DRUGS Flashcards

Question

Atenolol

Answer 1

Beta-blocker, used to slow heart rate

Answer 2

beta-blocker, used to slow heart rate

Answer 3

Calcium channel blocker, used to slow heart rate

Answer 4

used to prevent thromboembolic disease

Answer 5

Loop diuretic, often used in treating CHF.

Answer 6

ACE-inhibitor and does help to decrease blood pressure in some cases by causing vasodilation, but in severe cases of hypertension it can't adequately control blood pressure.

Answer 7

Protein-losing nephropathy; works by preventing the conversion of angiotensin I to angiotensin II, thus reducing aldosterone concentrations and causing diuresis. It's dilatory effects on the efferent arterioles of glomeruli help to palliate protein losing nephropathies. It is often used in conjunction with diuretics.

Answer 8

positive inotrope; a calcium sensitizer that increases cardiac contractility. It is used in cats with DCM.

Answer 9

T4 supplementation, used to treat hypothyroidism

Answer 10

T3 supplementation, used to treat hypothyroidism

Answer 11

Corticosteroids, treating with any agent that is an adulticide may potentially result in embolization, release of antigen, and acute death, making this a controversial choice. Corticosteroids work well in reducing inflammation associated with infection and will help alleviate clinical signs. Treatment: Prednisolone and Heartgard.

Answer 12

Prokinetic and anti-emetic drug. The mechanism for its anti-emetic effects is from antagonism of dopamine at its receptors in the chemo-receptor trigger zone of the brain.

Answer 13

is an anti-emetic. It is a neurokinin-1 inhibitor, which inhibits substance P in the CNS.

Answer 14

is an H2 receptor blocker, reduces gastric acid secretion.

Answer 15

proton pump inhibitor, that reduces gastric acid secretion

Answer 16

treatment for hypertension. It is a calcium channel blocker and works by preventing calcium influx into vascular smooth muscle cells, thereby causing vasodilation; this relaxes the vessels and allows for reduced blood pressure

Answer 17

effective at clearing Giardia and reducing cyst shedding of this zoonotic disease. Care should always be taken with metronidazole in kittens due to potential side effects.

Answer 18

Methocarbamol; Strychnine is found in some snail baits and other poisons

Answer 19

Milbemycin

Answer 20

It causes renal toxicity.

Answer 21

It causes neurotoxicity therefore, it should never be used.

Answer 22

Sterile hemorrhagic cystitis

Answer 23

It can cause heart failure

Answer 24

Neomycin (aminoglycoside), for this reason it is sometimes used orally to alter intestinal flora without systemic absorption.

Answer 25

Atropine; because it thickens bronchial secretions and encourages mucous plugging of the airway

Answer 26

a non-fermentable fiber that increases the transit rate of ingesta, increasing the frequency of defecation

Answer 27

Lime sulfur dip (likely several treatments); the image is a dermatophyte microsporum canis (causes ringworm)

Answer 28

Calcium channel blocker. Slows the heart by inhibiting the influx of calcium into the myocardial cells. Used to treat Supraventricular tachycardias, hypertrophic cardiomyopathy and hypertension.

Answer 29

Bone marrow suppression

Answer 30

Phenylpropanolamine

Answer 31

sulfa containing drugs

Answer 32

Vincristine chemotherapy

Answer 33

Enalapril; is an ACE-inhibitor which blunts the adverse effects of the renin-angiotensin-aldosterone system thereby reducing sodium and fluid retention. Additionally, ACE-inhibitors cause mild vasodilation by preventing the production of angiotensin-II, which reduces ventricular afterload. Lastly, enalapril and other ACE-inhibitors are protective to cardiac muscle by blunting aldosterone and other hormones which induce cardiac remodeling.

Answer 34

Apomorphine; an opioid dopaminergic agonist that acts on the chemoreceptor trigger zone to induce vomiting in dogs. It can be administered IM, SC, IV or in the conjunctival sac.

Answer 35

Bone Marrow Suppression

Answer 36

Atenolol; beta blockers are beneficial in patients with subaortic stenosis because they reduce myocardial oxygen demand, lessen the frequency of ventricular arrhythmias, and provide cardiac muscle protection. May need prophylactic antibiotics for any situation in which the dog may develop bacteremia since subaortic stenosis is known to carry a high risk of developing infective endocarditis.

Answer 37

Anaphylaxis; L-asparaginase is a protein enzyme and therefore may elicit an immune response. Anaphylaxis is rare but usually would occur only after a patient had received a prior dose and developed antibodies to it. Pancreatitis is also associated with it's use

Answer 38

Paralytic ileus

Answer 39

hepatotoxicity

Answer 40

Cardiotoxicity and pancreatitis is also associated with it's use

Answer 41

temporary apnea

Answer 42

Praziquantel

Answer 43

Pacemaker implantation; this is the only way to restore normal heart rate which will require referral to a cardiologist

Answer 44

Mast cell tumors; palladia is a receptor tyrosine kinase inhibitor

Answer 45

Doxapram; is a central nervous stimulant that has effects on respiratory centers. It is thought that it may work by stimulating the reflex activation of carotid and aortic chemoreceptors. When performing a laryngeal exam the goal is to have the patient just deep enough so you can perform the exam. Injectable anesthetics such as thiopental or propofol are often used. Doxapram is to help stimulate respiration to confirm diagnosis.

Answer 46

Doxorubicin

Answer 47

Amitraz; however ivermectin and milbemycin are also used to treat this condition in part because it is difficult to obtain amitraz

Answer 48

Toceranib phosphate (Palladia); inhibitor of a membrane-bound signaling molecule called a receptor tyrosine kinase.

Answer 49

Topical dexamethasone; the goal in treatment of idiopathic uveitis is to reduce inflammation and resultant intraocular damage. Topical steroids are frequently used (prednisolone or dexamethasone, but NOT hydrocortisone). Topical NSAIDS such as flurbiprofen or Voltaren are newer treatment options.

Answer 50

Chloramphenicol

Answer 51

Doxycycline; it can result in delayed bone growth and discoloration of the teeth in young growing animals

Answer 52

Azathioprine; the mainstay of treatment are immunosuppression with corticosteroids and other drugs such as azathioprine or cyclosporine.

Answer 53

Cholinesterse inhibitors; the dog has Myasthenia Gravis, which is caused by antibody-mediated destruction of acetylcholine receptors. Cholinesterase inhibitors decrease the break down of acetylcholine, making more acetylcholine available to bind to the remaining acetylcholine receptors. Myasthnia Gravis can be caused by immune mediated disease (related to hypothyroidism), paraneoplastic syndrome (associated with thymoma), and can be familial in certain breeds (Newfoundland and Great Dane).

Answer 54

Alfoxalaner (Nexguard) is the best choice, this medication contains an adulticide; whereas pyriproxyfen and Lufenuron are only insect growth regulators. Spinosad should never be used with extra-label doses of Ivermectin and is probably why this client discontinued the flea meds in the first place. Permethrin is an excellent flea medication, it is a repellent and an adulticide, but it is toxic to cats. Fibronil is toxic to rabbits.

Answer 55

Non-steroidal anti-inflammatory therapy and strict rest; literature shows that 50% of dogs with clinical signs of intervertebral disc disease will improve with medical management alone. Medical management involves restricted activity and anti-inflammatory therapy. Prednisone, methyl-prednisolone sodium succinate, and non-steroidal anti-inflammatories are commonly used. Prednisone, if used, should be prescribed at an anti-inflammatory dose not immunosuppressive. Dexamethasone sodium phosphate has only been shown to increase the likelihood of side effects and complications such as urinary tract infection and is therefore not recommended.

Answer 56

Immunosuppressive therapy, often starting with prednisone and sometimes including an additional immunosuppressive drug such as azathioprine or cyclophosphamide.

Answer 57

Provide a lidocaine bolus followed by a continuous infusion of lidocaine; this patient is exhibiting premature ventricular contractions which is commonly observed after splenectomy. Any patient that has a splenectomy should be monitored closely for that reason. Most of the time these are not severe enough to require treatment. There are some general guidlines for when to treat VPCs which include excessive pulse deficits, the patient is clinically affected, a heart rate greater than 180bpm, or greater than 20 second stretch of continuous VPCs.

Answer 58

It causes bone marrow suppression resulting in severe thrombocytopenia and neutropenia.

Answer 59

Oxygen, ampicillin, and enrofloxacin; the radiograph represents severe bronchopenumonia. Aggressive broad spectrum antimicrobial therapy with ampicillin and enrofloxacin is the best answer, with supportive care with oxygen as needed. Furosemide and oxygen would be the recommended treatments for a dog with CHF. Sedation and oxygen might be needed for a dog in severe distress from airway obstruction. Corticosteroids would not be an acceptable primary treatment for pneumonia.

Answer 60

No anti-arrhythmic at this time; there are several general guidlines/recommendations regarding treatment of VPCs which is what is shown on the ECG strip. These include if the HR is over 180bpm, pulse deficits, clinical signs and VPCs for over 20 seconds in duration. In this case, the HR is not elevated. The PE are not suggesitve of an immediate problem secondary to the arrhythmia. It is recommende that the patient is evaluated regularly and ideally have a consultation with a cardiologist to ensure the progression of heart disease is being minimized.

Answer 61

Isoproterenol; it is a non-specific beta receptor agonist, and will increase the ventricular rate in response to atrial fibrillation, thus is inappropriate in the mangement of this dysrhythmia. The ECG shows atrial fibrillation. Atenolol is a beta-blocker and will slow AV nodal conduction to decrease the ventricular response rate to atrial fibrillation. Procainamide is a class 1A anti-arrhythmic and can be used in aattempts to convert atrial fibrillation to a normal sinus rhythm, though it is rearely effective. Diltiazem is a calcium channel blocker and can be used to slow AV nodal conduction and ventricular response rate. Digoxin will increase vagal tone to the AV node to slow conduction and decrease the heart rate.

Answer 62

Carpal arthrodesis; arthrodesis is the treatment of choice for severe hyperextension injuries to the carpus. This procedure is accomplished by debridement of the articular cartilage of the joints, implantation of a cancellous autograft into the debrided joint spaces, and fixing a bone plate across the injured joints.

Answer 63

Prolonged antifungal treatment with Fluconazole

Answer 64

Cephalexin for 8 weeks; deep pyodermas involve tissues deeper than the epidermis, including the dermis and even subcutis. The skin may heal on the surface before the deeper infection is resolved; making clinical cure difficult to assess. In general, deep infection can require 6-8 weeks of antibiotic treatment (and even 12 weeks for severe cases) for resolution. Deep pyoderma can be secondary to allergies, skin fold anomalies, endocrine disorders, immune mediated skin diseases, bacterial and/or fungal skin infections, or migrating foreign bodies. Determining the underlying etiology will help with resolution and minimize chances of treatment failure and re-occurrence. Diagnostics should include skin scraping and impressions, culturing for bacteria and fungi, biopsy, and bloodwork. Treatments typically include antimicrobials that have demonstrated effectiveness, antifungals if needed, and frequent topical treatments with chlorhexidine shampoo and removal of the dead tissue and debris. Incidentally, the GSD are predisposed to severe deep pyodermas that can be difficult to treat. Discussing this with your client will help give them realistic expectations for treatment. GSD are at a higher risk of developing dry eye from Trimethoprim-sulfa; therefore, it is not recommended for this condition due to the length of time required to treat a deep pyoderma.

Answer 65

clean the area frequently with benxoyl peroxide shampoo or gel; chin acne is a chronic inflammatory disorder of young short coated animals. It is characterized by folliculitis and furunculosis. Secondary bacterial infections can develop if it becomes more advanced. There has been some association seen after contact with plastic water and food bowls, and switching to a different material may help; however, the evidence is more anecdotal and is extrapolated from studies in humans and cats. The chin and lips should be kept as clean as possible with frequent bathing and antibiotic ointment to prevent plugging of the follicles. Some cases can be simply managed by modifying behaviors that can traumatize the chin (chasing balls) and topical antibiotics. Severe cases will need long courses of systemic antibiotics to resolve the infection and then topical corticosteroids to prevent new lesions. The papules should not be expressed, as this can increase inflammation. Benzoyl peroxide is a good choice for a topical antibiotic since it has follicular flushing action.

Answer 66

Morphine; it should not be used in patients with mast cell tumors for this reason. Butorphanol causes no increase in histamine even though it is also an opioid. Acepromazine actually has some antihistamine effect. Ketamine does not affect histamine levels.

Answer 67

H2 blocker; the cells in the picture are mast cells. They are characterized by a single round nucleus with dark purple staining granules in the cytoplasm. This dog has multiple mast cell tumors that grew rapidly over the course of a week. H1 blockers (diphenhydramine) and H2 blockers (famotidine, cimetidine, ranitidine, etc) are commonly prescribed as supportive care for dogs with gross mast cell disease due to the histamine release by the mast cells. This histamine release causes increased gastric acid secretion, predisposing to gastric ulceration and GI bleeding. Surgical removal is the definitive therpay for mast cell tumors.

Answer 68

Carbonic anhydrase inhibitor; (such as dorzolamide) act by decreasing aqueous production, which is partially dependent on the conversion of carbon dioxide to bicarbonate. It can be used topically or systemically. Latanoprost (Xalatan) is a prostaglandin analog frequently used topically in the treatment of glaucoma. IV mannitol works to decrease IOP through its properties as an osmotic attractant; it is not used topically. Atropine is contraindicated in some glaucoma cases. Tacrolimus is used as a topical immunosuppressant and used most commonly for dry eye.

Answer 69

Anihistamines, corticosteroids, and epinephrine; the dog has angioedema +/- anaphylaxis, likely caused by an insect bite or sting. A snake bit should also be ruled out by trying to visualize the bite or questioning the owners. This is a type I hypersensitivity reaction and is treated by removing the offending agent if possible and providing supportive care with antihistamines, corticosteroids, and epinephrine as needed.

Answer 70

Further diagnostics to search for an underlying systemic disease; adult dogs that develop generalized demodicosis usually have an underlying systemic disease that compromises their immune system and predisposes them to such infections. Often times these dogs may be on long courses of steroids. Keep in mind that although generalized demodicosis starts in puppyhood (3-18 months) if it's not adequately treated the patient can carry the disease into adulthood. So it is not uncommon to make the diagnosis (with no underlying cause) at 2-5 years of age. Euthanasia is premature here since an underlying disease has not been identified yet. Demodex is host-specific and is not considered to be zoonotic. There is no indication to treat with antifungals at this point since a yeast infection has not been identified.

Answer 71

Metronidazole; typically, inflammatory bowel disease is characterized histologically as lymphoplasmacytic inflammation within the GI tract. Treatment is aimed at suppressing the inflammation with glucocorticoid therapy (not NSAIDs), a novel protein diet, and often times metronidazole, which is thought to have some immunomodulatory effects. Fenbendazole and sulfadimethoxine are anti-parasitic medications.

Answer 72

Give a dose of dexamethasone SP that is approximately 5 times the physiologic dose of prednisone before surgery followed by twice the regular dose of prednisone the following day; during times of stress Addisonian patients require additional amounts of glucocorticoids or else they are at risk of going into a crisis. The exact amount of additional glucocorticoid to administer is not known but it is generally accepted that patients should receive 2-10x a physiologic dose of prednisone. The physiologic dose of prednisone is considered by many to be 0.1mg/kg/day but there is some variation depending on the source. Therefore, the best answer is to give a dose of dexamethasone that is approximately 5x the physiologic dose of prednisone followed by twice the regular dose of prednisone the following day.

Answer 73

Cyclosporine eye drops; clinical signs and findings are consistent with a diagnosis of KCS. The key is the reduced Schirmer tear test results. Mucoid discharge is a classic finding as there is immune mediated adenitis of the tear glands and the Pug is unable to produce normal tears. Since the disease is immune mediated, cyclosporine is indicated to reverse this process and stimulate tear production. Another acceptable option would be tacrolimus.

Answer 74

Topical antifungal therapy (i.e. Clotrimazole); topical antifungal therapy is considered more efficacious and less costly than long-term systemic antifungal therapy. Corticosteroids would be contraindicated. Surgery and antibiotics would not be successful in controlling a fungal infection. The currently recognized treatment of choice is clotrimazole, a synthetic imidazole that has an 80% cure rate with single administration. The main potential complication is CNS exposure to the drug if there has been erosion of the cribriform plate.

Answer 75

Cardiac pacemaker implantation; the dog here is described to have 3rd degree AV block, where no impulses are conducted from the atria to the ventricles. The sinus node controls the atrial rate, but the ventricular rate relies on subsidiary pacemakers presented in the His-Purkinje system of the ventricle. Complete or 3rd degree AV block, in the dog most commonly develops due to age-related degeneration/fibrosis of the cardiac conduction system. Medical therapy for 3rd degree AV block involves increasing the heart rate with atropine or isoproterenol; however, success with medical therapy is limited, so pacemaker implantation is the therapy of choice.

Answer 76

Clindamycin; since you are suspicious of methicillin resistance, using cephalosporins such as Convenia or Simplicef would not be useful. Trimethoprim-sulfa will probably be effective however, this antibiotic should be avoided in Dobermans as they are prone to side effects such as anemia, thrombocytopenia, arthritis, and renal toxicity. The side effects are due to a type III hypersensitivity. Chloramphenicol may also be effective agaainst the infection, but clindamycin would be a better choice, as it has fewer side effects. Chloramphenicol can cause peripheral neuropathy, gastrointestinal upset, bone marrow suppression and hepatotoxicity. Additionally, chloramphenicol can also cause aplastic anemia in humans. Clindamycin can cause GI upset, but seems to be better tolerated than chloramphenicol.

Answer 77

Xanthine; allopurinol is used in the treatment of urate stone forming Dalmations. It acts by inhibiting the enzyme, xanthine oxidase, which metabolizes xanthine. The idea is that by stopping the purine metabolism pathway at this point, uric acid will not be formed in high quantities. However, if given at too high of a dose, xanthine will accumulate to levels where xanthine stones will form.

Answer 78

Omega-3 Fatty Acids; consuming high concentration of omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) has been shown to result in the preferential use of these compounds to form eicosanoids. Eicosanoids derive from either omega-3 or omega-6 fatty acids. Omega-6 eicosanoids are generally pro-inflammatory, while omega-3 eicosanoids are less inflammatory. Omega-3 fatty acid supplementation results in a decrease in pro-inflammatory omega-6 eicosanoids; providing potential benefit to patients with osteoarthritis. Carnitine is thought to potentially aid in weight loss as it is involved in fat metabolism, but there are limitied studies demonstrating significant clinical benefit to supplementation at this time. Glucosamine is a precursor of glycosaminoglycans which is a major constituent of the joint and thought to be of great importance for joint helath. Chondroitin is also an important constituent of cartilage and helps provide resistance to compressive force. It is commonly administered in conjunction with glucosamine. The amount of clinical benefit of glucosamine and chondroitin supplementation is not well established.

Answer 79

Tell the owner the dog has a guarded to poor prognosis and may need hemodialysis; 4-MP and ethanol act by preventing alchohol dehydrogenase from converting ethylene glycol to its toxic metabolites. In animals where oliguric renal failure has already begun, most of the ethylene glycol will already have been matabolized, so there is no benefit to giving ethanol or 4-MP. Activated chargoal should only be given if the ethylene glycol was ingested with in two hours

Answer 80

Benign neglect; histiocytomas are typically benign and will often present as a small, raised mass that may or may not be ulcerated. Fortunately, these masses usually regress on their own, and surgical or medical intervention is typically not necessary.

Answer 81

Systemic antibiotics; most of the lesions have a deep bacterial infection so topical antibiotics may not penetrate the area well enough to resolve the infection. Management also includes treating the underlying cause. Many veterinarians will also prescribe topical or intralesional steroids. If no cause is found, then antidepressants or anxiolytics may be started.

Answer 82

daily chlorhexidine rinses; daily usage kills off normal bacterial flora in the mouth and will stain the teeth over time. Daily chlorhexidine use is sometimes advocated as a long-term treatment of severe periodontal disease, but alternative therapies should be recommended if possible. Raw hide chews, daily teeth brushing, and chew toys all help to reduce plaque and calculus when used regularly. Enrofloxacin is not a very good choice for oral infections since it is ineffective against anaerobic bacteria. Beta-lactam antibiotics (especially clavamox) or clindamycin are better choices for oral infections because of their activity against anaerobes.

Answer 83

Atipamezole; medetomidine is an alpha 2 agonist sedative/analgesic often used for premedication to general anesthesia, chemical restraint, and for epidural anesthesia/analgesia. Atipamezole is a potent alpha 2 antagonist that reverses the effects of alpha 2 agonists. Other alpha 2 antagonists include yohimbine and tolazoline.

Answer 84

Remove the bone plate and start antbiotics; implants such as bone plates and screws can often be a nidus for infection. The lucencies around the bone plate and screws suggest instability of the implants, and the draining tract is suggestive of infection. Since the bone is already fully healed, the best treatment for this dog would be to remove the bone plate and screws and start antibiotics.

Answer 85

right forelimb amputation followed by chemotherapy; greyhounds are one of the most predisposed breeds to osteosarcoma. Any geriatric greyhound with lameness should be evaluated promptly for this reason. Unless the patient has a highly suspicious history of living in, or being exposed to areas with high levels of fungal organisms, the radiographic findings are almost confirmatory for osteosarcoma. Regardless of a strong suspcion, core biopsies or needle aspirate of the lesion should be obtained prior to a definitive treatment. The appropriate treatment in dogs without radiographic evidence of metastasis is amputation followed by chemotherapy. Amputation alone will provide an average survival time of 2-6 months, while amputation and chemo will provide 9-12 months. definitive radiation therapy is not possible for these tumors. However, radiation therapy is great when using it as a palliative mode of therapy. The only feature of the blood work which is of note is the ALP. Studies have shown that an elevated ALP is associated with a more aggressive tumor. Aside from informing the owners this potential, it is still recommended to proceed with amputation and chemotherapy. In these situations, some surgeons and oncologists may recommend performing a CT of the chest to evaluate the chest for metastasis more thoroughly prior to proceeding with surgery and chemo.

Answer 86

Piroxicam and carboplatin chemotherapy; transitional cell carcinoma of the bladder in dogs can be palliatively managed with non-steroidal anti-inflammatory drugs such as piroxicam. Progression-free interval and survival can be extended with the addition of chemotherapy. The most commonly used agents are carboplatin, cisplatin, and mitoxantrone. Although, cisplatin is effective against TCC, it has increased nephrotoxicity with piroxicam and is less cmmonly used these days in the author's experience. Secondary infections can be treated with appropriate antibiotics.

Answer 87

Doxorubicin. Cold compress to contain the spread; IV chemo can cause severe tissue necrosis (Doxorubicin) or irritation (vincristine) if extravaasation occurs. Treatment for both should begin immediately. In both cases, the catheter should be left in place and as much of the drug should be aspirated as possible. Treatment for doxorubicin extravasation involves cold compressing the site to promote vasoconstriction, however perivascular necrosis may still occur and may progress days to weeks later. In severe cases involving doxorubicin, debridement or limb amputation may be needed. Vincristine extravasation should be treated with warm compresses to dispense the drug and enhance systemic absorption. Extravasation should be prevented through patient restraint training, use of catheters that have been placed on the first stick, and careful monitoring during administration. The peripheral veins should be avoided for blood draws if possible on all patients receiving chemotherapy.

Answer 88

Decreased gastrointestinal tone and motility; atropine is an anticholinergic, often used during premedication and intraoperatively to increase heart rate. It causes a decrease in tear secretion, salivary secretion and GI tone and motility. Atropine reduces the influence of the vagus nerve on the heart but does not block it completely. Lidocaine is used to treat VPCs.

Answer 89

laryngeal inflammation; following intubation is the most common complication seen with clotrimazole treatment. Seizures are a possible sequela if the cribriform plate is compromised, if this were the case, the complication would likely be fatal. With severe swelling, the administration of corticosteroids and re-intubation is indicated. Sometimes these dogs may need to be intubated for days.

Answer 90

Aspergillosis; clotrimazole is instilled into the frontal sinus and nasal cavity following debridement of the fungal plaques and irrigation with saline. Swabs are placed in the external nares to ensure the clotrimazole stays in place for 10-15 minutes.

Answer 91

bone marrow suppression; this is a hormone and like many other hormones, can result in bone marrow suppression. This is one of the reasons veterinarians choose to use phenylpropanolamine for urinary incontinence. This drug is a weak alpha agonist and works on the muscles of the urethra to increase sphincter tone. KCS is more likely to occur with sulfa containing drugs. Most drugs can cause some sort of diarrhea as a side effect, but rarely will it be hemorrhagic.

Answer 92

Carprofen; is a NSAID and has analgesic properties but may exacerbate the chronic renal disease by causing decreased blood perfusion to the kidneys by vasoconstricting the afferent arteries by diminishing the effects of prostaglandins. Dexmedetomidine and ketamine can each be used as a CRI to provide pain control. Butorphanol is an opioid that has partial agonist and antagonist effects on the mu and kappa receptors. Tramadol is a synthetic opioid. Gabapentin is an anticonvulsant that is often used for its analgesic effects, particularly against neuropathic pain.

Answer 93

Insulin; diabetes mellitus is the most likely diagnosis. The classic 4 signs of DM are PU, PD, Polyphagia and weight loss. The dog in this picture has bilateral cataracts. Diabetic cataracts wil occur in most dogs within 6-12 months of diagnosis of diabetes mellitus despite therapy. Diabetic cataracts DO NOT occur in cats. Thyroxine is for hypothyroidism and methimazole is for hyperthyroidism. A sodium chloride infusion could be indicated for a patient presenting with diabetic ketoacidosis, but based on the history, this appears to be a stable diabetic. Amphogel (aluminium hydroxide) is a phosphate binding agent and is not the best choice for treatment of diabetes mellitus.

Answer 94

Apomorphine is the drug of choice to induce emesis in dogs that have eaten a toxic substance. Apomorphine is a dopamine agonist and may be reveresed with naloxone.

Answer 95

Xylazine; yohimbine for reversal

Answer 96

Doxorubicin; perivascularization of this drug causes a severe irreversible tissue slough that may require amputation. Some other chemotherapy drugs such as vincristine cause a more localized severe reaction if perivascularized. L-Asparaginase can be safely given SQ or IM. Cisplatin can be given intralesionally. Carboplatin is always given IV but if perivascularized, does not cause a severe reaction.

Answer 97

Enrofloxacin causes cartilage abnoramlities in growing puppies; bubble-like changes to articular cartilage can be seen when given to dogs from 2- to 8-months of age. Enamel hypoplasia and teeth staining is caused by tetracycline antibiotics given to young animals. With enrofloxacin, therapeutic levels are reached throughout most of the body except CSF.

Answer 98

Propofol; ketamine causes an increase in HR and BP, it is considered seizureogenic and has poor muscle relaxation effects, however it provides good analgesia. Thiopental is an ultra fast acting thiobarbiturate that causes an increased heart rate, increased blood pressure, and decreased cardiac contractility. It is also an arrhythmogenic agent. Morphine is an opioid that causes bradycardia. Propofol does not result in any significant cardiac changes. It is ultra-short in duration, can cause apnea and myoclonus, and is considered anticonvulsive. It may cause a mild bradycardia but you mainly see that when used in combination with other opiates. More recently propofol has been associated with myocardial depression and hypotension in critically ill dogs and may not be the indiction agent of choice as a result. Despite these findings, propofol still has the least effect on heart rate.

Answer 99

Pericardiocentesis; the radiograph and case are a good example of pericardial effusion with the classic finding of a markedly enlarged heart with a globoid shape. The most common type of effusion by far is hemorrhage which can be idiopathic or from neoplasia such as hemangiosarcoma. Based on this finding, in conjunction with the dog's tachycardia, a pericaardial tap for both diagnostic and therapeutic purooses is indicated. Furosemide is contraindicated in cases of pericardial effusion because it will decreased preload in the right side of the heart and can promote circulatory failure. Melarsomine is the treatment for heartworm. Antibiotics are very unlikely to help this dog unless the effusion is from some sort of infectious pericarditis, which would be extremely unusual in dogs.

Answer 100

Oxytetracycline

Answer 101

Hypotension; it may cause paraphimosis in male horses, but this is not very common. However, because of this many veterinarians will not use Acepromazine in stallions. Acepromazine actually has antiarrhythogenic properties and it does reduce the seizure threshold, but seizures are not as common as hypotension.

Answer 102

Penicillin G IM

Answer 103

Quinidine; it is a class IA sodium channel blocker that has vagolytic properties which prolong the refractory period of the myocardium. This is not a perfect solution, as it does not work in all cases and can be associated with side effects including oral ulcers, hypotension, and allergic reactions. For these reasons, other treatments such as electrical cardioversion and alternative drugs such as flecainide are sometimes tried. When evaluating an ECG strip for atrial fibrillation, look for irregular R-R intervals and the classic fibrillation wave of the base line. Lidocaine is a sodium channel blocker used primarily for ventricular arrhythmias. Furosemide is a loop diuretic used to treat CHF and atropine is an anticholinergic used primarily for supraventricular bradyarrhythmias.

Answer 104

Ivermectin; skin lesions are caused by reaction to the migrating microfilaria of Onchocerca cervicalis. The adult worms live in the ligamentum nuchae. Culicoides midges act as intermediate hosts and transmit microfilaria to sites such as eyes, eyelids, forehead and ventral midline. Ivermectin or moxidectin generally bring about marked improvement within 2-3 weeks. Microfilaria are not killed by the other answer choices provided.

Answer 105

short, low arc stride, landing toe first; bone spavin is osteoarthritis of the distal intertarsal joint and/or the tarsometatarsal joint. Horses with bone spavin tend to have a shortened forward flight of the hoof with decreased hock action and they tend to drag the toe. A gait with the hindleg rigid extension, pulling forward dragging the toe is seen with upward fixation of the patella. Minimal weight bearing and marked foot sensitivity is seen with conditions of the feet such as subsolar abscesses and septic navicular bursitis (also known as "street nail"). A leaning forward stance is seen with navicular disease. Horses with navicular disease also tend to have short strides and place the toe first.

Answer 106

Topical anti-fungals; the horse in the question has dermatophytosis, or ringworm. Horses are most commonly affected with Trichophyton equinum, T mentagrophytes and Microsporum gypseum. M. canis, M. equinum and T. verrucosum are also sometimes the causative agents. The disease typically causes alopecia and crusting around the saddle and girth regions. Diagnosis is made by dermatophyte test media (DTM) or visualization of the fungal elements on KOH preps. Topical azole antigungals are most useful in treating the disease. Systemic antifungals are expensive and have unproven efficiacy. Antibiotics such as penicillin and cephalexin are not effective against fungus. Excison of the lesions is not necessary.

Answer 107

administer oxytocin (IM or IV) and lavage the uterus to facilitate removal; most texts state that the placenta in a mare is retained after greater than 3 hours post-parturition; therefore, this would be considered a retained placenta. Oxytocin, along with uterine lavage, will cause the uterus to contract and facilitate expulsion of the placenta. Strong physical traction on the retained placenta is generally considered contraindicated, as you may tear the placenta and leave remnants of it within the uterus, resulting in possible complications. Broad spectrum antimicrobials are often administered to decrease the incidence of metritis but alone would not be appropriate.

Answer 108

Omeprazole; is a proton pump inhibitor and has been found to be more effective in the equine at reducing gastric acidity and raising gastric pH than the others.

Answer 109

Xylazine; has the lower receptor affinity, duration of action and has the largest dose requirement of the alpha 2 agonists. Although xylazine will provide the shortest duration of action, clinicians are told to be careful when using xyalazine and working with the hind limbs because these horses can have sudden rapid limb movement known as a phantom kick. Sedative effects of xylazine last for about 20 minutes. Sedative effects of detomidine typically last approximately 90 minutes; however, peak sedation is achieved for 10-20 minutes. Romifidine is similar to detomidine; however the side effects are believed to be decreased.

Answer 110

the horse had a positive Coombs test and Coggin's test; in this case, the probable cause of the IMHA is the equine infectious anemia retrovirus. It is known that corticosteroids tend to cause recrudescence of viremia and worsen anemia in infected animals. If a horse is receiving an antibiotic prior to development of IMHA, the drug should be discontinued, because it may be the cause of the anemia due to a drug reaction. In such an instance, a completely different class of antibiotic should be chosen in it's place.

Answer 111

Guaifenesin; the exact mechanism is unknown, however, we do know that guaifenesin acts centrally by blocking nerve impulse transmission at the internuncial neuron level in the subcortical brain, brain stem, and spinal cord. Veterinarians should be careful not to give too much guaifenesin because early signs of toxicity are in the form of increased rigidity. So vets tend to give more guaifenesin, causing respiratory and cardiac arrest. Ketamine is a dissociative agent and is known for its ability to cause hypertonia. Atracurium is a non-depolarizing neuromuscular blocking agent that acts by competitively binding to cholinergic receptors at the motor endplate. Succinylcholine is a depolarizing neuromuscular blocking agent.

Answer 112

Rest and NSAIDs; splints or intraosseous desmitis is inflammation of the intraosseous ligament between the 3rd metacarpal (or metatarsal) bone with the small metacarpal (or metatarsal) bones. Periostitis occurs with new bone formation along the splint bones or small metacarpals (or metatarsals) usually due to repetitive concussion, excessive training, poor conformation, or improper shoeing. Radiographs are necessary to distinguish this condition from fractures of the splint bones.

Answer 113

Furosemide; the discharge is blood with the most likely diagnosis being exercise-induced pulmonary hemorrhage (EIPH). One of the most commonly administered medications for EIPH is furosemide, which seems to decrease the incidence or lessen the severity of bleeding. The exact mechanism by which this occurs is not completely known but may be associated with reduced pulmonary capillary pressure.

Answer 114

Pergolide; dopamine agonist that is used to treat Parkinson's disease in humans. The drug acts to suppress pituitary hormone secretion.

Answer 115

Ponazuril; EPM can be tricky to diagnose because the clinical signs can be quite variable, but the key findings are the "3 A's" - Asymmetry, Ataxia and Atrophy. The onset of signs are frequently gradual but rapid progression is seen in some cases. Differential diagnosis can include cervical vertebral malformation, equine degenerative myeloencephalopathy, equine herpes myeloencephalitis, polyneuritis equi, and verminous myeloencephalitis. However, the asymmetric and multifocal signs as well as the horse's age and gradual onset of signs make EPM most likely. Treatment options include: Ponazuril (Marquis) antiprotozoal past Diclazuril (Protazil) antiprotozoal pellets Nitazoxanide (Navigator) antiprotozoal paste Sulfadiazine-pyrimethamine combination

Answer 116

Aminocaproic acid; this medication is believed to facilitate clot stabilization by blocking the activation of plasminogen to plasmin. Plasmin is the active enzyme that dissolves clots; therefore, aminocapric acid inhibits fibrinolysis.

Answer 117

Enrofloxacin; is a fluoroquinolone and thus, its mechansim of action involves the inhibition of DNA gyrase. The reason you don't want to use it in foals is because it can result in arthrotoxicity and subsequent erosion of cartilage. Ampicillin, gentamicin, and amikacin are commonly used to provide broad-spectrum coverage against potential septicemia. Ampicillin is a penicillin; gentamicin and amikacin are both aminoglycosides. Cefazolin is a first-generation cephalosporin that is occasionally used in the face of septicemia if a penicillin is not available.

Answer 118

Phenoxybenzamine; this is an alpha-adrenergic antagonist promoting vasodilation and restoration of blood flow to the digits. Prednisone is contraindicated in laminitis because corticosteroids are believed to induce the condition. Antibiotics are not indicated unless a secondary bacterial infection develops. Application of a horse shoe would not help and would be very painful in an already sensitive and painful condition. Other medications used to restore blood flow to the digits include acepromazine, isoxsuprine hydrochloride, dimethylsulfoxide (DMSO), heparin, and nitroglycerine.

Answer 119

Neomycin; this is followed by Gentamicin and then Amikacin. Streptomycin is the least nephrotoxic aminoglycoside. Amphotericin B is an anti-fungal and not an aminoglycoside.

DRUGS Flashcards

Pharmacology (144 cards)