Drugs

Question 1

What is an example of a first generation antihistamine?

Answer 1

Chlorpheniramine

Question 2

What sort of antihistamine is diphenhydramine?

Answer 2

First generation

Question 3

Give an example of a second generation antihistamine

Answer 3

Loratadine

Question 4

Name a drug that antagonises seratonin.

Answer 4

Metaclopramide

Question 5

What other major molecule does metaclopramide antagonise?

Answer 5

Dopamine

Question 6

Which drug is specifically a 5HT4 antagonist? Where is this receptor located?

Answer 6

Cisapride - located in the gut

Question 7

Give an example of an SSRI

Answer 7

Fluoxetine

Question 8

What does PGE2 do?

Answer 8

Pyrogen Promotes mucous secretion and inhibits acid secretion in the GI Contraction of pregnant uterus

Question 9

What does PGF2alpha do? What is it used for in veterinary medicine?

Answer 9

Causes luteolysis Contraction of uterine muscle in parturition Used for synchornising oestrus in cattle, inducing abortion

Question 10

What does Thromboxane A2 do?

Answer 10

Aggregation of platelets and vasoconstriction

Question 11

A glucocorticoid with a moderately insoluble ester will have a _____ action. (long or short)

Answer 11

Longer

Question 12

What is an Addisonian crisis and how could an animal have an ‘iatrogenic’ one?

Answer 12

It is a deficiency of glucocorticoids and mineralocorticoids. Could be precipitated by abrupt cessation of glucocorticoid therapy.

Question 13

Name two immunosuppressant drugs that are often used in combination with glucocorticoids to treat autoimmune disease.

Answer 13

Azathioprine Cyclosporine

Question 14

What is the mechanism of action of azathioprine?

Answer 14

Interferes with purine nucleotide synthesis and thence inhibits DNA synthesis and cell proliferation.

Question 15

What are three side effects of azathioprine?

Answer 15

Myelosuppression so neutropenia, thrombocytopenia and anaemia, GI toxicity, hepatotoxicity

Question 16

How would you monitor a patient on azathioprine for side effects?

Answer 16

CBC every 2 weeks to check for cytopenias, biochem every 2 weeks to check liver function

Question 17

What is the mechanism of action of cyclosporine?

Answer 17

Complexes with calcineurin and thence inhibits IL-2 transcription and IFNgamma secretion so inhibits T cell activation and proliferation.

Question 18

What is the generalised function of NSAIDs and how does this relate to the function of glucocorticoids?

Answer 18

Inhibit COX-1 and COX-2 More specific inhibitors of inflammation than GCCs, which inhibit both prostanoids and leukotrienes

Question 19

What are the three big functions of NSAIDs?

Answer 19

1. Antipyretic
2. Analgesic
3. Anti-inflammatory

Question 20

What drug can you give to reduce the risk of NSAID-mediated GI ulceration?

Answer 20

Misoprostol

Question 21

Give two examples of drugs that are marketed to target both COX1 and COX2.

Answer 21

Aspirin

Phenylbutazone

Question 22

Give two examples of drugs that are marketed to target COX2 preferentially

Answer 22

Meloxicam

Carprofen

Question 23

Give two examples of drugs that are marketed to target COX2 ONLY

Answer 23

Deracoxib

Mavacoxib

Question 24

What are the two most common applications of NSAIDs in vet?

Answer 24

Osteoarthritis in cats and dogs

Post operative pain

Question 25

Why are there only two NSAID products licensed for use in cats? What are they?

Answer 25

Because NSAIDs metabolised in the liver and cats have limited glucuronidation capacity, so the drug effects last longer Meloxicam and robencoxib

Question 26

If you have a patient who has been on glucocorticoids long-term, but they need mild pain relif, what are your two options?

Answer 26

1. Taper the GCCs and wait for the washout period to be over before starting NSAIDs 2. Start tapering the GCCs but start the NSAIDs anyway. Use misoprostol to mitigate the risk.

Question 27

Give an example (brand name and drug name) of a disease-modifying osteoarthritis drug. Is it an NSAID?

Answer 27

Pentosan polysulfate (cartrophen) NOT an NSAID

Question 28

What is the mechanism of action for apoquel? What is its application?

Answer 28

Inhibits JAK-1 dependent cytokines to control inflammation Use in pruritis and allergic dermatitis

Question 29

What are the 7 classes of chemotherapeutic drugs? CHAT MAP

Answer 29

Cytotoxic antibiotics Hormones Alkylating agents Tyrosine kinase inhibitors Mitotic spindle inhibitors Antimetabolites Platinating agents

Question 30

What is an example of a cytotoxic antibiotic and how does it work?

Answer 30

Doxorubicin Inhibits toposiomerase II which is involved in DNA cleavage, unwinding and rejoining Also intercalates DNA and therefore prevents DNA replication and thus cell division

Question 31

What is an example of a hormone used in chemotherapy? How does it work?

Answer 31

High dose glucocorticoids Lymphocytolytic; also increases appetite which is good

Question 32

What is an example of an alkylating agent and how does it work?

Answer 32

Cyclophosphamide Cross-links DNA to inhibit replication and cause cell apoptosis because DNA is damaged Can also be immunosuppressive

Question 33

What is a side effect of cyclophosphamide use?

Answer 33

Any of: - myelosuppression - alopecia - sterile haemorrhagic cystitis

Question 34

What is an example of a tyrosine kinase inhibitor? Why is this a good chemotherapeutic?

Answer 34

Toceranib (brand name Palladia) TK receptors commonly upregulated in neoplasms and signalling via them promotes cellular growth and proliferation

Question 35

What is an example of a mitotic spindle inhibitor? What parts of the cell cycle is this active at?

Answer 35

Vincristine G2 and M

Question 36

Give one side effect of vincristine.

Answer 36

Any of: - peripheral neurotoxicity because neurons use tubulin, constipation, myelosuppression

Question 37

What is an example of an anti-metabolite? How does it work?

Answer 37

Azathioprine Homologue of normal cellular molecule - interferes with purine synthesis and therefore inhibits DNA synthesis

Question 38

What is an example of a platinating agent and how does it work?

Answer 38

Cisplatin Crosslinks in DNA by binding guanine residues therefore preventing replication and cell division

Question 39

Give one side effect of cisplatin

Answer 39

Any of: - nausea, vomiting, myelosuppression, renal toxicity due to drug being excreted this way and platinum deposition in glomeruli