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ACVIM Generals > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

MOA, side effects of cimetidine, famotidine, ranitidine

A

MOA: H2 receptor antagonists —> decrease H+ secretion and Pepsi open secretion. Cimetidine also has immunomodulatory effects. Ranitidine also has prokinetic effects (acetylcholinesterase inhibitor)

Side effects: bradycardia, hypotension, arrhythmias (with rapid IV admin); cytopenia with cimetidine

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2
Q

MOA, side effects of omeprazole, pantoprazole, esomeprazole

A

PPIs - inhibits H+/K+ ATPases on parietal cells

SE: diarrhea

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3
Q

MOA, side effects of misoprostal

A

MOA: synthetic PGE1 analog

SE: GI upset, uterine contractions, vaginal bleeding

Exposure risk to female owners

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4
Q

MOA, side effects of sucralfate

A

MOA: reacts with HCl in stomach forming a paste-like complex that binds the protein across exudates at ulcer sites —> creates a physiochemical barrier

SE: generally well-tolerated, rarely constipation

Considerations: best given on an empty stomach and separated from other drugs by two hours.

**Impairs absorption of antacids, ciprofloxacin, digoxin, ketoconazole, levothyroxine, macrolides, penicillamine, tetracyclines, theophylline, fat soluble vitamins, and warfarin

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5
Q

MOA, side effects of true antacids (calcium carbonate, sodium bicarbonate, magnesium salts, aluminum salts, and phosphate binders)

A

MOA: inorganic, relatively insoluble starts that partially neutralize gastric HCl when dissolved in the stomach (however large doses are needed to raise pH significantly)

SE: generally well tolerated

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6
Q

MOA, side effects of amyloid pine

A

MOA: calcium channel blocker —> results in peripheral arterial dilation with minimal cardiac effects

SE: reversible gingival hyperplasia, hypotension, bradycardia, inappetence

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7
Q

When used for hypertension, what magnitude of blood pressure reduction would you expect when giving amlodipine with an ACEi vs. ARB?

A

ACEi: 30-70mmHg
ARB: 10-20mmHg

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8
Q

MOA and side effects of enalapril and benazepril

A

MOA: angiotensin converting enzyme (ACE) inhibitor

SE: GI upset, hypotension, weakness, azotemia, and hyperkalemia

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9
Q

Enalapril has __ excretion

Benazepril has __ excretion

A

Enalapril = renal

Benazepril = hepatic

Benazepril may be preferred in cats with renal disease

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10
Q

MOA, side effects of telmisartan

A

MOA: angiotensin-II receptor blocker (ARB) - specifically blocks type 1 receptor (with 3000x more affinity than type 2)

Side effects: GI upset, hypotension, weakness, azotemia, hyperkalemia

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11
Q

MOA and side effects of atenolol

A

MOA: Beta-1 blocker

SE: diarrhea, inappetence, lethargy, bradycardia, hypotension, impaired AV condition, congestive HF, bronchoconstriction (less so with Beta-1 specific drugs), syncope

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12
Q

Amphotericin B is fungiSTATIC/CIDAL and concentration DEPENDENT/INDEPENDENT

A

Fungicidal

Concentration DEPENDENT

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13
Q

Spectrum, side effects of amphotericin B

A

Spectrum: broad spectrum (most systemic fungal infections, disseminated sporotrichosis, candidiasis, aspergillosis)

Side effects: nephrotoxicity in >80% of patients; anaphylaxis, fever, vomiting, anorexia, thrombophlebitis, hepatic dysfunction

**Newer formulas are available that increase hydrophobicity —> increased delivery to target site with decreased delivery to kidney

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14
Q

Polyenes antifungals and MOA

A

Amphotericin B
Nystatin, natamycin

MOA: interference with cell membrane function by binding ergosterol, forming pores in the fungal cell membrane which alters permeability

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15
Q

Spectrum of nystatin and natamycin

A

Broad spectrum

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16
Q

Route of administration of amphotericin B vs. nystatin

A

Amphotericin B = IV
Nystatin = topical

17
Q

Azole antifungals and MOA

A

Types: Ketoconazole, itraconazole, fluconazole, voriconazole, posiconazole

MOA: inhibition of cell membrane (ergosterol) synthesis

18
Q

Azoles are fugniCIDAL/STATIC

A

Fungistatic

19
Q

Spectrum and side effects of ketaconazole

A

Spectrum: topical mycotic infections (dermatology ties), Malassezia, dimorphism fungi (cryptococcosis)

Side effects: GI signs, hepatotoxicity (mild to moderate increases in ALT), ataxia, alopecia; can block cholesterol, cortisol, and androgen synthesis; lightening of hair coat

20
Q

Spectrum and side effects of itraconazole

A

Spectrum: broad (most fungal diseases)

SE: GI signs, hepatotoxicity, vasculitis/ulcerative skin lesions

**No blockage of adrenal steroid or testosterone synthesis compared to ketoconazole

21
Q

Which azole can reach the CSF?

A

Fluconazole

22
Q

Spectrum and side effects of fluconazole

A

Spectrum: most candida, dermatophytes, dimorphic fungi (cryptococcus, coccidiomycosis, histoplasmosis, blastomycosis)

Side effects: GI signs and mild elevation in liver enzymes

23
Q

Spectrum and side effects of voriconazole

A

Spectrum: wide

SE: teratogenic, GI upset, hepatotoxicity

24
Q

Spectrum and side effects of posaconazole

A

Spectrum: wide
SE: GI upset, hepatotoxicity

25
Q

What class of antifungal is terbinafine and what is the MOA

A

Class: Allylamine

MOA: inhibits synthesis of ergosterol (main sterol in fungal cell membrane)

26
Q

Terbinafine is fungiSTATIC/CIDAL

A

Fungicidal

27
Q

Spectrum and side effects of terbinafine

A

Spectrum: Broad (aspergillosis, blastomycosis, cryptococcosis, histoplasmosis, coccidiomycosis, Malassezia)

SE: mile liver enzyme elevations, GI upset, facial dermatitis and pruritis in cats

28
Q

What class of antifungal is caspofungin and what is its MOA

A

Class: Echinocandin

MOA: blocks synthesis of the cell wall by interrupting glucagon synth ease complex

29
Q

Spectrum and side effects of caspofungin

A

Spectrum: disseminated Candida infections (fungicidal) and aspergillosis (fungistatic)

SE: fever, phlebitis, rash (histamine-release) and increased ALT

30
Q

MOA of griseofulvin; cidal or static?

A

MOA: inhibits mitosis via disruption of the mitosis spindles causing mitosis arrest

Fungistatic

31
Q

Spectrum and side effects of griseofulvin

A

Spectrum: limited to organisms causing dermatophytosis; NOT effective against yeasts

SE: vomiting, teratogenesis and anemia (at high doses in cats)

32
Q

What is lufenuron and it’s MOA

A

Benzylphenol urea derived from insecticide used as an oral flea control; can be used as antifungal

MOA: interferes with chitin synthesis (in outer cell wall of fungi)

33
Q

What is 5-flucytosine and MOA

A

Originally anti-cancer, can be used as antifungal but rapid resistance develops (especially for cryptococcosis and candidiasis)

MOA: interferes with RNA and DNA synthesis after conversion to 5-FU (prevents synthesis in fungal cell)

Fungistatic and time dependent

Spectrum: Limited (cryptococcosis, candidiasis, aspergillosis, sporotrichosis)

SE: BM suppression, GI upset

34
Q

What classes of antiarrhythmics are used for tx of supraventricular tachycardia

A

Beta blockers
Calcium channel blockers
Digoxin

35
Q

What classes of antiarrhythmics are used for tx of ventricular tachycardia

A

Acronym = SPAAM
Sotalol
Procainamide
Atenolol
Amiodarone
Mexiletine

36
Q

What is used to treat bradyarrhythmias?

A

Pacemaker

37
Q

MOA of pimobendan

A

Calcium sensitizer (acts on heart muscle) → positive inotrope

Phosphodiesterase-3 inhibitor arterial and venous vasodilation) – arterial vasodilation (decreasing after load) and venous vasodilation

ACVIM Generals (16 decks)

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