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Flashcards in Chapter 4 - Key Terms & Outline Deck (88):
1

Target organ and response of the Alpha-1 receptor

Target organ & its response:
1. Arterioles - Constriction
2. Urethra - Increased tone
3. Eye - Dilation of pupil

2

Target organ and response of the Alpha-2 receptor

Target organ & its response:
1. Skeletal muscle - Constriction

3

Target organ and response of the Beta-1 receptor

Target organ & its response:
1. Heart - Increased rate, conduction, and contractility
2. Kidneys - Renin release

4

Target organ and response of the Beta-2 receptor

Target organ & its response:
1. Skeletal blood vessels - Dilation
2. Bronchioles - Dilation

5

Target organ and response of the Dopaminergic receptor

Target organ & its response:
1. Kidneys - Dilation of blood vessels
2. Heart - Dilation of coronary vessels
3. Mesenteric blood vessels - Dilation

6

Define adrenergic

An action or a receptor that is activated by epinephrine or norepinephrine (sympathetic nervous system = fight-or-flight response)

7

Define anticholinergic

Blocking nerve impulse transmission through the parasympathetic nervous system; also called parasympatholytic.
Anticholinergic drugs may be used for the treatment of diarrhea or vomiting.

8

Define acetylcholine

A neurotransmitter that allows a nerve impulse to cross the synaptic junction (gap) between two nerve fibers or between a nerve fiber and an organ (e.g. muscle, gland).

9

Define acetylcholinesterase

An enzyme that brings about the breakdown of acetylcholine in the synaptic gap.

10

Define analgesia

The absence of the sensation of pain.

11

Define anesthesia

The loss of all sensation. May be described as local (affecting a small area), regional, or surgical (accompanied by unconsciousness).

12

Define autonomic nervous system

That portion of the nervous system that controls involuntary activities.

13

Define catalepsy

A state of involuntary muscle rigidity that is accompanied by immobility, amnesia, and variable amounts of analgesia. Some reflexes may be preserved.

14

Define catecholamine

The class of neurotransmitters that includes dopamine, epinephrine, and norepinephrine. When given therapeutically, catecholamines mimic the effects of stimulating the sympathetic nervous system.

15

Define cholinergic

Activated by or transmitted through acetylcholine; also called parasympathomimetic. Cholinergic drugs increase activity in the GI tract.

16

Define effector

A gland, organ, or tissue that responds to nerve stimulation with a specific action.

17

Define ganglionic synapse

The site of the synapse between neuron one and neuron two of the autonomic nervous system.

18

Define muscarinic receptors

Receptors activated by acetylcholine and muscarine that are found in glands, the heart, and smooth muscle.
An acronym for remembering muscarinic effects is SLUD:
S = Salivation
L = Lacrimation
U = Urination
D = Defecation

19

Define nicotinic receptors

Receptors activated by acetylcholine and nicotine found at the neuromuscular junction of the skeletal muscle and at the ganglionic synapses.

20

Define parasympathetic nervous system

That portion of the autonomic nervous system that arises from the cranio-sacral portion of the spinal cord, is mediated by the neurotransmitter acetylcholine, and is concerned primarily with conserving and restoring a steady state in the body.

21

Define parasympathomimetic

A drug that mimics the effects of stimulating the parasympathetic nervous system.

22

Define sympathetic nervous system

That portion of the autonomic nervous system that arises from the thoracolumbar spinal cord, is mediated by catecholamines, and is concerned with the fight-or-flight response.

23

Define sympathomimetic

A drug that mimics the effects of stimulating the sympathetic nervous system.

24

Clinical uses of cholinergics

- Aid in diagnosis of myasthenia gravis (neuromuscular disorder)
- Reduce intraocular pressure of glaucoma
- Stimulate GI motility
- Treat urinary retention
- Control vomiting
- Act as an antidote for neuromuscular blockers

25

Direct-acting cholinergics

- Acetylcholine
- Carbamylcholine (GI tract atony & uterine contraction stimulation in swine)
- Bethanechol (GI & urinary tract atony)
- Pilocarpine (reduce intraocular pressure from glaucoma)
- Metoclopramide (control vomiting; promote gastric tract emptying)

26

Indirect-acting cholinergics

- Edrophonium (diagnose myasthenia gravis)
- Neostigmine (treat urine retention; GI atony; antidote to neuromuscular blocking agents)
- Physostigmine (treat urine retention; GI atony; antidote to neuromuscular blocking agents)
- Organophosphate compounds (insecticide dips)
- Demecarium (preventative mgmt of glaucoma)
- Pyridostigmine (treat myasthenia gravis)

27

Adverse side effects of cholinergic agents

- Bradycardia
- Hypotension
- Heart block
- Lacrimation
- Diarrhea
- Vomiting
- Increased intestinal activity
- Intestinal rupture
- Increased bronchial secretions

28

Clinical uses of anticholinergics

- Treat diarrhea and vomiting via a decrease in GI motility
- Drying of secretions and prevention of bradycardia before anesthesia
- Dilation of pupils for ophthalmic examination
- Relief of ciliary spasm of the eye
- Treatment of sinus bradycardia

29

Anticholinergic drugs

*Atropine
*Methscopolamine
*Glycopyrrolate
*Aminopentamide
*Propantheline
*Pralidoxime

30

Adverse side effects of anticholinergic agents

- Drowsiness
- Disorientation
- Tachycardia
- Photophobia
- Constipation
- Anxiety
- Burning at the injection site

31

Clinical uses of adrenergics

- Stimulate heart to beat during cardiac arrest
- Reverse hypotension and bronchoconstriction of anaphylactic shock
- Strengthen heart during congestive heart failure
- Correct hypotension through vasoconstriction
- Reduce capillary bleeding through vasoconstriction
- Treat urinary incontinence
- Reduce MM congestion in allergic conditions
- Prolong effects of local anesthetic agents
- Treat glaucoma

32

Adrenergic drugs

*Epinephrine (increases HR & CO; constricts skin blood vessels; dilates muscle blood vessels; dilates bronchioles; increases metabolic rate)
*Norepinephrine (vasopressor = raise BP)
*Isoproterenol (bronchodilation)
*Phenylephrine (nasal vasoconstrictor)
*Dopamine (treats shock and CHF; increases renal perfusion)
*Phenylpropanolamine (treats urinary incontinence in dogs)
*Dobutamine (short-term treatment of heart failure)
*Albuterol (bronchodilation)

33

Adverse side effects of adrenergic agents

- Tachycardia
- Hypertension
- Nervousness
- Cardiac arrhythmias
(Hypertension, arrythmia, and pulmonary edema may occur with an overdose)

34

Clinical uses of alpha blockers (adrenergic blocking agents) and drugs

Limited use in veterinary medicine!
*Phenoxybenzamine (hypotensive vasodilator; treatment of laminitis in horses; urethral obstruction in cats)
*Aacepromazine (tranquilizer causes vasodilation)
*Prazosin (hypotensive agent)
*Yohimbine (antidote for xylazine toxicity; xylazine antagonist)
*Atipamezole (reversal agent for dexmedetomidine)

35

Adverse side effects of alpha blockers

- Hypotension
- Tachycardia
- Muscle tremors
- Seizures

36

Clinical uses of beta blockers (adrenergic blocking agents) and drugs

Used to treat glaucoma, arrhythmias, and hypertrophic cardiomyopathy!
*Propanolol (treat cardiac arrhythmias and hypertrophic cardiomyopathy)
*Timolol (treat glaucoma)
*Atenolol (treat cardiac arrhythmias and hypertrophic cardiomyopathy)
*Carteolol (antiglaucoma medication)
*Levobunolol (antiglaucoma medication)
*Metipranolol (antiglaucoma medication)

37

Adverse side effects of beta blockers

- Bradycardia
- Hypotension
- Worsening of heart failure
- Bronchoconstriction
- Heart block
- Syncope

38

Tranquilizers

Phenothiazine Derivatives (vomiting, mild pruritus, sedation/tranquilization)
Benzodiazepine Derivatives (sedation, anxiety and behavioral disorder relief, seizures, appetite stimulation)
Xylazine Hydrochloride (sedation, analgesia, short-term anesthesia - combined w/other agts, induce vomiting)
Detomidine Hydrochloride (sedation & analgesia in horses)
Medetomidine (easing PE, minor surgery, minor dentals not requiring intubation)
Dexmedetomidine (sedative, preanesthetic, analgesic in dogs & cats, anesthetic when combined w/other agts such as opioids and ketamine = "kitty magic")
Romifidine (sedative to ease PE,Tx and preanesthetic)

39

Use of barbiturates in veterinary medicine

Barbiturates are CNS depressants and are used as:
*Sedatives
*Anticonvulsants
*General anesthetics
*Euthanasia agents

40

Barbiturates

Long-acting (oxybarbiturates, 8 - 12 hrs)
Short-acting (oxybarbiturates, 45 min - 1.5 hrs)
Ultrashort-acting (thiobarbiturates, 5 - 30 min)

41

Adverse side effects of barbiturates

- CNS depression
- Paradoxical CNS excitement
- Severe respiratory depression
- CV depression
- Tissue irritation

42

Clinical uses for dissociative agents

- Sedation
- Restraint
- Analgesia
- Anesthesia

43

Dissociative agents

*Ketamine HCl (Class III controlled substance; anesthetic; analgesic)
*Tiletamine HCl (Class III controlled substance; anesthetic; analgesic)

44

Adverse side effects of dissociative agents

- Spastic jerking movement
- Convulsions
- Respiratory depression
- Burning at the IM injection site
- Drying of the cornea

45

Clinical uses for opioid agonists

- Analgesia
- Sedation
- Restraint
- Anesthesia
- Treatment of coughing
- Treatment of diarrhea

46

Opioid agonists

Naturally occuring:
- Opium
- Morphine sulfate (Class II)
Synthetic opioids:
- Meperidine (Demerol)
- Oxymorphone (Numorphan and Opana)
- Butorphanol tartrate (Torbutrol and Torbugesic - Class IV)
- Fentanyl (Recuvrya, Sublimaze and Duragesic - Class II)
- Hydrocodone bitartrate (Hycodan and Tussigon - Class III)
- Etorphine (M-99; zoo & exotics only; Class II)
- Pentazocine (Talwin - Class IV)
- Diphenoxylate (Lomotil - Class V)
- Apomorphine (Apokyn)
- Methadone (Dolophine - Class II)
- Codeine (Class II when used alone; Class III or V when used in combo)
- Carfentanil (Wildnil - Class II)

47

Adverse side effects of opioid agonists

- Respiratory depression (profound in an overdose)
- Excitement (cats & horses)
- Nausea
- Vomiting
- Diarrhea
- Defecation
- Panting
- Convulsions

48

Clinical uses for opioid antagonists

Antagonize effects of opioid agents

49

Opioid antagonists

- Naloxone (naloxone HCl injection, Narcan)
- Nalorphine (Nalline)
- Butorphanol-mu antagonist

50

Adverse side effects of opioid antagonists

- Naloxone: few side effects if correct dose is given
- Nalorphine: respiratory depression
- Butorphanol-mu: rarely used as an antagonist

51

Clinical uses for neuroleptanalgesics

- Sedation
- Restraint
- Anesthesia

52

Neuroleptanalgesics

- Fentanyl and droperidol (Innovar-Vet no longer available; similar compounded product can be formulated)
- Acepromazine and morphine
- Acepromazine and oxymorphone
- Xylazine and butorphanol

53

Adverse side effects of neuroleptanalgesics

- Panting
- Flatulence
- Personality changes
- Increased sound sensitivity
- Bradycardia
Overdose risks:
- Severe CNS, respiratory and cardiovascular system depression

54

Seizure prevention or control drugs

- Diazepam (Valium)
- Pentobarbital (Nembutal and other generics)
- Phenobarbital (Luminal, Solfoton and other generics - Class IV)
- Primidone (Mysoline, Neurosyn)
- Phenytoin sodium (Dilantin)
- Bromide
- Clorazepate (Tranxene-SD)
- Felbamate (Felbatol)
- Gabapentin (Neurontin)
- Levetiracetam (Keppra)
- Zonisamide (Zonegran)

55

Adverse side effects of seizure drugs

- Drowsiness
- CNS depression
- Anxiety
- Agitation
- Polyuria
- Polydipsia
- Hepatotoxicity (phenobarbital and primidone)
!!! RESERPINE & PHENOTHIAZINE should NOT be given to epileptic animals !!!

56

Clinical uses for inhalant anesthetics

Induce and maintain general anesthesia

57

Inhalant anesthetics

- Isoflurane (Forane, IsoFlo, Isothesia)
- Sevoflurane (Ultane, SevoFlo)
- Halothane (Fluothane)
- Methoxyflurane (Metofane)
- Nitrous oxide (must ALWAYS be given with oxygen to prevent hypoxia)

58

Adverse side effects of inhalant anesthetics

- Cardiac dysrhythmias
- Halothane hepatitis
- Renal toxicity (i.e. with Methoxyflurane)
- Distention of intestines and other gas-filled areas (i.e. with nitrous oxide)

59

Clinical uses of propofol

- Anesthetic induction:
* before administration of an inhalant anesthetic
* for outpatient procedures
* substitute for barbiturates in sighthounds
* for patients w/pre-existing cardiac arrythmia
- Anesthetic agent for dogs undergoing c-section (does NOT cross placental barrier)

60

Propofol drugs

- Rapinovet
- Propoflo
- Diprivan
- PropoFlo-28
- PropoClear

61

Adverse side effects of propofol

- Apnea
- Seizurelike signs
- Prolonged recovery and Heinz body production may be seen in cats w/repeated use

62

Clinical use of Glyceryl Guaiacolate or Guaifenesin (Guailaxin, Gecolate)

- Induction or prolongation of GA in large animals
- Occasional use as an expectorant

63

Glyceryl Guaiacolate or Guaifenesin (Guailaxin, Gecolate) drugs

- Guaifenesin Injection
- GuaifenJect

64

Adverse side effects of Glyceryl Guaiacolate or Guaifenesin (Guailaxin, Gecolate)

- Limited side effects
- Hemolysis when solution is greater than 5%

65

Clinical uses of CNS stimulants

- Stimulate respiration in newborns
- Use during or after anesthesia

66

CNS stimulant drugs

- Doxapram (Dopram-V or Dopram):
* 1-2 drops placed under tongue or injected into umbilical vein of newborn may be enough to stimulate respirations
- Pentylenetetrazol (Metrazol - limited use in VM)
- Caffeine
- Amphetamines (limited use in VM)

67

Adverse side effects of CNS stimulants

Rare and usually associated w/overdoses:
- Hypertension
- Seizures
- Hyperventilation

68

Clinical uses for neuromuscular blocking drugs

- Adjunct to GA (e.g. ophthalmic or orthopedic surgery)
- Facilitate endotracheal intubation

69

Neuromuscular blocking drugs

DEPOLARIZING:
- Succinylcholine chloride (Anectine)
- Decamethonium (Syncurine)
NONDEPOLARIZING:
- d-Tubocurarine chloride (Curare)
- Gallamine (Flaxedil)
- Pancuronium bromide (Pavulon)
- Vecuronium bromide (Norcuron)
- Atracurium (Tracrium)

70

Clinical uses of Antianxiety medications (Benzodiazepines)

- Tx of fears and phobias
- Separation anxiety
- Aggression
- Anxiety-induced stereotypes
- Urine marking in cats
- Appetite stimulation

71

Antianxiety drugs (Benzodiazepines)

BENZODIAZEPINES:
- Diazepam (Valium)
- Alprazolam (Xanax)
- Lorazepam (Ativan)

72

Adverse side effects of Benzodiazepines

- Lethargy
- Ataxia
- Polyuria and polydipisa (PUPD)
- Hyperexcitability
- Hepatic necrosis (cats)

73

Clinical uses of Antianxiety medications (Azapirones)

- Control of urine spraying/marking
- Control of fearfulness and anxiety

74

Antianxiety drugs (Azapirones)

AZAPIRONES:
- Buspirone (Buspar)

75

Adverse side effects of Azapirones

- Few serious side effects

76

Clinical uses of Antidepressants (Tricyclics)

- Tx of separation anxiety
- Obsessive disorders (e.g. lick granuloma, tail chasing)
- Fearful aggression
- Hyperactivity
- Hypervocalization
- Urine marking

77

Antidepressants (Tricyclics)

- Amitriptyline (Elavil, generics)
- Imipramine (Tofranil)
- Clomipramine (Anafranil, Clomicalm)

78

Adverse side effects of antidepressants (tricyclics)

- Sedation
- Tachycardia
- Heart block
- Mydriasis
- Dry mouth
- Reduced tear production
- Urine retention
- Constipation

79

Clinical uses of Antidepressants (Monoamine Oxidase-B Inhibitors)

- Tx of old dog dementia
- Tx of canine cushing's disease

80

Antidepressants (Monoamine Oxidase-B Inhibitors)

- Selegiline (Eldepryl, Zelapar, Anipryl)

81

Adverse side effects of antidepressants (Monoamine Oxidase-B Inhibitors)

- Vomiting
- Diarrhea
- Anorexia
- Restlessness
- Lethargy
- Salivation
- Shaking
- Deafness

82

Clinical uses of Antidepressants (Synthetic progestins)

- Tx of urine spraying/marking
- Intermale aggression
- Dominance aggression

83

Antidepressants (Synthetic progestins)

- Megestrol acetate (Megace, Ovaban)
- Medroxyprogesterone (Depo-Provera)

84

Adverse side effects of antidepressants (Synthetic progestins)

- Transient diabetes mellitus (cats)
- PUPD
- Increased weight gain
- Personality changes
- Endometritis
- Endometrial hyperplasia
- Mammary hypertrophy
- Mammary tumor
- Adrenal atrophy
- Lactation

85

Misc. Behavioral Agents

* Gabapentin - anxiety or social phobias
* Clorazepate (Tranxene-SD - Class IV) - anxiety or social phobias
* Methylphenidate (Ritalin - Class II) - hyperactivity in dogs

86

Clinical uses of euthanasia agents

- produce a rapid and humane death

87

Euthanasia agent drugs

- Pentobarbital sodium (Sleepaway, Socumb-6GR, FatalPlus, pentobarbital generic - Class II, IV use only)
- Pentobarbital sodium containing rhodamine B, a bluish-red dye (Beuthanasia-D, Euthasol, SomnaSol - Class III, IV use only)
-

88

Adverse side effects of euthanasia agents

- Muscle twitching
- Delayed death if drug is injected outside the vein