VTNE pharm

All drugs need to be stored and handled so that they are safe for the patient, client, and veterinary staff. When handling drugs that are concidered cytotoxic or hazardous, personal protective apparel (PPA) should be worn. With which of the following drugs is it imperative to pay special attention to safe handling?

-Ascorbic Acid

-Metoclopramide

-Sucralfate

-Vincristine

-Metronidazole

Vincristine is a chemotheraputic agent and PPA including gloves, gowns, and a face shield should be worn when using this drug. Ascorbic acid is Vitamin C and probably poses minimal risk when handling. Metronidazole and sucralfate are not hazardous via handling.

An 11-year old male German shepherd dog with previously diagnosed dilated cardiomyopathy (DCM) presents to your clinic following a dog fight. The dog is significantly aggressive and resistant to handling. What medication should NOT be used to sedate this patient?

-Dexmedetomidine

-Atropine

-Midazolam

-Butorphanol

-Buprenorphine

Dexmedetomidine should only be used in patients with normal cardiac function as it can cause a significant reduction in cardiac output due to reduced heart rate. It should be avoided whenever possible in patients that have compromised cardiac function. Butorphanol and buprenorphine would be better options for sedation as these drugs would not have as much effect on cardiac output and would provide some pain relief. Midazolam can be used to sedate the patient via IM administration and, although it would not provide any pain control, it would allow for safer handling of the patient. Atropine is not a sedative, but an anticholinergic used most commonly to increase heart rate.

A Golden retriever ingests several tablespoons of antifreeze. This will cause the most damage to what organ system?

-Cardiac

-Renal

-Hepatic

-Gastrointestinal

-Nervous

Renal

Ethylene glycol (EG), the primary ingredient in antifreeze, causes damage to the renal system (kidneys). EG causes damage to the renal tubular epithelium, causing build up of oxalate crystals in the renal tubules and metabolic acidosis.

Which is safe to put in the ears if the tympanum may be ruptured?

-Chlorhexidine

-Gentamicin

-Neomycin

-0.9% NaCl

Saline (0.9% sodium chloride) is considered safe.

The others listed (especially aminoglycoside antibiotics) could potentially be ototoxic if the eardrum is not intact.

Which of the following medications is commonly found over-the-counter (OTC)?

-Diphenhydramine

-Pimobendan

-Hydrocodone

-Doxycycline

Diphenhydramine

The other name for diphenhydramine is Benadryl and can be found over-the-counter.

Hydrocodone is commonly used as a cough suppressant in veterinary medicine and is a controlled substance requiring a prescription.

Doxycycline (an antibiotic) and Pimobendan (a heart medication) are by prescription only.

How many milliliters of 50% dextrose should be added to a 100 ml solution of Lactated Ringer's Solution to make it 2.5%?

0.5 ml

5 ml

10 ml

1 ml

50 ml

To answer this question, the following formula should be implemented:

C(1)V(1) = C(2)V(2)

C is the concentration

V is the volume

C(1) =0.5

V(1) = x

C(2) = 0.025

V(2) = 100 ml

0.5x = 0.025(100)

x = 5 ml

5 ml of 50% dextrose should be added to 100 ml in order to make a 2.5% solution.

How many milliliters should be administered to a 100-kg patient that needs 50 mg of a 2.5% solution?

25 ml

125 ml

2 ml

2.5 ml

Percent is equal to weight (in Grams) / 100 parts volume (in mLs)

(This is based on water since 1 mL weighs 1 Gram):

Example: A 3% solution: 3 Grams / 100 mL or 3000 mg / 100 mL or 30 mg/mL

The easiest way to remember is to just add a zero onto any percentage for the milligrams (i.e. 2% solution = 20 mg/ml; 10% solution = 100 mg/ml, etc.)

In this situation a 2.5% solution is equivalent to 25 mg/ml. Therefore:

50 mg / (25 mg/ml) = 2 ml

A drug that is a cholinergic agent will have which of the following effects?

-Dilate the pupil

-Slow the heart rate

-Cause central nervous system depression

-Decrease salivation

-Decrease intestinal motility

Slow the heart rate

Cholinergic agents are drugs that mimic the effects of acetylcholine within the autonomic nervous system. These drugs stimulate the parasympathetic nervous system. They promote salivation, lacrimation, urination, and defecation (sometimes abbreviated SLUD or referred to as "rest and digest" functions). They can cause pupil constriction or decreased heart rate. A commonly used cholinergic drug is bethanechol which is structurally similar to acetylcholine but resists degradation. It is used to treat gastric atony or urinary retention in the bladder.

A patient is hospitalized with a resistant infection and is getting Amikacin injections and IV fluid therapy. Amikacin can cause kidney damage. What could you do to monitor for early renal side effects?

-Check a daily urine protein

-Monitor urine output

-Renal ultrasound daily

-Check the urine specific gravity twice daily

Check a daily urine protein.

Proteinuria can be one of the first things seen if there is damage to the kidneys. Urine output and specific gravity would not be reliable indicators since this patient is on IV fluids. Ultrasound would not be helpful picking up early kidney damage since this occurs at a microscopic level in the renal tubules. Kidney changes can be seen with ultrasound only if gross disease is present in the renal architecture. BUN and creatinine levels can be helpful, however, remember that usually these values do not become elevated until more than 70% of the renal function has been compromised.

What quantity of drug is found in 200 mLs of a 10% solution?

20 milligrams

20 grams

2,000 milligrams

2,000 grams

20 grams.

A 10% solution is equal to 100 mg/mL. The easiest way to remember this conversion is to add a zero to the percentage. (10%= 100 mg/mL, 15% = 150 mg/mL, etc.)

If 1 mL is equal to 100 mg, then to find out the quantity of drug in 200 mLs, multiply 100 mg X 200 = 20,000 mg. There are 20,000 mg in 200 mLs of a 10% solution.

But none of the choices are 20,000 mg. We need to go one step further and determine how many grams this is.

1 gram is equal to 1,000 mg. We need to divide the milligrams by 1,000.

So, 20,000mg / 1,000 = 20 grams.

Which chemotherapy drug is contraindicated for use in cats?

Cisplatin

Vincristine

L-Aspariginase

Prednisone

Doxorubicin

Cisplatin cannot be used in cats as it causes pulmonary toxicity. Remember the phrase "Cisplatin splats cats".

Which drug could be used to decrease intracranial pressure?

Mitotane

Mannitol

Ivermectin

Phenobarbital

Mannitol is an osmotic diuretic. It can reduce intraocular and intracerebral pressures. It can also help to reduce edema and enhance urinary excretion of some toxins.

This drug can also crystallize, so a filter needle should be used.

Which medication is considered a gastric "band-aid"?

Sucralfate

Metoclopramide

Metronidazole

Pepcid-AC

Sucralfate.

Sucralfate (Carafate) acts as a sticky paste that binds with proteins found in ulcers and adheres there like a band-aid to aid in protection and healing.

Pepcid (famotidine) is an antacid that helps to decrease the gastric acid that can cause an ulcer to occur.

Metoclopramide is a pro-motility agent that helps to reduce vomiting.

Metronidazole is an antibiotic often used in treating diarrhea.

A client calls the clinic and says her 12 pound mixed breed dog was just stung by a bee and his face is starting to swell. You recommend she brings her pet in immediately, and the doctor recommends she give Benadryl 12.5 mg orally now before she leaves her house. The woman has some Benadryl liquid that is 12.5 mg per teaspoon. How many milliliters should she give her pet?

1.5 mLs

2.5 mLs

0.5 mLs

5 mLs

5 mls.

1 teaspoon is equal to 5 milliliters.

How many liters of 50% dextrose should be added to 5 liters of 0.9% saline to make a 5% dextrose solution?

0.5 L

0.75 L

0.25 L

0.05 L

0.5 L

To answer this question, the following formula should be implemented:

C(1)V(1) = C(2)V(2)

C is the concentration

V is the volume

C(1) =0.5

V(1) = x

C(2) = 0.05

V(2) = 5 L

0.5x = 0.05(5)

x = 0.5 L

0.5 L of 50% dextrose should be added to one liter in order to make a 5% solution.

Which of the following drugs should be used with extreme caution in ruminants?

Atropine

Acepromazine

Lidocaine

Xylazine

Xylazine.

Xylazine is an alpha-2 adrenergic agonist and is classified as a sedative/analgesic with muscle relaxant properties. It is not approved for any species to be consumed for food purposes.

Ruminants are very sensitive to xylazine and it is not used much in these animals. In fact, ruminants generally require only 1/10 of the dosage required for horses to exhibit the same effect.

Due to the unique GI system of the ruminant, much care must be taken when administering drugs so as not to interfere with proper digestion, and xylazine inreases risk of ileus.

Diphenhydramine is typically used in treating which of the following conditions?

Allergic reactions

Auto-immune conditions

Keratoconjunctivitis sicca

Urinary incontinence

Urinary tract infections

Allergic Reactions.

Diphenhydramine is also known as Benadryl. It is a an anti-histamine most commonly used for treating allergies or allergic reactions.

A urinary tract infection would require an antibiotic. Keratoconjunctivitis sicca is an immune mediated condition and is usually treated with cyclosporine. Auto-immune conditions also call for immunosuppressive agents. Urinary incontinence may be treated with phenylpropanolamine.

Which drug can be given as a tablet into the conjunctival sac in the eye to induce vomiting?

Apomorphine

Xylazine

Hydrogen peroxide

Morphine

Apomorphine can be given as an injectable or in tablet form that can be dissolved into the eye to induce emesis. Giving it orally is not as effective. It acts by dopamine stimulation.

Which of the following drugs is considered an alpha-2 agonist?

Atropine

Atipamezole

Dexmedetomidine

Yohimbine

Dexmedetomidine.

Dexmedetomidine (Dexdomitor) is a sedative/analgesic that acts on the alpha-2 receptors of the brain. Xylazine is also an important alpha-2 agonist to know.

Atipamezole is the reversal for dexmedetomidine. Therefore it is an alpha-2 adrenergic antagonist (it antagonizes the effects of the dexmedetomidine).

Yohimbine is an alpha-2 blocker used to reverse xylazine (which is an alpha-2 agonist).

Atropine is an anticholinergic drug (parasympatholytic).

A 20-kg patient is currently receiving 52 ml/hr of Lactated Ringer's Solution. The clinician has requested that 2 mg/kg/day of metoclopramide be added to the bag. Metoclopramide is available as a 5 mg/ml solution. How many milliliters do you need to add to a 1 liter bag?

6.5 ml

3 ml

0.8 ml

45 ml

6.5 ml.

This is definitely a more complicated calculation question, but when broken down it is not insurmountable.

A 20-kg patient will need 40 mg/day of metoclopramide (20 kg x 2 mg/kg/day)

Since the fluid is being administered at an hourly rate, we need to figure out how much metoclopramide we are administering per hour.

40 mg/day / (24 hr) = 1.7 mg/hr

To determine how much volume of metoclopramide is needed, the following math is performed:

1.7 mg/hr / (52 ml/hr) x (1000 ml)= 32.6 mg (Notice how the units cancel out.)

32.6 mg / (5 mg/ml) = 6.5 ml

Administration of which antimicrobial is MOST LIKELY to result in diarrhea in the adult horse?

Gentacin

Enrofloxacin

Erythromycin

Penicillin

Ceftiofur

Erythromycin.

Many antimicrobials can result in diarrhea in horses because of disruption of the normal intestinal flora. Of the drugs listed, erythromycin has the highest likelihood of contributing to the development of diarrhea. Erythromycin is administered to foals with Rhodococcus equi pneumonia but is rarely used in adult horses because of its common association with the development of diarrhea. All the other listed drugs can be administered to horses.

A client rushes in her puppy which was accidentally dropped and received a trauma to the head. Which medication is an osmotic diuretic and may be used to help decrease intracranial pressure in a situation like this?

Dobutamine

Mannitol

Dexdomitor

Diazepam

Mannitol.

Mannitol is an osmotic diuretic that is often given to help decrease intracranial pressure in cases of trauma or seizures. It may also help to decrease intraocular pressures in acute glaucoma cases by dehydrating the vitreous humor. It also has some renal vasodilation properties and is sometimes given in cases of oliguric renal failure to help stimulate urine production. The other medications listed are not osmotic diuretics and would not be used in this situation. Dexdomitor (dexmedetomidine) is an alpha-2 adrenoreceptor agonist and is often used for sedation. Diazepam is often used to stop seizure activity and causes muscle relaxation. Vasopressors, such as dobutamine, cause vasoconstriction and work to increase blood pressure.

Frequently, the doctor will ask that a prescription for Cephalexin be filled. How many 500 mg capsules should be sent home for a dog receiving 22 mg/kg PO TID for 10 days? The dog weighs 50 lbs.

45

15

30

60

30.

To get the answer, the body weight must first be converted to kilograms.

50 lbs / 2.2 kg/lb = 22.7 kg (There are 2.2 lbs per kilogram)

Then,

22.7 kg x (22mg/kg) = 499.4 mg

This is rounded up to 500 mg. The patient takes 3 capsules per day for 10 days.

3 x 10 = 30

The patient should be sent home with 30 capsules.

A patient that is currently receiving 30 ml/hr of NaCl needs a medication added to the fluid bag. The clinician would like the patient to receive a total of 3 mg/kg/day of this medication. The medication comes in a 10 mg/ml solution. How many mL should be added to the bag if it is a 250 mL bag and the patient weighs 10kg?

4 ml

10 ml

6 ml

1 ml

12.5 ml

1 ml.

A 10-kg patient will need 30 mg/day of the medication (10 kg x 3 mg/kg/day)

Since the fluid is being administered at an hourly rate we need to figure out how much medication we are administering per hour.

30 mg/day / (24 hr) = 1.25 mg/hr

To determine how much volume of the medication is needed the following math is performed:

1.25 mg/hr / (30 ml/hr) x (250 ml) = 10.4 mg (Notice how the units cancel out)

10.4 mg / (10 mg/ml) = 1 ml

What toxicity is caused by ingestion of pennies?

Zinc toxicity

No toxicity is caused by penny ingestion

Nickel toxicity

Lead toxicity

Zinc toxicity.

Any penny minted after 1982 contains a large amount of zinc, leading to zinc toxicity in animals even from just a single penny.

Flunixin meglumine is sometimes used in horses, cattle, and pigs for which purpose?

For constipation

For tapeworm infestation

For acid reflux

For analgesia

For analgesia.

Flunixin meglumine (Banamine) is a non-narcotic, non-steroidal anti-inflammatory drug used to provide analgesia and to reduce inflammation. It may also be used as a fever reducer.

Pyrethrin (which is used to kill fleas) is derived or extracted from which of the following plants?

Chrysanthemum

Bougainvillea

Hibiscus

Stargazer lily

Pyrethrin comes from the Chrysanthemum plant and acts on the nervous system to cause flea death.

A 1200-gram bird needs to receive an injection of an antibiotic. The antibiotic dose to be administered is 15 mg/kg. It comes in a 10 mg/ml solution. How many milliliters does this bird need?

1800 ml

1.8 ml

9 ml

18 ml

1.8 ml.

The first thing to do is to convert the body weight into kilograms. In this way, the units will not get mixed up. There are 1000 grams in one kilo, so...

1200 g/ (1000 g/kg) = 1.2 kg

1.2 kg x (15 mg/kg) = 18 mg

18 mg / (10mg/ml) = 1.8 ml

Which of the following is an expected side effect of atropine?

Cause pupillary constriction

Cause inhibition of excessive salivation

Cause bradycardia

Cause mild sedation

Cause inhibition of excessive salivation.

Atropine functions as a sympathetic, competitive antagonist of muscarinic cholinergic receptors. It inhibits salivary secretions, causes increased heart rate, and causes dilation of pupils. It is not a sedative.

What is the most frequently observed side effect associated with acepromazine use in geldings?

Paraphimosis

Seizures

Arrhythmias

Hypotension

hypotension.

Acepromazine will reliably cause hypotension. Acepromazine may cause paraphimosis in male horses, but this is uncommon. However, due to the risk of paraphimosis, many veterinarians will not use acepromazine on stallions. Acepromazine actually has anti-arrhythmogenic properties. Acepromazine does reduce the seizure threshold, but seizures are not as common as hypotension.

The doctor hands you a written prescription for spironolactone and asks you to give it to a client while they are checking out. The client asks you to remind her what this medication is for again, and you reply that:

It is a diuretic for her pet's congestive heart failure

It is a corticosteroid used for treating Addison's disease

It is an anti-inflammatory for her pet's post-operative pain

It is a steroid inhibitor used for treating Cushing's disease

It is a diuretic for her pet's congestive heart failure.

Spironolactone is an aldosterone antagonist and a potassium sparing diuretic used as an adjunctive treatment for heart failure. If furosemide is not enough to control the pulmonary edema, sometimes spironolactone is added on as an additional diuretic to keep fluid out of the lungs.

A 5-week old cat received emergency surgery for a laceration. What antibiotic should NOT be used in this patient?

Amoxicillin

Cefazolin

Ticarcillin

Clindamycin

Enrofloxacin

Enrofloxacin.

Young animals should not receive enrofloxacin (Baytril) due to risk of cartilage defects (mostly in young large breed dogs). This drug must be used with caution and at lower doses in cats because it may cause blindness.

You are instructed to give a medication which you are told is an antipyretic. What will this medication do?

Prevent vomiting

Reduce gastric acid

Reduce fever

Provide sedation

Reduce fever.

Anti-pyretics reduce fever. An example of an anti-pyretic medication is ketofen (Ketoprofen) which is a non-steroidal anti-inflammatory. The term pyrexia means fever.

An example of an acid reducer (antacid) would be famotidine (Pepcid AC).

A medication which would prevent vomiting would be an antiemetic. Examples of this include maropitant (Cerenia) or metoclopramide (Reglan). Reglan also has upper GI pro-kinetic properties.

Which medication given for diarrhea can cause the stools to appear dark in color, like melena?

Sucralfate

Forti-flora

Tylosin

Pepto Bismol

Metronidazole

Pepto Bismol.

Pepto Bismol and some formulations of KaoPectate contain bismuth subsalicylate, which causes darkening of the stool and acts by anti-secretory effects on the intestine.

Sucralfate is given to help sooth esophageal and gastric ulcers. Metronidazole and Tylosin are antibiotics.

Forti-flora is given to help restore the normal gastrointestinal flora.

Which medication is commonly given to patients with organophosphate toxicity?

Morphine

Vitamin K

IV vodka

Atropine

Atropine is an anticholinergic drug and is an important treatment of organophosphate toxicity. This is because organophosphates are acetylcholinesterase inhibitors, and toxicity allows a buildup of acetylcholine. Atropine counteracts these effects.

What purpose is the administration of the drug Guaifenesin typically used for in horses?

Intestinal Prokinetic

Muscle relaxation

Antimicrobial

Anti-inflammatory

Expectorant

Muscle relaxation.

Guaifenesin is administered intravenously to horses to provide relaxation of skeletal muscles during induction of general anesthesia. The exact mechanism of action is unknown but believed to be related to central depression of nerve impulse transmission. Although guaifenesin is administered orally in some species as an expectorant, this is not the typical reason for its administration in horses.

What clinical syndrome can result from bedding a horse on shavings made from the Black Walnut (Juglans nigra) tree?

Contact dermatitis

Nothing/no Effect

Contact alopecia

Laminitis

Foot abscessation

Laminitis.

Contact with Black Walnut shavings can cause laminitis in the horse within 10-12 hours of being placed on the bedding. Severity of laminitis can be mild to severe and may also be accompanied by limb edema.

Which of the following can cause severe gastritis and should be used with extreme caution when inducing vomiting?

Hydromorphone

Xylazine

Apomorphine

Hydrogen peroxide

Hydrogen peroxide is often used over-the-counter to induce emesis in dogs. It can cause a severe gastritis due to its effects on the stomach lining and should be used with caution. Apomorphine and hydromorphone are both opiates. Xylazine is an alpha 2 agonist.

Acepromazine concentration is 10 mg/mL. You are instructed to make a dilute acepromazine solution at 1 mg/mL. Which of the following could be used for how much acepromazine and how much sterile water are mixed to make this concentration?

9 mL acepromazine and 1 mL sterile water

10 mL acepromazine and 25 mL sterile water

1 mL acepromazine and 9 mL sterile water

0.1 mL acepromazine and 2.5 mL sterile water

1 mL acepromazine and 9 mL sterile water.

1 mL of acepromazine is equal to 10 mg (since ace is 10 mg/mL). This 10 mg mixed in 9 mL of sterile water results in a concentration of 1 mg/mL.

1 mL (10 mg) of ace + 9 mL of sterile water = 10 mL total volume

10 mg / 10mL = 1 mg/mL

A 5-year old female spayed Yorkie presents with a history of decreased vision. The doctor asks you to perform tonometry on this dog. Which of the following may be used as a topical anesthetic to the eyes so that you may check the intraocular pressures with your Tonopen?

Proparacaine

Benzocaine

Bupivacaine

Lidocaine

Proparacaine is a topical anesthetic for the eyes. The other choices should not be used in the eyes. The other options are local anesthetic agents but are likely to cause irritation and/or corneal ulceration.

Which of the following routes of administration would give a drug the highest bioavailability?

Intramuscular

Subcutaneous

Intravenous

Oral

Intravenous.

Absorption of a drug is the movement of the drug from the site of administration into the systemic circulation. The route of administration directly affects how bioavailable the drug is. When a drug is given IV (intravenous), there is no absorption phase because it is injected directly into the systemic circulation. So drugs given IV have 100% bioavailability.

Drugs given intramuscularly (IM) have a high bioavailability as well, but not as high as the IV route. Drugs given subcutaneously (SQ) and orally (P.O.) must pass several barriers and thus will usually have a lower bioavailability.

You find Otodectes cynotis in an ear swab you prepared for a kitten that has been scratching her ears and has dark coffee ground looking debris in them. What could be used to treat this?

Albon

Ivermectin

Clavamox

Fluconazole

Ivermectin.

Ivermectin 0.01% can be applied topically to the ears to treat ear mites.

Fluconazole is an anti-fungal that would be effective against Malassezia (yeast).

Clavamox would be beneficial for a bacterial ear infection.

Albon is used to treat coccidia (an intestinal parasite).

Which of the following medications would be beneficial to a patient who is being treated for an NSAID overdose?

Cortisone

Potassium

Misoprostol

Lactulose

Misoprostol is a protective prostaglandin used to treat overdoses of NSAIDs, and helps to provide protection to the gastric mucosa.

Overdoses of NSAIDS would cause a high incidence of gastric damage or ulceration. Other concerns would be liver or kidney damage. Potassium would not provide any protection against these effects. Cortisone (or any type of steroid) would be contraindicated in a toxicity such as this as it may exacerbate the signs. Lactulose is a stool softener and would not be beneficial to the GI tract.

Which of the following medications should be used with caution in cats, as it could cause blindness in some cats?

Enrofloxacin

Clindamycin

Amoxicillin

Metacam

Enrofloxacin (Baytril) is used in cats at no higher than a 5mg/kg per dose. Higher doses increase the risk for blindness in cats, and in general this drug should be used with caution because of this potential side effect.

A canine patient presents for his annual exam. The owner states they will be taking a road trip and "Bailey" gets extremely car sick. What medication has been FDA approved for motion sickness in dogs?

Metoclopramide (Reglan)

Maropitant (Cerenia)

Diphenhydramine (Benadryl)

Meclizine (Dramamine)

Maropitant (Cerenia).

Cerenia is the only medication that has been approved for motion sickness in dogs. The other medications have been used for similar purposes, but don't work as well for motion sickness specifically in dogs.

Which of the following drugs is a controlled substance?

Medetomidine

Acepromazine

Hydrocodone

Propofol

Hydrocodone.

Hydrocodone (Hycodan, Tussigon) is an opiate agonist and is a controlled narcotic. It is often used for its anti-tussive properties in animals that are coughing.

The other drugs listed are not controlled.

A drug that is an anti-cholinergic agent will have which of the following effects?

Suppress the cough reflex

Decrease heart rate

Constrict the pupil of the eye

Decrease salivation

Decrease salivation.

Anti-cholinergic agents are drugs that antagonize the effects of acetylcholine in the autonomic nervous system. Commonly used examples of anticholinergic agents include atropine and pilocarpine. They are commonly used prior to anesthesia because they increase the heart rate (most anesthetic drugs decrease heart rate) and decrease oral secretions, which can aid intubation.

Pyrethrin (which is used to kill fleas) is derived or extracted from which of the following plants?

Hibiscus

Chrysanthemum

Bougainvillea

Stargazer lily

Pyrethrin comes from the Chrysanthemum plant and acts on the nervous system to cause flea death.

Sometimes drugs, such as phenobarbital, are given in a higher dose as a loading dose and then tapered back to a maintenance dose. This helps the drug to accumulate to a therapeutic level in the body until the concentration plateaus. When this occurs, the drug has reached which of the following?

Bioavailability

Half-life

Steady state

Nadir

The steady state is the accumulation of a drug concentration in the body until the concentration plateaus.

A nadir is a low point, often used to describe the lowest blood sugar during a glucose curve.

Half-life describes the time it takes for the blood concentration of a drug to drop to half of its steady state.

The bioavailability is the degree to which an administered drug is absorbed. The drug may be absorbed even if peak concentrations or steady state has not yet been reached.

A client rushes in her puppy which was accidentally dropped and received a trauma to the head. Which medication is an osmotic diuretic and may be used to help decrease intracranial pressure in a situation like this?

Dexdomitor

Mannitol

Dobutamine

Diazepam

Mannitol is an osmotic diuretic that is often given to help decrease intracranial pressure in cases of trauma or seizures. It may also help to decrease intraocular pressures in acute glaucoma cases by dehydrating the vitreous humor. It also has some renal vasodilation properties and is sometimes given in cases of oliguric renal failure to help stimulate urine production. The other medications listed are not osmotic diuretics and would not be used in this situation. Dexdomitor (dexmedetomidine) is an alpha-2 adrenoreceptor agonist and is often used for sedation. Diazepam is often used to stop seizure activity and causes muscle relaxation. Vasopressors, such as dobutamine, cause vasoconstriction and work to increase blood pressure.

Potassium citrate is most often given to dogs for which of the following reasons?

Boost energy level

Immune function

Prevent bladder stones

Arthritis pain

Prevent bladder stones.

Potassium citrate is often supplemented in the diet to help prevent formation of calcium oxalate bladder stones.

What adverse side effect can occur in cats given metoclopramide?

Aggressive behavior

Estrus behavior

Cyanosis

Dilated and fixed pupils

Aggressive behavior.

Rare side effects that can occur are nervous, jittery, or aggressive behaviors. The antidote for these types of behaviors is diphenhydramine (Benadryl). Head bobbing can also rarely occur as a side effect of Reglan (metoclopramide).

Which of the following drugs increases gastrointestinal motility?

Barium

Diphenhydramine

Metoclopramide

Famotidine

Metoclopramide.

Prokinetic drugs, such as metoclopramide, increase gastrointestinal motility. Metoclopramide (Reglan) also acts centrally as an antiemetic by blocking dopamine and serotonin receptors in the chemo-receptor-trigger-zone (CRTZ). Famotidine is an H2 blocker. Diphenhydramine helps prevent mast cell degranulation. Barium is used to perform contrast studies of the gastrointestinal tract.

Chronic administration of prednisone to animals can cause an iatrogenic form of what condition?

Bang's disease

Tyzzer's disease

Cushing's disease

Addison's disease

Cushing's disease (hyperadrenocorticism) naturally occurs when the adrenal glands produce too much cortisol. This can be due to a functional adrenal tumor or due to a functional pituitary tumor that secretes ACTH (adrenocorticotropic hormone) which stimulates cortisol secretion from the adrenal gland. Prednisone is a synthetic glucocorticoid, and chronic administration for conditions such as allergies can lead to iatrogenic Cushing's disease. Addison's disease (hypoadrenocorticism) occurs due to inadequate cortisol levels and can be caused by prompt withdrawal of prednisone after prolonged use. Tyzzer's disease is a bacterial disease caused by Clostridium piliforme. Bang's disease, or Brucellosis, is an infectious disease of cattle caused by the bacteria Brucella abortus.

An iatrogenic disease is one caused by a medical or surgical procedure.

Activated charcoal would be used for which of the following?

Snail bait ingestion

Thermal skin burns

Fluoroscopy

Foreign body ingestion

Snail bait ingestion.

Activated charcoal is a black liquid administered orally to prevent absorption of toxins through the gastrointestinal tract. It is often used after induction of emesis or after gastric lavage is performed.

An 8-year old female spayed Dalmatian presents to your clinic for dribbling urine when sleeping. Bloodwork and urinalysis are performed, and phenylpropanolamine is prescribed. How will this drug help treat the dog's problem?

It alkalinizes the urine, decreasing urinary crystal formation

It acidifies the urine, decreasing urinary crystal formation

It increases re-absorption of water by the kidneys, resulting in decreased urine volume

It provides hormonal replacement to reverse the condition

It kills Gram-negative bacteria

It increases the tone of the urethral sphincter

It increases the tone of the urethral sphincter

Phenylpropanolamine is an alpha-adrenergic agonist and causes tightening of the urethral sphincter. It is used to treat "sphincter mechanism incontinence". This is a non-hormonal treatment frequently used to treat incontinence. Older dogs, particularly female spayed dogs, commonly develop urinary incontinence due to weakness of the urethral sphincter. In some cases, this may be "hormone-responsive" meaning that hormone replacement (estrogen-based in females) may reverse the condition.

Urine acidifying or alkalinizing agents could be useful in treating animals prone to formation of urinary calculi. Diethylstilbestrol (DES) is the most common estrogen replacement drug used in dogs to treat incontinence.

Which of these is an effective drug to induce emesis in the dog?

Apomorphine

Azathioprine

Magnesium hydroxide

Xylazine

The correct answer is apomorphine. Apomorphine is an opioid dopaminergic agonist that acts on the chemoreceptor trigger zone to induce vomiting in dogs. It can be administered IM, SC, IV, or in the conjunctival sac. Xylazine is a fairly effective emetic in the cat but is not used in the dog for this purpose. Azathioprine is an immunosuppressive drug not used to induce vomiting. Magnesium hydroxide or Milk of Magnesia is a cathartic but is not used for vomiting.

What does a beta-2 adrenergic agonist cause?

Slowed heart rate

Salivation

Constricted pupils

Bronchodilation

The beta-2 adrenergic agonists are often used in treating cases of "asthma" or other conditions that require bronchodilation as a treatment. Examples of short acting beta-2 agonists are terbutaline and albuterol.

How do oral flea control products such as Program or Sentinel work?

Stopping egg hatching

Killing adult fleas directly

Paralyzing the nervous system of the flea

Sterilizing the male flea to prevent reproduction

Stopping egg hatching.

These products interfere with chitin synthesis. The flea's "egg tooth", which is made of chitin, is no longer able to help the flea hatch from the egg. Another possible correct choice, but not provided, would be that females produce sterile eggs. Female fleas may produce 150-300 eggs per week (or up to 50 eggs a day). These products do not kill adult fleas.

A 6-year old Doberman cardiac arrested and was resuscitated. However, the dog has a consistently low systolic blood pressure of 60 mmHg. What drug may be prescribed to increase the blood pressure and via what route?

Hydromorphone via intravenous administration

Terbutaline via subcutaneous administration

Dopamine via intravenous infusion

Dopamine via intramuscular administration

Dopamine via intravenous infusion.

Dopamine increases blood pressure by increasing systemic vascular resistance and is administered via intravenous constant rate infusion. Dopamine is not labeled for intramuscular use. Hydromorphone is an opioid and may cause a reduction in the patient's blood pressure. Terbutaline is a bronchodilator.

Which toxicity is not a common concern in cattle?

Lead toxicity

Aspergillus toxicosis

Iron toxicity

Salt toxicity

Iron toxicity is most common in newborn pigs. Aspergillus toxicosis is caused by moldy feed. Salt toxicity is caused by consumption of excessive salt and lack of adequate amounts of water. Lead toxicity is associated with seeding and harvesting activities when used oil and battery disposal from machinery is handled improperly.

Sulfasalazine is sometimes used in veterinary medicine to treat which chronic condition?

Hepatitis

Bronchitis

Colitis

Pancreatitis

Colitis.

Sulfasalazine (Azulfadine) is used in treating chronic intestinal conditions, such as ulcerative colitis, because it reduces inflammation in the colon. It is a sulfonamide antibiotic.

Which of the following over-the-counter medications is sometimes given for diarrhea?

Famotidine

Simethicone

Diphenhydramine

Bismuth subsalicylate

Bismuth subsalicylate is an anti-diarrheal medication which is found in Pepto-Bismol and Kaopectate. It also has some antacid properties.

Famotidine (Pepcid AC) is an antacid or H2-receptor antagonist or blocker.

Simethicone, found in Gas-X, is used to reduce gas symptoms.

Diphenhydramine (Benadryl) is an antihistamine used for allergies and allergic reactions.

A 7-kg Dachshund "Rudy" is being treated for pancreatitis and has been vomiting. You are asked to start him on a constant rate infusion of metoclopramide at 2 mg per kilogram per day (mg/kg/day). He is on a fluid rate of 23 mL/hr. Metoclopramide comes in a concentration of 5mg/mL. How much metoclopramide will you add to a liter bag of LRS?

8 mL

1.2 mL

3 mL

5 mL

5 mL.

Constant rate infusions are not something that an entry level technician would typically perform. However, the VTNE may have some questions on CRI and it will benefit you to know how to do these calculations. To solve this problem, break down the basic parts to make it less overwhelming:

1) Convert pounds to kilograms- Note that in this problem the units are already in kg so no conversion is necessary. Make sure to pay attention to this.

2) Calculate the number of hours an infusion will last by dividing the volume in the bag (1 Liter, or 1,000 mL) by the rate per hour: 1,000 mL/23mL/hr = 43 hours

We want to make sure the units match the equation in the problem which asks for mg/kg/DAY. So divide the hours by 24 (since there are 24 hours in a day):

43 hours/24 hours/day = 1.8 days

4) Now plug into the equation: 2mg/7kg/1.8 days= 25 mg

5) Calculate the quantity of metoclopramide to add by now dividing the 25 mg by the concentration of the drug (5 mg/mL) : 25mg/5mg/mL = 5 mL

To be truly accurate when adding drugs to a bag like this, you should discard 5 mL of fluids from the bag prior to adding the 5 mL of metoclopramide.

The veterinarian orders 3 mg/kg diphenhydramine IM for a 60-pound dog. The concentration is 50 mg/mL. How much should you give the dog?

0.8 mL

2.5 mL

1.2 mL

3.2 mL

1.6 mL

1.6 mL

First convert to kilograms: 60 pounds/ 2.2= 27kg

Now calculate how many miligrams you need to give: 27kg X 3mg= 81mg

Finally figure out how many milliliters 81mg would be: 81mg/ 50mg/mL= 1.63 mL

Which antibiotic often used for diarrhea has potential to cause a neurologic side effect?

Bismuth subsalicylate

Metronidazole

Amoxicillin

Tylosin

Metronidazole is used frequently for treating diarrhea. It can cause neurologic symptoms in some sensitive patients or at higher dosages. The treatment for metronidazole toxicity is supportive care, including Diazepam as a main treatment.

Owners with pets on higher dosages of this medication should be advised of this potential side effect. The most common use for higher doses is treatment of Giardia. Fenbendazole is often a safer option for this parasite.

A patient that is currently receiving 30 ml/hr of NaCl needs a medication added to the fluid bag. The clinician would like the patient to receive a total of 3 mg/kg/day of this medication. The medication comes in a 10 mg/ml solution. How many mL should be added to the bag if it is a 250 mL bag and the patient weighs 10kg?

1 ml

12.5 ml

6 ml

4 ml

10 ml

1 mL

A 10-kg patient will need 30 mg/day of the medication (10 kg x 3 mg/kg/day)

Since the fluid is being administered at an hourly rate we need to figure out how much medication we are administering per hour.

30 mg/day / (24 hr) = 1.25 mg/hr

To determine how much volume of the medication is needed the following math is performed:

1.25 mg/hr / (30 ml/hr) x (250 ml) = 10.4 mg (Notice how the units cancel out)

10.4 mg / (10 mg/ml) = 1 ml

A 2-year old domestic short hair cat presents for ingestion of the flowers seen in the picture below. The ingestion occurred about 2 hours ago and no clinical signs have been noted yet. What does the ingestion of this plant cause in cats?

Hypoglycemia

Renal failure

Seizures

Muscle paralysis

The flowers are Tiger Lilies. Lilies of all different varieties as well as their leaves cause acute renal failure in cats when ingested. Treatment is similar to any other cause for renal failure and includes high rates of IV fluids, supportive medications, and occasionally diuretics such as furosemide or mannitol if the patient is anuric or oliguric.

Image used with permission, from Feline Medicine (Sparkes), courtesy of Manson Publishing.

What is the primary toxic principle in chocolate?

Cacao

Serotonin

Theobromine

Cholinesterase inhibitors

Sucrose

Theobromine.

Methylxanthines are the primary toxic principles in chocolate. Specifically, these are theobromine and caffeine.

Some bacteria produce beta-lacatamases that destroy or inactivate penicillins. What beta-lactamase inhibitor is added to amoxicillin to prevent this from occurring?

Procaine

Clavulanic acid

Sulfamethoxazole

Chloride

Clavulanic acid is a beta-lactamase inhibitor added to amoxicillin to prevent some types of antibiotic resistance.

Sulfamethoxazole is a sulfonamide bacteriostatic antibiotic typically given with trimethoprim. Sulfa medications can cause side effects such as dry eye, acute hepatitis, and bone-marrow toxicity.

Procaine is a local anesthetic, historically added to penicillin to reduce the pain associated with the injection.

Clavulanic acid contains a potassium salt, but not chloride.

Which of the following is false regarding the use of insulin?

It can be given intramuscularly

Shake well before use

Keep refrigerated

It causes blood sugar to decrease when administered

Shake well before use.

Insulin should never be shaken. It should only be gently rolled prior to use.

Insulin should be refrigerated, and although typically given subcutaneously, it can be given intramuscularly and is often given this way in cases of diabetic ketoacidosis.

Insulin causes a drop in blood glucose.

What is the most frequently observed side effect associated with acepromazine use in geldings?

Arrhythmias

Hypotension

Paraphimosis

Seizures

The correct answer is hypotension. Acepromazine will reliably cause hypotension. Acepromazine may cause paraphimosis in male horses, but this is uncommon. However, due to the risk of paraphimosis, many veterinarians will not use acepromazine on stallions. Acepromazine actually has anti-arrhythmogenic properties. Acepromazine does reduce the seizure threshold, but seizures are not as common as hypotension.

Clomipramine is a veterinary approved drug used most commonly to treat which condition?

Epilepsy

Allergies

Urinary incontinence

Separation anxiety

Separation anxiety.

Clomipramine (Clomicalm) is most often used to treat generalized anxiety or separation anxiety in small animals. It is also approved for obsessive compulsive behaviors in dogs.

Chlorpheniramine sounds similar, and is an anti-histamine used in treating allergies. The most commonly prescribed medication for urinary incontinence is phenylpropanolamine. Potassium-bromide and phenobarbitol are commonly used medications for epilepsy.

How many milliliters of dextrose should be added to a 60 ml syringe of 0.9% NaCl to make a 2.5% dextrose solution? The patient weighs 20 kg, and the dextrose in the hospital comes in a 50% concentration.

6 ml

3 ml

1.5 ml

120 ml

0.6 ml

To answer this question, use the following equation:

C(1)V(1) = C(2)V(2)

C is the concentration

V is the volume

C(1) =0.025

V(1) = 60 ml

C(2) = 0.50

V(2) = x

0.025(60)= 0.50x

x = 3 ml

Note that the body weight is completely unnecessary to calculate the answer to this problem.

200 ml of 25% dextrose should be added to one liter in order to make a 5% solution.

Quinidine is a medication used to treat which condition in horses?

Colic

Atrial fibrillation

Laminitis

Corneal ulceration

Quinidine is a class 1 antiarrhythmic medication used mostly in horses to treat atrial fibrillation.

Keratoconjunctivitis sicca (dry eye) can result from the use of which medication?

Enrofloxacin

Prednisone

Trimethoprim-sulfa (TMS)

Cyclosporine

Enalapril

Trimethoprim-sulfa (TMS).

The sulfa drugs can cause dry eye in some patients and therefore overuse should be avoided. If a patient is started on a sulfa drug, tear production should be monitored.

You are asked to start a dog on maintenance fluids. The dog weighs 80 pounds. What fluid rate do you start on this dog?

25 mL/hr

90 mL/hr

150 mL/hr

45 mL/hr

90 mL/hr

There are several ways to calculate maintenance fluids. Some are more accurate than others, with the more accurate ones requiring more complex math. Fortunately, in most patients, being off by a few milliliters does not adversely affect the patient. The most basic calculation to approxiamte maintenance rate fluids in a dog is: 60mL/kg/day

80 pounds/2.2= 36 kg

60mL X 36 kg = 2160 mL per day

2160 mL/24 hours in a day = 90 mL per hour

Which of the following would not typically be caused by tetanus in the horse?

Inability to chew or swallow

Convulsions

Muscular rigidity

Spontaneous abortion

Respiratory arrest

Spontaneous abortion.

The toxin that causes tetanus in horses results in convulsions and muscle rigidity that starts in the hindquarters and moves towards the forequarters. In some cases, the tongue is paralyzed and the animal can not chew or swallow. Paralysis of the respiratory muscles can lead to respiratory arrest. Spontaneous abortions are not a symptom of tetnus.

An owner brings a box of rat poison to your hospital and says her dog ingested it. You help the doctor induce vomiting. Which of the following would be an appropriate treatment for an animal that has ingested an anticoagulant rodenticide?

Give atropine

Give IV vodka

Give diazepam

Give vitamin K

Give vitamin K.

It takes at least a few days for anticoagulant rodenticides to cause prolonged bleeding times and clinical hemorrhage. This could likely be prevented with early intervention with decontamination and Vitamin K1 administration. In patients that have prolonged bleeding times, plasma is also indicated.

The bright green vomit confirms the owners suspicion of rodenticide ingestion because many rat poison contains a bright green dye. Dogs that ingest these products may have bright green vomit or stool.

An anthelmintic is used for treating which of the following?

Mange

Fleas

Intestinal parasites

Ticks

Anthelmintics are drugs used for expulsion of intestinal worms. Ivermectin, praziquantel, fenbendazole, pyrantel, etc. are a few examples of anthelmintics.

Which drug inhibits platelet aggregation?

Enalapril

Aspirin

Amoxicillin

Metronidazole

Aspirin has antithrombotic effects (it is a COX-1 inhibitor); it blocks the platelet enzyme cyclooxygenase (aspirin is a Cox-1 inhibitor) resulting in inhibition of platelet aggregation.

An 11-year old male German shepherd dog with previously diagnosed dilated cardiomyopathy (DCM) presents to your clinic following a dog fight. The dog is significantly aggressive and resistant to handling. What medication should NOT be used to sedate this patient?

Buprenorphine

Atropine

Dexmedetomidine

Midazolam

Butorphanol

Dexmedetomidine should only be used in patients with normal cardiac function as it can cause a significant reduction in cardiac output due to reduced heart rate. It should be avoided whenever possible in patients that have compromised cardiac function. Butorphanol and buprenorphine would be better options for sedation as these drugs would not have as much effect on cardiac output and would provide some pain relief. Midazolam can be used to sedate the patient via IM administration and, although it would not provide any pain control, it would allow for safer handling of the patient. Atropine is not a sedative, but an anticholinergic used most commonly to increase heart rate.

Which medication is typically given through a filter?

Cefazolin

Metoclopramide

Dexamethasone

Mannitol

Mannitol forms crystals in solution. An in-line 5 micron IV filter or filter needle is recommended.

None of the other choices require a filter for administration. Blood products are frequently filtered prior to IV administration.

Which of the following over-the-counter medications is sometimes given for diarrhea?

Bismuth subsalicylate

Famotidine

Diphenhydramine

Simethicone

Bismuth subsalicylate is an anti-diarrheal medication which is found in Pepto-Bismol and Kaopectate. It also has some antacid properties.

Famotidine (Pepcid AC) is an antacid or H2-receptor antagonist or blocker.

Simethicone, found in Gas-X, is used to reduce gas symptoms.

Diphenhydramine (Benadryl) is an antihistamine used for allergies and allergic reactions.

You are developing a template for the drug labels at your new hospital. Every prescription drug label should include the following statement:

For veterinary use only

Shake well for liquid medications

Caution: Federal law restricts this drug to use by the order of a licensed veterinarian

Stop this medication and contact your veterinarian should any adverse reactions occur

Give as directed by your veterinarian

Caution: Federal law restricts this drug to use by the order of a licensed veterinarian

Federal regulation requiring labels to bear statements such as "For veterinary use only" represent a sales policy and hold no legal basis. Every label should include the caution label (as indicated in the correct answer), dosage, route of administration, quantity of ingredient, and a lot or control number. While the other choices may be of value, they are not legally required.

You need to perform a CBC and take thoracic radiographs on a somewhat fractious cat. You sedate the cat with an intramuscular injection of medetomidine. While on the X-ray table, you become concerned that the cat is not doing well, and the veterinarian asks you to reverse the effects of medetomidine. What should you give the cat?

Atipamezole

Yohimbine

Flumazenil

Naloxone

Atropine

Atipamezole (trade name: Antisedan), an alpha-2 antagonist, is the reversal agent for medetomidine (trade name: Dormitor). Medetomidine is an alpha-2 agonist.

Xylazine would be another example of an alpha-2 agonist. Yohimbine is its reversal agent. Other alpha-2 agonists are clonidine, detomidine, dexmeditomidine and romifidine.

Flumazenil is a reversal agent for benzodiazepines.

Naloxone is used to reverse opioids.

Atropine is a muscarinic antagonist of acetylcholine and may be dangerous to use after administration of alpha-2 agonists. This is because alpha-2 agonists cause marked vasoconstriction and high afterload on the heart. Giving atropine and increasing the heart rate can place further stress on the heart. You do not want to set in motion peripheral vasoconstriction and compensatory bradycardia brought on by the alpha-2, thereby increasing the heart rate against the high afterload.

A patient presents with red eyes and the owner reports he has been rubbing his face on the carpet. He is currently taking the sulfa-based drug Primor for a skin infection. What side effect of this medication could cause these symptoms?

Dry Eye

Uveitis

Glaucoma

Epiphora

Dendritic ulcer formation

Dry Eye.

Tears are made up of 3 components, lipid, mucous, and liquid. The liquid and mucous portion of the tear film may decrease from sulfa drugs, thus resulting in dry eye (kerratoconjunctivitis sicca/KCS). Sometimes this problem can be irreversible. This patient should receive a Schirmer Tear Test to test for KCS. The eyes should also be stained, because corneal ulceration can occur secondary to the low tear production.

Glaucoma is increased intraocular pressure. Uveitis is inflammation in the uveal tract inside the eye. Epiphora is excessive tearing, which is the opposite of KCS. Dendritic ulcers are most typically seen in cats with herpesvirus infection.

A dog or cat with a hypomotile intestinal tract might most benefit from which of the following medications?

Omeprazole

Metronidazole

Famotidine

Metoclopramide

Metoclopramide (Reglan) is used in cases of hypomotility due to its prokinetic properties.

Cisapride is another drug that is used to treat hypomotility.

Which of the following best describes the therapeutic index of a drug?

The range of microbial species that a drug is effective against

The ratio between the effective dose and the toxic dose

The ratio between the maximum effective dose and the minimum effective dose

The number of milligrams of a drug that is needed to be effective divided by 100

The amount of variability in the response of a population to a drug

The ratio between the effective dose and the toxic dose

The therapeutic index is a measure of a drug's safety margin. It is defined as the ratio between the effective dose (ED50) and the lethal dose (LD50) to a population.

What is the "antidote" or treatment for Flagyl toxicity in animals?

Phenobarbital

Metoclopramide

Valium

Sucralfate

Valium.

Flagyl (metronidazole) can cause neurologic side effects. The treatment of these side effects is Valium (diazepam) and supportive care. The treatment using Valium is related to modulating GABA receptors in the cerebellar and vestibular systems.

A tablet may have enteric coating to serve what purpose?

To protect the medication from being destroyed by the acids of the stomach

It increases transit time so the drug can make it to the colon more quickly for absorption

It slows transit time so that the drug will be absorbed mostly through the stomach wall

It prevents gastric ulceration

To protect the medication from being destroyed by the acids of the stomach.

Enteric coatings are used to protect the medication from the acidic stomach environment so that more of the active drug can make it and be absorbed in the small intestine.

The enteric coating does not increase or decrease transit time. Drugs are mostly absorbed in the small intestine, not the colon.

There is an enzyme in about 40% of rabbits that neutralizes a common drug. What drug is not used in rabbits because of this?

Metoclopramide

Butorphanol

Atropine

Enrofloxicin

Atropine esterase is produced by rabbits and acts to neutralize atropine.

A chihuahua is diagnosed with pituitary-dependent hyperadrenocorticism. Which of the following medications may be used for treating Cushing's disease in this patient?

Trilostane

Prednisone

DOCP

Pimobendan

Trilostane (Vetoryl) is a steroid inhibitor used in the treatment of Cushing's disease. This medication works by stopping the production of cortisol in the adrenal glands. In Cushing's disease (hyperadrenocorticism), the adrenal glands are over-producing cortisol due to either a tumor on the pituitary gland stimulating the adrenal glands, or due to a tumor on an adrenal glad itself. This medication is reversible (it doesn't actually destroy the adrenal gland as does mitotane (Lysodren). Trilostane is also sometimes used to treat Alopecia X.

Prednisone is a steroid, and you would not want to give a steroid to a dog who is already over-producing steroids. DOCP (desoxycorticosterone pivalate) or Percorten-V is also a steroid injectable used in treating hypoadrenocorticism (Addison's disease).

Pimobendan is an inodilator heart medication, most often used in treating congestive heart faliure.

Which organ(s) most commonly break down or process medications and excrete them from the body?

Gastrointestinal tract

Lungs and liver

Pancreas and kidneys

Gastrointestinal tract and liver

Liver and kidneys

Liver and kidneys.

The four main ways medications are excreted from the body are through the kidneys, liver, skin, and lungs. Most drugs are processed by the liver and then the kidneys. Therefore, animals with kidney or liver problems can have problems processing certain medications; this can raise the drug levels higher since excretion may be impaired.

Which of the following foods is considered toxic to parrots?

Blueberries

Cheese

Chicken

Habanero peppers

Avocado

Avocado.

A toxin found in the Guatemalan type of avocado causes myocardial necrosis in parrots. Blueberries and peppers (even "hot" peppers) are not toxic to psittacines. Chicken and cheese are high in fats and are not appropriate to feed parrots, but there is no toxicity associated with them.

You want to give a 22 pound cat a 5 mg/kg dose of a drug. The drug comes as a 2.5% solution. How many milliliters should you give the cat?

4.4

8.8

.2

20

2

.4

2 mL.

First, you must recognize that the cat's weight is given in pounds and should immediately be converted to kilograms. There are 2.2 lbs/kg so this is a 10 kg cat.

Second, you must be able to convert a percent solution to mg/ml. A 2.5% solution is 25 mg/ml. This is hard for some students to remember. A memory tip is that a 100% solution would be 1 gram/ml. Therefore a 50% solution would be 500mg/ml, and a 5% solution would be 50 mg/ml.

The math to solve this question is:

22 lbs x (1 kg/2.2 lbs) x 5mg/kg x (1ml/25mg) = 2 ml

Which of the following is expected from a positive inotropic drug?

Decrease in adrenal gland stimulation

Prevention of arrhythmias

Dramatic decrease blood pressure

Increase in cardiac contractility

Increase in cardiac contractility.

Positive inotropes mostly work by making more calcium available to the muscle and thus increase cardiac contractility.

Digoxin is a positive inotrope and acts by inhibiting the sodium-potassium ATPase pump of the cells. Toxicity can cause arrhythmias and a slow heart rate. It should be avoided or used with extreme caution in patients with renal disease or hypokalemia because it increases the risk of toxicosis.

A 6-year old Doberman cardiac arrested and was resuscitated. However, the dog has a consistently low systolic blood pressure of 60 mmHg. What drug may be prescribed to increase the blood pressure and via what route?

Dopamine via intravenous infusion

Terbutaline via subcutaneous administration

Dopamine via intramuscular administration

Hydromorphone via intravenous administration

Dopamine via intravenous infusion.

Dopamine increases blood pressure by increasing systemic vascular resistance and is administered via intravenous constant rate infusion. Dopamine is not labeled for intramuscular use. Hydromorphone is an opioid and may cause a reduction in the patient's blood pressure. Terbutaline is a bronchodilator.

Which drug is known as an ACE-inhibitor?

Acepromazine

Enalapril

Diphenhydramine

Metoclopramide

Enalapril.

Ace-inhibitors like enalapril are vasodilators which block angiotensin-converting enzyme to prevent angiotensin II (a vacosconstrictor) and aldosterone (causes sodium retention) from forming. Ace-inhibitors help to relax smooth muscle in the arterioles and veins. They are most commonly used in cases of heart and kidney disease.

Note that ace-inhibitor drugs usually end in a "pril" (benazapril, captopril, enalapril, etc.)

Diphenhydramine is typically used in treating which of the following conditions?

Keratoconjunctivitis sicca

Allergic reactions

Urinary incontinence

Urinary tract infections

Auto-immune conditions

Allergic reactions.

Diphenhydramine is also known as Benadryl. It is a an anti-histamine most commonly used for treating allergies or allergic reactions.

A urinary tract infection would require an antibiotic. Keratoconjunctivitis sicca is an immune mediated condition and is usually treated with cyclosporine. Auto-immune conditions also call for immunosuppressive agents. Urinary incontinence may be treated with phenylpropanolamine.