Veterinary Skin Therapeutics Quiz

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Questions and Answers

What is the minimum recommended duration for treating deep pyoderma?

  • At least 2 weeks after resolution of clinical lesions
  • At least 1 week after symptoms appear
  • At least 3 weeks following clinical resolution
  • At least 4-6 weeks including not less than 2 weeks after resolution of clinical lesions (correct)

Which type of antibiotic is oxytetracycline classified as?

  • Bacteriostatic, time-dependent (correct)
  • Bacteriostatic, concentration-dependent
  • Bactericidal, concentration-dependent
  • Bactericidal, time-dependent

What mechanism do sulfonamides and dihydrofolate reductase inhibitors primarily target?

  • Folic acid production (correct)
  • RNA synthesis
  • Protein synthesis
  • Cell wall synthesis

Which condition is cited as a common use for lincosamide antibiotics?

<p>Wound infections in horses (D)</p> Signup and view all the answers

What is often combined with sulfadiazine to enhance its effect?

<p>Trimethoprim (D)</p> Signup and view all the answers

What is the primary mechanism of action of oclacitinib?

<p>Inhibition of Janus kinase (JAK) enzyme activity (C)</p> Signup and view all the answers

Which of the following is a known adverse effect of ciclosporin?

<p>Gingival hyperplasia (A), Muscle cramps (B)</p> Signup and view all the answers

What specific cytokine does lokivetmab target?

<p>Canine interleukin-31 (IL-31) (D)</p> Signup and view all the answers

What is a potential unwanted effect of oclacitinib due to its mechanism of action?

<p>Development of new (sub)cutaneous lumps (C)</p> Signup and view all the answers

How long may it typically take for improvement to occur when starting treatment with certain anti-inflammatory therapies?

<p>2-4 weeks (C)</p> Signup and view all the answers

What is the primary action of glucocorticoids in the treatment of allergic dermatitis?

<p>Alter DNA transcription through specific receptors (C)</p> Signup and view all the answers

How do calcineurin inhibitors function in the management of atopic dermatitis?

<p>Inhibit activation of T-lymphocytes during antigenic stimulation (A)</p> Signup and view all the answers

Which of the following is a mode of action of oclacitinib in treating pruritis?

<p>Blocking clinically significant cytokines that rely on JAK (C)</p> Signup and view all the answers

What is a primary characteristic of lokivetmab in treating atopic dermatitis?

<p>It is a caninised monoclonal antibody targeting IL-31. (B)</p> Signup and view all the answers

When considering therapy for atopic dermatitis, which factor should NOT be taken into account?

<p>The color of the animal's fur (A)</p> Signup and view all the answers

What is an effect of using alpha-2-adrenoceptor agonists like xylazine in mammals?

<p>Sedation (A)</p> Signup and view all the answers

Which of the following is a commonly used glucocorticoid?

<p>Dexamethasone (B)</p> Signup and view all the answers

What is the purpose of insect growth regulators like methoprene?

<p>To affect developing stages of insects (C)</p> Signup and view all the answers

What strategy is recommended for stopping chronic glucocorticoid therapy?

<p>Gradually decrease the dose by 20-25% every 4-6 weeks (D)</p> Signup and view all the answers

Which medication is an example of a calcineurin inhibitor?

<p>Ciclosporin (D)</p> Signup and view all the answers

Which medications act as H1-receptor antagonists to counteract allergic responses?

<p>Cetirizine (D)</p> Signup and view all the answers

What is the recommended duration for administering essential fatty acids to observe their effects?

<p>8-10 weeks (C)</p> Signup and view all the answers

What common side effect is associated with glucocorticoids like prednisolone?

<p>Restlessness (D)</p> Signup and view all the answers

Which combination is commonly formulated for effective ectoparasitic control?

<p>Insect growth regulator and insecticide (B)</p> Signup and view all the answers

Which class of antibacterial medications is well-known for treating skin diseases?

<p>Amoxicillin/clavulanate (C)</p> Signup and view all the answers

How does ciclosporin primarily exert its therapeutic effects?

<p>By inhibiting T-lymphocyte activation (B)</p> Signup and view all the answers

Which mechanism of action do adult ectoparasiticides like ivermectin utilize?

<p>Glutamate-chloride channels (A)</p> Signup and view all the answers

What is a key consideration when selecting anti-inflammatory agents for skin diseases?

<p>Shared plan with clients (A)</p> Signup and view all the answers

What is the main advantage of allergen-specific immunotherapy?

<p>Long-term tolerance development (C)</p> Signup and view all the answers

Which antifungal is the systemic choice commonly selected for treatment?

<p>Itraconazole (D)</p> Signup and view all the answers

What do insect growth regulators specifically target in the lifecycle of insects and arthropods?

<p>Eggs, larvae, and pupae (D)</p> Signup and view all the answers

What is the mechanism of action for fipronil?

<p>Inhibits GABA complex (D)</p> Signup and view all the answers

Which ectoparasiticide should not be used in rabbits due to potential severe side effects?

<p>Fipronil (C)</p> Signup and view all the answers

Which insecticide belongs to the neonicotinoid group and has high affinity for post-synaptic nicotinic ACh receptors?

<p>Imidacloprid (C)</p> Signup and view all the answers

What is the active component of macrocyclic lactones that opens glutamate-chloride channels?

<p>Moxidectin (D)</p> Signup and view all the answers

Which ectoparasiticide is particularly known for its neurotoxic effects in cats?

<p>Cypermethrin (D)</p> Signup and view all the answers

Which of the following mechanisms do pyrethroids primarily employ to affect ectoparasites?

<p>Act on sodium channels (D)</p> Signup and view all the answers

Amitraz is primarily used to treat which types of parasites?

<p>Mites (D)</p> Signup and view all the answers

Which of the following statements best describes the action of neonicotinoids?

<p>They paralyze and kill fleas by targeting nicotinic ACh receptors. (A)</p> Signup and view all the answers

Flashcards

What is the mechanism of action of tetracyclines?

Tetracyclines are a class of antibiotics that inhibit protein synthesis in bacteria, resulting in a bacteriostatic effect. This means they stop the bacteria from multiplying but don't directly kill them. Their effectiveness is time-dependent, meaning the longer they are present, the more effective they are.

How do sulfonamides and dihydrofolate reductase inhibitors work?

Sulfonamides and dihydrofolate reductase inhibitors, often combined as trimethoprim-sulfamethoxazole (TMP-SMX), interfere with the production of folic acid in bacteria. This disrupts their ability to synthesize purines, essential building blocks for DNA. This action is bactericidal, meaning it directly kills bacteria, and is time-dependent.

What is the mechanism of action of lincosamides?

Lincosamides are a group of antibiotics that inhibit protein synthesis in bacteria, leading to a bacteriostatic effect. Their action is time-dependent, meaning their effectiveness increases with longer exposure.

What does it mean for an antibiotic to be 'time-dependent'?

Time-dependent antibiotics are most effective when their concentration in the body remains above a certain threshold for an extended period. This means that regular dosing and maintaining adequate blood levels is crucial for their effectiveness.

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What does 'bacteriostatic' mean?

Bacteriostatic antibiotics inhibit the growth and multiplication of bacteria without directly killing them. They rely on the host's immune system to eliminate the bacteria.

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Itraconazole

An antifungal medication used to treat ringworm in horses.

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Ectoparasiticides

Chemicals used to kill or control ectoparasites (external parasites) on animals.

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Macrocytic Lactones

A group of drugs that work by affecting the nervous system of parasites, resulting in paralysis and death. Examples include selamectin, ivermectin, and moxidectin.

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Fipronil

Belongs to the phenylpyrazole group. A commonly used insecticide that inhibits GABA complex in parasites causing uncontrolled nervous activity and death. However, it's very dangerous for rabbits.

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Neonicotinoids

A group of insecticides that work by binding to nicotinic acetylcholine (ACh) receptors in parasites, causing paralysis and death. Examples include imidacloprid and nitenpyram.

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Pyrethroids

A group of insecticides that work by affecting sodium channels in parasites, resulting in initial excitement followed by paralysis and death. Examples include permethrin, cypermethrin, and flumethrin.

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Amitraz

A formamidine insecticide/acaracide that acts as an octopamine receptor agonist, causing increased nervous activity in synapses and rapid detachment/death of parasites.

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Demodicosis

A type of mite infection that requires weekly washes with amitraz until two negative skin scrapings/hair plucks collected two weeks apart.

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What does oclacitinib do?

A medicine used for certain skin conditions in dogs, it works by blocking substances that cause inflammation.

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What is Lokivetmab (Cytopoint)?

A medicine for atopic dermatitis in dogs, it works by specifically targeting an inflammatory protein called IL-31.

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What are JAK inhibitors?

A class of drugs that block the activity of various proteins involved in inflammation. They have various uses in dogs.

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What are some side effects of ciclosporin?

Common side effects of ciclosporin include transient vomiting and diarrhoea, and an increase in gum size.

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What's ciclosporin used for in dogs?

Cyclosporin is a medicine for certain skin conditions in dogs. It helps reduce inflammation.

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What are alpha-2-adrenoceptor agonists?

A class of drugs that act as alpha-2-adrenoceptor agonists, leading to sedation and bradycardia in mammals. Their effects can be reversed by using an alpha-2-adrenoreceptor antagonist like atipamezole.

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What are insect growth regulators?

A type of insecticide that affects developing stages of insects (eggs, pupae, larvae), but not adult parasites. It takes several weeks for the effects to be visible, so it's often combined with an adulticide.

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What is an adulticide?

A type of insecticide that kills adult insects.

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What is a combination product for insect control?

The combination of an adulticide and an insect growth regulator, providing broader spectrum control by acting on both adult and developing stages of insects.

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What are glucocorticoids?

Highly effective anti-inflammatory drugs frequently used in veterinary medicine. They have a range of side effects, especially when used chronically.

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What are calcineurin inhibitors?

A type of medication with more targeted T-cell suppression than glucocorticoids, providing comparable efficacy for pruritus (itching). It inhibits the activation of T-lymphocytes.

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What is polydipsia, polyuria, and polyphagia?

One of the most common side effects of chronic glucocorticoid therapy. It is characterized by excessive thirst, urination, and hunger.

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What is iatrogenic hyperadrenocortism?

A serious condition that can occur due to prolonged glucocorticoid use, leading to Cushing's disease in dogs. It is characterized by a variety of symptoms, including weight gain, lethargy, and increased water consumption.

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Glucocorticoids' mode of action

A class of drugs that bind to cytoplasmic receptors, then enter the nucleus and alter DNA transcription. This leads to widespread effects including reducing inflammation, suppressing the immune system, and preventing scarring.

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Calcineurin inhibitors' mode of action

These drugs block the activation of T-lymphocytes, preventing them from producing IL-2 and other T-cell cytokines. This stops the immune system from overreacting to allergens.

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Janus kinase (JAK) inhibitors' mode of action

This type of drug blocks the activity of JAK enzymes, which stops pro-inflammatory cytokines from causing allergic reactions and itching.

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Lokivetmab's mode of action

Lokivetmab specifically targets IL-31, a cytokine that plays a key role in skin inflammation and itchiness.

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Antihistamines' mode of action

These drugs work by blocking histamine receptors, thus reducing the inflammatory and itch-inducing effects of histamine.

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How do antihistamines work?

Antihistamines like chlorphenamine, promethazine, and cetirizine block histamine from binding to H1 receptors, which are found on nerve endings, smooth muscles, and glandular cells.

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What are the limitations of antihistamines for treating allergies?

Antihistamines can be effective in treating allergic reactions, but their effectiveness can vary. They may work best when taken before exposure to the allergen. Not responding to one antihistamine doesn't mean you won't respond to another.

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How do essential fatty acids help manage allergies?

Essential fatty acids, like omega-3 and omega-6, can have weak anti-inflammatory effects by interacting with the arachidonic acid cascade. They may also help reduce the need for steroids.

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What is allergen-specific immunotherapy?

Allergen-specific immunotherapy, often called allergy shots, can help desensitize individuals to specific allergens by gradually exposing them to increasing doses of the allergen over time.

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What are some commonly used antibacterial medications for skin infections?

Antibacterials like cephalexin, amoxicillin/clavulanate, clindamycin, fucidic acid, and polymyxin B are commonly used to treat bacterial infections of the skin.

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What are common topical and systemic antifungals for skin infections?

Miconazole and nystatin are topical antifungals used for treating fungal infections of the skin. Itraconazole is a systemic antifungal commonly used for more severe skin infections.

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How do adult ectoparasiticides work?

Adult ectoparasiticides like selamectin, ivermectin, moxidectin, fipronil, alfoxalaner, imidacloprid, permethrin, and amitraz target different mechanisms in parasites, effectively controlling them.

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Study Notes

Therapeutics for Skin

  • The presentation covers various medications used to treat skin conditions in animals.
  • Different classes of medications are used to treat various aspects of skin conditions, including infections, infestations, inflammation and allergies.
  • Learning outcomes include describing the classes of medications used for skin disease, modes of action of anti-inflammatory drugs, long-term corticosteroid regimens, and distinguishing between anti-inflammatory agents.

Drug Therapies

  • Infections and infestations: Antimicrobials (antibiotics, antifungals, antiyeast) and ectoparasiticides are used
  • Inflammation and allergies: Glucocorticosteroids, cyclosporin, oclacitinib, lokivetmab, antihistamines, and essential fatty acids are used.

Antibacterials

  • Inhibit cell wall synthesis: Penicillins, cephalosporins, carbapenems, monobactams, vancomycin.
  • Inhibit protein synthesis: Aminoglycosides, chloramphenicol, tetracyclines, clindamycin, macrolides, fusidic acid, streptogramins.
  • Inhibit nucleic acid synthesis: Fluoroquinolones, metronidazole, rifamycins, sulfonamides, trimethoprim

β-lactam antibiotics

  • Inhibit bacterial growth by interfering with the transpeptidation of bacterial cell wall synthesis.
  • Bactericidal, time-dependent.
  • Examples include amoxicillin and cefalexin.
  • Duration of treatment varies depending on the severity of the condition.

Tetracyclines

  • Inhibit protein synthesis in susceptible bacteria.
  • Bacteriostatic, time-dependent.
  • Examples include oxytetracycline and doxycycline.

Sulfonamides, DRIs, and combination antibiotics

  • Inhibit the production of folic acid, which affects purine synthesis.
  • Usually combined (TMS), which is bactericidal, time-dependent.
  • Inhibit protein synthesis, are bacteriostatic, and time-dependent.
  • Examples include clindamycin.

Fusidic acid and Polymyxin B

  • Fusidic acid inhibits bacterial protein synthesis (bacteriostatic), but in high concentrations can be bactericidal.
  • Effective against Gram-positive bacteria, particularly Staphylococcus pseudintermedius.
  • Polymyxin B disrupts bacterial cytoplasmic membranes, which is bactericidal, and is effective against Gram-negative bacteria.

Antifungals and antiyeasts- Topical

  • Imidazoles (miconazole, ketoconazole, enilconazole) inhibit ergosterol incorporation, increasing cell wall permeability and leakage
  • Miconazole is an antifungal with activity against yeasts.
  • Nystatin is a broad-spectrum antifungal, effective against Candida.

Antifungals- Oral

  • Triazoles, such as itraconazole, are the systemic treatment of choice.
  • Griseofulvin is absorbed over a prolonged period and prevents fungal invasion of cells

Ectoparasiticides- general mechanisms

  • Act on the nervous system (AChE inhibitors, Na + channel blockers, nicotinic ACh receptor antagonists, GABA and Cl- channel inhibitors)
  • Inhibit insect growth and development.
  • Ectoparasite repellent

Ectoparasiticides

  • Macrocyclic lactones (selamectin, ivermectin, moxidectin) affect open glutamate-chloride channels.
  • Phenylpyrazoles (fipronil), are insecticides and acaracides that inhibit the GABA complex, impacting chloride channels, potentially causing seizures in rabbits.
  • Imidacloprid and nitenpyram belong to the neonicotinoid insecticides and are highly effective on post-synaptic nicotinic receptors, causing paralysis.
  • Pyrethroids (permethrin/cypermethrin/flumethrin) affect sodium channels, initially causing excitement followed by paralysis.
  • Amitraz is a formamidine insecticide/acaracide that increases nervous activity, leading to rapid detachment and death of parasites.

Ectoparasiticides (Insect growth regulators)

  • Insect growth regulators (e.g., methoprene) affect developing stages of insects (eggs, pupae, larvae) and arthropods but not the adult parasite.

Bewildering number of products

  • There are many medications available for treatment of skin conditions, pet owners may request specific kinds.
  • Clinicians should follow a practice policy to make appropriate treatment decisions.

Allergy and inflammation

  • Inflammation is complex and involves multiple inflammatory mediators.

Glucocorticoids

  • Are highly effective anti-inflammatory drugs.
  • Examples include prednisolone and dexamethasone.
  • Have wide-ranging side effects.
  • Long-term use needs careful tapering of dosages to prevent adrenal atrophy.

Calcineurin inhibitors

  • Ciclosporin has more targeted T-cell suppression than glucocorticoids.
  • Inhibits activation of T-lymphocytes by reducing IL-2 production.

Oclacitinib

  • A Janus kinase (JAK) inhibitor, it inhibits a variety of cytokines associated with allergic responses.

Lokivetmab

  • A caninised monoclonal antibody that targets the pro-inflammatory cytokine interleukin-31 (IL-31).

Other anti-inflammatory therapies

  • Antihistamines (e.g., chlorphenamine) antagonize histamine binding to H1 receptors.
  • Essential fatty acids (omega-3 and omega-6) might have a weak anti-inflammatory effect.

Key Points

  • Summarizes the main points from each section.
  • Highlights various medications and treatment approaches.

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