Pharma Midterm 2 Flashcards
(250 cards)
1
Q
define a central muscle relaxant
A
relative specific depressant action on CNS
(causing decreased motor activity or paralysis of voluntary muscles without loss of consciousness)
2
Q
Which CNS inhibitory drug demonstrate the strongest muscle relaxant effect
A
Phenotiazine
3
Q
Which CNS inhibitory drug demonstrate the weakest muscle relaxant effect
A
Anaesthetics
4
Q
What are the medical uses of muscle relaxant?
A
- central myorelaxants can potentiate the effect of anesthetics drugs and combinations
- used in control of certain spasmodic and painful disorders of skeletal (spinal) muscle
5
Q
Give the main central muscle relaxant drugs?
A
- guaiphenesin
- baclofen
- Methocarbamol
- Carisoprodol
6
Q
What is the indication for Guaiphenesin ?
A
- horse, cattle, sheep (with anaesthesia)
- équine tetanus, strychnine poisoning in dogs
7
Q
What is baclophen mechanism of action ?
A
- GABAb agonist
8
Q
indication of Baclophen?
A
- spasm of skeletal muscle
- spinal cord injury and pain caused by injuries
- use in dogs to treat urinary retention (reduces urethral resistance)
9
Q
How is Carisoprodol used?
A
useful against various types of pain because of its potentiating effect on opioid analgesics
10
Q
Indication for the use of Methocarbamol?
A
muscle inflammation, traumatic muscle spasm
11
Q
Which ligand bounds to the nicotinic receptor
A
Acetycholine
12
Q
What are the uses of neuromuscular blocking agents?
A
- adjuvant in surgical anaesthesia
- assist in intubation
- corneal or retinal surgeries to obtain relaxation of extra ocular muscles
- therapy of spastic disorder
with an IV or systemic administration
13
Q
Give the main peripheral muscle relaxants?
A
- Suxamethonium
- Atracurium
- Pancuronium
- Rocuronium
- Vecuronium
- Tubocurarine
14
Q
what are the undesirable side effects of depolarizing agents (peripheral muscle relaxants)?
A
- Bradycardia
- increased intra-ocular and intragastric pressure
- Anaphylaxis or malignant hyperthermia
15
Q
What are the 2 groups of competitive neuromuscular blocking agents?
A
- Benzylisoquinoline (metabolised in blood plasma, HA release)
- Aminosteroid (metabolised in Liver, no HA release)
16
Q
d- tubocurarine
A
long acting
HA release
excretion via urine
17
Q
Atracurium
A
intermediate acting
safe in liver, kidney patients
not used in vet med
18
Q
Sympahtetic nervous system
A
fight or flight
19
Q
Parasympathetic nervous system
A
rest and digest
20
Q
Transmitter for sympathetic nervous system?
A
norepinephrine
21
Q
Where is the M2 muscarinic Ach receptors found, and what is its effect
A
heart
inhibition
22
Q
Where are the M1, M3 Ach receptor found and what do they do?
A
- stomach, glands, bronchial smooth muscle, eye ciliary muscle (excitation)
- vascular endothelium (inhibition)
23
Q
Give an antagonist to Acetylcholine
A
Atropine
24
Q
Give a drug used against spasms
A
Atropine
25
effect of parasympathomimetics on the heart
negative chronotropic
26
effect of parasympathomimetics on the GI-tract
smooth muscle contraction
vomiting, diarrhea
27
effect of parasympathomimetics on the Resp tract
bronchoconstriction & increase bronchial secretion
28
effect of parasympathomimetics on the urinary tract
bladder contraction
29
What Is the difference between direction and indirect parasympathomimetics
direct : binds to Ach receptors
indirect: inhibition of Ach-esterase -> Ach degradation is reduced
30
Which parasympathomimetics is not used therapeutically
Acetylcholine
31
Which parasympathomimetics is only used locally, applied in uterus in case of metritis , and in glaucoma therapy as eye drops?
Carbachol
32
Which parasympathomimetics is a M-Ach R selective and used for urinary bladder atony?
Bethanechol
33
Which parasympathomimetics are M-Ach R selective?
Bethanechol
Methacholine
Mainly in human practice
34
Which parasympathomimetics are non-selective M-Ach R?
Acetylcholine
Carbachol
35
Give a direct parasympathomimetic, what
Pilocarpine
Used in ophthalmology :
- glaucoma therapy
- Keratoconjunctivitis sicca (KCS)
36
Give the indirect parasympathomimetics
Physostigmine
Pyridostigmine
Neostigmine
37
Which indirect parasympathomimetics has a very small therapeutic index systemically?
Physostigmine
38
Which indirect parasympathomimetics is used as a myasthenia gravis treatment given IV or IM
Neostigmine
39
Which indirect parasympathomimetics is used as a myasthenia gravis treatment given orally
Pyridostigmine
40
Which indirect parasympathomimetics is an irreversible inhibitor of AchE
Organophosphates
41
Which indirect parasympathomimetics is a competitive inhibition in neuromuscular junction and has a short effect
Edrophonium
42
How are Parasympatholytics used in the cardiovascular system
to lift cholinergic blockade of the heart
43
How are Parasympatholytics used for Resp tract
for bronchodilator and decrease mucus secretion
44
Why are Parasympatholytics used as premedication before surgery?
- antagonist bradycardia
- decrease saliva production
- decreasing bronchial secretion
- earlier inhalation anaesthetics
45
How can Parasympatholytics be used for therapy?
- eye treatment (short and long acting)
- bronchodilation (asthma)
- antidote in case of toxicoses (organophosphate toxicosis)
- antidiarrheal (ruminant)
- antispasmodics (used in colic horses)
46
Which specie is relatively resistant to atropine
Rabbit
47
Give the active substances of Parasympatholytics
- atropine (premedication)
- glycopyrrolate (premedication)
- homatropine (diagnostic eye exam)
- tropicamide (diagnostic eye exam)
- ipratropium (asthma)
- benzethimid (antidiarrheal)
- Butyl-scopolamine (antispasmodic)
48
What is the action of a1 receptor once activated
Smooth muscle contraction
Vasoconstriction
Mydriasis
49
What is the a2 receptor action once activated
Inhibition of NA Release
GI relaxation
Inhibition of insulin release
50
B1 receptor action
Cardiac, positive inotropic and chronotropic
51
B2 receptor action
Vasodilatation
Bronchodilatation
Uterus relaxation
52
B3 receptor action
Lipolysis in fat tissue
53
Cardiovascular effects of Sympathomimetics
+ chronotropic
+ inotropic
Vasodilation (b2 agonist)
Vasconstriction (a1 agonist)
54
Gastrointestinal effect of Sympathomimetics
Smooth muscle relaxation
GI Atony
55
Resp effects of Sympathomimetics
Bronchodilation
Decrease bronchial secretion
56
List the nonselective Sympathomimetics, and the receptors they act on
- adrenaline (b1,2 < a)
- noradrenaline (b1 and a1)
- dopamine ( D1 < b1< a1)
57
Give a Selective sympathomimetics for b1
Dobutamine, cardiogenic shock
58
Give a Selective sympathomimetics for b receptors
Isoproterenol
59
Give the b2 agonists
Clenbuterol
Salbutamole
Terbutaline
Salmeterole
Isoxsuprine
60
What happens if a b2 agonist is used in higher dosage
Acts on b1 receptors, cardiac effect
61
Indication to use b2 agonist
Horse RAO
feline asthma
Bronchitis, bronchopneumonia
Tracheal hypoplasia
Tracheal collapse
62
Give a Selective sympathomimetics of a1 R
Phenylephrine, vasoconstriction
Xylometazoline
Oxymetazoline
Naphazoline
Tetryzoline
63
Give a Selective sympathomimetics of a1 used for urinary bladder sphincter constriction
Phenylpropanolamine
64
What are the a2 agonist
Sedate hypnotics
- xylasine
- detomidine
- medetomidine
- romifidine
65
Give non selective a-antagonists
- phenoxybenzamine (urethra sphincter relaxation)
- phentolamine
- tolazoline
66
Give a1 antagonist
Prazosine
Doxasozine
67
a2 antagonist
Atipamezole
Yohimbine
68
B receptor antagonist
Propranolol
Timolol
69
B1 R antagonists
Metoprolol
Atenolol
70
Where is cortisole made in the body
Adrenal cortex
71
What is cortisol's effect on the body
has a negative effect on Hypothalamus and hypophysis
72
What is the meaning of a glucocorticoid
glucose activated cortex steroid
73
Main physiological and pathological effect of glucocorticoid
stress hormone
diabetogenic
gluconeogenesis increase
muscle atrophy
decreased growth
polyuria/polydipsia
skin thinning
74
Pharmacological effects of glucocorticoids
anti inflammatory
antiallergic
immunosuppressive
antishock
neuroprotective
75
Where is the glucocorticoid's receptor
intracellular
76
what is the mechanism of action of glucocorticoids
inhibits (cytokines) or induces certain genes
77
For what treatment would glucocorticoids be used in cats and horses?
asthma
78
Which mechanisms do glucocorticoid inhibits?
lipoxygenase (asthma)
Cyclooxygenase
Epoxigenase
79
How are glucocorticoids antiinflammatory and immunosuppressive drugs?
inhibits PLA2
inhibits expression of IL1-2-6
decrease TNF & IFN synthesis
apoptosis in lymphocytes
80
How do glucocorticoid have a neuroprotective effect?
NOT FOR BRAIN TRAUMA
counteract lipidperoxidation and enhance microcirculation
81
Which drug has for active substance acetate? how long does it act for?
Prednisolone, 5-6 days
82
Which drug has for active substance dipropionate? how long does it act for?
Betamethasone, 3 weeks
83
List the Glucocorticoids according to their potency
cortisol
Prednisolone
Methyprednisolone
Triamcinolone
Betamethasone
Dexamethasone
Beclomethason
Fluticason
84
Side effects of glucocorticoids
HT - hypophysis - adrenal cortex axis inhibition
gastric ulcers
hepatopathy (ALKP increase)
Pancreatitis
Glaucoma
Thinning of skin, delayed wound
Appearing of tumor
Polyphagia
85
Why would glucocorticoid be used in a high dosage
Only once, IV if
shock
spinal trauma
86
How could glucocorticoid Be used in an ADT
Using Prednisolone, methylprednisolone
every other day
87
How could glucocorticoid Be used in an ADT
Using Prednisolone, methylprednisolone
every other day
88
Which pathway do NSAIDs inhibit
Cylcooxigenase (COX)
PGF, PGE, PGI, TX
89
what's the main physiological role of PGE, TXA
Stomach: intestine protection
decrease acid secretion
Blood clotting
Kidney : increased blood flow
90
What are the most important side effects of NSAIDs
renal toxicity
intestinal ulceration and ulceration
91
where can we find COX1 isoenzyme
stomach, kidney, platelets
(constitutive)
92
Where can we find COX2 isoenzyme
Macrophages
(Induced by inflammation)
93
What other name is there for acetaminophen?
Paracetamol
94
What are the main effect of paracetamol and metamizole
analgesic
antipyretic
NO ANTI INFLAMMATORY EFFECT
95
Ketoprofen and aspirin are also known as
Traditional NSAID drug
(mainly COX 1 inhibition)
96
Meloxicam, Carprofen, Deracoxib, Firocoxib are inhibiting which isoenzyme
COX 2
97
Give the drugs that act as COX 2 inhibition
Meloxicam, Carprofen, Deracoxib, Firocoxib
98
What are the pharmacological effects of NSAIDs
Anti Inflammatory
Analgesic
Antipyretic
Platelet aggregation inhibition (antiendotoxin, spasmolytic, antineoplastic)
99
Example of antiendotoxin drug?
Meloxicam
100
Meloxicam has for pharmacological effect?
Antiendotoxin
101
Example of spasmolytic NSAID drug?
Flunixin
102
Flunixin has for pharmacological effect?
Spasmolytic
103
Example of anti neoplastic drug?
Pyroxicam
104
Pyroxicam has for pharmacological effect?
Anti neoplastic
105
Give the loading dose and maintaining dose of Carprofen
LD: 4.4mg/Kg
MD: 2.2 mg/Kg
106
Which NSAIDs can be given to cats with half of the dose?
Meloxicam
107
can the fullness of the stomach have an effect on NSAIDs action?
Yes will affect the absorption
108
Give the Loading dose and maintaining dose of Meloxicam?
LD: 0.2mg/Kg
MD: 0.1 mg/Kg
109
What are all the side effects of NSAIDs?
- GI ulceration
- Kidney damage
- Hepatotoxicity (rarely - NAPQI)
- Platelet aggregation inhibition
- Methaemoglobinaemia (NAPQI converts Fe2 ->Fe3)
- cartilage damage
- fetal damage
- placental retention
110
What is the active substance Acetysalycilic acid known as?
Aspirin
111
Give the drugs from the Arilpropionic acid group
Ketoprofen
Vedaprofen
Carprofen (hepatopathy)
112
Give the drugs under the Oxicams group
Piroxicam
Meloxicam (antiendotoxin)
113
Which drug is considered as an Anilin derivates
Paracetamol
114
Which drug is considered as Pyrazolines and what does it inhibit?
Metamizole sodium, COX3
115
Give the drugs belonging to the coxib groups
Deracoxib
Firocoxib
Robenacoxib
Cimicoxib
Mavacoxib
116
Compared to other NSAIDs what are the effects of Coxibs?
Low GI side effects
same side effects on kidneys
Higher cardiovascular effect than other NSAIDs
117
Why are JAK inhibitors useful to use as anti-inflammatory?
After recognizing a cytokine, the receptor induces the transcription of inflammatory processes
118
Most common JAK inhibitor
Oclacitinib
119
What type of drug is Oclacitinib
JAK inhibitor
120
Which indication is Oclacitinib most commonly used?
Atopic dermatitis
121
What is the action of Oclacitinib?
Primary JAK 1 inhibitor
IL-4,13 and 31 inhibited
122
What are the pharmacological effects of JAK inhibitors?
Anti inflammatory
Anti allergic
Anti pruritus
123
How can JAK inhibitors be administered
Orally
124
What is the mechanism of action of anti histamines
Inverse Agonist
125
What is the difference between 1st and 2nd generation antihistamine
2nd G cannot cross the blood brain barrier
126
1st generation of antihistamine drugs
Chloropyramin
Diphenhydramine
Cyproheptadine (can increase appetite)
127
2nd generation anti histamine
loratadine
cetirizine
levocetirizine
128
Side effects of 1st generation anti histamines?
CNS depression
Cardiac toxicity
Anticholinergic
129
What are the 4 categories of drugs that can be used to act as immunosuppression?
Antimetabolites
Alkalating agents
Glucocorticoids
Cytokine gene expression inhibition
130
Give a folic acid antagonist drug
methotrexate
131
give a pyrimidine analogue drug
leflunomide
132
Give a purine analogue drug
azathioprin
133
Give a calcineurine inhibitor drug
cyclosporine
134
Antimetabolites have which effects?
anti neoplastics
135
How does folic acid antagonist act?
Apoptosis of activated T cells
136
What type of drug is cyclophosphamide?
Alkylating agent
angine-plastic agent, auto immune disorders
137
How can cyclosporin be applied
Orally, and locally
138
What could cause an arrhythmia?
ectopic impulse (anormal sinus rythme)
cardiomyopathy
re-entry
drugs
électrolyte imbalance
139
What is the class I anti arrhythmia drugs
Na-Channel blockers
140
What is the effect of lidocaine on the ERP
decreases
141
what is the effect of Quinidine on the ERP
increases
142
What are the major effects of Quinidine
Anti-Vagal effect
negative inotropic effect
(NOTTO BE USED IN HEART FAILURE)
143
Which animal can quinidine be used PO or IV
Horses
144
Examples of I. A. anti arrhythmia drugs:
Quinidine
Procainamide
Mexiletine
145
In which situation is lidocaine used
Immediate treatment of life threatening ventricular arrhythmias
146
What can be used in case of lidocaine overdose
Diazepam
147
Mexiletine is used for which treatment?
ventricular arrhythmia at home
given orally
148
what are class II antiarhythmic drugs
Beta receptor blocker
149
What are the indication of Class II anti arrhythmic drugs
supraventricular and ventricular arrhythmias
preventing sudden death
hyperthyroidism
methylxanthine poisoning
150
what can be used in case of methylxanthine poisoning?
beta blockers
151
What kind of drug is Propranolol
Beta blocker 1 and 2
152
Example of beta blocker 1
metoprolol
atenolol
esmolol
153
What is the Class III antiarrhytmic drugs?
K+ Channel blocker, ERP increase
154
Class III drug that has a beta blocker effect and is excellent in boxer cardiomyopathy?
Solatol
155
Which class II drug has class I, II, III, IV effects?
Amiodarone
156
What is a Class IV antiarrhytmic drug?
Ca2+ channel blocker
Decreases Ca2+ influx --> decreases contraction and vasodilatation
157
Which class IV drugs act on the heart with a negative inotropic effect ?
verapamil
diltiazem
158
What is the effect of dihydropyridine type drug
dilate the vessels
159
What heart condition mostly occurs in large dog breeds
hypertrophic / dilation cardiomyopathy
160
What are the main factors affecting heart performance
Preload
Contractility
Afterload
Frequency
161
What type of drug is used to lower the preload
diuretics
162
Which drugs are used to increase frequency and which one is the best?
Adrenaline, Dobutamine ( the best only acts on b1)
163
What are the treatment option to increase contractility
digitalis glycosides
PDE inhibitors
164
What are the treatment option to decrease preload and afterload
ACE inhibitors
PDE inhibitors
165
What are PDE inhibitors called
Inodilators
166
How do we administer drugs in acute heart failure
IV
167
Which drugs are used in case of chronic heart failure
Digitalis glycosides
Pimobendan
168
Pharmacological effect of Digoxin?
+ inotropic
increases parasympathetic nervous system (heart will slow down)
169
Cardiac drug level has to be measured after 3-5 days
Digoxin
170
Why is Digoxin very toxic?
very small therapeutic index
accumulation in myocytes (take a break of 1 day in the treatment every week to avoid overdose)
171
Digoxin antidote
Lidocaine
172
Cardiac side effects of Digoxin
arythmias, bradycardia
173
Digoxin contraindications
kidney failure,
outflow obstroction
174
Effects of Pimobendan
+ inotropic
arterial/venous dilatation
175
contraindication of Pimobendan
outflow obstruction
176
Administration, side effects, contraindication of Pimobendan
twice daily orally, 1 hour before feeding
minimal side effects
outflow obstruction
177
Broncho constriction , airway hyper responsiveness and airway inflammation is a characteristic of
Asthma
178
RAO means
recurrent airway obstruction
179
COPD means
chronic obstructive pulmonary disease
180
COPD is divided into 2 frequent diseases
emphysema
chronic bronchitis
181
What types of drugs can be used as bronchodilators
beta 2 receptors drugs
182
in which species is asthma more frequent
Cat
183
In which species is RAO most common
Equine
184
Which cells need to be blocked before the allergy starts ?
Mast cells
185
The 4 types of drugs used in the respiratory system?
bronchodilators
respiratory antiinflammatory
antitussives
mucolytics, expectorants
186
in which case should bronchodilators be used
anaphylaxis: adrenaline, GCsteroids
allergic bronchitis
asthma, RAO
pneumonia
187
What are the bronchodilators
sympathomimetics
anticholinergic substances
Xanthine derivates
188
What receptors do sympathomimetics act on for bronchodilation?
Beta 2
189
What receptors do non-selective sympathomimetics act on like adrenaline?
beta 1,2 and alpha 1 R
190
Which case can we use adrenaline as bronchodilators?
life threatening, IV, IM or intratracheal
191
What other non selective sympathomimetics can be used for bronchodilaton?
Adrenaline
Ephedrine
Isoproterenol (doesn't act on alpha 1)
192
Selective sympathomimetics used as bronchodilators examples
short acting beta2 agonist:
Salbutamol (not for maintenance)
long acting beta2 agonists:
terbutaline (feline asthma)
clenbuterol (horse )
Salmeterol
193
What can be a side effect of a sympathomimetics?
beta1: cardiac effect (tachycardia, arrhythmia)
beta2: skeletal muscle tremor
alpha1: vasoconstriction and hypertension
194
What are the effects of parasympatholytics on the respiratory tract
bronchodilator and decreased mucous secretion
195
Example of bronchodilators parasympatholytics drugs?
Atropine
Glycopyrrolate
Ipratropium (doesn't crossBBB)
196
Example of methylxanthine derivatives bronchodilators drugs
aminophyllin
propentophyllin
pentoxyfillin
197
What are the therapeutic uses of methylxanthines
acute/chronic asthma that is unresponsive to beta-adrenoreceptor agonist
198
What are the indications of respiratory antiinflammatories
asthma
RAO
199
Which types of drugs can be used as respiratory antiinflammatories
inhalation glucocorticoids
chromones
leukotriene antagonists
200
Which respiratory antiinflammatories is the most effective
inhalation glucocorticoids
201
What are the effects of inhalation glucocorticoids
decreased mucous production
increasing diameter
202
Which inhalation glucocorticoid is used in Eq?
Beclomethasone
Fluticasone
203
Chromones are used as
prevention
204
Zileuton is a
leukotrien synthesis inhibitor
205
zafirlukast is a
leukotriene antagonists
206
define antitussive
any medicine used to suppress or relieve
coughing
207
define mucolytic
destroying or dissolving mucus
208
define expectorants
drugs that loosen and clear mucus and phlegm from the respiratory tract
209
What combination is used to treat asthma long term
Glucocorticoids and beta2 mimetics
210
What are the central antitussives
morphine derivatives
211
Main antitussives
Codein (NOT IN FE)
dihydrocodeine
hydrocodone
butorphanol
tramadol (safe in fe)
Dextrometorphan (safe in fe)
212
Examples of mucolytics
N-Acetylcysteine
Carbocystein
213
Example of expectorants
Bromhexin (Ambroxol)
Dembrexine
Guaifenesin
214
What effects does Guaifenesin have?
muscle relaxant
expectorant
215
Which expectorant is only used in horse
dembrexine
216
What is the rule regarding treatment with expectorants
DO NOT combine antitussif and expectorant
217
Which expectorant CAN be combined with antitussif
Guaifenesin
218
indication of ACE inhibitors
heart failure (dog, horses)
hypertension ( dog, cats)
proteinuria
219
Pharmacological effect of ACE inhibitors
vasodilation
ventilation
water excretion
Decrease preload/afterload
220
Administration of ACE
orally
221
ACE inhibitor safe for liver failure patients
lisinopril
222
type of treatment of ACE inhibitors
onset action 4-6 hours so only long term treatment not acute
223
ACE inhibitor excreted by kidney
Enalapril
ramipril
224
ACE inhibitor excreted by bile and its dose
Benazepril
D: 0,25-0,5mg/Kg
225
ACE inhibitors side effects
azotaemia
hypotension
226
Angiotensin II receptor antagonists
Telmisartan
227
What is organic nitrates' pharmacological effect?
arterial and VENOUS dilation
228
organic nitrates drug example
Nitroglycerin
229
Indication & Administration of Organic nitrates
Acute heart failure of decompensated chronic heart failure
first pass effects, IV, sublingual
transdermal patch, ointment
230
Ca2 channel blocker two main groups
dihydropyridines
non-dihydropyridines
231
dihydropyridines drug
Amlodipine
232
Amlodipine indication
arterial vasodilation
233
Amlodipine side effect
cat hypertension
234
alpha 1 antagonists used for urinary bladder release
Prazosin
Doxazosin
235
Drug belonging to osmotic diuretics group
Mannitol
236
Mannitol indication
life threatening edemas
acute renal failure
ophtalmology
237
Administration of Mannitol
IV
238
What are called the Natriuretics acting on the proximal tubule
Carboanhydrase inhibitors
(mild diuretics 10% of reabsorption)
239
indication of carboanhydrase inhibitors
glaucoma
alkalizing urine
240
Carboanhydrase inhibitors drugs and their administration
Acetazolamide (oral)
dorzolamide (eye drops)
brinzolamide (eye drops)
241
Where do the loop diuretics act?
loop of Henle
242
which are the most effective natriuretic
loop diuretics
243
loop diuretics drug example
Furosemide (potassium complementation needed)
244
Indication for furosemide
heart failure
edemas
245
Side effect of furosemide
hypokalemia
hypotension (Fe)
246
Doses of furosemide for max dose for Canine, Fe, Eq.
1-5 mg/kg
Ca: 8 mg/kg max
Fe: 4mg/kg max
Horse: 1-2 mg/Kg
247
Which type of natriuretic act on the distal tubule
Thiazides
248
Example of thiazides & drugs main usage
Hydrochlorothiazides
against Ca oxalate urolithiasis
249
2 groups in the potassium sparing diuretics
Amiloride, triamterene
Aldosterone antagonists
250
Indication of Spironolactone
antagonist aldosterone in CHF
preventing diuretic induced "aldosterone-escape"
