Pharmacology - Chapter 2

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Pharmacology - Chapter 2
2013-09-23 20:21:12
vet tech pharmacology

Pharmacology - Dr. Younger
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  1. Drugs that stop or help prevent development of cancer
    antineoplastic agent
  2. System for measuring/weighing drugs and solutions
    apothecary system
  3. cancer
    carcinogenic effect
  4. Drug that has toxic effects on the cells > commonly used in cancer meds
    cytotoxic drug
  5. Provides info on how to clean up/handle/work with substances in  safe way
    MSDS - material data safety sheet
  6. Decimal measuring system based on meter, liter and gram as units of length, capacity and
    weight or mass
    metric system
  7. Over The Counter
  8. Level of controlled substance that can’t be prescribed by a vet
  9. Term means poisonous to cells
  10. MSDS
    material safety data sheet
  11. OSHA
    Occupational Safety and Health Administration
  12. Mix of two drugs to make another
  13. Type of dangerous drugs used to treat cancer
    antineoplastic drug
  14. System of measurement that includes TBS, Pt. Gallon, lbs.
  15. capable of producing birth defects
  16. The DEA typically requires maintaining the controlled substance logs for a minimum of 5 years. True or False
    False. Two years is the typical recommended minimum.
  17. Adding acepromazine tranquilizer to a bottle of ketamine is not considered compounding as long as it is not sold to another practice. True or False
    False. Mixing two drugs in a syringe, bottle, or container is considered compounding because you are then administering these as a new combined drug with physical and pharamacological interactions.
  18. If a drug is labeled as "store at room temperature," then keeping it in a refrigerator to keep it cool is acceptable. True or False
    False. "Room temperature" is 59-86 F, whereas a refrigerator would keep drugs cool (46-59 F) to cold (not exceeding 46 F). "Warm" and "excessive heat" also describe specific ranges of temperature.
  19. The use of pill vial caps that are not childproof is illegal in veterinary medicine because they violate the Poison Prevention Packaging Act of 1970. True or False
    False. The Poison Prevention Packaging Act does not apply to veterinarians. However, there is an ethical obligation to warn pet owners of the risk of accidental ingestion of medication in containers that are not childproof and to emphasize keeping the medication out of reach of children.
  20. Schedule C-III substances have a greater potential for abuse than C-V substances. True or False
    True. The smaller the roman number, the more potential for abuse.
  21. Schedule C-II drug prescriptions may not be refilled; a new prescription must be written for each treatment period. True or False
    True. C-II drugs are the most potentially abusive drugs veterinarians are legally allowed to prescribe.
  22. Generally, a three-ring notebook or spiral notebook is sufficient for maintaining a controlled substance log. True or False
    False. Although not a regulation, it is recommended that the log be kept in a bound notebook of sequentially numbered pages to reduce the risk of a page being removed and replaced by another page with adjusted inventory information to hide diversion of abuse substances.
  23. 2 g = ? mg
  24. 5 mg = ? g
  25. 14 lb = ? kg
  26. 23 kg = ? lb
  27. 83 kg = ? mg
  28. 65 kg = ? lb
  29. 0.4 kg = ? g
  30. 0.003 lb = ? mg
  31. 15 lb = ? g
  32. 0.00043 kg = ? mg
  33. 25,488 mg = ? lb
  34. 0.0092 lb = ? mg
  35. 25 mL = ? L
  36. 43 cc = ? mL
  37. 1.5 L = ? mL
  38. 800 cc = ? L
  39. 0.055 L = ? mL
  40. 0.25 mL = ? L
  41. The doctor asks you to prepare a dose of ketamine sufficient to restrain a 15-lb cat. The drug formulary recommends using 15 mg/kg intravenously or intramuscularly. The concentration of ketamine in the vial is 100 mg/mL. What volume of ketamine is required for this cat?
    Convert 15 to kilograms. First: 15 lb x 1 kg/2.2 lb = 6.82 kg. Now determine how much drug is needed for this sized cat: 6.82 kg x 15 mg/kg = 102.3 mg of drug needed. Now determine how much physical drug you need to inject: 102.3 mg x 1 mL/100 mg = 1.02 mL. Note that when multiplying the dose by the concentration in the bottle, the problem has to be set up so the "mg" in the numerator and denominator cancel each other out, leaving "mL" by itself on top. The 1.02 mL is rounded to the nearest 1/10 mL = 1.0 mL
  42. The veterinarian asks you to fill a prescription for butorphanol for a coughing dog, dispensing sufficient tablets for 5 days of treatment. The dog weighs 55 lb. The recommended dose is 0.08 mg/kg. The tablets are available in 1-, 5-, and 10-mg sizes. The charge is $0.35 per tablet. How many tablets are required for a single dose? If the dosage specifies use q6h, how many tablets are required for each day of treatment? How many tablets should you dispense for the total 5 days of treatment? What is the charge for the dispensed medication?
    First convert the dog's weight to kilograms: 55 lb x 1 kg/2.2 lb = 25 kg. Now determine how much drug a 25-kg dog will need: 25 kg x 0.08 mg/kg = 2 mg of drug needed. Now select the tablet size, keeping in mind that you do not want to break a tablet into anything smaller than one half of a tablet. If the 1-mg tablet size is used then we need: 2 mg x 1 tablet/1 mg = 2 tablets per dose. Now determine how many tablets you will need for 5 days of treatment if the drug is to be given q6h (every 6 hours). You would need 2 tablets/dose x 4 doses/day x 5 days = 40 tablets for the 5-day period. Cost of the medication of 40 tablets x $0.35/tablet = $14.00
  43. The veterinarian want to medicate a 16-lb Chihuahua, a 27-lb terrier, and a 66-lb collie. The recommended dosage is 3 to 5 mg/kg given once daily. You are to dispense enough medication to last each dog 180 days (6 months). The 50-mg tablets cost $0.03 each, the 100-mg tablets cost $0.05 each, and the 200-mg tablets cost $0.07 each. What are the minimal and maximal daily doses (in milligrams) for each dog based ont he recommended dosage range? How many tablets and what size are required for each dog each day? How much does the medication for the 180 days of treatment cost for each dog?
    • 16-lb Chihuahua = 7.27 kg = dose range of 21.8 mg to 36.4 mg; use 1/2 of 50-mg tablet. 1/2 tablet/dose x 1 dose/day x 180 days = 90 of the 50-mg tablets needed. 90 tablets x $0.03 = $2.70 for the 180 days.
    • 27-lb terrier X = 12.3 kg = dose range of 36.8 mg to 61.4 mg; use 1 whole 50-mg tablet per dose. 1 tablet/dose x 1 dose/day x 180 days = 180 tablets. 180 x $0.03 = $5.40 for 180 days.
    • 66-lb collie = 30 kg = dose range of 90 to 150 mg; use either 1 of the 100-mg tablets, of 1 1/2 of the 100-mg tablets, or 1/2 of the 200-mg tablets; costs would be $9.00, $13.00, or $6.30
  44. What is the concentration of drug (in milligrams per milliliter) in a 10% solution? In a 43% solution?
    • 10% solution = 10g/100 mL = 10,000 mg/100 mL = 100 mg/mL
    • 43% solution = 43 g/100 mL = 43,000 mg/100 mL = 430 mg/mL
  45. How many milligrams of drug are in 0.13 L of a 7.5% solution?
    7.5% solution = 7.5 g/100mL = 7500 mg/100 mL = 75 mg/mL. If there is 75 mg/mL, you want to know how many are in 0.13 L or 130 mL. 130 mL x 75 mg/mL = 9750 mg in 130 mL of solution
  46. A pet owner is passing through town and stops by your veterinary clinic to see whether she can pick up some "car sickness" tablets for her dog. The owner is on a cross-country car trip and has no more of the motion sickness medication that was dispensed by her veterinarian. The doctor is not in the clinic at the moment. Is it legal to dispense the medication if you first telephone the doctor to obtain permission?
    A valid/veterinarian/client/patient relationship does not exist in this case. The veterinarian has not seen this animal, does not know what type of medication the animal is currently using for motion sickness, and does not know if there are any physical contraindications that would prevent the safe use of the drug in this animal.
  47. Translate:
    give 3 mg q4h PO prn
    Give 3 mg every 4 hours by mouth as needed
  48. Translate:
    disp 1 bottle-give 2 gtt OU b.i.d.
    Dispense 1 bottle; give 2 drops in both eyes two times daily
  49. Translate:
    give 2 cc IP stat
    Give 2 mL by the intraperitoneal route immediately
  50. Translate:
    needs to have 3L qd
    Needs to have 3L every day
  51. Translate:
    15 mg IV t.i.d.
    15 mg intravenously three times daily
  52. Translate:
    4.5 mL of the 5 mg/mL concentration q.i.d.
    4.5 mL of the 5 mg/mL concentration 4 times daily
  53. You are the technician who orders most of the drugs for your veterinary practice. Can you legally order drugs that are listed as C-II? Can any licensed veterinarian order such drugs?
    Technicians cannot legally order C-II drugs. Only a veterinarian with a current state license, state controlled substance permit, and DEA certification number can order C-II drugs.
  54. The veterinarian stores his controlled substances in a 1-cubic-foot metal tool box with a heavy-duty padlock. Is this adequate storage for schedule drugs? What about a wooden cabinet with a lock?
    • This is not adequate. A thief can pick up and carry the box off. The storage compartment has to be made of a material of "substantial construction" that cannot be removed.
    • A wooden cabinet, if locked and the key controlled by the veterinarian, may provide sufficient security as long as the cabinet cannot be easily broken into.
  55. The veterinarian wants to clear out some old records, including some controlled substance logs that are 6 years old. Is it legal to discard these logs?
    Generally, yes. The minimum requirement for DEA standard is 2 years. However, some states may require keeping the logs for longer than 2 years.
  56. A fellow staff member routinely uses a surgical mask and a single pair of latex surgical gloves during preparation and administration of antineoplastic drugs. Is this adequate protection?
    Surgical masks in one layer are porous enough to allow an aerosolized drug to pass through them. A single pair of latex surgical gloves may not be enough to prevent a drug from getting through.
  57. A veterinarian in another practice sees that there is a market for the "blue goo" concoction that he compounded as a teat dip to prevent mastitis. Can the doctor legally sell this product to your practice if he applies a label to each bottle stating "for use by or on the order of a licensed veterinarian"?
    If the veterinarian is selling "blue goo" to other practices with or without a label, this is drug manufacturing as opposed to compounding the product for a specific client and a specific animal. This would be considered illegal.
  58. A diabetic dog is being treated in the clinic. The dog requires 3.2 units (U) of insulin both the morning and evening. U-100 insulin has a concentration of 100 units of insulin/mL and is supplied as 10-mL vials. A the insulin dosage listed above, how many full doses (3.2 units) of insulin for this dog are contained in this vial?
    "Units" are just another way of measuring concentration of the drug (insulin in this case) in a solution. The U-100 preparation of insulin contains 100U of insulin/mL. There are 10 mL in a vial, hence 100 U.mL x 10 mL = 1000U of insulin in one vial. The dog requires 3.2 U per dose, thus the number of doses from this vial would be 1000 U x 1 dose/3.2 units - 312.5 doses = 312 doses (a half of a dose is of no value)
  59. The veterinarian asks you to dispense digoxin for a client's dog. The recommended dose is 0.22 mg/m2 , with m2 being the number of square meters of body surface area. The dog's body surface area is 0.8 m2. The digoxin elixir is available in a concentration of 0.15 mg/mL. To prevent overdosing, the doctor instructs you to use 60% of the calculated normal dose for this dog. How many milliliters of digoxin elixir should this dog receive for each dose?
    Meters squared (m2) is another way of describing the animal instead of kilograms or pounds of body weight. Use meters squared in the same way as kilograms and pounds of body weight. 0.8 m2 x 0.22 mg/m2 0.176 mg. 0.176 mg x 1 mL/0.15mg = 1.17 mL to be given at full strength. The veterinarian wants you to use 60% of the original dose. Therefore 60% = 0.60 and 60% of the dose would be 0.60 x 1.17 mL = 0.7 mL of drug. You can also calculate the reduction in dose by taking the calculated dose in mg (0.176 mg) and determining what 60% of that would be (0.1056 mg) and then determining the milliliters of elixir to be used: 0.1056 mg x 1 mL/0.15 mg = 0.7 mL
  60. You were calculating the total number of tablets to be dispensed and somehow came up with tan unusable answer. The dog weighs 42 lb (19.1 kg). The dose is 10 mg/kg t.i.d. for 10 days and the tablet size is 50 mg. You calculated the dose by multiplying 19.1 kg by 10 mg/kg  to get 191 mg per dose. You wanted to determine the total milligrams needed for the 10 days, so you took the 191 mg per dose and multiplied it by three doses per day (t.i.d.) to get 573 mg and then multiplied that by 10 days to get 5730 mg total for 10 days. The 5730 mg total comes out to 114.6, the 50-mg tablets that you rounded to 115 tablets to cover the 10 days. But when you attempt to determine how many tablets the owner needs to give the dog with each dose, the number of tablets per dose does not make sense. Determine how many tablets this animal would get per dose based on this calculation of total milligrams of drug needed for the 10 days and determine where the mistake in logic was made in doing this calculation.
    The number of tablets per dose for this dog would be determined by dividing the 115 total tablets by 10 days and three times a day dosing: 115 / 10 = 11.5. 11.5 / 3 = 3.8333 tablets per dose. No client is going to be able to slice off 0.8333 of a tablet. The error came in determining total milligrams of drug needed for the whole 10 days. What needed to be done is determine the milligrams of drug needed for one dose, then convert that amount into the tablet dose. The milligram dose was 190.1, which translates into 3.8 of the 50-mg tablets per dose. Round that 3.8 tablets to 4 tablets per dose. Now determine how many tablets are needed per day (4 tablets per dose x 3 doses per day = 12 tablets) and how many are needed for 10 days (12 tablets per day x 10 days = 120 tablets total).
  61. A client wants to buy $10 worth of vitamins for his dog. The doctor asks you to dispense the medication but not to exceed the $10 value. The dog weighs 8 lb. The recommended dosage is 8 mg/kg given once daily. The medication is supplied as 15-mg tablets. A bottle of 1000 tablets costs $130. How many day's worth of tablets can you dispense for $10?
    8-16 dog = 3.636-kg dog. At a dose of 8 mg/kg, this dog needs a dose of 29.1 mg. Tablets are 15 mg in size so the dog gets 2 tablets per dose. Each tablet costs $0.13 ($130 divided by 10) and the dog gets two tablets a day; therefore the cost per day of tablets is 2 x $0.13 = $0.26 per day. If the client only has $10, then we divide the $10 by the cost per day to determine how many days of medication the client can have. $10 x day/$0.26 = 38.4 days = 38 days (a partial day does not count)