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UI Pharmacology > Final > Flashcards

Final Flashcards

1
Q

Term for hormone like substances that are synthesized and fxn in a localized area.

A

Autacoids

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2
Q

What are the 2 biogenic amines?

A

histamine and serotonin

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3
Q

What autacoids are polypeptides?

A

angiotensin and kinins

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4
Q

Term for histamine release caused by things other than IgE?

A

anaphylactoid

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5
Q

What are the 3 main causes of histamine release?

A

local injury, immune mediated, drugs, etc

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6
Q

What is the role of the H1 receptor?

A

smooth muscle contraction, vascular dilation and permeability, sedation

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7
Q

What is the role of the H2 receptor?

A

gastric acid and pepsin secretion, vasodilation

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8
Q

What is the “triple response” of histamine intradermally?

A

redness, flare, wheal

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9
Q

What is the MOA of first and second generation anti-histamines?

A

reversible competitive inhibitors of histamine

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10
Q

What are the other receptors first generation antihistamines act on?

A

antimuscarinic, alpha adrenergic

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11
Q

What is a potent antagonist of serotonin?

A

cyproheptadine

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12
Q

What generation of anti histamines penetrate BBB?

A

first gen

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13
Q

What is the primary and secondary tx of systemic anaphylaxis?

A

primary - epinephrine

secondary - antihistamines

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14
Q

What are the 4 H2 receptor antagonists (systemic antacids)?

A

cimetidine, ranitidine, famotidine, nizatidine

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15
Q

What H2 antagonist is a potent CYP450 inducer?

A

cimetidine

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16
Q

What drug stabalizess membrane and prevents release of histamine from mast cells?

A

cromolyn sodium

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17
Q

What 2 cells store pre-made histamine in the body?

A

mast cells - tissue

basophils - blood

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18
Q

What 2 tissues continually synthesize histamine?

A

GI tract (enterochromaffin like cells of stomach)
CNS (axons)
(both are non mast cell pool)

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19
Q

Where is serotonin produced and stored in the body?

A

GI tract - enterochromaffin cells (90%)
CNS
Blood - stored in platelets

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20
Q

What are the physio effects of serotonin in muscles?

A

contracts non vascular smooth muscle (uterine, gastric, intestinal, bronchial)

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21
Q

What are the 5 effects of serotonin in the body?

A
  1. contract non vascular smooth muscle
  2. Emesis (via CRTZ)
  3. stimulates nerve endings
  4. regulates behavior
  5. local vasoconstriction and hemostasis
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22
Q

What serotonin antagonist is an appetite stimulant in cats only?

A

cyproheptadine

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23
Q

What serotonin agonist is used in tx of gastric empyting disorders and other motility disorders?

A

cisapride

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24
Q

What are the 3 5-HT3 receptor antagonists that are used for cancer chemo induced emesis?

A

ondansetron, dolasetron, ganesetron

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25
Q

What are examples of selevtive serotonin reuptake inhibitors?

A

fluoxetine, paroxetine, sertraline, fluvoxamine, nefazodone

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26
Q

What are the MOA of TCAs like clomipramine, amitriptyline, desipramine, doxepin, imipramine?

A

block reuptake of norepinephrine and serotonin

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27
Q

What are the 2 common mechanisms of ectopic dysrhythmias?

A

reentry phenomenon

enhanced automaticity

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28
Q

What are examples of selevtive serotonin reuptake inhibitors?

A

fluoxetine, paroxetine, sertraline, fluvoxamine, nefazodone

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29
Q

What are the MOA of TCAs like clomipramine, amitriptyline, desipramine, doxepin, imipramine?

A

block reuptake of norepinephrine and serotonin

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30
Q

What are the 2 common mechanisms of ectopic dysrhythmias?

A 
reentry phenomenon (piece is damaged)
enhanced automaticity
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31
Q

What is the goal of treating supraventricular arrythmias?

A

control conduction velocity through AV node

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32
Q

What is the goal of tx ventricular arrythmias?

A

decrease excitability

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33
Q

What is the goal of tx of re-entry arrythmias?

A

decrease conduction velocity or prolong refractory period

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34
Q

What is the goal of tx of all arrythmias?

A

decrease excitability by sympathetic outflow, correct electrolytes

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35
Q

What are the 4 classes of antidysrhythmic drugs and their MOA?

A 
class 1 - NA channel blocker
Class 2 - beta blocker
class 3 - K channel blocker
class 4 - calcium channel blocker
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36
Q

What is the main usage of quinidine in VM? What else does it treat?

A

atrial fibrillation in horses

txs acute and chronic supraventricular dysrhythmias

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37
Q

What are the two class 1a antiarrythmic drugs?

A

Procainamide and quinidine

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38
Q

What are the 3 different subclasses of class 1 antiarrythmic drugs? What effect do they have on refractory period?

A

1a - lengthen AP and refractory period
1b - shorten AP and refractory period
1c - decrease rate of phase 0 depolarization

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39
Q

What are the 2 class 1b antiarrythmic drugs?

A

lidocaine, mexiletine

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40
Q

What arrythmias does lidocaine treat?

A

acute control of ventricular dysrhythmias

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41
Q

What drug can be used long term is and called “oral lidocaine”?

A

mexiletine

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42
Q

What beta blocker is non-selective?

A

propranolol

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43
Q

What are the 3 clinical inications of beta blockers as anti-arrythmics?

A

rate control of supraventricular and ventricular tachyarrythmias
excessive sympathetic tone (hyperthyroid)
anti-hypertension

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44
Q

What is the half life order of the 3 beta blockers?

A

atenolol>propranolol>esmolol

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45
Q

What are the 3 adverse effects of beta blockers?

A

exacerbation of HF or nodal dysfunction
bronchoconstriction
prevention of glycogenolysis (not good in diabetes)

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46
Q

What is the MOA of class III antiarrythmic drugs?

A

decrease proportion of cardiac cycle where muscle is excitable (prolong cardiac depolarization and refractory period of muscle)

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47
Q

What anti-arrythmic drug has a wide spectrum of activity on refractory supra and ventricular tachydysrhytmias?

A

amiodarone

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48
Q

What is sotalol used for?

A

sustained ventricular tachycardia, ventricular or atrial fibrillation (non selective B blocker at lower doses)

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49
Q

What are the 2 adverse effects of sotalol?

A

mild negative inotrophy (caution CHF)

exacerbate nodal dysfunction (beta blocker)

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50
Q

What is the MOA of class IV anti arrythmic drugs?

A

inhibit L type calcium channels - decrease slow inward current

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51
Q

What drug is used to control hypertrophic cardiomyopathy in cats and supraventricular tachyarrythmias?

A

diltazem

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52
Q

What 2 drugs are Class IV anti arrythmic drugs?

A

diltiazem

verpamil (more potent)

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53
Q

What are the 3 drugs used for acute tx of VPCs or V tachs?

A

lidocaine
procainamide
esmolol

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54
Q

What are the 4 drugs used for acute tx of supraventricular arrythmias?

A

procainamide
diltiazem
esmolol
lidocaine?

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55
Q

What are the 2 drugs used for acute tx of combined supraventricular and ventricular tachydysrhtymias?

A

procainamide

esmolol

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56
Q

What is the preferred cox2/cox1 ratio for an NSAID?

A

less than 1 = more specific for cox2

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57
Q

What are the 5 main pharmacological actions of NSAIDs?

A

antipyretic
anti-inflammatory
analgesic (NOT severe visceral pain and broken bones)
anti-platelets

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58
Q

What 2 NSAIDs have improved absorption when given with food?

A

tepoxalin and deracoxib

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59
Q

Are NSAIDs weak acids or bases?

A

weak acids (well absorbed from stomach)

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60
Q

What is the Vd of NSAIDs?

A

small –> binds to albumin (caution in dehydrated animals)

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61
Q

What are the 7 shared SE of NSAIDs?

A 
GI ulceration
protein losing enteropathy
CNS despression
Sodium and fluid retention
renal damage
increase bleeding time
hepatotoxicty
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62
Q

What 4 drug classes do NSAIDs interact with?

A

Fursomide (diminishes CV effects)
ACE inhibitors
Fluoroquinolones (seizures)
Antacids (interefere with absorption)

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63
Q

What are the 3 therapeutic uses of NSAIDs?

A

musculoskeletal disorders
spetic and endotoxic shock
pain and inflammation

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64
Q

What is the difference of effect of acetaminophen versus other NSAIDs?

A

no anti-inflammatory and antiplatelet activities

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65
Q

What does acetominophen toxicity cause in cats? dogs?

A

cats - heinz body anemia

dogs - hepatotoxicity

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66
Q

What is the antidote of acetominophen?

A

N-acetylcysteine

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67
Q

What NSAID is used for soft tissue problems in horses?

A

naproxen

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68
Q

What NSAID is used for musculoskeltal disorders, visceral pain, and inflammation in horses and also helps in cattle with respiratory dz and endotoxemia?

A

flunixin meglumine

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69
Q

What is the most commonly used NSAID and is approved for dogs and horses but banned in food animals?

A

phenylbutazone ( should be avoided in dogs - better drugs)

70
Q

What drug do some consider the NSAID of choice for cats?

A

ketoprofen

71
Q

What are the 2 bad side effects of meloxicam in cats?

A

acute renal failure and death

72
Q

What drug inhibits both cyclooxygenases and 5-lipoxygenase enzyme activities?

A

tepoxalin

73
Q

What species is etodolac approved for?

A

dogs only (do not use in cats!)

74
Q

What NSAID is approved to be used topically in horses and also as a opthalmic drug?

A

diclofenac sodium

75
Q

What NSAID is both antiinflammatory and antitumor (indirect)? Used for transitional cell carcinomas of the bladder.

A

piroxicam

76
Q

What human approved NSAID is being used in cats for feline asthma and in dogs fo atopic dermatitis?

A

zafilukast

77
Q

What NSAID doesnt inhibit COX, but instead traps superoxide radicals?

A

orgotein

78
Q

What are the two uses for orgotein?

A

horses - soft tissue inflammation

dogs - spondylitic syndromes or vertebral dz

79
Q

What NSAID can penetrate all biological membranes and is a solvent?

A

DMSO, dimethyl sulfoxide

80
Q

What do glucosamine and chondroitin sulfate work synergistically to do?

A

inhibit cartilage breakdown

81
Q

What are the 4 effects of hyaluronic acid intra articulary?

A

joint lube, shock absorbtion, anti inflammatory, nutrition for cartilage

82
Q

What effects do glucocorticoids have on water balance?

A

inhibit ADH, increase ECF and GFR

83
Q

What effects do glucocorticoids have on the CV system?

A

+ chrono and inotropic, sensitize to catecholamines

84
Q

What 3 things does the “steroid” base of the glucocorticoid determine?

A

potency of antiinflammatory and mineralcorticoids

duraction of action at specific site

85
Q

What is the potency hierarhy of “soft” glucocorticoids?

A

fluticasone>belcomethasone == budesonide

86
Q

Term for alkaloids derived from opium including morphine and codeine.

A

opiates

87
Q

Term for all naturally occuring and synthetic compounds that act on opiod receptors.

A

opiods

88
Q

What are the 3 opiod receptors?

A

mu, kappa,, delta

89
Q

What are the effects of the MOP receptor?

A

analgesia, sedation, euphoria, resp depression, g.i. stimulation, physical dependence

90
Q

What are the effects of the KOP receptor?

A

antitussive, spinal analgesia, sedation, miosis, g.i. stimulation, increased appetite

91
Q

What are the effects of the DOP receptor?

A

analgesia, emotion, increased appetite

92
Q

What is the general MOA of opiod receptors?

A

inhibit release of excitatory transmitters from small diameter primary afferent fibers (C and fine myelinated A fibers)

93
Q

Whare are Mu receptors located?

A

peripheral and supraspinal

94
Q

Where are Kappa receptors located?

A

spinal

95
Q

Where are delta receptors located?

A

spinal and supraspinal

96
Q

What is the origin of endogenous opiod peptides?

A

cleavage of POMC

97
Q

What are the three endogenous opiods?

A

B-endorphin, met-enkephalin, Dynorphin A

98
Q

What pain pathways do opiods activate/inhibit?

A

activate descending pathways that inhibit primary afferents presynaptically and inhibit STT cells postsynaptically

99
Q

What is the MOA of opiods?

A

Gi and Gq –> inhibit adenyl cyclase –> hyperpolarization

100
Q

What effect do opiods have on GABA receptors?

A

inhibit GABA which allows dopamine to have positive effect on inhibitory neurons

101
Q

What opiod receptor is responsible for dysphoria?

A

KOP

102
Q

What two opiod receptors have GI effects that include induction of emesis and constipation?

A

MOP and KOP

103
Q

What opiod receptor has “ceiling effect” on respiratory depression and doesnt cause death?

A

KOP

104
Q

What are the non lethal side effects of opiods?

A

emesis, constipation, inhibition of gastric, pancreatic, and biliary excretion, urinary retention, hypotension, changes in pupillary diameter, changes in body temp, increased intracranial pressure

105
Q

What species do opiods cause hypothermia?

A

rabbits and dogs (others -> hyperthermia)

106
Q

What species do opiods reduce the pupillary size?

A

miosis - dogs, humans, rabbits

others - mydraisis

107
Q

How is tolerance developed in opiods?

A

inhibits AC –> AC expression increases –>cesation leads to high cAMP levels

108
Q

What is the prototype of a full mu receptor agonist? partial mu receptor agonist?

A

full - morphine

partial agonist - codeine

109
Q

What is the prototype drug of a opiod mixed agonist-antagonist? antagonist only?

A

mixed - butorphanol

antagonist - naloxone

110
Q

What are the MOAs of tramadol?

A

weak partial MOP agonist but also interacts with KOP and DOP receptors
also weak inhibitor of NE and 5-HT uptake

111
Q

What is the cause of the wide variation of effects of tramadol?

A

active metabolite M1 –> individual varied production

112
Q

What are the 4 clinical analgesic applications of opiods?

A

analgesia, neuroleptanalgesia, spinal analgesia, preanesthetic

113
Q

What are the 4 clinical uses of opiods that do not have to do with pain?

A

antitussives, emetics, antispasmodics, immobilization

114
Q

Term for when a opiod antagonist wears off before agonist.

A

renarcotization

115
Q

Which opiod receptor is most susceptible to antagonism?

A

MOP

116
Q

What schedule drug is morphine?

A

2

117
Q

What schedule drug is hydrocodone?

A

3

118
Q

What schedule drug is propoxyphene? diphenoxylate?

A

prop- 4

diphen - 5

119
Q

What is the difference between a gas and a vapor?

A

gas - at proper temp and pressure

vapor - gaseous state of material below boiling point

120
Q

What is vapor pressure?

A

pressure = force/area

121
Q

What is STP?

A

standard temp pressure?

0 degrees C, 760 mmHg

122
Q

How does partial pressure differ from volume %?

A

partial pressure = # of molecules

volume % = number of molecules as it relates to total number of molecule present

123
Q

Will the partial pressure of a gas be higher or lower at high altitude compared to sea level?

A

same but volume % will be higher (less molecules at higher altitudes)

124
Q

What is daltons law?

A

mixture of gases exerts same pressure if it were alone (additive)

125
Q

Term for the temperature above which a substance cannot be liquefied?

A

critical temp

126
Q

What are partition coefficients?

A

related to solubility of an agent in different media

127
Q

What are biological properties of an ideal anesthetic agent?

A 
low blood:gas solubility
high oil:gas solubility
minimal SE
no biotransformation
non toxic
128
Q

What are the 3 inflow factors for anesthesia?

A

increase minute ventilation
oxygen flow rates
inspired anesthetic concentration (turn up vaporizer)

129
Q

What are the 3 outflow factors for anesthesia?

A

solubility
cardiac output
alveolar to venous anesthetic gradient

130
Q

How can the inspired anesthetic concentration be increased?

A

splitting ratio - increasing concentration in circuit increases alveolar partial pressure

131
Q

Will a high or low B:G partition give longer induction times?

A

the higher the B:G = long induction

132
Q

What is the hierarchy of B:G partitions?

A

Halothane>isoflurane> sevoflurane

133
Q

Will a high or low cardiac output prolong induction time?

A

high CO = long induction time

134
Q

What 3 things affect the elimination of anesthetic via lungs?

A

increased minute ventilation
increased CO
solubility
(different from outflow factors….alveolar to venous anesthetic gradient instead of ventilation)

135
Q

Definition of MAC.

A

amount (%) at 1 atm required to prevent movement in 50% of population

136
Q

What MAC produces surgical anesthesia?

A

MACx1.3 to 1.5

137
Q

What are the MACs of Isoflurane for dog, cat, and horse?

A

dog - 1.3
cat - 1.6
horse - 1.3

138
Q

What are the MACs of Sevoflurane for dog, cat, horse?

A

dog - 2.4
cat - 2.6
horse - 2.3

139
Q

What are some physio factors that decrease the MAC?

A

ACIDOSIS, hypoxia, induced hypotension, hypothermia, pregnancy, opiods, acepromazine

140
Q

What are some physio factors that increase the MAC?

A

duration of anesthesia, alkalosis, hyperoxia, thyroid, hyperkalemia, naloxone

141
Q

What are the effects of inhalent anesthetics on the CNS?

A

decrease in oxygen req

effect on cerebral blood flow autoregulation

142
Q

What are the SE of inhalents on the CV system?

A

myocardial depression
vasodilation
sympathomimitis (NO only)

143
Q

What are the two biggest concerns of side effects in inhalent anesthetics?

A

hypoventilation and vasodilation

144
Q

What are the SE of inhalents on the respiratory system?

A 
respiratory acidosis (leads to arrythmias)
bronchodilation
interfere with hypoxic pulmonary vasocontriction
145
Q

Which inhalent needs a special vaporizor?

A

desflurane (boils at room temp)

146
Q

What is an example of neuroleptanalgesia?

A

fentanyl + doperidol

147
Q

What is the Frank Starling Law?

A

greater volume of blood in heart during diastole = more forceful contraction

148
Q

What class of diuretics is best for edema, especially pulmonary?

A

loop diuretics - supplement K

149
Q

What class of drugs are venodilators?

A

nitric oxide donors (nitrates)

150
Q

What class of drugs are arteriolar dilators?

A

hydralazine, calcium channel blockers

151
Q

What classes of drugs are mixed vasodilators

A

alpha 1 antagonist (pure artery dilator?)

ACE inhibitors

152
Q

What are two important considerations when using nitroglycerin to venodilate?

A

tolerance

extensive first pass hepatic metabolism –> transdermal cream

153
Q

What venodilator is helpful in small breed dogs with mitral regurgitation?

A

isosorbide dinitrate

154
Q

What venodilator is used in hypertensive crisis and given IV?

A

nitroprusside

155
Q

What is the MOA of hydralazine?

A

increases vasodilatory prostaglandins –> directly dilates arterioles

156
Q

What is a common SE of hydralazine?

A

GI upset

157
Q

What artery dilator is selective for blocking calcium channesl in smooth muscle only?

A

dihydropyridines (amlodipine, other pines)

158
Q

What is the main use of amlodipine?

A

arteriolar vasodilation in hypertensive cats

159
Q

What receptors does carvedilol act on?

A

pure alpha 1 antagonist

also B1 and B2 antagonist

160
Q

What is the use of prazosin in CHF?

A

alpha 1 antagonist, reduces afterload, mixed dilator, no beta activity

161
Q

What are the 3 major effects of Angiotensin 2?

A

direct vasoconstriction, aldosterone release, ADH release

162
Q

What ACE inhibitor does not reduce GFR and is good to use in cats?

A

benazepril

163
Q

What are the 4 ACE inhibitors?

A

enalapril, captopril, lisinopril (all reduce GFR)

164
Q

What are the 3 adverce effects of ACE inhibitors?

A

vomiting or dirrhea, decreased kidney fxn, hyponatremia

165
Q

What is the MOA of ACE inhibitors and kidney dysfucntion?

A

angiotensin 2 preferentially constrics efferent arterioles increasing GFR —> ace blocks these

166
Q

What are the 3 classes of positive inotropes?

A

digitalis, inodilators (calcium sensitizers, bipyridines), sympathomimetics

167
Q

What is the MOA of digoxin?

A

inhibits Na/K atpase that is responsible for membrane potential

168
Q

What are the 3 indictions for digoxin?

A

positive inotrope in dilated cardiomyopathy
supraventricular tachyarrhythmias
degenerative valve dz

169
Q

What is the MOA of positive inotropic drugs?

A

inhibit myocardial phosphodiesterase –> increase in cAMP and calcium avaailability

170
Q

What drug increases contractility without increase in O2 consumption? What is MOA?

A

pimobendan

increases affinity of troponin C for calcium and inhibits PDE3 in vascular smooth muscle –> vasodilation

171
Q

What positive inotropic drug is used for acute mgmt of heart failure and cardiogenic shock?

A

dobutamine

UI Pharmacology (2 decks)

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