jorg pharm
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- What are four serious electrophysiological effects of Digitalis toxicosis?
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Sinus bradycardia
sinoatrial arrest of exit block
second or third degree AV conduction delay
Ventricular dysrythmias - What are the four broad causes for Digitalis toxicity?
-
overdose
increased absorbtion
decreased renal clearance
hypokalemic state - What are the GI signs of Digitalis tox?
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colic
anorexia
vomiting
diarrhea - What are the neurologic signs of Digitalis tox?
-
depression
fatigue
confusion
dizziness - What is the mechanism of action for Bypyridine derivitives?
- the inhibit PDE which increases cAMP = increased calcium concentrations in the myocardial cells
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Drugs to decrease Preload:
What is the mechanism of action of nitroglycerin and when is it's use indicated? -
It directly relaxes venous smooth muscle and provides the precurser for NO
It is used for the treatment of acute cardiogenic pulmonary edema - what is the mechanism of action of hydralazine?
- It is a direct-acting arteriolar dialator. It prevents calcium influx into smooth muscle.
- What are the general effects of ACE inhibitors in patients with excessive RAAS?
-
prevent venous and arterial constriction
reduce Na retention and water retention by inhibiting aldosterone release - What is the mechanism of action for Sodium nitroprusside and when is it indicated for use?
-
It is a direct acting arteriolar and venodilator
It is used in acute/severe hypertension, acute heart failure secondary to mitral regurgitation - Metabolites of what drug can possibly cause cyanide toxicity
- sodium nitroprusside
- what ion channels are affected by class I, III, and IV?
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Class I - Block Na channels
class III - block outward K channels
class IV - Ca channel blockers - What drug is used to treat A fib in the horse?
- quinidine
- What is the protocol for quinidine treatment for a fib in the horse?
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give through stomach tube and use test dose to monitor for toxicity.
10-15g doses every 3 hrs for 3 doses -
What is a serious side effect of lidocaine use?
what is an early warning sign? -
seizures
nystagmus - Amiodarone is a class III antiarrhythmic drug which blocks K, what else does it block?
- It is also a Ca and beta blocker
- Sotalol is not only a K blocker, what else does it block?
- It is also a beta blocker
- What are the factors that affect drug detection in race horses?
-
urine flow rate
blood flow
horse variability
feed
disease
exercise - What are some pharmacological factors that affect drug detection?
-
Dosage
dosing interval
route of admin
drug interactions - What is a jug?
- one liter of electrolyte with or without extra additives
- What is a runnin jug?
- 500 cc usually dexolyte solution
- What is a drench?
- solution given orally or by NG tube
- What is a bleeder?
- Jargon for a horse with EIPH
- What is a block?
- Injection administered sub-Q in problem area
- What is a blister?
- counter-irritant med used to irritate a general area in order to increase blood flow and recruit healing factors
- What are two drugs used for analgesia in lame race horses?
- Sarapin and Methylcarbamine
- Name three drugs that are used to treat gastric ulcers in horses.
-
omeprazole
cimetidine
ranitidine - What is the mechanism of action for heparin?
- It must combine with alpha globulin or antithrobin III. together they inhibit factors in both pathways and inhance degradation of thrombin and decrease thrombin formation
- What is the mechanism of aspirin?
- irreversibly binds to COX 1 and 2in platelets rendering them useless forever
- What test is used to monitor cumarin therapy?
- OSPT test
- What clotting factors are dependent on Vit K?
- II, VII, IX, X
- Name five local hemostatics.
-
gelatin sponge
fibrinogen
epinephrine hydrochloride
silver nitrate
cautery - What is the mechanism of action for NSAIDS?
- They inhibit COX 1 and COX 2 enzymes
- Which NSAID has an irreversible action?
- aspirin
- how do nsaids decrease elevated body temp?
- by inhibiting COX enzymes, PG synthesis is inhibited and PGE2 is responsible for hypothalamus activation of elevated temp
- Which drug is most associated with anti-thrombotic activity?
- aspirin
- How do Nsaids cause gastric ulcers?
- PG's inhibit acid secretion, promote mucous secretion and inhance mucosal blood flow. nsaids inhibit PG's so ulcers are a risk
- phenylbutazone is used for mostly what kind of pain in horses?
- musculoskeletal
- What is the site of action for loop diuretics?
- thick ascending limb of loop of henle
- What are the indications for furosamide use?
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treatment of CHF to reduce preload
acute pulmonary edema
edema caused by renal insufficiency
mammary edema in cattle
hypertension
prevent EIPH in horses - Waht are the contraindications for furosamide usage?
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anuria
severe volume depletion
hypersensitivity to sulfonamides - What is the site of action for Triamterene?
- late distal tubule and collecting duct
- What properties must osmotic diuretics have?
-
freely filterable
limited reabsorption
pahrmacologically inert
should not be metabolized - How does Digoxin work as a positive ionotrope?
- Inhibits the Na-K ATPase in myocytes Since Ca moves out of the cell with Na, Ca is sequestered in the SR and more is available during contracction
- How does Digoxin work as a negative chronotrope?
- slows AV nodal conduction and ventricular response to A.fibb
- What broad classes of drugs would one use to reduce preload?
-
diuretics
vasodialators
ACE inhibitors - Which K+ sparing diuretic competes with aldosterone for binding sites in the late distal tubule?
- spironolactone
- How are K+ sparing diuretics administered?
- orally