1
Q
What is pharmacology
A
Study of how drugs affect a biological system
2
Q
What is a drug
A
Any chemical agent which affects any biological process
3
Q
What are the mechanisms of action for drugs
A
Replace/substitute for other chemicals, increase or stimulate certain cellular activities, depress or slow certain cellular activities, and interfere w/ function of foreign cells
4
Q
What is drug classification based on
A
Chemical structure, main effect, therapeutic use, and mechanism of action
5
Q
What are the 3 types of drug nomenclature
A
Chemical name, generic name, and trade name
6
Q
What are the 3 forms of drug formulation
A
Dosage (mg/kg), concentration (mg/ml), and injection volume (ml/kg)
7
Q
How are drugs developed
A
10-15 (or more) years for development/testing/approval that can be broken down into stages such as drug discovery and screening, pre clinical safety and toxicity testing, and evaluating drugs in humans
8
Q
What is the drug discovery and drug screening stage (stage 1)
A
Chemical development w/ in vitro studies to look at the function in cells, tissues, and at receptors
9
Q
What is the pre clinical safety and toxicity testing stage (stage 2)
A
In vivo animal studies w/ pharmacology and behavioral pharmacology by looking at potency/efficacy (ED50) and tolerance then for toxicity looking at acute or chronic, LD50, teratogenicity, and carcinogenicity
10
Q
What are teratogens
A
Something that causes a birth defect
11
Q
What is LD50
A
Lethel dose in 50% of population
12
Q
When are animals used for stage 2 of drug development
A
When no alternatives or non-animal replacements exist
13
Q
What is carcinogenicity
A
Causes cancer
14
Q
What is stage 3 in drug development
A
To evaluate the drugs in humans the preclinical testing is sent to the FDA that reviews the process and could approve clinical trials
15
Q
What is a phase 1 drug clinical trial
A
Healthy adults volunteers w/ about 20-80 individuals looking for safety, pharmicokentics, and side effects
16
Q
What is a phase 2 drug clinical trial
A
W/ <300 patients looking at efficacy, safety, pharmicokentics, and side effects this is single blind placebo controlled
17
Q
What is a single blind placebo clinical trial
A
A placebo is used but the patient doesn’t know which one they get
18
Q
What is a phase 3 drug clinical trial
A
Specific patient subpopulations typically <3000 looking for specific indications that is double blind placebo controlled
19
Q
What is a phase 4 drug clinical trial
A
Post FDA approval that looks for specific indications for drug utilization patterns, additional efficacy, monitors rare or severe side effects or toxicity
20
Q
What is pharmacokinetics
A
What the body does to drug
21
Q
What is pharmacodynamics
A
What the drug does to the body
22
Q
What are pharmacotherapeutics
A
The clinical purpose or indication
23
Q
What is pharmacognosy
A
Identifying crude materials as drugs
24
Q
W/in pharmacognosy what are sources of drugs
A
Plants, animals, minerals, microbes, and synthetics
25
What is pharmacodynamics reliant on
Drug receptors, chemical interactions, effect/efficacy, and toxicity/adverse effects
26
What factors influence drug effects
Weight, age, gender, physiological/pathological factors, genetic factors, immunological factors, pyschological factors, environmental factors, tolerance, cumulation, and drug interactions
27
What are the types of drug interactions
Drug-drug, drug-alternative therapy interactions, drug-food interactives, and drug-laboratory test interactions
28
In what situations can drug interactions may occur
At the site of absorption, during distribution, during biotransformation, during excretion, and at site of action
29
What happens if you increase a dose of a drug w/ a low therapeutic index
Increased dose of a drug w/ a low therapeutic index increases the likelihood of toxicity
30
What does the Y axis mean on a dose response curve
Efficacy
31
What does the X axis mean on a dose response curve
Potency
32
What factors affect the response to a drug
Dosage, route of administration, rate of absorption, rate of elimination, physiochemical properties of the drug, patient metabolism, and patient signalment
33
What are enteral routes to administer drugs
PO, rectal, sublingual, and buccally
34
What are parenteral ways to administer to drugs
Inhalation, IM, SC, IP, topical, and intrathecal
35
Which route of drug administration is the most likely to have a toxic effect
IV
36
What are immune privileged sites
Brain, eye, and testes
37
What is the blood brain barrier
Tight junctions of endothelial cells this is not fully formed at birth
38
What are the functions of the blood brain barrier
Protects brain from foreign substances that may cause injury, protects brain from hormones, neurotransmitters, and immune cells, and maintains a constant environment
39
What are the 4 aspects of pharmacokinetics
Absorption, distribution, metabolism, and excretion
40
What is bioavailability
The amount of the drug given compared to the amount that actually reaches the bloodstream
41
What influences drug absorption
Route of administration, time, dose, metabolism, age, sex, physical activity, stress, concurrent disease, and previous surgery
42
What does distribution of drugs depend on
Lipid solubility, ionization, perfusion of the tissue, and protein binding
43
What does t1/2 (half life) mean
Time required for plasma concentration of a drug to be reduced by 50%
44
What does ED50 (effective dose)
Dose of a drug that is effective for 50% of the population exposed to the drug
45
What is a critical concentration
What is needed to cause a therapeutic effect
46
What is a loading dose
A higher dose than what is needed for treatment
47
What is a dynamic equilibrium
Actual concentration a drug reaches in the body
48
What are the forms of absorption in pharmacokinetics
Passive diffusion or active transport
49
What can the biological half life of a drug allow us to understand
Determine dosing intervals, know expected time to steady state, and know expected time to wash out
50
What are pharmacokinetic considerations in practice
Onset of drug action, drug half life, timing of peak effect, duration of drug effects, metabolism or biotransformation of drug, and site of excretion
51
What are the different types of adverse drug reactions
Dose related, allergic, and idiosyncratic
52
What does idiosyncratic mean
Unpredictable side effect
53
What are the 4 methods of movement of drug molecules
Passive diffusion, facilitated diffusion, active transport, and pinocytosis/phagocytosis
54
What are characteristics of passive diffusion
Molecules move from a high to low concentration w/o using ATP
55
What is the fastest method drug molecules move
Passive diffusion
56
What are characteristics of facilitated diffusion
Requires carrier molecule such as plasma proteins to move molecules from a high to low concentration w/o ATP
57
What is the slowest method of drug molecule movement
Pinocytosis or phagocytosis
58
What determines the rate of movement of drug molecules
Concentration gradient, drug molecule size, lipophilic vs hydrophilic, temperature, and thickness of membrane
59
What are hydrophilic molecules
Good perfusion of ionized molecules to systemic tissue via fluid
60
What is lipophilic molecules
Non-ionized molecules that readily penetrates the cell membranes that is readily GI absorption and can penetrate the blood brain barrier
61
Which type of molecules best to be given orally
Lipophilic
62
What is the drug pKa
Acid dissociation constant is the pH at which concentrations of ionized and nonionized forms are equal or a measure of the tendency of a molecule or ion to keep a protein (H+) at its ionization center
63
What happens to an acidic drug if it is exposed to a higher pH (alklaine) area
It becomes ionized (hydrophilic)
64
What happens to an acidic drug placed into a lower pH (acidic) area
It becomes nonionized (lipophilic)
65
What happens to an alkaline drug placed in a higher pH (alkline) area
It becomes nonionized (lipophilic)
66
What happens to an alkaline drug that is placed into a lower pH (acidic) area
It becomes ionized (hydrophilic)
67
What can we use PKA and its relationship to pH to determine
The best method of administration for bioavailability
68
What can reduce the amount of drugs bound to proteins
Liver disease, protein losing enteropathy, protein losing nephropathy, sepsis, and mainutrition
69
What factors can influence the absorption of the drug
Hydration status, protein levels, acid/base status, membrane thickness, and lipophilic vs hydrophilic
70
What is bacteriostatics
Inhibits the growth of bacterial and allows immune system to fight it off
71
What does ZOI mean
Zone of inhibition
72
What is the minimum inhibitory concentration (MIC)
The lowest concentration of an antibiotic which still inhibits bacterial growth
73
What is the kirby bauer method
Spreading the microorganism on a agar media then placing disks impregnated w/ antibiotics to determine what antibiotic the microorganism is susceptible to
74
What kind of susceptibility assessment is the kirby-bauer an example of
Qualitative
75
What kind of susceptibility assessment is MIC
Quantitative
76
How is MIC used to decide antimicrobials/anti infectives
The MIC is compared to the clinical breakpoint to determine at what concentration of the drug is affective against the microorganism
77
What is the dilution method used for
Measuring the MIC of antimicrobials by making mutliple different dilutions of the concentration of the antibiotic to see what concentrations of the drug will kill the microorganism
78
What is the gradient method
Take a strip impregnanted w/ antimicrobials that is placed on the agar w/ growth then determine the lowest concentration that kills the microorganism by looking at where the inhibition ellipses intersects the strip
79
What is concentration dependent
The concentration of the medication needs to be above a certain level for it to work w/ these we see rate and extent of killing increases as peak drug concentration increases
80
What is time dependent
Needs to be given over a certain amount of time in order to work because the activity of the drug continues as long as the plasma concentration is greater than MIC
81
What is AUC/MIC
Combination of concentration and time but falls under concentration
82
What type of drugs tend to be concentration dependent
Drugs inhibiting protein or nucleic acid synthesis
83
What does using antimicrobials that are concentration dependent result in
Longer dosing intervals w/ maintaining efficacy and less frequent dosing increasing client compliance
84
What type of drugs tend to be time dependent antimicrobials
Those that inhibit cell wall synthesis, macrolides, and some protein synthesis inhibitors
85
What does using time dependent antimicrobials result in
More frequent dosing intervals to keep free concentration of the drug above the MIC for a specific fraction of time between doses
86
What are antimicrobials
Catch all term that kills microorganisms
87
What is antimicrobial resistance
Either aquired w/ repeated exposure to an antimicrobial or inherent such as it doesnt have what the method of action of the drug affects
88
What are aerobes
Grows in areas w/ oxygen
89
What are anaerobes
Grow in areas w/o oxygen
90
What is antimicrobial stewardship
The attempt to use antimicrobials responsibly to avoid resistance or other unintended consequences
91
What are methods of diagnosing infections
Cytology w/ inflammatory cells that have bacteria inside them, histopathology, culture, and antigen testing
92
What is the word for having inflammatory cells that have intracellular bacteria
Septic
93
What are considerations for choosing anti-infectives
Species, patient signalment, concurrent disease/medications, target site, focal/multifocal/diffuse disease, dosing route/regimen, potential side effects, duration of treatment, pathogen type, and antimicrobial resistance
94
What things go into antimicrobial stewardship
Diagnosis of bacterial disease, re-evaluation of the need for antimicrobial use, consideration of non-antibiotic alternative to prevent, control, or treat, and judicious use of antimicrobial drugs when needed
95
What are the 5 Ds that are associated w/ antimicrobial stewardship
Right drug, dose, duration, drug route, and antimicrobial de-escalation
96
What website is a good resource for antimicrobial use
iscaid.org
97
What is the external layer of gram positive bacteria
Peptidoglycan
98
What are the 5 main mechanisms of action of antimicrobials
Inhibit metabolism, damage cell membrane, inhibit protein synthesis, inhibit cell wall synthesis, and inhibit nucleic acid synthesis
99
What are examples of antimicrobials that affect cell wall synthesis
Penicillins, amoxicillins, clavomox, bacitracin (Neo-Poly-Bac)
100
What are examples of antimicrobials that can damage the cell membrane
Polymyxin B
101
What are examples of antimicrobials that affect DNA synthesis
Metronidazole (nitroimidazoles) and fluroquinolones (baytril)
102
What does beta lactam do
Interrupts the cross linking of cell wall synthesis
103
How is antimicrobials that inhibit cell wall synthesis excreted
In urine
104
What are the categories of antimicrobials that inhibit cell wall synthesis
Penicillins and chephlosporins
105
What are examples of beta lactams
Penicillins and cephalosporins
106
What are characteristics of penicillins
Time dependent (BID or TID), can be given IM or IV, and bactericidal
107
Who discovered penicillins and when
Sir alexander fleming in 1928
108
What are penicillins used for
Streptococcal infections, UTI, clostridial infections (tetanus), pneumonia, and enteritis
109
What type of bacterias are resistant to penicillins
Bacteria that produce beta lactamase
110
What penicillin is commonly used in equine
Sodium or potassium penicillin G
111
Why should sodium or potassium penicillin G be given slowly over 5 minutes
Since it is given IV it could cause arrhythmias
112
How is procain penicillin G stored and how is it given
In the fridge and is given IM
113
How is amoxicillin given and what are side effects
PO w/ side effects including GI issues or various allergic reactions
114
How can ampicillin given
SQ, IM, or IV
115
What are potentiated aminopenicillins
Something is added to the penicillins to increase their efficiacy
116
What are sulbactam and clavulanic acid that can be added to aminopenicillins
Beta lactamase inhibitors to prevent anything from affecting the drug
117
How can ampicillin sulbactam be given and what can happen if given IV
IV or IM and thrombophlebitis if given IV
118
How can amoxicillin clavulanate be given and are their any risks
PO and may cause allergic reaction or GI upset
119
What is generation 1 cephalosporins
Used against gram positive this can be used against UTI, skin, soft tissue, and derm issues
120
What are 2nd generation cephalosporins
Broader spectrum not used in vet med
121
What are 3rd generation of cephalosporins
Used against gram negatives
122
What are 4th generation cephalosporins
Extended spectrum w/ increased resistance to hydrolysis and beta lactamases
123
What are examples of 1st generation cephalosporins
Cephalexin, cefazolin, cefadroxil, and cephapirin
124
What are examples of 3rd generation of cephalosporins
Cefovecin, cefpodaxime, ceftiofur, and ceftriaxone
125
What is bacitracin used for
Topical gram positive infections
126
What is the major caution of using fluoroquinolones
It can cause retinal degeneration in cats leading to blindness and cartilage abnormalities in young/growing animals
127
What type of bacteria are fluoroquinolones affective against the most
Aerobes
128
What are examples of fluoroquinolones
Enrofloxacin (baytril), ciprofloxacin, danofloxacin (advocin), marbofloxacin (zeniquin), orbifloxacin (orbax), and pradofloxacin (veraflox)
129
What are unique characteristics of ciprofloxacin
It has low bioavailbility when given orally, inversely related to pet size, and hypersensitivity
130
What are nucleotide synthesis inhibitors
Fluoroquinolones, nitroimidazoles, and rifamycins
131
What is the only nucleotide synthesis inhibitor that inhibits RNA synthesis
Rifamycins
132
What is the other name for metronidazole
Flagyl
133
What is the method of action of polymixins
Damage the plasma membrane
134
What is the main concern w/ using polymixins
Can cause anaphylaxis in cats
135
What antibiotics inhibits protein synthesis
Aminoglycosides, tetracyclines, macrolides, lincosamides, and amphenicols
136
How can aminoglycosides be given
Either topical or injectable
137
What is the withdrawl time of gentamicin in cattle
18 months old
138
Why can't gentamicin be given in rabbits
Can cause nephrotoxicity
139
Why is neomycin only used topically
It is nephrotoxic if given other routes
140
What are concerns when using neomycin in cats
Can cause anaphlaxis
141
What are affects of tetracyclines
Anti inflammatory, immunomodulating, and neuromuscular blocking effects
142
Where are tetracyclines have good bioavailability
GI
143
What should tetracyclines not be given w/
Milk, antacids, penicillins, and diuretcis
144
What can tetracyclines cause if given at a high dose
Nephrotoxic and hepatotoxic
145
What are adverse affects of doxycycline
GI issues and esophageal strictures in cats
146
How can gentamicin be given
Opthalmic, otic, nebulization, and parenteral
147
What are tobramycins used for
Systemic infections such as pneumonia, soft tissue, and nebulization
148
What can tetracyclines be used for
Mycoplasma spp, spirochetes, chlamydia, and rickettsial spp
149
What is doxycycline used for
Rickettsiae, mycoplasma, leptospira, bartonella, bordetella, chlamydia, and pneumonia
150
What are macrolides used against
Used against gram positive
151
What is azithromycin (zithromax) used for
Gram positive, mycoplasma spp, URI, pneumonia, and vomiting dogs
152
What is tylan used for
Chronic diarrhea in SA
153
What is a caution when using tilmicosin (microlides)
It is cardiotoxic to swine, humans, and goats
154
What can tulathromycin (draxxin) be used for
SQ for pneumonia (cattle and pigs), foot rot, and pink eye in cattle
155
What animals should lincosamides and beta lactams not be used for
Hindgut fermenters such as horses and rabbits
156
What can lincosamides be used for
Toxoplasma spp and mycoplasma
157
What is an example of lincosamides
Clindamycin
158
What is clindamycin used for
Wounds abscesses, osteomyelitis, periodontitis, stomatitis toxoplasma, and pneumonia
159
What is lincomycin used for
Soft tissues and derm issues in dogs and cats, and infectious arthritis or pneumoia in pigs
160
What are amphenicols used
Chloramphenicol (viceton and chloromycetin) and florfenicol (nuflor, aquaflor, and resflor)
161
How can chloramphenicols be given (viceton and chloromycetin)
PO, parental, and ophthalmic
162
What is chloramphenicols used for (viceton and chloromyectin)
Meningitis, bronchitis, pyoderma, rickettsia, mycoplasma, and chlamydia
163
What can chloramphenicols (viceton and chloromycetin) cause in humans
Aplastic anemia
164
What are contraindications of chlorampenicols (viceton and chloromycetin)
Anemia, hepatic disease, or renal disease
165
What is the method of action of sulfonamides
Inhibition of metabolic processes
166
What are sulfonamides affective against
Gram positive, gram negative, and protozoa
167
What is SMT
Sulfadiazine/trimethropim or sulfamethoxazole/trimethoprim
168
What are brand names of SMTs
Tribrissin, tucoprim, and uniprim
169
What are SMTs used for
Derm, soft tissue, and prostate infections
170
What are possible side affects of SMTs
KCS, hypersensitivity, hepatitis, and GI signs
171
What is sulfadimethoxine (albon and sulfaMed) used for
Coccidiosis in SA, strangles in horses, and respiratory, foot rot, and coccidiosis in cattle
172
Wht are side effects of sulfadimethoxine (albon and sulfamed)
Crystalluria and hematuria
173
What is sulfadimethoxine/ormetoprim (primor) used for
Skin or soft tissue infections in dogs and coccidiosis in poultry
174
Where should antimicrobials that are cleared by the kidneys or that are nephrotoxic given in reptiles
In the cranial half of the animal
175
Where are most injectable drugs given to reptiles
Renal portal system
176
What are bacterialstatic drugs
Sulfonamides, amphenicols, lincosamides, macrolides, and tetracyclines
177
What are broad spectrum
Imipenem, carbapenem, tetracyclines, lincosamides, and amphenicols
178
What medications can't legally be given to food producing animals
Nitroimidazoles
179
Which antimicrobial class is used to treat tritrichomonas foetus in cats
Nitroimidazoles
180
What drug class is gentamicin in
Aminoglycosides
181
What classes contain antimicrobials that also have immunomodulating activity
Tetracycline and nitroimidaxoles
182
What classes can be used to treat tick borne infections
Tetracyclines and fluoroquinolones
183
Which classes have been linked to GI upset and esophegeal strictures in cats
Lincosamides and tetracyclines
Vet Tech 3
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