Davis Lectures

Question 1

3 important products of the Cox I pathway?

Answer 1

Thromboxane A2
PGE2
PGI2

Question 2

How can you avoid adverse reactions with NSAIDs?

Answer 2

Dr. P

know your Drug, the Risk factors, and your Patient

Question 3

Most common adverse event seen with NSAID use? Cause?

Answer 3

Gastrointestinal problems

Cause: overdosing

Question 4

Which side effect of NSAIDs can be avoided by making sure the animal has free access to water?

Answer 4

Kidney problems

Question 5

Why is acetaminophen different from traditional NSAIDs?

Answer 5

It doesn’t inhibit Cox I or Cox II; it acts UPSTREAM and inhibits their precursors

Question 6

The use of which NSAID is contraindicated in cats?

Answer 6

Acetaminophen

Question 7

Excluding Acetaminophen, name 3 non-preferential NSAIDs

Answer 7

Aspirin
Fluixin meglumine
Phenylbutazone

Question 8

Name 2 Cox-II preferential NSAIDs

Answer 8

Carprofen

Meloxicam

Question 9

Name the 3 Cox II selective NSAIDs

Answer 9

Deracoxib
Firocoxib
Robenacoxib

Question 10

Though aspirin is an NSAID, what is its primary indication?

Answer 10

antithrombotic properties (inhibits platelet activity)

Question 11

Which non-preferential NSAID is primarily indicated for equine use?

Answer 11

Fluixin meglumine

Question 12

Which NSAID cannot be given as IM injection and why?

Answer 12

Fluixin meglumine;

will cause clostridial myositis

Question 13

Which NSAID, commonly used to treat musculoskeletal pain in horses and cattle, is toxic to cats?

Answer 13

Phenylbutazone

Question 14

If phenybutazone is given outside the vein, what can happen?

Answer 14

necrosis of tissue

Question 15

A Cox I: Cox 2 ratio that’s >1 indicates what?

Answer 15

The drug will preferentially bind Cox II compared to Cox I

Question 16

Which Cox-II preferential drugs was the first to be approved for animal use?

Answer 16

Carprofen

Question 17

Which Cox-II pref drug is popular among zoo, wildlife, and exotic animals?

Answer 17

Meloxicam

Question 18

Which NSAID puts cats at risk for renal failure and thus should only be given as a single dose?

Answer 18

Meloxicam

Question 19

Which Cox-II selective NSAID was first approved for use in dogs?

Answer 19

Deracoxib

Question 20

Which Cox-II selective NSAID is associated with ELDU? How?

Answer 20

Firocoxib

People using the chews to treat horses when the chews are for dogs

Question 21

Which Cox-II selective NSAID is specifically approved for use in cats?

Answer 21

Robenacoxib

Question 22

Which area of the body has the highest concentration of mast cells?

Answer 22

Skin

Question 23

Major “shock organ” of cats, cows, sheep, and humans

Answer 23

Lungs (bronchoconstriction)

Question 24

Name 4 important locations of histamine receptors?

Answer 24

Pre-capillary arterioles
post-capillary arterioles
cardiac (H2)
smooth muscle

Question 25

Describe an important regulatory function of histamine in the GI tract

Answer 25

stimulates parietal cells to secrete HCl

Question 26

How do physiologic histamine antagonists differ from the drugs we use to antagonize histamine?

Answer 26

Physiologic antagonists just perform functions that are OPPOSITE to histamine, but they do not bind or occupy histamine's receptor

Question 27

Name 2 important differences between 1st and 2nd generation anti-histamines

Answer 27

2nd generation antihistamines - -LESS Lipophilic (don't cross BBB and cause sedation) - -preferentially bind peripheral H1 receptors

Question 28

Name the model 1st and 2nd generation antihistamines

Answer 28

1st--Diphenhydramine | 2nd- Loratadine

Question 29

Which group of drugs should be used with caution in pregnant animals due to risk to the fetus?

Answer 29

Antihistamines

Question 30

Describe the signals involved with appetite regulation?

Answer 30

BG in low-->lateral hypothalamus turns on-->feel hungry-->eat-->BG rises-->ventromedial nucleus of hypothalamus turns on-->stop eating

Question 31

Name the neurotransmitters responsible for 1) Appetite stimulation (4) 2) Decreasing food intake (2)

Answer 31

1) GABA, Dopamine, NE, Ghrelin | 2) Serotonin, Calcitonin

Question 32

Name the 3 areas of the brain capable of stimulating emesis?

Answer 32

Emetic center CRTZ Vestibular apparatus

Question 33

Which receptors are common to all 3 areas that control emesis?

Answer 33

Histamine (H1) Serotonin Acetylcholine

Question 34

Name the PRIMARY receptor in the following locations: 1) CRTZ 2) Vestibular apparatus

Answer 34

1) Dopamine (D2) | 2) Histamine (H1)

Question 35

Apomorphine: MOA and area it functions at?

Answer 35

Dopamine (D2) agonist; works in CRTZ

Question 36

Meclizine: Receptor and location(s) of action?

Answer 36

Histamine H1 antagonist | CRTZ and vestibular apparatus

Question 37

Metoclopramide: Receptor and location(s) of action?

Answer 37

dopamine antagonist | CRTZ

Question 38

Which model anti-emetic drug, when given at high doses, can inhibit receptors in all three areas associated with vomiting? Which receptor?

Answer 38

Metocloproamide; | can target serotonin receptors

Question 39

Which anti-emetic is also an appetite stimulant? MOA?

Answer 39

Cyproheptadine | Serotonin antagonist

Question 40

A serotonin antagonist that can works in all 3 emetic areas (more powerful than Cyproheptadine)

Answer 40

Ondansetron

Question 41

Maropitant: Receptor and location(s) of action?

Answer 41

NK-1 receptor blocker (prevents substance P interaction) | Emetic center and CRTZ

Question 42

Name the receptor interactions associated with metoclopramide?

Answer 42

Antagonizes: Dopamine and Serotonin (5-HT-3) Agonist: Serotonin (5-HT-4)

Question 43

Bismuth subsalicylate: 1) what's it used for 2) MOA

Answer 43

1) anti-diarrheal | 2) anti-secretory by inhibiting prostaglandin production; also protectant

Question 44

How can NSAIDs and steroids lead to ulcer formation in small animals?

Answer 44

NSAIDs decrease prostaglandin synthesis (important for mucous and bicarb secretion) Steroids increase gastric acid formation

Question 45

Which area of the equine stomach is most prone to ulceration?

Answer 45

Non-glandular epithelium

Question 46

Name the product of each of the cell types: 1) parietal cells 2) enterochromaffin cells 3) G cells 4) Chief cells 5) D cells

Answer 46

1) HCl 2) histamine (stimulates HCl) 3) Gastrin 4) pepsinogen 5) somtatostatin (reduces acid secretion)

Question 47

Omeprazole: | MOA? Why does it take so long to be effective?

Answer 47

Proton pump inhibitor; has to populate ALL pumps to be effective

Question 48

Famotidine & Ranitidine: | MOA? Are the effects immediate or delayed?

Answer 48

H2 receptor antagonist; immediate effects (reduction in acid secretion)

Question 49

What is an additional positive outcome of using Ranitidine?

Answer 49

inhibits acetylcholinesterase which increases motility in GI tract (prokinetic)

Question 50

What is an additional positive feature of Famotidine?

Answer 50

It has a long duration of action (once daily dosing)

Question 51

Name 3 drugs important in the "roll" aspect of ulcer treatment

Answer 51

Magnesium Hydroxide Sucralfate Misoprostel

Question 52

Which ulcer drug is especially useful in NSAID-induced gastric ulcers? Special precautions?

Answer 52

Misoprostel don't use around pregnant women

Question 53

Define: Protectant Adsorbent

Answer 53

1) coats the GI epithelium to prevent irritation/erosion | 2) physically binds chemical compounds to prevent their absorption

Question 54

Kaloin & Pectin MOA?

Answer 54

used together; bind bacteria and their products (anti-diarrhea)

Question 55

How do laxatives and cathartic differ?

Answer 55

Laxative--promote elimination of soft-stool Cathartics--promote fluid evacuation (pull fluid into GI tract)

Question 56

Emollient: Model drug? How does it work?

Answer 56

Mineral Oil | coats the surface of the stool/impaction-->lubricated surface= easier passage

Question 57

Simple Bulk: model drug? how does it work?

Answer 57

Psyllium seed | absorbs water and causes impaction to expand-->colonic distention and reflex peristalsis

Question 58

3 different classes of cathartics?

Answer 58

Osmotic irritant enemas

Question 59

Two drugs that represent osmotic cathartics?

Answer 59

Magnesium hydroxide | Lactulose

Question 60

What's an additional benefit of using lactulose?

Answer 60

Acidifies colon contents which attracts ammonia to be expelled (good for PSS)

Question 61

Model drugs for liver protection?

Answer 61

Ursodiol | SAMe

Question 62

Which drug can be used to treat cholestasis?

Answer 62

Ursodiol

Question 63

This drug is a useful supplement in liver disease and can also be used to help treat aceteminophen toxicity in cats

Answer 63

SAMe