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Otic system book Flashcards

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1
Q

What are dermatologic conditions commonly seen in veterinary practice?

A

Ectoparasitic problems, allergies, skin diseases

Common skin problems include those caused by fleas, ticks, and mosquitoes.

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2
Q

What is the role of a veterinary technician in managing dermatologic conditions?

A

Obtaining complete history, performing diagnostic procedures, providing client education

Client education is crucial for understanding medication purposes and usage.

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3
Q

What are the three layers of the skin?

A

Epidermis(basal, spinous, granular, clear, horny), dermis (corium), hypodermis (subcutis)

The dermis provides most of the skin’s thickness.

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4
Q

What is the function of the skin?

A

Barrier against pathogens, sensory perception, thermoregulation, immunologic defense, vitamin D3 production

The skin also serves as a reservoir for electrolytes.

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5
Q

What diagnostic procedures are used to determine the cause of skin disease?

A

Skin scrapings, allergy testing, dermatophyte tests

Skin scraping identifies mites like Sarcoptes and Demodex.

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6
Q

What is the epidermal turnover rate?

A

21 to 22 days

This is the time it takes for epidermal cells to reach the outer layer.

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7
Q

What are the phases of hair growth?

A

Anagen (growth), telogen (rest), catagen (intermediate)

Dogs and cats have multiple hairs per follicle, unlike humans.

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8
Q

What are the four stages of normal wound healing?

A

Inflammation, débridement, repair, maturation

Each phase contributes to the healing process.

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9
Q

What is primary intention healing?

A

Healing of a clean, uninfected surgical incision approximated by sutures

There is no area for granulation tissue to fill.

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10
Q

What is secondary intention healing?

A

Healing of a larger wound that requires granulation tissue to fill the opening

This occurs when sutures cannot be used.

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11
Q

What is the function of the dermis?

A

Provides stability, flexibility, and contains structures like hair follicles, sebaceous glands

It is also involved in wound repair.

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12
Q

What is colloidal oatmeal used for?

A

Topical anti-inflammatory and antipruritic agent

It is thought to inhibit prostaglandin production.

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13
Q

What are the clinical uses of aluminum acetate solution?

A

Treatment of superficial skin problems like acute moist dermatitis

It is also known as Burow’s solution.

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14
Q

What are the common adverse side effects of aluminum acetate solution?

A

Avoid contact with eyes, do not prevent evaporation from skin

Gloves should be worn during application.

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15
Q

What are essential fatty acids used for in dermatology?

A

Antipruritic and anti-inflammatory properties

They help with conditions like atopic dermatitis and seborrhea.

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16
Q

What factors contribute to proper wound healing?

A

Patient factors, wound characteristics, external factors

Includes age, nutritional status, and environmental conditions.

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17
Q

Fill in the blank: The _______ is the deepest layer of the skin.

A

hypodermis

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18
Q

True or False: The epidermis includes a population of normal microorganisms.

A

True

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19
Q

What is diphenhydramine?

A

A first-generation antihistamine with local anesthetic properties.

Can be absorbed transdermally but not enough to cause systemic effects.

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20
Q

List the dosage forms of diphenhydramine.

A
  • ResiHist Leave-On Lotion
  • Benadryl (human label)
  • Benasoothe
  • AtopiCream
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21
Q

What are the adverse side effects of diphenhydramine?

A

Avoid contact with eyes or mucous membranes. Should not be applied to oozing skin. Gloves should be worn during application.

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22
Q

What is the clinical use of topical lidocaine?

A

Applied as a skin anesthetic and helps with pruritus.

May treat acute moist dermatitis, pruritic lesions, or painful skin conditions.

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23
Q

List the dosage forms of topical lidocaine.

A
  • Allercaine
  • Allerspray
  • DermaCool with Lidocaine Spray
  • Hexa-Caine
  • Biocaine
  • EMLA Cream
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24
Q

What are the adverse side effects of topical lidocaine?

A

Avoid contact with eyes and do not use in ears. Gloves should be worn during application.

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25
What is phytosphingosine used for?
Treating localized inflammatory and pruritic cases, such as atopic dermatitis.
26
List the dosage forms of phytosphingosine.
* Douxo Calm Gel * Douxo Calm Micro-emulsion Spray * Douxo Calm Shampoo * Douxo Seborrhea Shampoo * Douxo Chlorhexidine PS * Douxo Seborrhea Micro-emulsion Spray * Douxo Seborrhea Spot-on
27
What are the adverse side effects of phytosphingosine?
May cause skin redness or irritation.
28
What are the clinical uses of pramoxine hydrogen chloride?
Has surface and local anesthetic characteristics affecting peripheral nerves.
29
List the dosage forms of pramoxine hydrogen chloride.
* Micro Pearls Advantage Dermal-Soothe Antiitch Spray * Relief Shampoo, Relief Spray * Pramosoothe HCl Spray * Resiprox Leave-On Lotion * Micro Pearls Advantage Dermal-Soothe Antiitch Shampoo, Cream Rinse * Pramoxine Antiitch Shampoo, Cream Rinse, Spray
30
What are the adverse side effects of pramoxine hydrogen chloride?
Avoid contact with eyes. Not for ophthalmic use. Gloves should be worn during application.
31
What are the clinical uses of phenol/menthol/camphor?
Used in equines for overexertion, soreness, or stiffness.
32
List the dosage forms of phenol/menthol/camphor.
* White Liniment * Choate’s Liniment * Cool Gel * Ice-O-Ge * Shin-O-Gel * Scarlet Oil Pump Spray
33
What are the adverse side effects of phenol/menthol/camphor?
May cause local irritation. Do not use near the eyes or on cats.
34
What is the clinical use of topical neutralized zinc gluconate?
Used for mild itching, mild bacterial infections, and dry skin.
35
List the dosage form of topical neutralized zinc gluconate.
* Maxi/Guard Zn7 Derm Solution, Spray
36
What are the clinical uses of topical corticosteroids?
Used for localized itching or inflammatory conditions.
37
List the dosage forms of topical corticosteroids.
* Gentocin Topical Spray * GentaSpray * Betagen Topical Spray * Gentamicin Topical Spray * GentaVed Topical Spray * Otomax Ointment * Vetromax Ointment * MalOtic Ointment * Icaderm Gel * Betamethasone Dipropionate Ointment, Cream, Lotion * Clotrimazole and Betamethasone Dipropionate * Lotrisone
38
What are the adverse side effects of topical corticosteroids?
Do not use in pregnant animals. Avoid contact with eyes.
39
What is the clinical use of topical hydrocortisone?
Useful for treating localized pruritus and/or inflammatory conditions.
40
List the dosage forms of topical hydrocortisone.
* CortiCalm Lotion * Sulfodene HC Antiitch Lotion * Zymox Topical Cream, Spray, Wipes * Relief HC Spray * Pramosoothe HC Spray * Cortispray * DermaCool HC Spray * Malacetic Ultra Shampoo, Spray * Malacetic HC Wipes * Cort/Astrin Solution * Corti-Derm Solution * Hydro-Plus * Buro-O-Cort 2:1 * Hydro-B 1020 * Cortisoothe Shampoo * Chlorhexidine 4% HC Shampoo * ResiCORT Leave-on Lotion
41
What are the adverse side effects of topical hydrocortisone?
May cause tuberculosis of the skin. Do not use in pregnant animals.
42
What is the clinical use of topical isoflupredone acetate?
Used for otic or skin itching/inflammation associated with bacterial infections.
43
List the dosage forms of topical isoflupredone acetate.
* Tritop * Neo-Predef with Tetracaine Powder
44
What are the adverse side effects of topical isoflupredone acetate?
May cause tuberculosis of the skin. Do not use in pregnant animals.
45
What is mometasone furoate used for?
Useful for treating itching and inflamed skin associated with bacterial or yeast infections.
46
List the dosage form of mometasone furoate.
* Mometamax Otic Suspension
47
What are the adverse side effects of mometasone furoate?
May cause tuberculosis of the skin. Do not use in pregnant animals.
48
What is the clinical use of topical triamcinolone acetonide?
Useful as an adjunct in treating pruritus.
49
List the dosage forms of topical triamcinolone acetonide.
* Medalone Cream * Cortalone Cream * Genesis Spray * Derma-Vet Cream, Ointment * Panalog Ointment * Animax Ointment * Quadritop Ointment * Dermalog Ointment * Dermalone Ointment * Resortin Ointment
50
What are the adverse side effects of topical triamcinolone acetonide?
Do not use on pregnant animals. Keep out of the eyes.
51
What is benzoyl peroxide used for?
Used topically for oily skin, pyodermas, furunculosis, and generalized demodicosis.
52
List the dosage forms of benzoyl peroxide.
* Pyoben Gel * OxyDex Shampoo, Gel * Micro Pearls Advantage Benzoyl Plus * Benzoyl Peroxide Shampoo * BPO-3 Shampoo * SulfOxyDex Shampoo * Oxiderm Shampoo * DermaBenSs Shampoo * PhytoVet PSS Shampoo
53
What are the adverse side effects of benzoyl peroxide?
Do not use around eyes or mucous membranes. Will bleach fabrics and pet fur.
54
What is topical clindamycin used for?
Used in the treatment of feline acne and abscesses.
55
List the dosage forms of topical clindamycin.
* ClinzGard—veterinary label * Clindamycin Phosphate * Cleocin T * Clindamax * Clindagel * Clindets * Evoclin
56
What are the adverse side effects of topical clindamycin?
Avoid use in individuals allergic to clindamycin.
57
What is topical gentamicin sulfate used for?
Used to treat primary and secondary bacterial infections.
58
List the dosage forms of topical gentamicin sulfate.
* Gentocin Topical Spray * GentaSpray * Betagen Topical Spray * Gentamicin Topical Spray * GentaVed Topical Spray * GenOne Spray * Otomax Ointment * DVMax Ointment * Vetromax Ointment * Mometamax Otic Suspension
59
What are the adverse side effects of topical gentamicin sulfate?
May be absorbed systemically if used on ulcers or burned skin.
60
What is mupirocin used for?
FDA-approved for treating pyoderma, interdigital cysts, and acne.
61
List the dosage forms of mupirocin.
* Muricin—veterinary label * Mupirocin * Bactroban Cream, Ointment * Centany
62
What are the adverse side effects of mupirocin?
Do not use in patients allergic to mupirocin.
63
What is salicylic acid used for?
Used to treat seborrheic disorders with antipruritic, antibacterial, keratoplastic, and keratolytic actions.
64
List the dosage forms of salicylic acid.
* KeraSolv Gel * Derma-Clens cream * Dermazole Shampoo * SebaLyt Shampoo * Nova Pearls Medicated Dandruff Shampoo * Keratolux Shampoo * Sebolux Shampoo * Oxiderm Shampoo * Oxiderm Shampoo + PS * Micro Pearls Advantage Seba-Hex Shampoo * NuSal-T * Solva-Ker Gel
65
What are the adverse side effects of salicylic acid?
Skin irritation is possible.
66
What is topical nitrofurazone used for?
Used to treat or prevent superficial infections.
67
List the dosage form of topical nitrofurazone.
* Nitrofurazone Soluble Dressing
68
What is silver sulfadiazine used for?
Used for second- and third-degree burns and skin infections caused by Pseudomonas spp.
69
List the dosage forms of silver sulfadiazine.
* Silvadene cream * Thermazene * SSD cream
70
What are the adverse side effects of silver sulfadiazine?
May react in patients hypersensitive to sulfonamides.
71
What is the clinical use of acetic acid/boric acid?
Used to treat skin infections caused by Staphylococcus spp., Pseudomonas spp., and Malassezia spp.
72
List the dosage forms of acetic acid/boric acid.
* MalAcetic Ultra Spray * Mal-A-Ket Shampoo, Wipes * MalAcetic HC Wipes * MalAcetic Shampoo, Spray Conditioner, Wet Wipes
73
What are the adverse side effects of acetic acid/boric acid?
Includes skin redness and irritation.
74
What is chlorhexidine used for?
Used as a topical antiseptic for disinfection of wounds and managing skin infections.
75
List the dosage forms of chlorhexidine.
* Chlorhexidine Spray, Flush (0.2%), Ointment * Chlorhexidine Solution, Concentrate, Scrub * Chlorhexidine Shampoo 2%, 4% * Malaseb Shampoo, Concentrate rinse, Spray, Flush * Douxo Chlorhexidine PS Micro-emulsion Spray * Chlorhex 2X 4% Spray * ChlorhexiDerm Spray, Flush * ChlorhexiDerm Plus Scrub * Ketoseb-D Spray, Flush, Wipes * Mal-A-Ket Plus TrizEDTA Spray, Flush, Wipes * TrizChlor 4 Shampoo, Spray, Flush, Wipes * Douxo Chlorhexidine 3% PS Pads * Dermachlor Flush Plus * Hexadene Flush * Nolvasan Shampoo * KetoChlor Shampoo * ResiKetoChlor Leave-On Conditioner
76
What are the adverse side effects of chlorhexidine?
May damage the eyes. Safe to use on cats, but irritation and corneal ulcer have been reported.
77
What is chloroxylenol (PCMX) used for?
Used as a topical antiseptic.
78
List the dosage forms of chloroxylenol (PCMX).
Not specified in the provided content.
79
True or False: Topical diphenhydramine can be used two weeks before allergy testing.
False
80
What is TrizChlor 4?
A veterinary-label product available in shampoo, spray, flush, and wipes forms.
81
What is the concentration of Chlorhexidine in Douxo Chlorhexidine pads?
3%.
82
What are the potential adverse side effects of Chlorhexidine?
May damage the eyes, irritation and corneal ulcer in cats.
83
What is Chloroxylenol also known as?
p-chloro-m-xylenol (PCMX).
84
What types of bacteria and viruses is Chloroxylenol effective against?
Gram-negative and gram-positive bacteria, RNA and DNA viruses.
85
What are the clinical uses of Chloroxylenol?
Preoperative scrub, cleaning wounds, treatment of bacteria, fungi, and yeast infections.
86
What are the veterinary-label dosage forms of Chloroxylenol?
* Medicated Shampoo * Vet Solutions Sebozole Shampoo * Vet Solutions Universal Medicated Shampoo.
87
What is a common adverse side effect of Chloroxylenol?
Skin irritation.
88
What are topical enzymes effective against?
Staphylococcus spp., Pseudomonas spp., Malassezia spp., Candida albicans, and Microsporum spp.
89
What are the dosage forms of topical enzymes?
* Zymox Topical Spray * Zymox Topical Cream * Zymox Enzymatic Shampoo * Zymox Rinse.
90
What are the potential adverse side effects of topical enzymes?
Uncommon.
91
What is the clinical use of Ethyl Lactate?
Treating bacterial skin infections and superficial pyodermas.
92
What is the dosage form of Ethyl Lactate?
Etiderm Shampoo.
93
What are the possible adverse side effects of Ethyl Lactate?
Erythema, pain, itching; avoid contact with eyes.
94
What is Enilconazole used for?
Treatment of dermatophytosis in small animals and horses.
95
What are the reported adverse effects of Enilconazole in felines?
* Hypersalivation * Vomiting * Anorexia * Weight loss * Muscle weakness * Increased ALT levels.
96
What are the clinical uses of topical Ketoconazole?
Used against dermatophytes and yeasts.
97
What are the dosage forms of topical Ketoconazole?
* Ketoseb-D Spray, Flush, Wipes * Dermachlor Flush * Mal-A-Ket Plus TrizEDTA Spray, Flush * MalAcetic Ultra Spray * Mal-A-Ket Shampoo, Wipes * Ketochlor Shampoo * ResiKetoChlor Leave-On Conditioner.
98
What are the possible adverse side effects of topical Ketoconazole?
Skin irritation.
99
What is Lime Sulfur used for?
Treatment of dermatophytosis, Malassezia, Cheyletiellosis, chiggers, and mange.
100
What are the dosage forms of Lime Sulfur?
* LimePlus Dip * Vet Solutions Lime Sulfur Dip * Vet Basics Lime Sulfur Dip.
101
What are the adverse side effects of Lime Sulfur?
* May stain porous surfaces * Skin irritation * Oral ingestion may cause nausea and oral ulcers.
102
What is the clinical use of topical Miconazole?
Treatment of dermatophytes and yeast.
103
What are the dosage forms of topical Miconazole?
* Micro Pearls Advantage Miconazole 1% Spray * Conofite Spray 1%, Conofite Cream 2% * MicaVed Spray 1% * Malaseb Shampoo, Concentrated Rinse, Spray, Flush * Micazole Spray, Lotion 1% * MicaVed Lotion 1% * Sebazole Shampoo.
104
What are the adverse side effects of topical Miconazole?
Avoid contact with eyes, skin irritation possible.
105
What is Nystatin used for?
Treating topical lesions caused by yeast or yeast-like organisms.
106
What are the dosage forms of Nystatin?
* Derma-Vet Cream, Ointment * Panalog Ointment * Animax Ointment * Quadritop Ointment * Dermalog Ointment * Resortin Ointment.
107
What are the possible adverse side effects of Nystatin?
Avoid contact with eyes; allergic reactions may occur.
108
What is Selenium Sulfide used for?
Treating seborrheic disorders and Malassezia.
109
What are the dosage forms of Selenium Sulfide?
* Selenium Sulfide * Selsun Blue Medicated Treatment * Head & Shoulders Intensive Treatment.
110
What are the adverse side effects of Selenium Sulfide?
Do not use on cats; may discolor jewelry and stain hair coats.
111
What is the clinical use of topical Terbinafine Hydrogen Chloride?
Treating local lesions caused by Malassezia.
112
What are the dosage forms of Terbinafine?
* Lamisil AT * Lamisil * Lamisil Advanced.
113
What are the possible adverse side effects of Terbinafine?
Skin irritation possible but usually rare.
114
What is Precipitated Sulfur used for?
Treating seborrhea.
115
What are the dosage forms of Precipitated Sulfur?
* SebaLyt Shampoo * Micro Pearls Advantage Seba-Hex Shampoo * Sebolux Shampoo * Oxiderm Shampoo + PS * Keratolux Shampoo * DermaPet DermaSebS Shampoo * Paraguard Shampoo * SulfOxyDex Shampoo.
116
What are the adverse side effects of Precipitated Sulfur?
Skin irritation possible; may cause drying, itching, and irritation.
117
What is the clinical use of Coal Tar?
Used for treating seborrhea oleosa.
118
What are the dosage forms of Coal Tar?
* NuSal T Shampoo * Sulfodene Shampoo * Sulfur and Tar Shampoo.
119
What are the adverse side effects of Coal Tar?
Carcinogenic risks may be associated; FDA states products with 5% or less are safe for human use.
120
What types of Tretinoin are there?
* Transretinoic acid * Vitamin A acid.
121
What are the clinical uses of Tretinoin?
Treating acanthosis nigricans, idiopathic nasal and footpad hyperkeratosis, callous pyodermas, and chin acne.
122
What are the dosage forms of Tretinoin?
* Renova * Retin-A Cream, Gel * Avita Cream, Gel * Altinac.
123
What are the adverse side effects of Tretinoin?
* Avoid sun exposure * Avoid contact with eyes and mouth. * May cause allergic reactions or local irritation.
124
What is Amitraz used for?
Treatment of generalized demodicosis and flea/tick prevention.
125
What are the dosage forms of Amitraz?
* Mitaban (no longer available) * Preventic collar.
126
What are the adverse side effects of Amitraz?
* Not for use in dogs younger than 4 months * Toxic to rabbits and cats.
127
What is Crotamiton used for?
Topical miticide and scabicide for treating scaly leg mites in birds.
128
What is the dosage form of Crotamiton?
Eurax—human label.
129
What are the adverse side effects of Crotamiton?
Irritation and allergic reactions possible.
130
What is Deltamethrin used for?
Killing fleas and ticks on dogs; repelling sand fly vectors.
131
What is the dosage form of Deltamethrin?
Scalibor Protector Band for Dogs.
132
What are the adverse side effects of Deltamethrin?
Do not use on dogs younger than 12 weeks; toxic to fish.
133
What is Dinotefuran Plus Pyriproxyfen used for?
Control of adult and all immature flea stages.
134
What are the dosage forms of Dinotefuran Plus Pyriproxyfen?
* Vectra for Cats and Kittens * Vectra for Dogs and Puppies * Vectra 3D.
135
What are the technician notes regarding Dinotefuran Plus Pyriproxyfen?
Do not use products containing permethrin on cats or in households with both dogs and cats.
136
What is Fipronil used for?
Treatment of fleas, ticks, and chewing lice.
137
What are the dosage forms of Fipronil?
* Frontline Spray Treatment * Frontline Plus for Cats and Kittens * Frontline Gold for Cats and Kittens * Frontline Plus for Dogs and Puppies * Frontline Gold for Dogs and Puppies.
138
What are the adverse side effects of Fipronil?
Not to be used on puppies younger than 8 weeks; effective after bathing.
139
What is Imidacloprid used for?
Treatment of adult and larval flea stages in dogs and cats.
140
What are the dosage forms of Imidacloprid?
* Advantage II for Dogs * Advantage II for Cats * K9 Advantix II * Advantage Multi for Dogs * Advantage Multi for Cats.
141
What are the adverse side effects of Imidacloprid?
Do not use in puppies younger than 7 weeks or kittens younger than 8 weeks.
142
What is (S)-Methoprene used for?
Eliminating insects by preventing the maturation of eggs and larvae.
143
What are the dosage forms of (S)-Methoprene?
* Adams Flea and Tick Spot On for Dogs and Cats * Frontline Plus for Cats and Kittens.
144
What are the adverse side effects of (S)-Methoprene?
Can be toxic to kittens when combined with permethrin or phenothrin.
145
What is the clinical use of Permethrin?
Acts as an adult insecticide and miticide against fleas, lice, and ticks.
146
What are the dosage forms of Permethrin?
* Adams Flea and Tick Spot On * K9 Advantix II.
147
What are the adverse side effects of Permethrin?
Can be toxic to cats; only use products indicated for use in cats.
148
What is Selamectin used for?
Protection against fleas and heartworms; treats ear mites and sarcoptic mange.
149
What are the dosage forms of Selamectin?
Revolution for Dogs and Cats.
150
What is Selamectin used for in dogs?
Protection against fleas and heartworms, treats and controls ear mites, indicated for sarcoptic mange, and controls tick infestations due to American dog ticks. ## Footnote Selamectin is for dogs 6 weeks of age or older.
151
What is the minimum age for using Revolution Plus for cats?
8 weeks of age and weighing greater than 2.8 lb. ## Footnote Revolution Plus is specifically formulated for cats.
152
What are the clinical uses of Topical Pyrethrins?
Acts as adult insecticides and miticides against fleas, lice, ticks, and Cheyletiella. ## Footnote Pyrethrins are commonly used in various topical products.
153
Name two dosage forms of Topical Pyrethrins.
* Adams Plus Flea and Tick Shampoo With IGR * Pyrethrins Dip and Spray
154
What should be avoided after applying Topical Pyrethrins to cats?
Do not allow cats to groom themselves after products such as dips or sprays have been applied.
155
What is Pyriproxyfen used for?
It is a second-generation IGR added to premise sprays and topical products to act against fleas. ## Footnote IGR stands for Insect Growth Regulator.
156
List three dosage forms that contain Pyriproxyfen.
* Advantage II for Dogs * Effipro Plus Topical Solution for Cats * Frontline Gold for Dogs and Puppies
157
What is the primary clinical use of Spinetoram?
Prevention and treatment of flea infestations in cats and kittens 8 weeks of age or older.
158
What is Fluralaner used for in dogs?
Treatment and prevention of flea and tick infestations for 12 weeks. ## Footnote It is indicated for dogs 6 months of age and older, weighing 4.4 lb or more.
159
What is the most common side effect of Fluralaner?
Vomiting.
160
What was the diagnosis for Heidi in the case scenario?
Fleas.
161
What product was given to Heidi for flea control?
Adams d-Limonene Flea & Tick Pet Shampoo and Nexgard chewables.
162
What is Afoxolaner used for?
Treat and control flea and tick infestations in dogs. ## Footnote It is not to be used in cats.
163
What are some possible side effects of Afoxolaner?
* Nausea * Vomiting * Diarrhea * Lethargy
164
What does Lufenuron prevent?
Prevents flea eggs from hatching.
165
Name a dosage form that contains Lufenuron.
Sentinel Flavor Tabs for Dogs.
166
What is Nitenpyram used for?
Flea adulticide that kills fleas within 30 minutes.
167
What is the minimum age for using Nitenpyram?
Over 4 weeks of age and weighing more than 2 lb.
168
What is Spinosad used for?
Kills fleas and is given once a month orally.
169
What is the minimum age for using Spinosad in cats?
14 weeks of age or older and must weigh >4.1 lb.
170
What is the most common side effect of Spinosad?
Vomiting.
171
Fill in the blank: Fluralaner is indicated for the treatment and prevention of flea infestations in cats and kittens _______.
6 months of age and older, weighing 2.6 lb or more.

pharmacology prt 2 (6 decks)

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