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Pharmacology > Exam 3 Bosco-Lauth > Flashcards

Exam 3 Bosco-Lauth Flashcards

1
Q

depolarizing NMJ blockers

A

Succinylcholine
non-competitive
prolonged depolarization
not reversible with AChE

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2
Q

non-depolarizing NMJ blockers

A

PAM
competitive
no depolarization
reversible with AChE

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3
Q

clinical uses of NMJ blockers

A

anytime skeletal m paralysis is desired
- intubuation
- ortho manipulations
- adjunct to GA
no sedative effects

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4
Q

NMJ blockers monitoring

A

depth of anesthesia hard to monitor due to loss of many signs (reflexes/rxn)
monitor hr, bp, rr, temp

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5
Q

NMJ blockers toxicity

A

respiratory paralysis
ganglionic blockade = hypotension
histamine release = bronchoconstriction, anaphylaxis, prolonged apnea, CV collapse
vagal reflex - bradycardia
malignant hyperthermia

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6
Q

Pancuronium
duration:
metabolism:
elimination:
toxicity:

A

long lasting
renal (half life increases with renal dz)
ganglionic blockade, no histamine release, blocks muscarinic receptors

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7
Q

Atracurium
duration:
metabolism:
elimination:
toxicity:

A

intermediate
spontaneous degradation (pH & temp dependent), hydrolysis by plasma esterases & renal elimination (half life does not increase with renal dz)
little/no ganglionic blockade, some histamine release

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8
Q

Mivacurium
duration:
metabolism:
elimination:
toxicity:

A

short
hydrolysis by plasma esterases (half life not increased with renal dz)
little/no ganglionic blockade, histamine release

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9
Q

Succinylcholine
duration:
metabolism:
elimination:
toxicity:

A

short - good for intubation
hydrolysis by butyrylcholinesterase
no ganglionic blockade, histamine release, hyperkalemia

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10
Q

what are the indications for the use of diuretics

A
  1. reduce extra cellular fluid volume (pulmonary congestion, ascites)
  2. oliguric renal failure
  3. hypertension (EIPH)
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11
Q

osmotic diuretic

A

mannitol

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12
Q

carbonic anhydrase inhibitor diuretics

A

acetazolamide

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13
Q

loop diuretics

A

furosemide (lasix)

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14
Q

thiazide diuretics

A

cholorthiazide

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15
Q

K+ sparing diuretics

A

spirnolactone, amiloride

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16
Q

Mannitol
location:
MOA:
contraindication or special properties:

A

proximal tubule, thin loop
increases osmotic gradient in lumen
- treats oliguric renal failure, cerebral edema, acute glaucoma
- don’t use in blocked patients or if intracranial bleeding

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17
Q

Acetazolamide
location:
MOA:
contraindication or special properties:

A

proximal tubule
inhibits bicarb reabsorption
- treats metabolic alkalosis, glaucoma, altitude sickness
- don’t use in acidotic patients
- may cause hypokalemia

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18
Q

Furosemide
location:
MOA:
contraindication or special properties:

A

thick ascending limb of LOH
inhibits NaCl reabsorption
treats oliguric renal failure, CHF, acute pulmonary hypertension, EIPH
may cause hypokalemia and hypocalcemia

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19
Q

significance of furosemide in horse racing

A

can mask other drug in the urine so it is banned on race days

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20
Q

chlorothiazide
location:
MOA:
contraindication or special properties:

A

distal tubule
blocks NaCl symporter
treats nephrogenic DI, udder edema, Ca uroliths
decreased dehydration so better for emergent renal failure

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21
Q

spironolactone
location:
MOA:
contraindication or special properties:

A

distal tubule
aldosterone antagonist at hormone level - blocks expression of multiple genes
better for chronic conditions - delayed onset/prolonged effect
used most often in combo with loop diuretic to prevent hypokalemia

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22
Q

amiloride
location:
MOA:
contraindication or special properties:

A

distal tubule
principal cell Na+ channel blocker
better for emergencies, immediate onset
combo with loop diuretic

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23
Q

demeclocycline
type of diuretic
MOA
use

A

aquaretic
anatagonizes ADH/vasopressin (V2) receptors = solute free clearance
maintain electrolyte balance

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24
Q

why should patients on cardiac glycosides like Digoxin not be on diuretics? if they are, what combo should be used?

A

risk of hypokalemia
loop diuretic (furosemide) + K+ sparing (spirnolactone) to prevent hypokalemia

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25
Q

2 pools of histamine

A
  1. mast cells & basophils
  2. skin, lungs, gastric mucosa
26
Q

two classes of histamine receptors and major functions

A
  1. H1 - smooth m function (vasodilation, bronchoconstriction), capillary permeability (swelling, edema) & pain, itching
  2. H2 - gastric mucosa - stimulates gastric acid secretion
27
Q

difference between first and second generation anti-histamines

A

1st gen - unionized at physiological pH - enter CNS, often sedation

2nd gen - ionized, less CNS, no sedation

28
Q

general clinical uses of H1 receptor antagonists

A

allergies, anaphylaxis, sedation or prevent motion sickness, bronchodilation, anti-pruritic, stings, decrease swelling/edema, pain relief

29
Q

general clinical uses of H2 receptor antagonists

A

reduce gastric acid secretion, ulcers, drug-induced gastritis or reflux

30
Q

major function of serotonin in GI tract and CNS

A

regulates gut motility
body temp, sleep, mood, behavior, pain
effects vary per species

31
Q

Know what an ergot alkaloid is and why such compounds can be of importance

A

serotonin agonist
role in GI and behavioral effects
cattle toxicity - convulsions, gangrene, weight loss

32
Q

Understand the mechanism of action of selective serotonin reuptake inhibitors and their general uses

A

SSRIs inhibit serotonin re-uptake leaving it in the synapse for longer
compulsive behaviors, separation anxiety, agression, psychogenic alopecia

33
Q

basic MOA by which immunomodulation is achieved

A

t or b cell inhibition or both

34
Q

general toxicities associated with NSI

A

vomiting in dogs
anorexia in cats
immunosuppression = more risk of infection and neoplasia

35
Q

rationale for using NSI

A

immunosuppression is desired
systemic autoimmune dz - IMHA, IMTP, SLE
integument autoimmune dz - pemphigus, discoid lupus

36
Q

Cyclosporine
MOA (class)
toxicity (major)
general uses

A

calcinurein inhibitor
vomting in dogs, anorexia in cats, weight loss, lethargy, PK monitoring
systemic immunosuppression (IMHA, IBD, IMPA, atopic dermatitis, perianal fistulas in dogs, organ transplants) & topical ophlamic (KCS)

37
Q

Tacrolimus
MOA (class)
toxicity (major)
general uses

A

calcinurein inhibitor
unacceptable systemic toxicity
topical - dermatoses in dogs

38
Q

Cyclophosphamide
MOA (class)
toxicity (major)
general uses

A

cytotoxic alkylating agent
sterile hemorrhagic cystitis!!
antineoplastic & immunosuppression

39
Q

Chlorambucil
MOA (class)
toxicity (major)
general uses

A

cytotoxic alkylating agent
less BMS; nausea, vomiting, diarrhea, alopecia
immune-mediated skin diseases (pemphigus) in cats

40
Q

Azathioprine
MOA (class)
toxicity (major)
general uses

A

cytotoxic inhibitors of purine synthesis
bone marrow suppression in cats
immunosuppressant in dogs, IBD, skin-dz, IMHA

41
Q

Mycophenolate mofetil
MOA (class)
toxicity (major)
general uses

A

cytotoxic inhibitors of purine synthesis
gastritis, diarrhea, intestinal inflam
caution in cats, IBD in dogs, organ transplants

42
Q

difference between glucocorticoids and NSAIDs

A

NSAIDs inhibit COX
glucocorticoids inhibit phospholipase A2 of the arachidonic acid cascade

43
Q

glucocorticoid general effects

A

anti-inflam - high doses, suppress inflam mediators (PG)
immunosuppression - suppress cell-mediated immunity & suppress WBC migration/function

44
Q

glucocorticoid effect on metabolism

A

hyperglycemia & insulin resistance (can lead to DM)
protein breakdown
lypolysis & redistribution of lipids

45
Q

glucocorticoids effect on cardiovascular system

A

vasoconstriction and cardiac contraction
mineralcorticoid effects

46
Q

glucocorticoids effect on respiratory system

A

bronchodilation
decreased histamine release

47
Q

glucocorticoids effect on integument

A

thinning, easy bruising, poor wound healing

48
Q

glucocorticoids immunological effects

A

too little or too much can decrease immune function

49
Q

glucocorticoids effect on skeletal m

A

high doses = muscle wasting

50
Q

glucocorticoids effect on electrolyte and water balance

A

PUPD

51
Q

glucocorticoid effect on GI

A

ulceration

52
Q

major side effect of corticosteroids

A

iatrogenic hypoadrenocorticism

53
Q

hydrocortisone
uses

A

topical for pruritis and inflam associated with allergies

54
Q

fludrocortisone
uses

A

cortisol and aldosterone replacement in hypoadrenocorticism

55
Q

which glucocorticoid has the greatest mineralocorticoid potency

A

fludrocortisone
125

56
Q

which glucocorticoid has the greatest anti-inflam potency

A

dexamethasone
25

57
Q

prednisone & methylprednisolone
uses

A

systemically for long-term management of allergy, chronic inflam and immunosuppression

58
Q

is prednisone or methylprednisolone preferred in cats/horses and in hepatic failure

A

methylprednisolone

59
Q

dexamethasone
uses

A

systemically for immediate relief of hypersensitivity, septic shock, long-term control of allergy and immunosuppression

60
Q

mitotane
MOA
uses

A

adrenal steroid inhibitor
reduction in all adrenal steroids except aldosterone
use in Cushing’s (hyperadrenocorticism) patients

Pharmacology (7 decks)

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