Cardiac and Respiratory Pharmacology
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Cardiac and Respiratory Pharmacology

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Questions and Answers

What effect does ketoconazole primarily have on cortisol synthesis?

  • Enhances cortisol synthesis
  • Inhibits cortisol synthesis (correct)
  • Has no effect on cortisol synthesis
  • Stimulates cortisol release

    • Which adverse effect is associated with the use of ketoconazole?

  • Anorexia and vomiting (correct)
  • Respiratory depression
  • Increased urinary retention
  • Muscle hypertrophy

    • Which of the following statements about itraconazole is true?

  • It has more adverse effects than ketoconazole
  • It is a cytochrome P450 inhibitor (correct)
  • It inhibits cortisol synthesis
  • It does not have potential drug interactions

    • What is a significant effect of amphotericin B on the fungal cell membrane?

    <p>Forms channels in the membrane</p> Signup and view all the answers

    Which of the following effects is NOT associated with ketoconazole?

    <p>Enhanced bone resorption</p> Signup and view all the answers

    What is one of the hematopoietic effects of amphotericin B?

    <p>Thrombocytosis</p> Signup and view all the answers

    What renal effect can ketoconazole cause?

    <p>Polyuria</p> Signup and view all the answers

    Which statement about the mechanism of action of amphotericin B is incorrect?

    <p>It has a high affinity for cholesterol</p> Signup and view all the answers

    What is a side effect of higher doses of narrow therapeutic index medications in cats?

    <p>Mydriasis</p> Signup and view all the answers

    Which statement is true regarding Milbemycin oxime?

    <p>It effectively prevents heartworms and treats L5 larvae.</p> Signup and view all the answers

    What is the proposed mechanism of action for Melarsomine?

    <p>Arsenical interactions with sulfhydryl groups in enzymes</p> Signup and view all the answers

    Which of the following is a contraindication for using Milbemycin oxime?

    <p>Class 4 heartworm disease</p> Signup and view all the answers

    What is a common side effect of Selamectin?

    <p>Pulmonary thromboembolism</p> Signup and view all the answers

    Which breed is noted for a higher incidence of toxicosis from narrow therapeutic index medications?

    <p>Collies</p> Signup and view all the answers

    What does Milbemycin oxime NOT treat?

    <p>Adult heartworms</p> Signup and view all the answers

    Which statement accurately describes the safety profile of heartworm preventative doses in collies?

    <p>It is reported to be safe.</p> Signup and view all the answers

    Which condition is contraindicated for the use of atenolol?

    <p>Myasthenia gravis</p> Signup and view all the answers

    What are the side effects of mexiletine?

    <p>GI upset</p> Signup and view all the answers

    Which type of arrhythmias is quinidine primarily indicated for?

    <p>Refractory ventricular arrhythmias</p> Signup and view all the answers

    What is a common side effect of sotalol?

    <p>Hypotension</p> Signup and view all the answers

    Which class of antiarrhythmics does mexiletine belong to?

    <p>Class I</p> Signup and view all the answers

    Which medication can cause a negative inotropic effect?

    <p>Esmolol</p> Signup and view all the answers

    What mechanism does Class III antiarrhythmics such as sotalol utilize?

    <p>Block potassium channels</p> Signup and view all the answers

    Which condition should not be treated with a drug that induces hypotension rapidly?

    <p>Hypertrophic heart disease</p> Signup and view all the answers

    What is a key benefit of using adrenergic signal transduction potentiators in cardiac treatment?

    <p>Increases myocardial contractility without increased oxygen consumption</p> Signup and view all the answers

    Which of the following is a contraindication for adrenergic agonists like albuterol?

    <p>Hypertension</p> Signup and view all the answers

    What is a common side effect associated with the use of nonselective beta-adrenergic agonists like epinephrine?

    <p>Tachycardia</p> Signup and view all the answers

    Which conditions can be indicated for the use of milrinone?

    <p>Arterial hypertension and CHF</p> Signup and view all the answers

    Which side effect is likely associated with terbutaline, a selective β-2 adrenergic receptor agonist?

    <p>Hyperglycemia</p> Signup and view all the answers

    What additional mechanism does pimobendan exhibit besides potentiating adrenergic signal transduction?

    <p>Increasing myocardial relaxation</p> Signup and view all the answers

    Which of the following statements about amrinone is incorrect?

    <p>It is a potent bronchodilator.</p> Signup and view all the answers

    What is a therapeutic use of albuterol?

    <p>Management of bronchospasm</p> Signup and view all the answers

    What is the main mechanism of action of Bethanechol?

    <p>Activation of muscarinic receptors</p> Signup and view all the answers

    Which of the following adverse effects is commonly associated with the use of Bethanechol?

    <p>SLUD symptoms</p> Signup and view all the answers

    Which beta-lactam antibiotic is specifically formulated to resist breakdown by beta-lactamases?

    <p>Clavulanate</p> Signup and view all the answers

    Which of the following statements accurately describes cephalosporins compared to penicillins?

    <p>Cephalosporins inhibit bacterial cell-wall synthesis.</p> Signup and view all the answers

    What distinguishes third-generation cephalosporins from first and second generations?

    <p>They often include coverage for Pseudomonas species.</p> Signup and view all the answers

    What are some common side effects of sulfonamides?

    <p>Idiosyncratic reactions and skin eruptions</p> Signup and view all the answers

    Which of the following is a contraindication for the use of certain beta-lactam antibiotics?

    <p>Hypotension</p> Signup and view all the answers

    What is the general spectrum of activity for standard penicillins?

    <p>Good activity against anaerobes and some gram-negative bacteria</p> Signup and view all the answers

    What is the primary action of endogenous catecholamines in relation to norepinephrine?

    <p>They act as a precursor for norepinephrine synthesis.</p> Signup and view all the answers

    Which medication is specifically indicated for short-term management of diabetics during hospitalization?

    <p>Regular insulin</p> Signup and view all the answers

    Which side effect is associated with the use of certain unspecified medications in the context discussed?

    <p>Polyuria</p> Signup and view all the answers

    What side effect is generally associated with higher doses of certain drugs mentioned?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is the effect of ACE inhibitors on the generation of angiotensin II?

    <p>They decrease its generation.</p> Signup and view all the answers

    In the context of renal function, which condition could be a contraindication for the use of certain medications discussed?

    <p>Pheochromocytoma</p> Signup and view all the answers

    Which type of insulin is characterized as having an intermediate action and is intended for maintenance therapy?

    <p>NPH insulin</p> Signup and view all the answers

    What is the secondary effect of ACE inhibitors besides decreasing angiotensin II production?

    <p>Reduction of proteinuria</p> Signup and view all the answers

    What mechanism of action does fenbendazole utilize to impair nematodes?

    <p>Binding to microtubules and inhibiting cell division</p> Signup and view all the answers

    Which adverse effect is most commonly associated with ivermectins in mammals?

    <p>Hyperexcitability followed by sedation</p> Signup and view all the answers

    Which of the following parasitic infections is fenbendazole effective against in cattle?

    <p>Haemonchus</p> Signup and view all the answers

    What is a key contraindication for the use of ivermectin in veterinary medicine?

    <p>Lactating dairy cows</p> Signup and view all the answers

    Which of the following statements is true regarding the efficacy of ivermectin?

    <p>It is ineffective against tapeworms</p> Signup and view all the answers

    What is a potential side effect following the administration of anthelmintic agents like ivermectin?

    <p>Local swelling and pruritus</p> Signup and view all the answers

    What condition is ivermectin NOT indicated for the treatment of in horses?

    <p>Tapeworms</p> Signup and view all the answers

    Which of the following is a mechanism by which ivermectin operates?

    <p>Potentiating the action of GABA</p> Signup and view all the answers

    What is a primary mechanism by which colchicine functions?

    <p>Microtubule inhibitor</p> Signup and view all the answers

    Which of the following side effects is associated with an overdose of a specific medication?

    <p>Tachycardia</p> Signup and view all the answers

    What is an important contraindication for the use of D-penicillamine?

    <p>Pregnancy</p> Signup and view all the answers

    What condition is trilostane primarily used to treat?

    <p>Hyperadrenocorticism</p> Signup and view all the answers

    Which of the following correctly describes a mechanism of action for mitotane?

    <p>Decreases glucocorticoid secretion</p> Signup and view all the answers

    What side effect is commonly associated with colchicine?

    <p>Peripheral neuropathy</p> Signup and view all the answers

    What is a significant side effect of high doses of D-penicillamine?

    <p>Hypocortisolemia</p> Signup and view all the answers

    Which indication is appropriate for using D-penicillamine?

    <p>Copper-associated hepatopathy</p> Signup and view all the answers

    What is the mechanism of action of Desoxycorticosterone pivalate (DOCP)?

    <p>It serves as a long-acting injectable mineralocorticoid.</p> Signup and view all the answers

    Which side effect is commonly associated with the use of mineralocorticoid supplementation?

    <p>Hyponatremia and hyperkalemia.</p> Signup and view all the answers

    Why might adjunct use of glucocorticoids be necessary with DOCP treatment?

    <p>To compensate for the lack of glucocorticoid activity in DOCP.</p> Signup and view all the answers

    What is the expected frequency of administration for Desoxycorticosterone pivalate in hypoadrenocorticism cases?

    <p>Every 25 to 28 days.</p> Signup and view all the answers

    What potential effect may occur when using drugs that decrease cortisol synthesis?

    <p>Adrenal enzyme inhibition.</p> Signup and view all the answers

    What is a notable characteristic of Glargine as an insulin formulation?

    <p>It provides a fairly flat glucose curve.</p> Signup and view all the answers

    Which of the following is a contraindication for using DOCP?

    <p>Inadequate glucocorticoid support.</p> Signup and view all the answers

    What is the relationship between glucagon and insulin as it pertains to blood glucose levels?

    <p>Glucagon increases blood glucose levels while insulin decreases them.</p> Signup and view all the answers

    What are the primary side effects associated with the rapid IV administration of a specific antiarrhythmic drug?

    <p>Hypotension and gastrointestinal upset</p> Signup and view all the answers

    Which of the following conditions is contraindicated for the use of atenolol in cats?

    <p>Second-degree AV block</p> Signup and view all the answers

    In what scenario is quinidine indicated for use?

    <p>Refractory ventricular arrhythmias</p> Signup and view all the answers

    What is a significant side effect of mexiletine that should be monitored?

    <p>Gastrointestinal upset</p> Signup and view all the answers

    Which statement accurately describes the primary pharmacological action of class III antiarrhythmics?

    <p>Blocking potassium channels to prolong the refractory period</p> Signup and view all the answers

    What is the main contraindication for using esmolol?

    <p>Bradyarrhythmias</p> Signup and view all the answers

    Which of the following best describes the mechanism of action for mexiletine?

    <p>It blocks sodium channels while prolonging the action potential</p> Signup and view all the answers

    What side effect is associated with class II and class III antiarrhythmics such as sotalol?

    <p>Negative inotropic effect</p> Signup and view all the answers

    What is the primary mechanism of action of methimazole?

    <p>Inhibits thyroid peroxidase and thyroid hormone synthesis</p> Signup and view all the answers

    Which of the following statements about lactulose is accurate?

    <p>It acts by trapping ammonia and reducing its absorption</p> Signup and view all the answers

    What is a significant contraindication for using radioiodine treatment?

    <p>Presence of underlying renal disease</p> Signup and view all the answers

    What is a commonly reported side effect of neomycin?

    <p>Bitter taste</p> Signup and view all the answers

    L-thyroxine is indicated for which of the following conditions?

    <p>Hypothyroidism</p> Signup and view all the answers

    Which statement best describes the side effects of metronidazole?

    <p>It leads to dose-dependent diarrhea</p> Signup and view all the answers

    Which of the following is a correct mechanism of action for drugs used in hepatic encephalopathy?

    <p>Convert to osmotically active acids in colon</p> Signup and view all the answers

    What is a key use of metronidazole besides treating hepatic encephalopathy?

    <p>It is used for anaerobic infections</p> Signup and view all the answers

    What is a potential risk associated with potassium supplementation?

    <p>Worsening of bradycardia</p> Signup and view all the answers

    Which two potential indications are associated with potassium citrate?

    <p>Reduction of calcium oxalate uroliths and interstitial cystitis</p> Signup and view all the answers

    Amitriptyline primarily acts by blocking which neurotransmitter reuptake?

    <p>Serotonin and norepinephrine</p> Signup and view all the answers

    Which side effect is commonly associated with amitriptyline?

    <p>Paradoxical hyperexcitability</p> Signup and view all the answers

    What is a contraindication for the use of amitriptyline?

    <p>Concomitant use of MAO inhibitors</p> Signup and view all the answers

    What is the primary mechanism of action of phenylpropanolamine?

    <p>Alpha-adrenergic agonist</p> Signup and view all the answers

    In which condition is phenylpropanolamine indicated?

    <p>Nasal congestion</p> Signup and view all the answers

    What effect does EPO (erythropoietin) have on blood cell production?

    <p>Stimulates erythropoiesis</p> Signup and view all the answers

    What is the primary mechanism of action of aminoglycosides?

    <p>Bind to ribosomal 30S subunit</p> Signup and view all the answers

    Which of the following statements regarding the side effects of fluoroquinolones is accurate?

    <p>They can lead to cartilage damage in growing animals</p> Signup and view all the answers

    What spectrum of activity do second-generation antibiotics provide?

    <p>Excellent gram-negative and gram-positive coverage but no anaerobes</p> Signup and view all the answers

    In terms of indications, which infection is metronidazole primarily used to treat?

    <p>Anaerobic infections</p> Signup and view all the answers

    Which specific side effect classifies aminoglycosides as requiring close monitoring?

    <p>Dose-dependent nephrotoxicity</p> Signup and view all the answers

    Which of the following is a significant concern when administering fluoroquinolones to growing animals?

    <p>Risk of cartilage damage</p> Signup and view all the answers

    Which of the following statements is true regarding the use of third-generation antibiotics?

    <p>They offer greatly extended gram-negative coverage</p> Signup and view all the answers

    Which of the following descriptions accurately reflects the indications for fluoroquinolones?

    <p>Used for several gram-negative infections</p> Signup and view all the answers

    Which antibiotic class is less sensitive to beta-lactamases and inhibits bacterial cell-wall synthesis?

    <p>Cephalosporins</p> Signup and view all the answers

    What is a common adverse effect associated with the use of standard penicillins?

    <p>Penicillin allergy</p> Signup and view all the answers

    Which of the following statements about third-generation cephalosporins is true?

    <p>They are classified but do not have an expanded spectrum.</p> Signup and view all the answers

    What is the main effect of Bethanechol on the bladder?

    <p>Increases bladder detrusor tone</p> Signup and view all the answers

    Which type of reactions can sulfonamides potentially cause?

    <p>Keratoconjunctivitis sicca (KCS)</p> Signup and view all the answers

    What clinical situation may indicate the use of extended-spectrum penicillins?

    <p>Infections involving Pseudomonas</p> Signup and view all the answers

    What condition is a contraindication for the use of certain beta-lactam antibiotics?

    <p>Equine colic</p> Signup and view all the answers

    Which of the following is NOT a side effect of Bethanechol?

    <p>Constipation</p> Signup and view all the answers

    What is the primary mechanism of action of fentanyl?

    <p>Full agonist at mu receptors</p> Signup and view all the answers

    Which indication is NOT commonly associated with the use of fentanyl?

    <p>Long-term chronic pain relief</p> Signup and view all the answers

    What is a potential side effect of fentanyl administration?

    <p>Respiratory depression</p> Signup and view all the answers

    How does hydromorphone compare in potency relative to morphine?

    <p>It is five times more potent than morphine</p> Signup and view all the answers

    Which of the following describes the duration of action of fentanyl?

    <p>20 to 30 minutes</p> Signup and view all the answers

    What is a significant property of transdermal fentanyl patches?

    <p>They can be used for more than 3 days.</p> Signup and view all the answers

    Which agent is characterized by a serotonergic effect that inhibits serotonin and norepinephrine reuptake?

    <p>Tramadol</p> Signup and view all the answers

    What side effect is typically associated with the use of hydromorphone?

    <p>Respiratory depression</p> Signup and view all the answers

    What is the primary mechanism of action for the opioid antidiarrheals mentioned?

    <p>They increase time available for water resorption.</p> Signup and view all the answers

    What is a side effect that is common to the use of opioids as antidiarrheal medications?

    <p>Constipation</p> Signup and view all the answers

    Which of the following is NOT a characteristic of the anticholinergics used as antidiarrheals?

    <p>They have a mechanism of action that involves opioid receptors.</p> Signup and view all the answers

    What is a contraindication for using opioids as antidiarrheal agents?

    <p>Infectious diarrhea caused by organisms like Salmonella</p> Signup and view all the answers

    What form of constipation treatment is characterized as a bulk-forming agent?

    <p>Psyllium</p> Signup and view all the answers

    What is a potential negative effect of using mineral oil for treating constipation?

    <p>Impairment of water resorption in the colon</p> Signup and view all the answers

    What type of medication is bismuth subsalicylate classified as?

    <p>Antidiarrheal</p> Signup and view all the answers

    Which symptom is associated with side effects of cyclosporine?

    <p>Alopecia</p> Signup and view all the answers

    What is the primary mechanism of action of azole antifungals?

    <p>Blocks synthesis of ergosterol</p> Signup and view all the answers

    Which of the following is a side effect associated with glucocorticoids?

    <p>Gastrointestinal upset</p> Signup and view all the answers

    In which scenario is fluconazole primarily indicated?

    <p>Management of systemic mycoses</p> Signup and view all the answers

    What is a characteristic of griseofulvin when used alone?

    <p>Rapidly induces resistance</p> Signup and view all the answers

    Which of the following conditions demonstrates a contraindication for azole antifungals in cats?

    <p>Hepatotoxicity</p> Signup and view all the answers

    What is one of the significant actions of griseofulvin within the body?

    <p>Accumulates in developing keratinocytes</p> Signup and view all the answers

    What key aspect distinguishes ketoconazole from other azole antifungals?

    <p>Increased risk of gastrointestinal side effects in cats</p> Signup and view all the answers

    What component does the action of glucocorticoids mainly target within cells?

    <p>Intracellular glucocorticoid receptor</p> Signup and view all the answers

    What is a primary effect of ACE inhibitors on systemic vascular resistance?

    <p>Decrease systemic vascular resistance</p> Signup and view all the answers

    In what condition are β-blockers mainly indicated?

    <p>Congestive heart failure</p> Signup and view all the answers

    What is one of the mechanisms through which prazosin reduces afterload?

    <p>α1 adrenergic antagonism</p> Signup and view all the answers

    Which side effect is commonly associated with the use of ACE inhibitors?

    <p>Gastrointestinal upset</p> Signup and view all the answers

    What distinguishes Class I antiarrhythmics from β-blockers?

    <p>Effect on refractory periods</p> Signup and view all the answers

    What is a significant effect of hydralazine as a vasodilator?

    <p>Direct arterial dilation</p> Signup and view all the answers

    Which condition is specifically listed as a contraindication for prazosin?

    <p>Digoxin toxicity</p> Signup and view all the answers

    Which of the following best describes a primary action of lidocaine as an antiarrhythmic?

    <p>Stabilization of myocardial membranes</p> Signup and view all the answers

    What is the primary mechanism of action of Methimazole?

    <p>Inhibits thyroid peroxidase and thyroid hormone synthesis</p> Signup and view all the answers

    What is a notable side effect associated with Lactulose use?

    <p>Dose-dependent diarrhea</p> Signup and view all the answers

    Neomycin primarily functions by what mechanism?

    <p>Inhibits ammonia generation in colon</p> Signup and view all the answers

    Which condition can be unmasked by the treatment of Radioiodine?

    <p>Underlying renal disease</p> Signup and view all the answers

    What is the indication for prescribing L-thyroxine?

    <p>Hypothyroidism</p> Signup and view all the answers

    What potential adverse reaction is associated with Metronidazole?

    <p>Cerebellar toxicity</p> Signup and view all the answers

    What is the main indication for using Neomycin?

    <p>Hepatic encephalopathy</p> Signup and view all the answers

    The treatment with Lactulose is primarily aimed at reducing what substance?

    <p>Ammonia absorption</p> Signup and view all the answers

    What is the primary mechanism of action for heartworm adulticide Thiacetarsamide?

    <p>Organic arsenical action leading to disruption of parasite function</p> Signup and view all the answers

    Which of the following best describes the side effects associated with the use of Thiacetarsamide?

    <p>Severe vesicant, nephrotoxicity, and hepatotoxicity possible</p> Signup and view all the answers

    In which of the following scenarios is the use of heartworm adulticide Thiacetarsamide most indicated?

    <p>For heartworm infection in dogs without microfilaria</p> Signup and view all the answers

    Which of the following statements about organophosphates (OPs) is accurate?

    <p>They can cause permanent nerve damage upon phosphorylation</p> Signup and view all the answers

    What signs might indicate muscarinic toxicosis from organophosphate exposure?

    <p>Miosis, salivation, and frequent urination</p> Signup and view all the answers

    Which statement regarding the reactivation of phosphorylated AchE is correct?

    <p>Once aged, reactivation of the enzyme is not possible</p> Signup and view all the answers

    What is one of the main features of the combination product Imidacloprid plus permethrin?

    <p>Topical application effective against fleas and lice</p> Signup and view all the answers

    Which of the following is NOT a known side effect of organophosphates?

    <p>Severe nephrotoxicity</p> Signup and view all the answers

    Study Notes

    Antiarrhythmics

    • Lidocaine IV used to treat ventricular arrhythmias that are unresponsive to lidocaine
    • Atenolol is the drug of choice for feline ventricular arrhythmias
    • Mexiletine is an oral analog of lidocaine and is the drug of choice for ventricular arrhythmias in dogs
    • Quinidine prolongs the duration of the action potential and refractory period in both the atria and the ventricles
    • Sotalol is a combination class II and III antiarrhythmic

    Cardiac Drugs

    • Pimobendan is a positive inotrope that enhances cardiac contractility without increasing myocardial oxygen consumption
    • Amrinone and milrinone are used to treat CHF, dilated cardiomyopathy or valvular disease, and arterial hypertension

    Bronchodilators

    • Terbutaline and Albuterol are selective beta-2 adrenergic receptor agonists used to treat bronchospasm
    • Epinephrine is a nonselective beta-adrenergic agonist that stimulates beta-1, beta-2 and beta- adrenergic receptors and is used to treat allergic reactions and acute severe bronchospasm

    Anti-Inflammatory Drugs

    • Corticosteroids have a broad spectrum of anti-inflammatory effects including:
      • Inhibition of inflammatory cell mediator release
      • Stimulation of mucous secretion
      • Enhancement of mucociliary clearance
    • Corticosteroids can cause side effects:
      • Increased intraocular pressure
      • Inhibition of ejaculation

    Antibiotics

    • Penicillins inhibit bacterial cell wall synthesis
    • Cephalosporins inhibit bacterial cell wall synthesis and are less sensitive to beta-lactamases
    • Ketoconazole is a cytochrome P450 inhibitor and can cause:
      • Anorexia and vomiting
      • Increases in ALT
      • Inhibition of cortisol synthesis
      • Many potential drug interactions

    Anti-Fungal Drugs

    • Amphotericin B selectively binds ergosterol, a major component of fungal cell membranes, and alters fungal membrane permeability
    • Milbemycin oxime is effective as a heartworm preventative and microfilaricide in dogs as well as controlling infections with hookworms, roundworms and whipworms
    • Selamectin is a topical anti-parasitic widely used in cats and dogs

    Heartworm medications

    • Melarsomine is an organic arsenical used to treat adult heartworms and L5 larvae in dogs

    Class I Antiarrhythmics

    • Lidocaine is used intravenously for lidocaine-refractory ventricular arrhythmias
    • Atenolol is the drug of choice for feline arrhythmias
    • Mexiletine is an oral analog of lidocaine
    • Mexiletine is the oral drug of choice for ventricular arrhythmias in dogs
    • Quinidine prolongs the duration of the action potential and refractory period in both the atria

    Class II Antiarrhythmics

    • Beta-blockers decrease the heart rate and contractility
    • Propranolol and atenolol are commonly used in veterinary medicine
    • Esmolol is used intravenously only (short half-life)

    Class III Antiarrhythmics

    • Block potassium channels
    • Prolong the refractory period
    • Increase the duration of the action potential
    • Have the greatest effects in Purkinje fibers and ventricular muscle

    Sotalol

    • Combination class II and class III antiarrhythmic
    • Nonselective beta-adrenergic receptor antagonist
    • Potassium channel blocker

    Antiarrhythmic Side Effects and Contraindications

    • GI upset
    • Do not use with second- or third-degree AV block
    • Drug-induced arrhythmias
    • May cause hypotension with rapid IV administration
    • Contraindicated in myasthenia gravis
    • Negative inotropic effect
    • Hypotension
    • Lethargy
    • Diarrhea
    • Bradyarrhythmias
    • Drug-drug interactions
    • Negative inotropy
    • Proarrhythmic
    • Bronchovestibular neurologic signs with overdose
    • Anorexia, GI upset

    Colchicine (Anti-Fibrotics)

    • Microtubule inhibitor
    • Inhibits procollagen secretion
    • Used empirically for fibrotic liver disease with or without ascites
    • GI upset (dose dependent)
    • Peripheral neuropathy, myopathy, and bone marrow suppression less common

    Decoppering Agents

    • D-penicillamine chelates plasma copper to allow urinary excretion

    D-penicillamine Indications

    • Biopsy diagnosis of copper-associated hepatopathy

    D-penicillamine Side Effects

    • GI upset (common)
    • Contraindicated in pregnancy

    Zinc Mechanisms

    • Decreases copper absorption
    • Induces metallothionein synthesis by enterocytes, which binds intestinal copper and prevents absorption
    • May also have anti-fibrotic effects

    Zinc Indications

    • Biopsy diagnosis of copper-associated hepatopathy

    Drugs for Adrenal Disease

    • Mitotane is toxic to zona fasciculata and zona reticularis layers of the adrenal glands and decreases glucocorticoid secretion
    • Trilostane inhibits adrenal enzyme 3-beta-hydroxysteroid dehydrogenase and decreases cortisol and aldosterone secretion

    Antidiabetic Drugs

    • Regular insulin is the most rapid onset and shortest acting insulin
    • NPH, Lente, PZI, and Ultralente insulin types are intermediate-acting and can be given subcutaneously or intramuscularly

    Oral Hypoglycemic Drugs

    • Glipizide is commonly used for hyperglycemia.

    Drugs for Renal Disease

    • Dopamine is sometimes used for oliguric renal failure; efficacy is controversial
    • ACE inhibitors (e.g., enalapril, benazepril) inhibit ACE to decrease generation of angiotensin II and secondarily decrease elaboration of aldosterone and antidiuretic hormone (ADH)

    Anticonvulsant Drugs

    • Bromides are a class of anticonvulsant drugs
    • Mammals have GABA neurotransmission limited to the CNS, and ivermectins are excluded from the CNS in most mammals

    Heartworm, Flea, and Endoparasite Prevention

    • Ivermectin potentiates the action of the inhibitory neurotransmitter GABA and is used in both horse and cattle
    • Milbemycin oxime is effective against a wide range of internal and external parasites

    Antihypertensives

    • Angiotensin-converting enzyme (ACE) inhibitors (e.g., enalapril, benazepril) are potent arterial vasodilators
    • ACE inhibitors directly act on vascular smooth muscle to decrease contractility by modifying calcium metabolism
    • ACE inhibitors decrease systemic vascular resistance and afterload
    • ACE inhibitors are indicated for congestive heart failure (CHF) and severe or refractory hypertension
    • ACE inhibitors can cause hypotension, reflex tachycardia, and gastrointestinal upset
    • Hydralazine is a potent arterial vasodilator
    • Hydralazine directly acts on vascular smooth muscle to decrease contractility by modifying calcium metabolism
    • Hydralazine decreases systemic vascular resistance and afterload
    • Hydralazine is indicated for CHF and severe or refractory hypertension
    • Hydralazine can cause hypotension, reflex tachycardia, and gastrointestinal upset
    • Prazosin is a -1 adrenergic antagonist and a balanced vasodilator that reduces preload and afterload
    • Prazosin is indicated for CHF and refractory hypertension
    • Prazosin can cause gastrointestinal upset, syncope (first-dose effect), and development of drug tolerance

    Antiarrhythmics

    • Class I antiarrhythmics, such as lidocaine, quinidine, procainamide, and mexiletine, share similar mechanisms of action
    • Class I antiarrhythmics decrease sinus heart rate, increase the refractory period of the atrioventricular node, decrease myocardial oxygen demand, and decrease ventricular automaticity
    • Procainamide is a potent arterial vasodilator, has a direct action on vascular smooth muscle to decrease contractility by modifying calcium metabolism, and decreases systemic vascular resistance and afterload
    • Procainamide has anticholinergic effects
    • Procainamide is indicated for atrial fibrillation, refractory supraventricular tachycardias, and ventricular arrhythmias
    • Procainamide can cause gastrointestinal upset, hypotension, worsening of CHF, and atrioventricular block
    • Beta blockers (Class II antiarrhythmics) are adrenergic receptor antagonists
    • Beta blockers decrease sinus heart rate, increase the refractory period of the AV node, decrease myocardial oxygen demand, and decrease myocardial contractility
    • Beta blockers have the same indications as for Class I antiarrhythmics

    Antidiarrheals

    • Opioids, such as diphenoxylate (Lomotil) and loperamide (Immodium), are synthetic opiate agonists without CNS side effects
    • Opioids increase segmental contractions of the gut but decrease downstream movement
    • Opioids increase the time available for water resorption and decrease bowel movement frequency
    • Opioids are indicated for short-term (<48 hours) therapy of acute diarrheas in dogs
    • Opioids can cause constipation and are contraindicated for infectious diarrheas
    • Anticholinergics, such as aminopentamide (Centrine) and propantheline (Pro-Banthine), are anticholinergic agents labeled for use as an antispasmodic antidiarrheal
    • Anticholinergics can cause adverse effects and contraindications, as formulations may vary in content and potency

    Treatment of Constipation

    • Lubricants, such as petrolatum (Laxatone), are used for daily therapy for hairballs and may be sufficient for mild constipation in cats
    • Mineral oil may impair water resorption in the colon and has a risk of aspiration
    • Bulking agents include psyllium (Metamucil) and hemicellulose-containing seed extract
    • Bulking agents are insoluble fiber sources that adsorb water and swell, increasing fecal bulk
    • Osmotics, such as lactulose, are osmotic laxatives that are nonabsorbable disaccharides
    • Lactulose acts as an osmotic cathartic
    • Lactulose is indicated for hepatic encephalopathy and constipation
    • Lactulose can cause dose-dependent diarrhea

    Thyroid Disease

    • Methimazole is a medication that inhibits thyroid peroxidase and thyroid hormone synthesis
    • Methimazole is indicated for medical management of hyperthyroidism
    • Methimazole can cause gastrointestinal upset, idiosyncratic reactions, and may unmask underlying renal disease
    • Radioiodine is actively captured by thyroid glands and destroys active thyroid tissue via local beta irradiation
    • Radioiodine is indicated for hyperthyroidism
    • Radioiodine requires a short quarantine and can unmask underlying renal disease
    • L-thyroxine is a physiologic replacement of T4 and is indicated for hypothyroidism

    Antifungals

    • Azole antifungals, such as ketoconazole, itraconazole, fluconazole, and clotrimazole, block the synthesis of ergosterol, an important component of fungal cytoplasmic membrane
    • Ketoconazole and itraconazole are used for dermatophytes, Blastomyces, Coccidioides, Histoplasma, Candida, Malassezia, and Cryptococcus
    • Topical clotrimazole is used for nasal aspergillosis
    • Fluconazole is used for systemic mycoses, especially with ocular, prostate, urinary, or CNS involvement
    • Griseofulvin is a medication that enters fungi through an energy-dependent mechanism
    • Griseofulvin binds to polymerized microtubules and disrupts mitosis, accumulating in developing keratinocytes
    • Griseofulvin is indicated for dermatophytes (Microsporum and Trichophyton) and has no effect on yeast
    • Griseofulvin can cause gastrointestinal upset, bone marrow suppression, neurotoxicity, hepatotoxicity, and teratogenicity in cats, particularly kittens

    Glucocorticoids

    • Glucocorticoids bind intracellular glucocorticoid receptors and modify the expression profile of genes containing the glucocorticoid response element (GRE)
    • Glucocorticoids have catabolic effects on metabolism

    Heartworm Adulticides

    • Thiacetarsamide was an organic arsenical heartworm adulticide
    • Thiacetarsamide had no effect on microfilaria
    • Thiacetarsamide was a severe vesicant with potential for nephrotoxicity and hepatotoxicity

    Insecticides and Acaricides

    • Organophosphates (OPs), such as dichlorvos (DDVP), are highly toxic to mammals, birds, and fish
    • OPs are potent anticholinesterase agents that inhibit acetylcholinesterase (AchE) via enzyme phosphorylation
    • OPs are considered irreversible AchE inhibitors
    • OPs are used as insecticides and acaricides
    • Carbamates inhibit AchE via carbamylation, a reversible process
    • Imidacloprid is a topical adulticide that kills fleas
    • Imidacloprid has no known toxicity and is not recommended for use in sick or pregnant animals
    • Imidacloprid is available in combination products with other insecticides
    • Permethrin inhibits voltage-gated sodium channels in nerves
    • Permethrin is a topical adulticide and insecticide
    • Permethrin is a broad-spectrum insecticide that kills fleas and ticks

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    Description

    Test your knowledge on antiarrhythmics, cardiac drugs, and bronchodilators. This quiz covers medications such as lidocaine, atenolol, and terbutaline, along with their uses and mechanisms. Perfect for veterinary pharmacology students or professionals.

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