Pharmocology Lecture

Question 1

What are drugs used for?

Answer 1

they are used to maintain health, reverse disease processes, relieve signs , prevents disease, alter the normal disease processes aids in diagnosis

Question 2

What are some drug sources?

Answer 2

Biological, Mineral/Chemical (AKA synthetic) and genetically engineered

Question 3

Biological Source of Drugs

Answer 3

Plants- alkaloids, glycosides, gums, resins/oil
Bacteria- antibiotics
Fungi- antiparasitic
Animals- insulin and heparin

Question 4

Mineral Sources of Drugs

Answer 4

Electrolytes: sodium, potassium, and chloride
Minerals: iron, zin, magnesium, and selenium

Question 5

Chemically Modified Sources of Drugs

Answer 5

Naturally occurring compound which is chemically altered to render it more effective or safer.
Example: 1st, 2nd, 3rd,4th and 5th generation cephalosporins

Question 6

Genetically Engineered Sources of Drugs

Answer 6

Genetic engineering is the process of using recombinant DNA technology to alter the genetic makeup of an organism
Example: Humulin and Epogen

Question 7

Drug Names

Answer 7

Chemical Name: Chemical Structure, (+/-)-2 P-isobutylphenyl) proprionic acid
Generic Name: compounds can only have one generic name, (example ibuprofen)
Trade Names: companies may purchase trade names for compounds (example Motrin and advil)

Question 8

Drug Names

Answer 8

Generic= diazepam
Trade: Valium
Generic: acetaminophen
Trade: tylenol
Generic: carprofen
Trade: rimadyl

Question 9

Drug Formulary

Answer 9

Contains the “legend” dugs (drugs which are available only by prescription)
Information- drug names, drug actions, drug effects, drug side effects, drug contra-indications, drug dosages, how supplied

Question 10

Drug Administration

Answer 10

Patient Factors- disease state, nutrition status, hydration status, temperament, generic factors and consciousness
Client Factors- ability, and duration of effects
Drug Factors- chemical nature and efficacy

Question 11

Drug Formulations

Answer 11

Solids: Bolus, Pastes, Powder, Tablet, Capsule, Suppository
Liquids: Emulsion, Tincture, Syrup, Spray

Question 12

Parenteral Medications

Answer 12

Subcutaneous (SQ)
Intramuscular (IM)
Intravenous (IV)

Question 13

The Six Rights

Answer 13

Right patient, right does, right drug, right route, right time, right documentation ( drug orders will alway be documented in the patients medical record)

Question 14

Right Time Interval

Answer 14

SID- once a day
BID- twice a day
QID- four times a day
Q1 HR- every 1 hr
QOD/EOD- every other day

Question 15

Routes of Drug Administration

Answer 15

Oral
Suppository
Topical
Subcutaneous
Intramuscular
Intravenous
Intraosseous
Intraperitoneal

Question 16

Topical: OD, OS, OU, AD, AS, AU

Answer 16

formulation designed for specific region
Skin
Ear: AU (both ears) AD (right ear) AS (left ear)
Eye: OU ( both eyes) OD (right eye) OS ( left eye)

Question 17

Oral ( per os): PO

Answer 17

By mouth
Adv: safe and easy
Disadvantage: slowest route of absorption
Bioavailability of the drug: must have GI barrier

Question 18

Intraperitoneal (IP)

Answer 18

Most common route in small mammals like mice and rats
Injection into the peritoneal cavity

Question 19

Subcutaneous (SQ)

Answer 19

Advantage: fairly safe route, faster absorption than oral route and large volumes can be administered
Disadvantage: slower absorption than IV/I’m , low absorption in dehydrated patients and thick solutions may rotate the skin

Question 20

Intramuscular

Answer 20

Injection into the muscle
Advantage: fairy rapid route, longer duration of action than IV , and can administer irritating substances deep into the muscles
Disadvantage: irritating, Inadvertent IV injection and nerve damage is possible

Question 21

Intramuscular Sites

Answer 21

Dog and Cat: Lumbar (epaxial) Quadriceps, Hamstrings, Triceps
Horse: injection triangle, pectoral, hamstring and gluteals
Cow: injection triangle
Bird: pectoral muscle

Question 22

Intravenous

Answer 22

Advantage: most rapid route, offers a route for irritating or caustic drugs
Disadvantage: drug must be formulated for IV use
+/- short duration

Question 23

Intraosseous

Answer 23

Advantage: rapid absorption, easily accessible when there is no vascular access
Disadvantage: requires great skill, may be uncomfortable for the patient, potential for infection, must use specific bones for birds, and can’t inject myelotoxic substances

Question 24

Epidural

Answer 24

Administration around the spinal cord

Question 25

Syringes

Answer 25

plastic or glass Many sizes Syringe parts: tip, needle hub, barrel, flange, plunger

Question 26

Needles

Answer 26

Supplied in different diameter sizes or “ gauges” Needles run from 27g( smallest) to 14g ( largest) Needles should always be placed into the insertion sight bevel up

Question 27

Reading a Syringe

Answer 27

Make sure all air bubbles are absent Read a the top of the plunger line Scale has large numbered lines and small non-numbered lines

Question 28

Drug Safety

Answer 28

Toxcity: lethal dose/ therapeutic range: LD50 Effective range: ED50 Margin of safety= therapeutic index: LD50/ED50 Example for a euthanasia solution= ED50=LD50 Example= ED50=10mg, LD50=100/100/10=10 Therapeutic index=10

Question 29

Pharmacokinetics

Answer 29

How drugs move in the body They move through the body by absorption, biotransformation/metabolism and excretion

Question 30

Drug absorption

Answer 30

Plasma level of drug is what is measured ◦ Depended on route and chemical nature of the drug

Question 31

Bioavailability

Answer 31

A term used to describe the amount of administered drug which reaches the blood High bioavai = almost completely absorbed Low Bioavai = poorly absorbed PO

Question 32

Drug Distribution

Answer 32

Transfer of absorbed drug to distant sites in the body ◦ Protein Binding ◦ Albumin & Globulin ◦ Tissue composition ◦ Blood Flow to area

Question 33

Absorption Barriers

Answer 33

Blood-Brain ◦ Tightest barrier Blood-Mammary/Blood Milk barrier Blood-Aqueous Blood-Placental

Question 34

Biotransformation

Answer 34

Metabolism: chemical alteration or breakdown of drugs ◦ Most takes place in the liver ◦ Affected by age, disease, Nutrional status, and species ◦ Usually makes drugs more water soluble

Question 35

Drug Excretion

Answer 35

Elimination of the drug from the body ◦ Renal (most important) ◦ Liver: fat soluble drugs excreted in bile ◦ Respiratory ◦GI ◦ Skin ◦ Mammary Gland

Question 36

Pharmacodynamics

Answer 36

How drugs exert their action or effect ◦ Agonist ◦ Turns on a cell function or receptor ◦ Antagonist ◦ Turns off a cell function or receptor

Question 37

Regulatory Agencies

Answer 37

Food and Drug Administration (FDA) US Dept. of Food & Agriculture (USDA) Environmental Protection Agency (EPA) Drug Enforcement Agency (DEA)

Question 38

Food and Drug Administration

Answer 38

Enforces laws that assure safety, effectiveness and labeling of drugs Regulates OTC, and “legend” drugs ◦ OTC: “over the counter” drugs which are available without a prescription ◦ Legend Drugs: Drugs which must be prescribed with a valid Doctor – Patient/Client/VET relationship ◦ Regular Rx drugs: patient must be seen within the last year

Question 39

FDA

Answer 39

Many drugs are not FDA approved for use in all species Veterinarians are exempted from laws which prohibit “extra label use” of the drug (under guidelines of the Animal Medicinal Drug Use Clarification Act of 1994)

Question 40

USDA (AKA US. Dept. of Food and Agriculture)

Answer 40

Regulates substances manufactured from living agents ◦ Antibodies ◦Toxoids ◦ Vaccines

Question 41

Environmental Protection Agency

Answer 41

Regulates insecticides, disinfectants, chemical waste products, etc.

Question 42

Drug Enforcement Agency (DEA)

Answer 42

Regulates the “Controlled Substances” ◦ Comprehensive Drug Abuse Prevention and Control Act of 1970 ◦ Identifies compounds which have a known human abuse potential

Question 43

Controlled Substances

Answer 43

Are classified into one of five “schedules” ◦ Schedule I ◦ High abuse potential: illegal substances; no accepted medical use ◦ Schedule II ◦ High abuse potential: accepted medical use ◦ Schedule III ◦ Moderate abuse potential ◦ Schedule IV ◦ Low abuse potential ◦ Schedule V ◦ Low abuse potential Must keep a controlled substances log, Must keep in a locked cabinet Must have established client-patient relationship and an exam has to be up to date Prescribing doctor must ◦ Have a valid state licensure ◦ Have a valid DEA license ◦ Have a valid Dr. - patient/client relationship ◦ File inventory log every 2 years ◦ File prescribed drug patient record every month (Schedule II CA) ◦ RVTS can hold a DEA license in CA for the purposes of ordering euthanasia agents while under the employ of a shelter or research facility

Question 44

Controlled Substacne Log

Answer 44

Must have for each substance ◦ Order number ◦ Supplier ◦ Amount received ◦ Date received ◦ Log must include name, date of birth, and address of patient who received the drug

Question 45

Disposal of Controlled Substances

Answer 45

Brokenvial: musthaveawitnesssignand date logbook Discarded portions: must have a witness sign and date Expireddrugs: shouldbedisposedusinga licensed reverse carrier

Question 46

Writing a Prescription

Answer 46

Review the 5 rights! Carefully observe the animal for any adverse reaction Question orders which are unclear, or possibly wrong Accurately create labels and affix them to the container Explain medication, route, effects and side effects to the client Record in patient medical record Client counseling

Question 47

The Prescription Label

Answer 47

Hospital name, address and phone number Prescribing Doctor Date prescribed Patient & client name Patient species Instructions for use Medication name & Strength: required on all dispensed drugs! Amount dispensed Expiration date Special Instructions (refrigerate, shake well, etc) Number of refills

Question 48

Dispensing Medication

Answer 48

In California, all pharmaceuticals must be dispensed in childproof containers

Question 49

Weights and Measures

Answer 49

Apothecary system Metric System ◦ Grains, drams Household system ◦ Ounces, pints, gallons Kg to g, mL to ug

Question 50

Basic dosage Calculations

Answer 50

Dose: thecalculatedamounttogive Dosage: the amount of drug to give per unit of body weight Concentration: the amount of drug per unit of measure

Question 51

Common Administration Abbreviations

Answer 51

AD/AS/AU •OD/OS/OU. •IM/IV/SQ/IP/IN. •Inj. •OTC •AM (easy) PM (easy) •SID/BID/TIC/QID •D/C •EOD -cc. -ml -kg -L. -PRN. -NPO. -PO - qd/q1h/q2h, etc. -Rx. -Dx. -Tx. -Sx - QOD. - tab. -cap -gtt