2021 Exam

Question 1

Explain the relationship between half-life, plasma drug accumulation, and fluctuation. List which are variables that can affect the half-life of drugs.

Answer 1

Shorter half-life = more fluctuation, less drug accumulation (depends on frequency of administration)

Half-life can be affected by species, clearance, volume of distribution.

Question 2

A drug is not working on a patient. You submit plasma samples for assessing the concentration.

TDM report indicates that the plasma drug concentration is within the therapeutic window. List three strategies you would implement for helping your patient.

Answer 2

Increase dose
Change treatment/drug
Decrease dosing interval

Question 3

List the primary indication for doxapram and sildenafil.

Answer 3

Doxapram: stimulating the respiratory center during an emergency

Sildenafil: pulmonary hypertension

Question 4

List five diseases for which loop diuretics are contraindicated.

Answer 4

1. Anuria
2. Dehydration
3. Vomiting / diarrhea
4. Hypotension
5. Hepatic encephalopathy

Question 5

Which diuretic can be used to treat nephrogenic diabetes insipidus?

Answer 5

Thiazide diuretics

Question 6

List a contraindication of calcitriol.

Answer 6

Hypercalcemia

Question 7

MOA: Mannitol

Answer 7

Osmotic diuretic at proximal tubules
Decrease water and sodium reabsorption

Question 8

MOA: Furosemide

Answer 8

Loop diuretic descending loop of Henle
Inhibits Na-K2Cl symporter

Question 9

MOA: Chlorothiazide

Answer 9

Thiazide diuretic - acts on distal collecting tubule
Inhibits Na/Cl transporter

Question 10

MOA: hydrochlorothiazide

Answer 10

Thiazide diuretic - acts on distal collecting tubule
Inhibits Na/Cl transporter

Question 11

MOA: trimatirene

Answer 11

Block Na+ channels in distal tubule

Question 12

MOA: amiloride

Answer 12

Block Na+ channels in distal tubule

Question 13

MOA: spironolactone

Answer 13

Inhibits aldosterone binding at distal tubule

Question 14

MOA: calcitriol

Answer 14

Replaces activated Vitamin D

Question 15

MOA: erythropoietin (EPO)

Answer 15

Increases RBC production

Question 16

MOA: epoetin alfa, darbepoetin alfa

Answer 16

increases RBC production by stimulating EPO

Question 17

MOA: clenbuterol

Answer 17

Bronchodilator, increases intracellular cAMP

Question 18

MOA: prednisone

Answer 18

Glucocorticoid
Decreases inflammation via a variety of mechanisms
Augment beta-2 adrenergic mediated bronchial smooth muscle relaxation

Question 19

Which of the factors listed influences the extent of drug accumulation in plasma?

a. fluctuation of plasma drug concentration
b. tmax
c. clearance
d. cmax
e. extent of protein binding
f. none

Answer 19

fluctuation of plasma drug concentration

Question 20

Which of the factors listed below influences the t1/2 of drugs w/linear kinetics disposition?

a. tmax
b. clearance
c. dose
d. dose frequency
e. drug conc at steady state
f. none

Answer 20

Clearance

Question 21

Indicate which of the following statements is INCORRECT concerning a valid VCP relationship?

a. a (licensed) vet can prescribe drugs only in the context of a valid VCPR
b. the vet has to assume the responsibility for making clinical judgements regarding the health of the animal(s) and the need for medical tx, and the client has agreed to follow the vet’s instructions
c. the vet does not need to be available for follow-up evaluation after starting the tx
d. the vet has to have sufficient knowledge of the animal(s) to initiate at least a general or preliminary dx of animal’s medical conditions
e. all above are correct
f. all above are incorrect

Answer 21

The vet does not need to be available for follow-up evaluation after starting the treatment.

Question 22

Before prescribing any approved human or animal drug for ELDU in food production animals you must:

a. carefully diagnose and evaluate the condition for which you are prescribing the drug
b. make sure procedures are in place, so your client maintains the identify of the tx animal(s)
c. establish a substantially extended withdrawal period supported by appropriate scientific information
d. take measures to ensure that no illegal drug residues occur in the treated animal(s), your client must follow your established withdrawal period
e. all above are correct
f. all are incorrect

Answer 22

All are correct

Question 23

Regarding compounded formulations, please indicate which statement is INCORRECT.

a. compounded formulations are preferred over generic formulations
b. vets must provide an extended withdrawal time for indicating compounded formulations in food animals
c. the score of a tablet could be considered as practicing compounding
d. the amount of product compounded should be on an individual animal basis
e. all are correct
f. all are incorrect

Answer 23

Compounded formulations are preferred over generic formulations

Question 24

You could prescribe a compounded formulation EXCEPT:

A. when there is a valid VCPR
B. when compounding is done w/approved drugs
c. when the pharmacy is producing the compounded formulation at a commercial scale
d. when there is a restricted distribution of the drug intended to be compounded
e. when the WDT can be established by the prescribing vet
f. none of the options

Answer 24

When the pharmacy is producing the compounded formulations at a commercial scale

Question 25

Regarding controlled substances, please indicate which of the statements below is INACCURATE: a. all drugs used in vet practice are considered controlled substances under the controlled substances act (CSA) b. the DEA is the federal agency that supervised the use and distribution of controlled substances c. controlled substances are divided into 5 schedules d. substances are placed in their respective schedules based on whether they have a currently accepted medical use in tx in the US, their relative abuse potential, and the likelihood of causing dependence when abused e. in order to use and dispense controlled substances, you do not need to be registered with the DEA f. none of the options are correct

Answer 25

All drugs used in vet practice are considered controlled substances under the Controlled Substances Act (CSA).

Question 26

How many days would you need to wait until the plasma drug concentration of a drug w/a t1/2 of 30d has reached steady-state following the repeated oral administration to a dog tx 1x/day. a. 3 days b. 60d c. 150d d. 15d e. 30d f. none of the above

Answer 26

150 days 5 T1/2 = 5x30d = 150d

Question 27

A long-time client, who always follows directions, calls your practice to tell you they adopted a senior, obese dog from the humane society. In your phone convo, the client asks you to prescribe carprofen because the client noticed the dog has moderate joint pain and suspects osteoarthritis. You agree that this dog could has OA and the dog may benefit from carprofen and weight loss. Indicate which of the statements below reflects correct approach to this situation: a. you prescribe carprofen for this patient b. you ask your client to bring the dog into the clinic for medical evaluation of the problem c. you tell your client that he can use the carprofen left from another perscription d. you recommend your client set up a zoom meeting to further discuss e. you ask your client to bring the dog to the clinic for medical evaluation of the problem, but in the meantime, you recommend your client to get some over the counter NSAIDs for tx

Answer 27

You ask your client to bring the dog into the clinic for medical evaluation of the problem.

Question 28

Which of the drugs (or group of drugs) listed below is not included in the list of drugs prohibited to use off the label in food animals? a. chloramphenicol b. clenbuterol c. furosemide d. phenylbutazone e. diethylstilbestrol f. glycopeptides g. cephalosporins

Answer 28

Furosemide

Question 29

T/F The FDA is responsible for the safety and efficacy of FDA-approved drugs used in extra-label manner.

Answer 29

False

Question 30

Therapeutic drug monitoring is highly likely to be indicated for drugs associated with all the statements below EXCEPT: a. drugs w/non-linear pharmacokinetics that may lead to rapid accumulation of drugs to toxic concentrations b. drugs assoc w/serious toxicity c. drugs w/a steep dose-response curve d. drugs w/a wide therapeutic range e. drugs w/a poorly defined or difficult detect clinical endpoint

Answer 30

Drugs with a wide therapeutic range

Question 31

Regarding TDM, please indicate which of the statements below is INCORRECT: a. the type of sample and the # of samples collected depend on the goal of monitoring and the amount of drug that is eliminated during a dosing interval b. for drugs w/a long T1/2 life relative to dosing interval, a single sample collected at any time is sufficient c. TDM is a tool to monitor plasma drug once, and it can be applied to MOST DRUGS used in vet med practice d. for drugs w/a short T1/2 life compared to dosing interval, a sample at the peak once is preferred if safety is a concern e. none

Answer 31

TDM is a tool to monitor plasma drug once, and it can be applied to MOST DRUGS used in vet med practice

Question 32

Which of the following statements about drug-drug interactions (DDI) is INCORRECT: a. induction of drug metabolism does not occur after a single administration, however, it may occur over time (2-3w) w/repeated administration of the induced b. induction of drug metabolism can result in a faster synthesis of a toxic metabolite c. induction of metabolism can result in a decrease in drug efficacy d. some DDI could result in beneficial pharmacological effects e. none

Answer 32

induction of metabolism can result in a decreased in drug efficacy actually result in an increase in drug efficacy

Question 33

Which of the following factors is relevant concerning the incidence and significance of drug-drug interactions: a. order of drug admin b. individual patient factors c. relative doses of the interacting drugs d. type of drug and condition being treated e. duration of tx f. all statements listed

Answer 33

All statements listed

Question 34

Furosemide is indicated for treating all these conditions EXCEPT: a. tx of edema due to cardia/hepatic causes b. increasing urine output in renal failure c. tx of edema due to renal causes d. increasing urine output in anuric patients e. exercise-induced pulmonary hemorrhage in horse f. none of the statements listed

Answer 34

Increasing urine output in anuric patients

Question 35

Which of the drugs listed below can exacerbate cranial hemorrhages: a. acetazolamide b. mannitol c. amiloride d. spironolactone e. chlorothiazide f. none

Answer 35

mannitol

Question 36

Indicate which drug could help to tx hypoglycemia a. acetazolamide b. furosemide c. amiloride d. spironolactone e. chlorothiazide f. none of the options

Answer 36

None of the options (is this correct?)

Question 37

Which of the diuretics listed below was shown to control nephrogenic diabetes insipidus? a. acetazolamide b. furosemide c. amiloride d. spironolactone e. chlorothiazide f. none of the options

Answer 37

Chlorothiazide

Question 38

Erythrocyte stimulating agents are indicated in which of the following situations: a. cat with polycythemia b. cat with hypotension c. cat w/a PCV of 10% d. cat w/a PCV of 35% e. none

Answer 38

Cat with a PCV of 10%

Question 39

Calcitriol is indicated for treating which of the following: a. tx of edema due to cardia/hepatic causes b. hypocalcemia c. hyperkalemia d. tx of renal anemia e. none of the options

Answer 39

Hypocalcemia

Question 40

Indicate which of the following drugs is an antitussive approved by the FDA for treating cough in dogs: a. tramadol b. codeine c. dextromethorphan d. butorphanol e. naloxone f. none

Answer 40

Butorphanol

Question 41

Indicate which of the following adverse effects is LESS LIKELY to be caused by the administration of opioids at antitussive doses in dogs: a. sedation b. diarrhea c. resp depression d. none

Answer 41

Diarrhea actually causes constipation

Question 42

All of the following statements regarding of treatment of reactive airway disease are true EXCEPT: a. human pharmaceutical products indicated for asthma that are formulated as inhalers can be used in dogs, cats, horses because space devices have developed for these species b. inhaled corticosteroids eliminate all risks of side effects c. theophylline is an effective bronchodilator but its use in vet patients has waned b/c of the risk of adverse effects d. corticosteroids (inhaled/systemic) are the most effective tx for reactive airway dz in vet species e. none of the options above

Answer 42

Inhaled corticosteroids eliminate all risks of side effects

Question 43

All of the following statements regarding bronchodilators are true EXCEPT: a. dextromethorphan has poor oral bioavailability in dogs and a very short T1/2 such that currently available formulation of dextromethorphan are not useful b. bronchodilators are used to tx reactive airway dz c. cromolyn has no bronchodilator effect d. Beta-2 receptor agnostics activates the protein G, resulting in activation of protein kinase A e. none of the above

Answer 43

Beta-2 receptor agonists activates the protein G, resulting in activation of protein kinase A

Question 44

Adrenergic agonist drugs (w/alpha and beta 1 and 2 agonistic activity) used as bronchodilators are expect to cause the following adverse effects EXCEPT: a. hypertension and tachycardia b. hypotension and bradycardia c. muscle tremors d. dec of pharmacological effect due to tolerance e. none of the above

Answer 44

Hypotension and bradycardia

Question 45

Anticholinergic drugs used as bronchodilators are assoc w/the following adverse effects except: a. bradycardia b. GI (ileus/constipation/dry mouth) c. CNS-excitation followed by depression/coma d. dec mucociliary clearnce e. none of the options

Answer 45

Bradycardia

Question 46

Which of the following corticosteroids is likely to be less effective/ineffective when administered orally to cats and horses: a. dexamethasone b. prednisone c. prednisolone d. none

Answer 46

Prednisone

Question 47

List a drug that may increase the nephrotoxic potential of furosemide.

Answer 47

NSAIDs - i.e. carprofen in dogs

Question 48

In order to establish an extended withdrawal time for a dug used in an off-label manner in a food animal, what is the best resource for you, the vet?

Answer 48

FARAD

Question 49

List 5 characteristics of drugs to be used in patients w/renal impairment

Answer 49

1. large therapeutic index 2. not nephrotoxic 3. low renal clearance 4. effective w/altered tissue fxn 5. effective w/dehydration/low BP

Question 50

List 2 samples of antimuscarinic drugs other than atropine

Answer 50

Glycopyrrolate Ipratropium bromide

Question 51

List three examples of corticosteroids used in vet med

Answer 51

Prednisone Prednisolone Dexamethasone

Question 52

List 3 beta-2 adrenergic receipt agonists used as bronchodilators

Answer 52

1. clenbuterol 2. epinephrine 3. albuterol also: terbutaline, isoproteranol, metaproterenol, salmeterol