Name the routes of administration and their bioavailability value
IV - 1
IM - 0.85
SQ - 0.75
PO - 0.45-0.56
IP - 0.45
Per rectum - 0.21
This is the movement of drug molecules from an area of high concentration to an area of low concentration across a semi-permeable membrane:
Passive Diffusion
Does passive diffusion require energy?
No
This is the movement of drug molecules being surrounded by a carrier molecule within the cell membrane and carried into the cell usually from an area of high concentration to an area of low concentration:
Facilitated Diffusion
Does facilitated diffusion require energy?
yes
This is the movement of drug molecules that are surrounded by carrier molecules within the cell membrane and carried into the cell against the concentration gradient:
Active Transport
Does active transport require energy?
Yes
This is where the drug molecules particularly large proteins and intact antibiotics are surrounded and/or engulfed by the cell's membrane and taken within the cell
Pino/phagocytosis
Do pino/phagocytosis require energy?
Yes
This is the movement of drug molecules from systemic circulation into tissues
distribution
This is the degree to which an administered drugs is absorbed.
bioavailability
This is the breaking up of a drug into smaller particles to be absorbed
dissolution
What form of drugs does not have a dissolution phase?
liquid forms
Describe ion trapping:
A drug in lipophilic form penetrates the cell membrane and enters the cell. The pH within the cell causes a dramatic shift to the hydrophilic form and the drug can no longer passively diffuse out of the cell. However since there is a set ratio of hydrophilic to lipophilic molecules any lipophilic molecules will diffuse out of the cell causing other hydrophilic molecules to convert to lipophilic to maintain that set ratio. Eventually this allows the drug to pass into systemic circulatiion.
What are SR tablets and why aren't they used much in small animal medicine?
Sustained Release tables are designed to dissolve slowly to allow small amounts of drug to be released into the system over a long period of time. Since the digestive tract of canine and feline patients is much shorter than humans, the drug will not have enough time to dissolve and be absorbed
Describe the first pass effect:
Once a drug is absorbed into systemic circulation it goes to the liver via the hepatic portal system. The liver assumes the drug is a foreign substance or xenobiotic and removes a substantial amount before allowing the remainder to reenter general circulation.
This is an drug completely dissolved in a sweetened alcohol base that is only administered orally.
Elixir
An example of an elixir would be:
Cardoxin
This is a drug completely dissolved in a heavy sugar solution like 85% dextrose.
Syrup
An example of a syrup would be:
Dirocide
These forms of medications are thicker than lotions and liniments that usually liquify at body temperature:
Ointments and pastes
What is the difference between and ointment and paste
Ointment is applied topically only
Paste is administered orally only
This form of medication is thicker than liniments that is meant to be dabbed or brushed on skin.
Lotion
This is a drug dissolved in an alcohol solution that is meant to only be applied topically.
Tincture
This is a small glass container that is opened by snapping of the neck and is for single use injectable medication.
Ampule
This is the removal of a drug from the body.
Excretion
What are the two main type of excretion?
renal excretion
hepatic excretion
4 factors that slow excretion
R.I.D.S
Renal dysfunction
Increased Sympathetic Tone
Dehydration
Shock
This describes how long it takes for the drug concentration in the blood to decrease by 50%.
drug half life
What is used to measure drug elimination?
a drug's half-life
This is the period from the last administration of drugs to when the animal can be legally slaughtered for human consumption or products like milk/eggs can be consumed.
Withdrawal time
This is when the concentration highs (peaks) and concentration lows (troughs) of a drug are roughly the same within the blood after 5 half-lives.
Steady State
How is the steady state calculated?
5 x t1/2 = steady state
An acid environment is better penetrated by which form of a drug?
lipophilic
An alkaline environment is better penetrated by which form of a drug?
hydrophilic
This is the state where the ionized to non-ionized ratio of a drug is 1:1 and describes a drugs alkaline or acid nature.
pKa
An acid drug is predominantly in which form in an acid environment?
non-ionized
An alkaline drugs is predominantly in which form in an alkaline environment?
non-ionized
A single use glass container with a rubber stopper that separates the solute from the diluent.
Vial
This is a drug made from ground up plant and animal parts that have been treated, filtered, refined and prepared into some medical form usually in batches or lots.
Extract
This refers to a type of drug that requires it to go through biotranformation phase 1 to become active.
Prodrug
ex: prednisone (K9) > b/t 1 > prednisolone (Fel)
Describe the MFO system:
Mixed Function Oxidase system is the most common group of enzymes in biotransformation phase 1. Repeatedly used drugs cause an increase in the number of enzymes available. This increases the rate at which these drugs are metabolized, thus causing induced metabolism
Describe Biotransformation Phase I.
After the drug exerts its effect and decomposes, it is returned back to the liver where it is either oxidized, reduced or hydrolized by the MFO system to a generally less active metabolite
Describe Biotransformation Phase II
After phase one the metabolite is conjugated with another molecule such as glucaronic acid, sulfate or glycine. This produces a more hydrophilic metabolite. Excretion is then possible by the kidney or liver since the hydrophilic form is unable to be reabsorbed through the lumen
This class of drugs has a HIGH potential for abuse and may lead to severe physiologic and psychological dependence.
C-II
ex: opium, ketamine, morphine
This class of drugs has SOME potential for abuse and may lead to low to moderate physiologic and high psychological dependence.
C-III
ex: barbituates, Telazol
This class of drugs has LOW potiential for abuse and has limited physiologic and psychological dependence.
C-IV
ex: butorphanol, valium
This class of drugs has the LOWEST potential for abuse and is subject to state and local regulations.
C-V
ex: Lomotil
This is the initial dose to reach theraputic range.
Loading dose
This is the dose needed to hold the level of drug in t he middle of the theraputic range.
Maintenance dose
What temperature is considered Cold Storage?
not to exceed 46 F
What temperature is considered Cool Storage?
between 46 and 59 F
What temperature is considered Room Temperature?
59 to 86 F
What temperature is considered Warm Storage?
between 86 and 104 F
What is considered Excessive Heat
greater than 104 F
How does perfusion affect absorption?
Well perfused tissues will absorb injected drugs quicker than poorly perfused tissues
How does perfusion affect distribution?
Well perfused tissues will show higher concentrations of drug than poorly perfused tissues
Name 4 well perfused tissues
Brain
Kidney
Liver
Heart
Name 4 poorly perfused tissues
Bone
Ligaments
Tendons
Fat
Name 4 barriers to drug passage
Placenta
Globe of the eye
Prostate
Blood/Spinal cord
This is an approximation of the extent to which a drug is distributed throughout the body - a larger number = more tissues penetrated
Volume of distribution (Vd)
This is a type of suspension in which two compounds are mixed in a jelly-like substance.
Gel
This is a type if suspension in which a drug mixed into an oil to be rubbed into the skin
liniment
This is where a drug is used safely and successfully by veterinarians but not specifically approved by the FDA
off (extra) label use
Which act place the FDA in the role of watchdog over the way veterinary drugs are used?
Federal Food, Drug and Cosmetics Act
Which act in 1994 gave Veterinarians the authority to use approved drugs in an off (extra) label manner?
The Animal Medical Drug Use Clarification Act
Requirements for a valid Rx:
Name, address, current phone number of veterinarian or clinic/hospital
Date written
Client's name, address
Species
Rx to mean "take thou of"
Drug name, concentration, number and type of units dispensed
Sig - to mean "write or label"
DEA # if it is a controlled substance
This is the term given to a drug that can be produced by multiple companies once the patent coverage is no longer in effect and is only required to be 90% pure by the FDA to be licensed.
Generic equivalent
FDA
Food and Drug Administration
DEA
Drug Enforcement Administration
MSDS
Material Safety Data Sheet
What does the MSDS contain?
Guidelines for protective precautions, clean up procedures, and first aid for accidental exposure to whichever substance the sheet is about.
What does a TM or an encircled R stand for?
Trademark or registered name = a name only that manufacturer may legally use, has the patent for by the federal government which allows them to recoup money spent on its development
This is a drug suspended in an emulsion of egg lecithin and soybean oil
p= Propoflo
np = propofol
This is a powdered drug compressed into a disk
tablet
This is a powdered drug surrounded by a gelatin casing
capsule
This is a powdered drug mixed with lactose or dextrose
Chewable Molded Tablet
This is a powdered drug mixed with and incorporated into a hard candy not generally used in Veterinary medicine
Lozenge/Troche
This is a type of suspension where two immiscible liquids when mixed together, one is suspended in small globules in the other
Emulsion
This is a general term applied to a solute that completely dissolves in a diluent and will not settle out
Solution
This is a general term applied to a solute that does not dissolve completely in a diluent when mixed and will settle out
Suspension
This is a substance that had the potential for physical, psychological addiction and/or abuse
controlled substance
This means to write or label
sig
syrup abbreviation
syp.
tablet abbreviation
tab.
drop abbreviation
gtt
capsule abbreviation
cap
extract abbreviation
ext
abbreviation for "every night at bedtime"
nightly
by abbreviation
per
ointment abbreviation
ung
cubic centimeter
cc
dispense abbreviation
disp
gram abbreviation
gm
grain abbreviation
gr
at once abbreviation
stat.
suppository abbreviation
supp.
suspension abbreviation
susp.
OSHA
Occupational Safety and Health Administration
What is OSHA for?
Provides a handbook that outlines guidelines for safe handling, storage, use, clean up and disposal of chemicals/drugs
solution abbreviation
soln.
Normal Saline abbreviation
NS
after meals abbreviation
p.c.
as needed abbreviation
p.r.n.
Four times a day abbreviation
q.i.d.
intramuscular abbreviation
IM
every other day abbreviation
q.o.d.
PDR
Physician's Desk Reference
VPB
Veterinary Pharmaceuticals and Biologics
BNDD
Bureau of Narcotics and Dangerous Drugs
Old name for the DEA
Components to therapeutic drug use
1. route of administration
2. dose
3. dose interval
Routes of Administration
intravenous - IV
intramuscular - IM
subcutaneous - SQ
oral - PO
intraperitoneal - IP
rectal
intraocular/intrarticular
This is the amount of time between administration of separate doses
dose interval
This is the dose interval and the dosage
dose regimen
This is the product of the dose and frequency of administration
total daily dose
This refers to how a drug is metabolized depending on the nature of the drug and the body's responses
Pharmacokinetics
The 4 classic drug movement steps
1. absorption
2. distribution
3. metabolism
4. excretion
This is the movement from the site of administration to systemic blood circulation
absorption
intravascular(venous) abbreviation
IV
Over-The-Counter abbreviation
OTC
What constitutes an OTC drug?
Based on toxicity and is determined by how adequately instructions made for the lay person to use with clarity and consistency
ounce abbreviation
oz
How many mL in 1 oz?
30mL
milliliter abbreviation
mL
How many mL in 1 L
1000mL
How many mL in 1 T
15 mL
How many mL in 1 tsp?
5mL
every abbreviation
q
elixir abbreviation
elix.
hour abbreviation
hr
pound abbreviation
lb
milligram abbreviation
mg
How many milligrams in 1 g
1000 mg
How many grams in 1 oz
28.3 g
How many mg in 1 grain
60 mg
before meals abbreviation
a.c.
Packet Insert Terms
Description of compostion
Indications
Precautions
Contraindications
Warnings
Adverse Reactions
Side Effects
This is the chemical definition on a package insert
Description of composition
This is a list for which a drug is approved on a package insert
Indications
These are reasons to use a drug on a package insert
Precautions
These are reasons NOT to use the drug on a package insert
Contraindication
These are potentially fatal reactions on a package insert
Warnings
These are undesirable reactions that could occur to make the animal sick on a package insert
Adverse reactions
These are any normal effect of a drug other than intended for therapeutic effect on a package insert
Side effects
tincture abbreviation
tintc.
two times a day abbreviation
b.i.d.
as desired abbreviation
ad lib
once a day abbreviation
s.i.d.
three times a day abbreviation
t.i.d.
Veterinary Technician definition
A student that has graduated from an AVMA accredited program
What 3 things can a vet tech not do
Diagnose
Prescribe treatment/medications
Perform surgery
right eye abbreviations
OD
left eye abbreviation
OS
both eyes abbreviation
OU
by mouth abbreviation
PO
According to Bill what does PO mean
via a body opening
liter abbreviation
L
subcutaneous abbreviation
SQ
Intraperitoneal abbreviation
IP
This is the movement of a drug from a tissue back to the blood and then to a second tissue
Redistribution
This is the movement of a drug from the intestinal tract, to the liver, to the blood and tissue, back to the liver, to the intestinal tract, then reabsorbed back from the gastrointestinal tract to the liver
enterohepatic circulation
This refers to a drug that combines with a receptor and cause a cell to produce a physiological change
agonist
How do you determine a drugs absorption degree according to availability?
Multiply the dose by the bioavailability factor
This is the lowest concentration of an antibiotic drug within theraputic range that stops bacterial growth
Minimum Inhibitory Concentration
This means decrease in number of platelets
Thrombocytopenia
This is a general term for disease causing agents
pathogen
This refers to the range of bacteria that can be killed by a particular antimicrobial
Spectrum of activity
This means to "kill" bacteria
Bactericidal
This refers to traces of leftover drug in the tissues long after the antimicrobial drug has been stopped
Residue
This is the chemical structure found in Penicilllins and Cephalosporins that some bacteria produce enzymes that target it for destruction
Beta lactam ring
This means having an allergic reaction to a drug
Hypersensitivity
This is the process by which one compound binds to another compound, causing it to precipitate our of solution and occurs in tetracyclines and calcium
chelate
This means toxic to the kidney and occurs with aminoglycosides
Nephrotoxic
This is the presence of crystals, typically precipitated drug molecules, in the urine
crystalluria
This means "skin plant" and refers to fungal agents such as "ringworm"
Dermatophyte
This is a term referring to the depression or stopping of bone marrow production of blood cells and occurs with chloramphenicol
Myelosuppression
This is the enzyme that is the target of quinolones and prevents the nuclear material of bacteria from being condensed thus preventing division
DNA Gyrase
Most often associated with tetracyclines, this drug-induced condition results in a glucosuria without hyperglycemia
Faconi's Syndrome
This means to inhibit bacterial growth
Bacteriostatic
This means a decreased number of white blood cells
Leukopenia
This term indicates bacteria can be inhibited or killed by a particular drug
Sensitive
This occurs when an oral antibiotic kills off the beneficial bacteria in the GI tract and allows pathogenic bacterial proliferation
Super/suprainfection
This means toxic to the ear and occurs with aminoglycosides
Ototoxic
This is a condition often associated with sulfonamides and is commonly called dry eye due to decreased function of the tear glands
Keratoconjuctivitis sicca (KCS)
This is the process by which bacteria are isolated and their susceptibility to different antimicrobial drugs is determined
Culture and sensitivity
This is a class of microbes that grow under conditions with little or no oxygen
Anaerobic
This means produces pus
pyogenic
This means to cause birth defects and is associated with griseofulvin use in cats
Teratogenic
Proprietary name for Griseofulvin
Fulvicin
This term translates to "against life"
antibiotic
This refers to bacterial resistance to several related antimicrobial drugs
Cross-resistance
This is the enzyme produced by some bacteria that can disable penicillins and cephalosporins
Beta lactamase
This means that a bacteria cannot be killed by a particular drug
Resistant
This class of microbes require oxygen to grow
aerobic
Give the 5 Antimicrobial mechanisms of action and an example(s) of each
1) Interferes with formation of bacterial cell wall - Penicillins/Cephalosporins
2) Damages bacterial cell membrane (none given)
3) Interferes with protein synthesis via ribosome interruption -
4) Interfere with critical enzymes for normal metabolism - Sulfonamides
5) Damage/alteration of Nucleic acids - Quinolones
What can render an aminoglycoside ineffective?
The presence of pus (pyogenic infection)
How are aminoglycosides taken up into tissues and what chemical does this process depend on?
Active transport / Oxygen
Because they readily uptake in the ear and kidney tissues, aminoglycosides are said to be what?
Ototoxic and nephrotoxic
Aminoglycoside mechanism of action can be enhanced by which class(es) of drugs?
Penicillins and cephalosporins
How is early aminoglycoside toxicosis detected?
The presence of casts and increased protein in the urine
At most physiologic pH levels, Aminoglycosides are typically lipophilic or hydrophilic?
hydrophilic
True or False: With aminoglycosides, the total daily dose should be t.i.d. instead of s.i.d.
False, because extended dosage intervals are necessary to allow plasma concentrations more time to decrease enough to prevent toxicity
These tetracyclines are able to penetrate through the blood-brain barrier better than others of the same class and have a slightly broader spectrum of activity
Doxycycline and Minocycline
These two drugs, when expired decompose to a nephrotoxic compound and are the cause of Fanconi's syndrome
Tetracycline
Oxytetracycline
Class of antimicrobials most associated with hypersensitivity reactions
Penicillins
Name the first quinolone approved in the US for cats and dogs
Enrofloxacin (Baytril)
This is the antifungal of choice for deep mycoses and will cause damage to the kidneys if not given with Dextrose 5% in water
Amphotericin B (Fungizone)
This vehicle for penicillin extends theraputic concentrations for up to 2 days
procaine
This vehicle for penicillin extends theraputic actions over 5 days
benzathine
What compound is used to potentiate amoxicillin?
Clavulanic acid
These are chemical agents that kill or prevent growth of pathogens on living tissues
antiseptics
These are antiseptics or disinfectants that reduce the number of microorganisms to a "safe" level
Sanitizers
These are chemical agents that kill or prevent growth on inanimate objects
disinfectants
This means "kills microbial spores"
sporicidal
This is an infection acquired during a period of hospitalization
nosocomial
This means "kills protozoa"
protozacidal
This is a glycocalyx coating over surgical implants that prevents antiseptics from reaching bacteria
biofilm
This mean "kills viruses"
viralcidal
Antiseptics or disinfectants that destroy all forms of microorganisms including spores
sterilizers
This means capable of killing cells
cytotoxic
This is a type of virus that is difficult to kill with most antiseptics
non-enveloped
This means "kills fungi"
fungicidal
This is an antiseptic combined with soap
scrub
This is an antiseptic (iodine) dissolved in an alcohol solution
tincture
This means "kills bacteria"
bacteriocidal
This biguanide compound is one the most commonly used antiseptic/disinfectant in veterinary medicine that precipitates with hard water, should be diluted, and inhibits fibroblasts
Chlorhexidine (Nolvasan)
This type of disinfectant is found in most handsoaps, mouthwashes and Lysol and have been reported to be neurotoxic and teratogenic in humans
Phenols
This term means "generates birth defects"
teratogenic
This is commonly found in surgical scrubs, can be inactivated by organic material, and is often combined with polyvinyl pyrrolidine to release it over time
iodine
This chemical is from the chlorine class and is effective against non-enveloped viruses like parvovirus
Sodium hypochlorite (bleach) 30:1
T/F: Color-fast bleaches have chlorine as their active ingredient
False
Which should be used to disinfect a surgery table: microbiostatic or microbiocidal?
microbiocidal
Which form of bacteria is more susceptible to disinfectants and antiseptics: the vegetative or spore form?
vegetative (active form)
Note: the spore for is the dormant form and therefore hard to kill
This is the group of adrenocorticosteroids associated with the antiinflammatory response that come from the zona fasciculata
glucocorticoids
These cyclooxygenase produced eicosanoids cause platelets to adhere to each other and thus contribute to the clotting mechanism
Thromboxanes
This means "loss of hair" and is a clinical sign of Cushing's disease.
Alopecia
This is the type of immunity provided by antibodies
humoral immunity
This is a condition of the kidney caused by a combination of NSAID use plus arterial hypotension and can lead to kidney failure
renal papillary necrosis
These eicosanoids are produced by lipooxygenase
leukotrienes
This is a type of disease caused by the body's own defense mechanisms turning against its own tissues
autoimmune reaction
This is the term for the increase in neutrophils and is a part of the "stress triad"
neutrophilia
This is the term meaning tissue destruction or break down; seen with corticosteroid use
catabolism
This refers to the outer part of the adrenal gland
cortex
Name the 3 layers of the adrenal cortex (outer to inner) and the group of steroids that comes from each
Zona glomerulosa: mineralocorticoids (aldosterone)
Zona fasciculata: glucocorticoids (cortisone)
Zona reticularis: sex hormones (5%) and some glucocorticoids
Name the enzyme that produces thromboxanes and prostaglandins
cyclooxygenase
Give 2 names which thromboxanes, prostaglandins and leukotrienes are collectively called.
Eicosanoids or Autocoids
This means low numbers of eosinophils and is a part of the "stress triad"
eosinopenia
This is the term for the production of glycogen in the liver
glycogenesis
This is the hormone produced in the hypothalamus that stimulates the anterior pituitary gland to release ACTH
Corticotropin releasing factor
This means decrease monocytes
monocytopenia
This means "decreased size": seen with muscles and skin in animals with exogenous corticosteroids
atrophy
This means a condition or disease "cause by the veterinarian"
Iatrogenic
This is the enzyme that produces leukotrienes
Lipooxygenase
This group of adrenocorticosteroids affects mainly the electrolytes and water balance in the body
mineralocorticoids
This is the creation of glucose from animo acids produced from protein catabolism
Gluconeogenesis
The means a "decrease of lymphocytes in circulation" and is part of the stress triad
lymphopenia
This is the chemical structure of a group that includes ibuprofen, naproxen and ketoprofen
Propionic acid
This is the series of enzymes that result in the production of eicosanoids(autocoids) after an injury
Arachadonic acid pathway (vane model)
This hormone release by the anterior pituitary gland stimulates the production of glucocorticoids in the zonal fasciculata
Adrenocorticotropic hormone
This is the dual-pathway NSAID because it blocks both COX and LOX
Tepoxalin (Zubrin)
This chondroprotective agent is a component of synovial fluid that acts as a lubricant, increases viscosity of the fluid
Hyaluronic acid
This is an intermediate acting corticosteroid that is not a "pred"
Triamcinolone acetate
PSGAGs
Polysulfated glycoaminoglycans
These effects are associated with corticosteroids
Maintain capillary integrity
Decreased fibroblast activity
Decreased T-lymphocyte activity
Decreased scar tissue formation
Increased neutrophils
Muscle wasting and atrophy
These two nutriceutical chondroprotective agents are precursors for PSGAGs
