset, sufficient duration, prompt recovery

Back 254

ideal characteristics of a local anesthetic

Front 255

Local anesthetics are weak acids or weak bases?

Back 255

weak bases

Front 256

Local anesthetics are water soluble or insoluble?

Back 256

water insoluble

Front 257

How does pKa relate to the onset of action of a local anesthetic?

Back 257

pka close to body's pH=rapid onset of action
pka higher than the body's pH=slower onset of action

Front 258

If you injected local anesthetic into inflammed tissue, will onset of action be faster or slower? pharm action?

Back 258

slower onset of action
pharm action: less-inflammation is acidic so a majority of the drug will be in the ionized form, which can't cross tissue membranes

Front 259

Lipophilicity will do what to toxicity?

Back 259

increase toxicity (decrease the TI)

Front 260

If I increase the protein binding of local anesthetics will this increase, decrease or not change the duration of action?

Back 260

increase protein binding=increased duration of action (less "free" active drug available at once)

Front 261

why would vasoconstriction be a good thing in regard to local anesthetics?

Back 261

vasoconstriction=limits absorption=increases the duration of action and decreases systemic toxicity

Front 262

T/F. Local anesthetics are generally more effective when they are applied to intact skin bc they can be absorbed more readily.

Back 262

False. local anesthetics are generally less effective on intact skin. they are more effective on broken skin.

Front 263

what is the mechanism of action of local anesthetics?

Back 263

block voltage gated channels thus preventing the initial phase of depolarization and subsequent development of an action potential.

Front 264

Amide type local anesthetics have rapid or slow elimination?

Back 264

rapid elimination bc they are widely distributed

Front 265

why is ester type local anesthetics distribution limited?

Back 265

bc they have a short half life which limits distribution, they are hydrolyzed and inactivated by plasma esterases

Front 266

If I give a local anesthetic to a pregnant cow will I have more time to work on her with the anesthetic or less time? why?

Back 266

more time. bc plasma esterases that eliminate local anesthetics are low in pregnant animals

Front 267

if you give local anesthetics intrathecally, what does this do to the action of the anesthetic?

Back 267

prolongs the action of the anesthetic bc spinal fluid is low in plasma esterase (like a pregnant animal)

Front 268

Where are amide local anesthetics metabolized? Why might this be an issue?

Back 268

They are metabolized in the liver, bad for cats bc they lack glucuronic acid

Front 269

what is the first sign of local anesthetic toxicity?

Back 269

muscle twitching

Front 270

what local anesthetic should you never give IV? why?

Back 270

bupivacaine=cardiotoxic=death

Front 271

what is a negative about ester type local anesthetics?

Back 271

they can cause allergic type reactions

Front 272

what drugs can cause methemoglobinemia?

Back 272

benzocaine, lidocaine, procaine

Front 273

What species is most suscetible to methemoglobinemia, with administration of what drugs?

Back 273

cats with administration of local anesthetics (ie benzocaine, lidocaine, procaine)

Front 274

which local anesthetic can be used IV for control of premature ventricular contractions?

Back 274

lidocaine

Front 275

What is a local anesthetic for horses with ectopic foci, atrial fibrillation and atrial flutter

Back 275

quinidine

Front 276

Can you give lidocaine orally?

Back 276

nope. first pass effect

Front 277

why use lidocaine with thiopental?

Back 277

decrease the dose of thiopental and prevent ventricular bigeminy

Front 278

why give IV lidocaine to horses?

Back 278

for gastric reflux
-it improves GI motility, that way you don't have to be tubing them all the time!

Front 279

what two local anesthetics are commonly used for opthalmology?

Back 279

-benoxinate
-procaracaine

Front 280

These are hormonal like substances that are synthesized and function in a localized area. In general they do not function like circulating hormones.

Back 280

autacoids (histamine and serotonin)

Front 281

These inhibit the senthesis, release or effects of autacoids.

Back 281

autacoid antagonists

Front 282

three major groups of autacoids?

Back 282

1. biogenic amines
2. polypeptide
3. phospholipid derived autacoids

Front 283

where are H1 receptors located?

Back 283

smm cell-contraction

Front 284

where are H2 receptors located?

Back 284

on parietal cells in the stomach

Front 285

where are H3 receptors located?

Back 285

in the CNS (located presynaptically)

Front 286

where is histamine made?

Back 286

in almost all mammalian cells

Front 287

What are two stores of histamine?

Back 287

1. mast cells and basophils store histamine
2. nonmast cells-histamine is synthesized and released constantly

Front 288

where is the highest concentration of histamine found?

Back 288

-in the hypothalamus

Front 289

what are three ways that histamine can be release?

Back 289

1. physical trauma to the membrane of mast cells or basophils
2. immune mediated release
3. drugs, peptides, venoms, others

Front 290

Describe the process involved when histamine is released during an immune mediated response.

Back 290

body produces Abs the first time it sees an antigen. it makes IgE from plasma cells, binds to receptors on mast cells and basophils which sensitizes these cells. So the second time the body encounters the same antigen there is release of histamine from mast cells and basophils that are already bound to IgE for that antigen (they are sensitized). this is an energy dependent process

Front 291

with histamine release will you see an increase or decrease in HR? vasodilation or vasoconstriction? hypertension or hypotension?

Back 291

increase HR=vasodilation=hypotension

Front 292

What do histamine antagonists do specifically?

Back 292

inhibit H1 receptors (antihistamines only inhibit H1 receptors, none of the other H receptors)

Front 293

What are the two types of antihistamines?

Back 293

first generation
second generation

Front 294

Which generation antihistamines block H1 receptors, muscarinics, dopamine, alpha adrenergics and serotonin?

Back 294

first generation

Front 295

which generation of antihistamines does cyproheptadine belong to?

Back 295

second generation

Front 296

Cyproheptidine blocks?

Back 296

serotonin

Front 297

which generation antihistamines are potent inducers of cytochrome p450s?

Back 297

second generation

Front 298

what is the main goal of antihistamine therapy?

Back 298

increase bronchodilation while maintaining normal blood pressure

Front 299

will antihistamines block gastric acid production?

Back 299

no. antihistamines only block H1 receptors, gastric acid come from parietal cells which have H2 receptors

Front 300

which generation antihistamines can cross the BBB?

Back 300

first generation=cause sedation

Front 301

what drugs do you use as antiemetics for motion sickness?

Back 301

can use antihistamines (benadryl)

Front 302

Cyproheptidine is used for what in cats?

Back 302

appetite stimulant
-and for photic head shaking in horses

Front 303

Antihistamines shouldn't be given to pregnant animals, why?

Back 303

teratogenic=cause abnormalities

Front 304

why do antihistamines work better in dogs?

Back 304

they have more histaminergic receptors than cats

Front 305

what are some examples of H2 receptor antagonists?

Back 305

-cimetidine, ranitidine, famotidine, nizatidine

Front 306

cimetidine and ranitidine are weak or potent inducers or inhibitors of p450s?

Back 306

weak INHIBITORS

Front 307

what two antihistamines are prokinetic and why?

Back 307

cimetidine and ranitidine bc they increase Ach levels=make you poo

Front 308

What drug stabilizes the membranes of cells and thus inhibits the release of histamine?

Back 308

cromolyn sodium

Front 309

You can give what drug IV to treat the immediate effects of anaphylaxis?

Back 309

IV epinephrine

Front 310

what drug is a potent antagonist of serotonin, is an appetite stimulant in cats, and is used in horses with cushing's disease

Back 310

cyproheptadine

Front 311

Elimination of Na ions?

Back 311

naturetic

Front 312

Elimination of solutes and water?

Back 312

diuretic

Front 313

Elimination of NaCl?
(which could affect bromide elimination)

Back 313

Saluretic

Front 314

In general we use these drugs for heart failure, mobilization of edema, prophylaxis of renal failure

Back 314

diuretics

Front 315

This is an osmotic diuretic for reduction of cerebral edema?

Back 315

-mannitol

Front 316

this type of diuretic is the most effective for prophylaxis of renal failure by initiating urine flow after shock, cardiac emergencies, and surgery?

Back 316

-osmotic diuretic

Front 317

What is an acidifying agent diuretic?

Back 317

ammonium chloride

Front 318

How does ammonium chloride work as a diuretic?

Back 318

Cl- being excreted in the urine drags some amount of Na with it which in turn draws water along with it

Front 319

How do you get tolerance to ammonium chloride?

Back 319

-acidic state initiates the formation of NH3. NH3 and H+ give NH4+ which replaces Na+ as the equivalent cation for Cl- secretion=decreases osmotic drag and diuresis is lost

Front 320

what is an example of a carbonic anhydrase inhibitor (diuretic)

Back 320

acetazolamide

Front 321

Can you use carbonic anhydrase inhibitors chronically for glaucoma?

Back 321

-yes. use topically you get no tolerance

Front 322

How do thiazide diuretics work?

Back 322

-inhibit Na resorption,

Front 323

With thiazide diuretics, where is the point of action? why is this significant?

Back 323

point of action is proximal to aldosterone controlled Na-K exchange. So K+ loss can be significant=hypokalemia

Front 324

These diuretics are diabetogenic in subclinical diabetes mellitus but show beneficial effects in reducing urine flow in diabetes insipidus. But you have to have K+ to convert proinsulin to insulin, so you get an increased glucose level, esp in those with diabetes mellitus

Back 324

thiazide diuretics

Front 325

what diuretics are used for nephrogenic diabetes insipidus, systemic hypertension

Back 325

thiazide diuretics

Front 326

How can thiazide diuretics cause hypocalcemia?

Back 326

-they increase the number of calcium binding receptors

Front 327

what is the prototype anthranilic acid derivative?

Back 327

-aka look diuretic
-prototype: furosemide=lasix

Front 328

What is the most potent, most commonly used diuretic in vet med?

Back 328

furosemide

Front 329

What drugs could cause ototoxicity in cats?

Back 329

furosemide (loop diuretics)

Front 330

what is the mechanism of action of K sparing diuretics?

Back 330

-act on collecting tubule to diminish Na reabsorption and K excretion
-there is potential for hyperkalemia

Front 331

Since there is potential for hyperkalemia with K sparing diuretics, what other diuretic can you use in conjunction to correct for this?

Back 331

thiazide, tends to loose too much K

Front 332

What diuretic should be used in conjuction with thiazide for congestive heart failure patients?

Back 332

K sparing diuretics