Veterinary Pharmacology

Front 1

gastric ulcers often develop during ________ as a co-morbidity

Back 1

hospitalization

Front 2

the stomach produces ____ and ___ which are potentially damaging to the gastric mucosa

Back 2

acid and proteolytic enzymes

Front 3

the three main modes of mucosal protection include:
1.
2.
3.

Back 3

1. gastric acid neutralization
2. mucosal protectants
3. inhibition of gastric acid secretion

Front 4

Misoprostol is a ________ and the MOA of Misoprostol is:

Back 4

A synthetic prostaglandin E1 analog.

To decrease parietal cell acid secretion

Front 5

NSAIDs interfere with ______ synthesis which results in _______, ________ and _______.

Back 5

prostaglandin synthesis, mucus secretion, blood flow and bicarbonate production

Front 6

T of F The better an NSAID is at blocking nociceptors the more severe the effect is on the gastric mucosa.

Back 6

T

Front 7

What are the indications for misoprostol administration? (2)

Back 7

NSAID induced gastric ulceration (overdoses/accidental consumption) or as preemptive with high doses of glucocorticoids

Front 8

Typically you would like to take a patient off NSAIDs for at least __ weeks before starting them on steroids

Back 8

2

Front 9

What are the adverse effects associated with misoprostol? What animals should you avoid them in?

Back 9

diarrhea, gastric upset

Pregnant animals- causes smooth muscle contraction

Front 10

Sucralfate reacts with gastric to form a ____ which then _____to the exposed submucosa.

Back 10

gel, adheres

Front 11

Sucralfate acts as a mucosal protectant by forming a direct ______ _______.

Back 11

physical barrier

Front 12

Sucralfate also has some minor _____ properties and there is some evidence for stimulation of ______ (which would increase mucus production and bicarbonate secretion)

Back 12

antacid, PGE2 and PGI2

Front 13

When is use of sucralfate indicated?
and if a lesion is in this section of the GIT ________ this drug would no longer be beneficial to the patient.

Back 13

esophageal, gastric or duodenal ulceration (gastric reflux, severe gastritis) or iatrogenic mucosal bleeding (NSAID gastritis, steroid induced lesions, surgical complications)

not indicated if the lesion is past the duodenum because it gets broken down

Front 14

you should administer sucralfate at least ___ min before antacids.

Back 14

30

Front 15

what is the easiest and cheapest way to administer sucralfate

Back 15

you make crush and suspend the sucralfate in tap water or feed them the tablet if they will eat a horse pill

Front 16

what important medications will sucralfate inhibit the absorption of?

Back 16

flurorquinolones, digoxin (and cimetidine but its not really considered an impt one)

Front 17

it is ______ expensive and is used for ____term treatment in patients

Back 17

moderately (25 cents per tablet), short

Front 18

Gastric acid is produced by the ____ cells in the stomach and the pH can reach as low as _____ in a carnivore stomach

Back 18

parietal, 1

Front 19

blocking of the histamine receptors is a type of ______ antagonism and hence relies on the relative __________ of histamine and antagonist

Back 19

competitive, concentrations

Front 20

proton pump blockers bind ______ and hence are considered ______ blockers of gastric acid secretion

Back 20

covalently, absolute

Front 21

T or F

H2 receptor blockers can completely abolish gastric acid production and can lower pH to below 5

Back 21

F that would be the PPIs

Front 22

which are more expensive proton pump inhibitors or H2 receptor blockers?

Back 22

proton pump inhibitors

Front 23

what protective mechanisms does the esophageal mucosa employ?

Back 23

not many! it will not heal easily in adverse conditions

Front 24

If you only have a gastric disease which antacid might you select?

Back 24

H2 receptor blockers

Front 25

if you have concurrent gastric and esophageal disease which type of antacid might you select

Back 25

a proton pump inhibitor

Front 26

list the three commonly used H2 blockers

Back 26

cimetiine, ranitidine, famotidine

Front 27

what is one of the major adverse effects of cimiedtidine? what is the outcome of this adverse effect?

Back 27

significant inhibitor of cytochrome P450. it interferes with drug metabolism

Front 28

how often must cimetidine be dosed?

Back 28

every 6-8 hours

Front 29

Ranitidine is known as _____ over the counter and has to be dosed _______.

Back 29

zantac, 2 x daily

Front 30

Famotidine has the least effect on this enzyme ______ but is the most ________

Back 30

cytochrome p450, expensive

Front 31

what is the MOA of omeprazole and what is its adverse effects

Back 31

MOA- irreversible inhibitor of parietal cell proton pumps. it mildly inhibits cytochrome p450.

Front 32

vomition is a ______ process and is controlled centrally by the _____ and ______.

Back 32

complex, chemoreceptor trigger zone, vomition center

Front 33

Maropitant is a ______ receptor antagonist which blocks the action of _____ in a common pathway to the vomition center

Back 33

NK1, substance P

Front 34

Maripotant needs to be dosed ___ x daily by _____ or per os.

Back 34

1, subcutaneous

Front 35

Maripotent is dispensed by the manufacturer in packages of 4 tablets because ____________.

Back 35

if the animal is still vomiting after this time it requires further work up

Front 36

The anitemetic effect of metoclopramide is predominantly _______. This is achieved by increasing ____ tone, decreasing ____ tone, increasing ________ and _______ motility.

Back 36

peripheral,
increasing LES tone
decreasing pyloric tone
increasing gastric and duodenal/jejunal motility

Front 37

Metoclopramide also has some ____ activity which can lead to ____ side effects. it is a _____ antagonist

Back 37

central, neurological, dopamine

Front 38

Metoclopramide has a prokinetic effect but is not particularly good at preventing ____.

Back 38

nausea

Front 39

Metoclopramide can be given as a _____ (dose form) and is not cost prohbitive.

Back 39

CRI

Front 40

how common are side effects of metoclopramide and what are they?

Back 40

uncommon!

restless, circling, whining, disorientation, seizures and frenzied behaviour

Front 41

Ondansetron/Dolasetron are available in ___ and ___ forms for about ___ dollars a dose. they should be adminstered ___ x daily

Back 41

IV and tablets

10 dollars

1-2

Front 42

ondansetron and dolasetron are ______ acting and are _____ receptor antagonists.

Back 42

centrally, serotonin/5HT3

Front 43

What is your first line choice when selecting an anti-emetic?

Back 43

maropitant

Front 44

many hospitalized patients are given _____ and _____ as single daily injections which is easy to maintain

Back 44

maropitant and 5HT3 antagonist

Front 45

What are some examples where it would be indicated to combine 3 antemetics?

Back 45

severe acute pancreatitis, gastric carcinoma, severe uremic gastropathy, chemotherapy related nausea and vomiting

Front 46

chronic GI enteroptathies include:

Back 46

chronic small intestinal diarrhea, weight loss, failure to thrive, vitamin malabsorption, steathorrea

Front 47

chronic enteropathies are most common in which if the companion animal species and in particular which breed

Back 47

large breed dogs, the german shepard

Front 48

which antibiotic has a good track record for the treatment of chronic enteropathies?

Back 48

tylosin

Front 49

What type of antibiotic is tylosin and what is its MOA

Back 49

macrolide, it inhibits protein synthesis

Front 50

Would tylosin be considered bactericidal or bacteriostatic? Which species is it marketed and labeled for use in?

Back 50

bacteriostatic

cattle, swine, poultry

Front 51

the beneficial effect of tylosin is through the promotion of which microbe in the GIT

Back 51

lactobacillus

Front 52

the optimum dose of tylosin is not clear but recently they have been recommending ___ mg/kg ___ x daily. patients need at least how many weeks therapy

Back 52

25, 2

6

Front 53

which drug is known as the great white hope of chronic GI disease?

Back 53

metronidazole

Front 54

patients on metronidazole often see a clinical response but with rapid _______

Back 54

recrudescence

Front 55

metronidazole is effective against _________ and ______ and in particular for diarrhea related to this parasite_______

Back 55

bacteria, protozoa

giardia

Front 56

You can see clinical benefits at a dose of ___mg/kg of metronidazole but to clear an infection of giardia completely you need to prescribe a dose of _____mg/kg BID for _____days

Back 56

10mg/kg

25 mg/kg 10 days

Front 57

Protozoal infections are better treated with _______ because of lower likelihood of toxicity and increased efficacy.

Back 57

fenbendazole

Front 58

Sulfasalazine is effective at treating conditions in this region of the GIT

Back 58

the colon

Front 59

In the colon, _______ is cleaved by the bacteria into sulfapyridine and 5-aminosalycylic acid.

Back 59

sulfasalazine

Front 60

What are the 3 general mechanisms behind diarrhea

Back 60

1.secretory
2.osmotic
3.motility

Front 61

secretory type diarrhea is often associated with _____ and _____

Back 61

bacterial toxins, some viruses

Front 62

osmotic type diarrhea is often associated with ________

Back 62

fat and carbohydrates not being absorbed

Front 63

motility type diarrhea is associated with ____, _____ and _______

Back 63

inflammation, drugs, some toxins

Front 64

The MOA of Loperamide is:

Back 64

motility modifier

Front 65

Opiate anitdiarrheals work by;

Back 65

1. reducing longitudinal colonic motility and increasing circumferential contractions
thereby increasing the duration of passage of ingesta

Front 66

When are opiate antidiarrheals contraindicated? (3)

Back 66

1.when the patient has bacterial infections or has consumed any other toxins
2. in cats
3. collie breeds

Front 67

Bismuth subsalicylate exerts its effects by being ______ protective

Back 67

directly

Front 68

salicyclate is an _________ so take care when dosing

Back 68

NSAID (aspirin)