VTNE Parmacology

136. Altrenogest, which is used for estrus synchronization in female animals, is a synthetic a. Estrogen b. Androgen c. Progestin d. Follicle-stimulating hormone (FSH)

136. c Progestins or progesterones usually have -gest in their drug name.

137. Serious potential side effects of estrogen administration include a. Hemorrhage and thromboembolism b. Bone marrow suppression and pyometra c. Cardiac arrhythmias and pulmonary edema d. Renal failure and gastric ulcers

137. b

1. Neonatal animals are less tolerant of some drugs than older animals, because in neonates the drugs are a. Biotransformed (metabolized) more rapidly b. Absorbed more slowly from the gastrointestinal tract c. Not biotransformed d. Biotransformed (metabolized) more slowly

1. d The neonatal liver is not equipped to deal efficiently with the biotransformation of most drugs until approximately 1 month of age

10. The most common adverse side effects of aminoglycoside antimicrobials are a. Nephrotoxicity b. Nephrotoxicity and ototoxicity c. Ototoxicity and neurotoxicity d. Nephrotoxicity, ototoxicity, and neurotoxicity

10. b Aminoglycoside drugs tend to concentrate in the kidneys and inner ears.

138. When diethylstilbestrol (DES), a synthetic estrogen, is used at higher doses, it can have the potentially dangerous side effect of a. Gastric ulceration b. Cardiac arrhythmias c. Bone marrow suppression d. Hepatopathy

138. c

100. What precautions should you take when applying DMSO to an animal's skin? a. Wear a facial mask to avoid inhaling the fumes. b. Apply a bandage to cover the area of application. c. DMSO is irritating and should not be applied to skin. d. Wear latex gloves to avoid contact with the drug.

100. d DMSO has the ability to penetrate intact skin; this is prevented if the person applying it wears gloves.

101. The surgeon has completed Buffy's surgical procedure and asks you to discontinue the inhalant anesthesia. What is absolutely necessary to do when terminating anesthesia in a patient that has been receiving nitrous oxide? a. Give an injection of the reversal agent. b. Observe carefully for signs of seizures. c. Allow the patient to recuperate in a quiet, dark area. d. Oxygenate for 5 to 10 minutes.

101. d This is necessary to minimize the effects of diffusion hypoxia, which occurs when nitrous oxide diffuses from the bloodstream into the lungs, thus diluting the oxygen concentration within the alveoli.

102. All of the following drugs are controlled substances, and their use must be logged except a. Propofol (PropoFlo) b. Diazepam (Valium) c. Ketamine (Ketaset) d. Oxymorphone (Numorphan)

102. a

103. Malignant hyperthermia is a phenomenon associated primarily with the use of what inhalant anesthetic? a. Nitrous oxide b. Sevoflurane (SevoFlo) c. Halothane (Fluothane) d. Isoflurane (AErrane)

103. c Malignant hyperthermia, a potential side effect of halothane anesthesia, is a greatly increased body temperature that can result in brain damage or death.

104. What drug is in the same class as thiopental? a. Ketamine b. Diazepam c. Phenobarbital d. Atropine

104. c Thiopental and phenobarbital are both barbiturate drugs.

105. An opioid analgesic often used in transdermal patches to control postsurgical pain is a. Fentanyl b. Pentazocine (Talwin) c. Meperidine (Demerol) d. Butorphanol (Torbugesic)

105. a

106. Mrs. Stillman's poodle Roxy has been diagnosed with idiopathic epilepsy. The doctor has decided to dispense what drug, which Mrs. Stillman can administer per rectum, in the event of a seizure at home? a. Pentobarbital b. Phenobarbital c. Diazepam (Valium) d. Acepromazine (PromAce)

106. c Diazepam, usually administered intravenously, is the anticonvulsant drug of choice in the emergency treatment of seizures. It is also absorbed well through the mucosal lining of the rectum, thereby providing the ability to treat a pet before arrival at the emergency facility.

107. A recent graduate veterinary technician is concerned that a sedated patient has a heart rate of 50 beats/min when the heart rate in a dog is normally 60 to 120 beats/min. You ask her which sedative the veterinarian used and were not at all surprised when she told you that the drug used was a. Medetomidine (Domitor) b. Diazepam (Valium) c. Ketamine (Ketaset) d. Acepromazine (PromAce)

107. a Although most anesthetic agents cause cardiovascular depression, medetomidine characteristically produces a profound bradycardia.

108. All of the following drugs are antagonists, used to reverse the effects of another drug except a. Yohimbine (Yobine) b. Detomidine (Dormosedan) c. Atipamezole (Antisedan) d. Naloxone (Narcan)

108. b Yohimbine is an antagonist to xylazine, atipamezole antagonizes the action of medetomidine (Domitor), and naloxone is a narcotic antagonist.

109. You are asked to work in the surgical recovery area. Oreo, a cat, is recovering from an exploratory laparotomy. Oreo was given morphine, in addition to other drugs. You anticipate all of the following except that a. Oreo will be hypersensitive to sounds. b. Oreo may vomit and defecate from being given opioids. c. Oreo most likely will have an elevated respiratory rate. d. Oreo would be most comfortable recovering in a dark, quiet room.

109. c Side effects of narcotic drugs include hypersensitivity to noise, vomiting, and defecation. Morphine will likely depress Oreo's respiratory system, thus producing a decreased rather than an elevated respiratory rate.

11. Which statement regarding tetracyclines is true? a. They are bactericidal. b. They alter the permeability of the cell wall and cause lysis. c. Currently many bacteria are resistant to them. d. They are unable to penetrate the bacterial cell wall.

11. c Tetracyclines have been in use for many years, and, as a result, the resistance to them is proportionately greater than with many other antiinfectives.

110. What gas anesthesia demands the greatest degree of patient monitoring, because anesthetic depth changes occur most rapidly? a. Nitrous oxide b. Sevoflurane (SevoFlo) c. Halothane (Fluothane) d. Isoflurane (AErrane)

110. b

111. Norepinephrine, epinephrine, and dopa-mine are the primary neurotransmitters for the a. Parasympathetic nervous system b. Sympathetic nervous system c. Central nervous system d. Peripheral nervous system

111. b

112. Beuthanasia solution is back ordered at the distributor, so your employer asks you to order a different euthanasia solution. In researching the available drugs, you are reminded that the active ingredient in most euthanasia solutions is a. Phenobarbital b. Pentobarbital c. Methohexital (Brevane) d. Thiopental (Pentothal)

112. b

139. Kaolin and pectin (Kaopectate) and bismuth subsalicylate (Pepto-Bismol) are examples of a. Narcotic analgesics b. Antispasmodics c. Anticholinergics d. Protectants

139. d Kaolin and pectin (Kaopectate) and bismuth subsalicylate (Pepto-Bismol) coat the intestinal mucosa, thereby protecting it from bacterial enterotoxins and other irritating substances.

113. You are working with an equine veterinarian on a breeding farm. You will be sedating a young stallion for an oral examination. You are well aware that the veterinarian will probably not be using what tranquilizer for the procedure? a. Xylazine (Rompun) b. Diazepam (Valium) c. Detomidine (Dormosedan) d. Acepromazine (PromAce)

113. d A potential side effect of acepromazine and other phenothiazine tranquilizers is penile prolapse (paraphimosis). It is therefore contraindicated for use in breeding stallions.

114. The newly hired veterinary assistant is cleaning up after a procedure and returns an opened bottle of propofol (PropoFlo) to the refrigerator, stating that it can be used tomorrow on another patient. You explain to her that a. Propofol should be stored at room temperature rather than in the refrigerator. b. The bottles are designed to contain only enough drug for one patient, and there likely will not be enough drug left to anesthetize another patient tomorrow. c. Bacteria will readily grow in propofol and will produce endotoxins, so it is unwise to use the remains of an opened bottle. d. The bottle has been contaminated from the first patient, and there is a possibility that contagious diseases can be transmitted in this way.

114. c Propofol contains no preservatives, and the emulsion promotes bacterial growth. Strict aseptic technique should be applied when withdrawing propofol, and it should be used within 6 hours of opening the container.

115. You are out on an ambulatory call with Dr. Burrows to Milkman's Dairy. You are asked to bring the xylazine from the truck to sedate the patient. You are well aware that when using this drug in the bovine, you must a. Use adequate doses, because cattle tend to be resistant to its effects b. Always use it concurrently with a barbiturate to achieve adequate analgesia c. Not use xylazine because it is contraindicated in this species d. Use it at about 1/10 of the equine dose

115. d Ruminants are extremely sensitive to xylazine when compared with horses, dogs, or cats, generally requiring approximately one-tenth the equine dose to exhibit the same effect.

116. You were assigned to work the front office at the hospital today. When you walk back to the treatment area, you notice a cat under anesthesia. The cat has eyes wide open and unblinking and limbs stiffly distended and is salivating profusely. Your highly educated guess is that this cat was anesthetized using which of the following drugs? a. Xylazine (Rompun) b. Medetomidine (Domitor) c. Ketamine (Ketaset) d. Propofol (PropoFlo)

116. c Ketamine is a dissociative anesthetic. It does not induce the muscle relaxation found in most other anesthetics. The eyes of feline patients remain open, necessitating the use of lubricating ophthalmic ointment; to reduce the effects of hypersalivation, atropine is often used.

117. A cow is accidentally dosed with an equine dose of xylazine. What drug should be immediately administered? a. None; the equine and bovine doses of xylazine are the same b. Epinephrine c. Naloxone d. Yohimbine

117. d Yohimbine is a specific antagonist for xylazine and reverses its depressant effects.

118. Acepromazine should be avoided in a. Patients with a history of seizures b. Aggressive patients c. Geriatric patients d. Doberman pinschers

118. a In veterinary medicine it is generally felt that phenothiazines should not be used in epileptic animals or in those susceptible to seizures because they lower the convulsive threshold and may precipitate seizures.

119. The behavioral drug group that may be used to stimulate appetite in cats is a. Benzodiazepines b. Tricyclic antidepressants c. Selective serotonin reuptake inhibitors d. Progestins

119. a Benzodiazepines may cause appetite stimulation in cats.

12. To what other drug class is a cephalosporin-class drug closely related? a. Tetracyclines b. Sulfas c. Penicillins d. Fluoroquinolones

12. c Cephalosporins and penicillins are both β-lactam drugs; animals with an allergy to one class are usually also allergic to the other class.

120. A progestin, often used in the past for the treatment of inappropriate elimination in cats, that has now fallen out of favor because of serious potential side effects, including mammary hyperplasia and adenocarcinoma, is a. Megestrol acetate (Ovaban) b. Oxazepam (Serax) c. Amitriptyline (Elavil) d. Fluoxetine (Prozac)

120. a

121. Which tricyclic antidepressant is now approved for used in dogs and cats to control separation anxiety? a. Buspirone (BuSpar) b. Selegiline (Anipryl) c. Paroxetine (Paxil) d. Clomipramine (Clomicalm)

121. d Clomicalm is a relatively new tricyclic antidepressant drug used in dogs and cats for obsessive compulsive disorders, including separation anxiety.

122. A 12-year-old spayed female golden retriever is brought into your clinic with a history of waking up in her bed in a puddle of urine. A complete blood count (CBC), profile, and urinalysis reveal no sign of urinary tract disease. The doctor tells you to fill a prescription for phenylpropanolamine. The doctor is choosing this drug because a. It treats bladder atony by increasing bladder tone. b. It treats urinary incontinence by decreasing urethral sphincter tone. c. It treats urinary incontinence by increasing urethral sphincter tone. d. It treats bladder atony by decreasing bladder tone.

122. c Phenylpropanolamine is used chiefly for the treatment of hypotonus of the urethral sphincter and resulting incontinence in dogs and cats.

123. Erythropoietin (Epogen) is primarily used in the following feline patients: a. Cats with anemia due to chronic renal failure b. Cats with anemia due to rodenticide toxicity c. Cats with aortic thromboembolism secondary to cardiomyopathy d. Cats suffering from Tylenol toxicity

123. a Erythropoietin is a hormone that regulates erythropoiesis (the production of red blood cells). It is used for treatment of the anemia associated with chronic renal failure.

124. Which of the following drugs is used to decrease gastric acid production by blocking histamine receptors in the stomach? a. Famotidine (Pepcid) b. Sucralfate (Carafate) c. Omeprazole (Prilosec) d. Erythropoietin (Epogen

124. a Famotidine is an H2 receptor blocker that decreases gastric acid production.

125. Amphojel and Basaljel are drugs in the general category of a. Potassium supplements b. Antihypertensives c. Urinary acidifiers d. Phosphate binders

125. d Patients with chronic renal failure often have hyperphosphatemia. Amphojel and Basaljel bind phosphates in the diet when given with food. This reduces the phosphorus intake from the GI tract and helps normalize the blood phosphorus level.

126. Mr. Williams just adopted a mixed-breed puppy from the local animal shelter, and it was suggested that he bring it to a veterinarian to treat the worms noticed in its feces. Mr. Williams wanted to save some money and went to the local pet shop to buy a dewormer. The product that he purchased was most likely a. Pyrantel pamoate (Nemex) b. Piperazine (Pipa-tabs) c. Fenbendazole (Panacur) d. Ivermectin (Ivomec)

126. b Piperazine is the vermifuge most commonly found in over-the-counter worming preparations. All other medications listed require a veterinarian's prescription.

127. A heartworm preventive that is also approved for the treatment of ear mites and sarcoptic mange is a. Diethylcarbamazine (Filaribits) b. Milbemycin (Interceptor) c. Ivermectin (Heartgard) d. Selamectin (Revolution)

127. d All listed medications are used for the prevention of heartworm infection. Only selamectin is additionally approved for the treatment of both ear mites and scabies.

128. If a drug package insert states that the drug is a coccidiostat, against what group of parasites will this drug be effective? a. Ascarids (Toxocara, Toxascaris) b. Tapeworms (Taenia) c. Protozoa (Eimeria, Isospora) d. Flukes (liver fluke, lung fluke)

128. c Coccidia are protozoan parasites. A coccidiostat is a drug that controls this type of infection.

129. Which of the following drugs can cause severe tissue necrosis if given perivascularly? a. Phenylbutazone (Butazolidin) b. Oxymorphone (Numorphan) c. Propofol (PropoFlo) d. Ketamine (Ketaset)

129. a All of these drugs may be administered intravenously. Of the listed drugs, only Phenylbutazone (Butazolidin) requires extreme care when injecting to avoid perivascular leakage.

13. Because of the manner in which they are excreted, sulfonamides are often effective against infections of a. Nervous tissue b. Urinary tract c. Skin d. Joint capsules

13. b Sulfonamide antibiotics are excreted in the urine and can be useful for urinary tract infections with susceptible organisms.

130. Which statement about organophosphates is incorrect? a. They are neurotoxic. b. They are used for control of endoparasites and ectoparasites. c. They have a narrow margin of safety. d. They have relatively few side effects.

130. d Organophosphate parasiticides have a very narrow margin of safety. Numerous side effects include vomiting, tremors, hyperexcitability, salivation, and diarrhea.

131. By what route is insulin usually administered in cases of uncomplicated diabetes? a. Intramuscular b. Subcutaneous c. Intravenous d. Oral

131. b

132. Insulin concentration is measured in a. Milligrams per milliliter b. Milliequivalents per milliliter c. Units per milliliter d. Grams per milliliter

132. c

133. Oral hypoglycemic drugs, such as glipizide (Glucotrol), are used to treat a. Diabetic ketoacidosis b. Non-insulin-dependent diabetes c. Hypoglycemia d. Pancreatitis

133. b Glipizide is a human oral antidiabetic agent that may be used in certain non-insulin-dependent diabetic cats. More often, the use of insulin is necessary.

134. The primary function of insulin is to a. Regulate the metabolic processes of the body b. Regulate digestion through secretion of gastrointestinal hormones c. Facilitate the entry of glucose into cells d. Control reproductive function

134. c

135. Resuspension of NPH insulin is done by a. Gently rolling the bottle b. Vigorous shaking of the bottle c. Gentle heating of the bottle in warm water d. Refrigeration of the bottle

135. a Clients must be instructed in proper techniques for withdrawing insulin into the syringe, including rolling the vial rather than shaking it before drawing it into the syringe.

14. The use of fluoroquinolones as antiinfective agents should be done with great caution or not at all in a. Dogs b. Cats c. Horses d. Birds

14. b At some doses, the fluoroquinolone drug Enrofloxacin has been associated with blindness in cats.

140. Psyllium and Metamucil are examples of a. Saline cathartics b. Bulk laxatives c. Lubricants d. Irritant cathartics

140. b

141. What is not a potential side effect of the phenothiazine antiemetics? a. CNS depression b. Diarrhea c. Lowering of the seizure threshold d. Hypotension

141. b Phenothiazine drugs characteristically cause central nervous system depression, hypotension, and a lowering of the seizure threshold.

142. A stool softener often helpful in patients recovering from anal surgery is a. Docusate sodium succinate (DSS, Colace) b. Magnesium hydroxide c. Mineral oil d. Bran

142. a Docusate is used in small animals when feces are hard or dry or in anorectal conditions when passing firm feces would be painful or detrimental to the animal's recovery.

143. The most widely used type of antiemetic drugs used to prevent motion sickness in dogs and cats are the a. Phenothiazines b. Antihistamines c. Anticholinergics d. Antispasmodics

143. a Phenothiazine antiemetics include acepromazine, chlorpromazine, and prochlorperazine.

144. The emetic of choice in cats is a. Xylazine b. Syrup of ipecac c. Apomorphine d. Hydrogen peroxide

144. a An adverse effect of xylazine when used as a sedative in cats is emesis. It is a safer and more effective emetic in cats than the other three drugs/compounds listed.

145. The emetic of choice in dogs is a. Xylazine b. Syrup of ipecac c. Apomorphine d. Hydrogen peroxide

145. c Apomorphine is a rapidly acting, centrally mediated emetic used often in dogs that have ingested a potentially toxic substance.

146. Spike the dog ingested his owner's cardiac medication about half an hour ago. The veterinarian instructs you to give him an emetic that may be administered into the conjunctival sac, then flush as necessary. The name of the drug is a. Xylazine b. Syrup of ipecac c. Apomorphine d. Hydrogen peroxide

146. c Apomorphine is administered as a tablet in the conjunctival sac.

147. A coating agent that forms an ulcer-adherent complex at the ulcer site is a. Kaopectate b. Sucralfate c. Cimetidine d. Misoprostol

147. b After oral administration, sucralfate reacts with hydrochloric acid in the stomach to form a paste like complex that binds to ulcer sites, forming a barrier that protects the ulcer from further damage.

148. Fleet (sodium phosphate) enemas are contraindicated in what species? a. Horses b. Ruminants c. Cats d. Pigs

148. c Cats may be particularly sensitive to the electrolyte imbalance effects of sodium phosphate enema solutions, and these products are not recommended for use in this species.

149. The principal site of drug biotransformation is the a. Liver b. Kidney c. Stomach d. Small intestine

149. a Drug biotransformation is the inactivation or metabolism of a drug.

15. The antiinfective drug that should be avoided in all food-producing animals is a. Lincosamides b. Cephalexin c. Enrofloxacin d. Chloramphenicol

15. d Chloramphenicol use is banned in food animals in the United States, because it may cause irreversible aplastic anemia in humans.

150. What drug is most likely to be prescribed to prevent motion sickness in dogs and cats? a. Apomorphine b. Syrup of ipecac c. Atropine d. Acepromazine

150. d Acepromazine is a sedative drug often used to help prevent motion sickness in dogs and cats.

151. A veterinarian prescribes erythropoietin (Epogen) for use in a dog in terminal renal failure. Why was this drug prescribed? a. For its fibrinolytic activity b. For its immunosuppressive activity c. For its ability to stimulate red blood cell production and release d. For its ability to reduce hypertension

151. c Animals in terminal renal failure are often anemic because of a deficit of endogenous erythropoietin. The administration of Epogen (a human-derived product) can stimulate the bone marrow to produce and release red blood cells.

152. Which of the following drugs is considered a biologic response modifier? a. Interferon b. Streptokinase c. Cephalosporin d. EDTA

152. a Interferon is administered to animals in an effort to enhance the function of the immune system. They are believed to have antiviral and antitumor activity. Interferon is derived from white blood cells and other cells of the body. It is recognized for its immunoregulatory effect.

153. Atropine is often given as a preanesthetic agent. It is classified as an anticholinergic drug. That means that it will likely have the following effects on an animal receiving the drug: a. Decreased heart rate, decreased salivation, and decreased GI motility b. Increased heart rate, increased salivation, and increased GI motility c. Increased heart rate, decreased salivation, and decreased GI motility d. Decreased heart rate, increased salivation, and increased GI motility

153. c Atropine is given as a preanesthetic agent to maintain heart rate and decrease oral secretions. Some less desirable effects include decreased GI motility and decreased lacrimal secretions.

185. Which of the following drugs is used as an adulticide to treat a heartworm-positive dog? a. Melarsomine (Immiticide) b. Ivermectin (Heartgard) c. Milbemycin (Interceptor) d. Moxidectin (ProHeart)

185. a Choices b to d are all microfilaricides that are used 6 weeks after the administration of an adulticide such as Immiticide.

154. A drug classified as an antagonist may exert its influence by a. Mimicking the activity of the neurotransmitter used in the impulse b. Preventing the breakdown of the neurotransmitter used in the impulse c. Blocking the neurotransmitter receptor on the effector organ d. Enhancing the release of the neurotransmitter used in the impulse

154. c An antagonist acts to reduce the likelihood of an activity (or impulse) from occurring. By blocking the receptor on an effector organ, an impulse is blocked. The other answers all describe the activity of an agonist.

155. A client is advised to discontinue aspirin therapy in his dysplastic dog before the dog undergoes surgery to remove a mammary tumor. The client asks you why this request was made. You tell him a. Aspirin decreases platelet aggregation and may increase the likelihood of hemorrhage. b. Aspirin may result in gastrointestinal ulceration. c. Aspirin may adversely affect hepatic biotransformation. d. Aspirin has an antiinflammatory effect.

155. a Aspirin therapy is discontinued before surgery because of concerns related to hemorrhage intraoperatively and postoperatively.

156. Duragesic (Fentanyl) transdermal patches are used most commonly in veterinary medicine to control a. Diarrhea b. Vomiting c. Seizures d. Pain

156. d Fentanyl patches are being increasingly used in veterinary medicine to control post-surgical pain. This is an example of a topical application producing systemic effects.

157. Acetylcysteine (Mucomyst) is an antidote for what type of drug toxicity? a. Opioid b. Acetaminophen c. Lidocaine d. Digoxin

157. b Acetylcysteine is a mucolytic agent that is administered as an antidote for acetaminophen toxicity.

158. An expectorant is a drug that acts to a. Suppress a productive cough b. Liquefy and dilute viscous secretions in the respiratory tract c. Suppress inflammatory cells in the respiratory tract d. Reduce the allergic component of respiratory disease

158. b By liquefying and diluting mucous secretions in the respiratory tract, an animal is better able to mobilize secretions and may actually demonstrate an increase in a productive cough.

159. The therapeutic range of a drug refers to which of the following? a. The plasma concentration at which therapeutic benefits should be observed b. The relationship of a drug's ability to achieve a desired effect versus causing a toxic effect c. The range of curative properties that a drug may exhibit d. The frequency of idiosyncratic reactions

159. a Drugs that achieve plasma, urine, and CSF concentrations in the therapeutic range are expected to have their desired therapeutic effect in an animal. Choice b is the definition for therapeutic index.

16. Penicillins are primarily excreted by the a. Small intestine b. Liver c. Kidney d. Stomach

16. c Some metabolism of penicillins occurs in the liver, but penicillins are mainly excreted intact by the kidneys.

160. Which of the following drugs are contraindicated in a patient that has a history of seizures? a. Diazepam b. Thiopental c. Acepromazine d. Fentanyl

160. c Acepromazine can act to lower the seizure threshold, thereby increasing the likelihood of seizure activity in epileptic animals. Diazepam is used to treat seizure activity.

161. Nutraceuticals is a category of drugs with which of the following characteristics? a. Genetically derived materials that enhance immune function b. Drugs that are derived from humans for use in animal c. Drugs that are undergoing clinical trials before FDA approval d. Nontoxic food components that have proven health benefits

161. d Nutraceuticals are nutrients or naturally occurring substances in food (which are often purified or extracted) that have demonstrated health benefits. These agents may not make health claims in their advertising. There is controversy over whether these represent drugs or foods. Their use is gaining in popularity in veterinary medicine.

162. What is the reversal agent for xylazine (Rompun)? a. Fentanyl b. Naloxone (Narcan) c. Acepromazine d. Yohimbine (Yobine)

162. d

163. The reversal agent used for opioid toxicity is a. Naloxone (Narcan) b. Yohimbine c. Acetylcysteine d. Diazepam

163. a Naloxone is a pure opioid antagonist and can be used to reverse the effects of opioids.

164. One of the adverse side effects of opioid administration is a. Increased seizure activity in epileptic animals b. Induction of cardiac arrhythmias c. Significant respiratory depression d. Systemic hypertension

164. c Opioids often cause respiratory depression in animals; thus, careful monitoring of respiratory parameters is required.

165. In which of the following circumstances should a thiobarbiturate drug be avoided? a. In a patient with respiratory alkalosis b. In obese patients c. In sight hounds and very thin patients d. In hyperproteinemic animals

165. c Thiobarbiturates redistribute to fat stores. In animals that are very thin (sight hounds, young animals, debilitated animals), this redistribution cannot occur; therefore blood levels remain high, increasing the likelihood of toxicity. Acidotic and hypoproteinemic animals also demonstrate increased sensitivity to thiobarbiturates.

166. What is a potential electrolyte imbalance that can occur as a result of administering a loop diuretic to a small animal? a. Hypokalemia b. Hyperkalemia c. Hypercalcemia d. Hypocalcemia

166. a Hypokalemia may result from long-term use of loop diuretics such as Salix because of increased excretion of potassium.

167. Which of the following drugs is used to treat feline hypertension? a. Amlodipine (Norvasc) b. Erythromycin c. Amitriptyline (Elavil) d. Atropine

167. a Norvasc is a calcium channel blocker that acts as an arteriolar vasodilator, thereby reducing cardiac afterload.

168. A cat is given ketamine as an anesthetic induction agent. The veterinary technician monitoring this animal may observe which of the following side effects? a. Bradycardia b. Hypotension c. Apneustic breathing d. Flaccid muscle tone

168. c Cats that receive ketamine as part of an anesthetic protocol demonstrate apneustic breathing (breath holding). They may also experience tachycardia and rigid muscle tone.

186. The antidote for warfarin (Dicumarol) poisoning is a. Vitamin C b. Naloxone c. Vitamin K d. Primidone

186. c Vitamin K is administered in rodenticide toxicity cases in an effort to restore the hemostatic cascade.

187. An example of an α2-agonist is a. Xylazine b. Propranolol c. Hydralazine d. Epinephrine

187. a Propranolol is a β-adrenergic blocking agent, hydralazine is an α-adrenergic blocking agent, and epinephrine is a sympathomimetic drug.

169. The category of drugs classified as ACE inhibitors has which of the following effects on the body? a. Increases preload and afterload on the heart b. Decreases preload and afterload on the heart c. Enhances fluid retention in the body d. Enhances the production of angiotensin II

169. b ACE inhibitors prevent angiotensin converting enzyme (ACE) from converting angiotensin I to angiotensin II. This indirectly prevents sodium and water retention and also prevents vasoconstriction. This, in turn, results in a decreased preload and afterload on the heart in congestive heart failure cases.

17. Acepromazine must be used with caution or not at all in a. Bitches b. Tomcats c. Cows d. Stallions

17. d Acepromazine may cause paraphimosis in stallions.

170. Nitroglycerin is given primarily to achieve which of the following effects? a. Vasodilation b. Vasoconstriction c. Antiarrhythmic d. ACE inhibitor

170. a Nitroglycerin is a potent venodilator, it and at higher doses, it may also act as an arteriodilator. It is given to improve cardiac output by decreasing cardiac preload.

171. For cats diagnosed with hypertrophic cardiomyopathy, a calcium channel blocker is often prescribed to relax the heart in an attempt to improve cardiac output. Which of the following drugs falls in this category? a. Procainamide b. Diltiazem c. Lidocaine d. Digoxin

171. b Diltiazem is a calcium channel blocker used in hypertrophic cardiomyopathy (HCM) cases to relax a heart with thickened walls and poor contractility.

172. Lidocaine is primarily used to control which of the following abnormalities? a. Atrial bradyarrhythmias b. Ventricular tachyarrhythmias c. Hypertension d. Excessive urine output

172. b Lidocaine is used to control premature ventricular contractions and ventricular tachycardia.

173. In dogs that have been receiving long-term glucocorticoid therapy (months to years), a sudden discontinuation of the drug may result in which of the following medical problems? a. Immunosuppression b. Iatrogenic addisonian crisis c. Polyuria and polydipsia d. Iatrogenic thyroid disease

173. b The sudden withdrawal of long-term glucocorticoids can precipitate an iatrogenic (caused by the treatment) addisonian (hypoadrenocorticism) crisis, because the animal has received exogenous steroids for such a long time that the hypothalamic-pituitary-adrenal axis is suppressed and cannot resume endogenous steroid production immediately when exogenous steroids are suddenly withdrawn.

174. In dogs that have been receiving long-term glucocorticoid therapy (months to years), which of the following endocrinopathies can occur? a. Hypothyroidism b. Hyperthyroidism c. Iatrogenic Cushings disease/hyperadrenocorticism

174. c Dogs that have received long-term exogenous steroids may develop the array of clinical signs associated with Cushings disease/hyperadrenocorticism.

175. Which of the following is/are not a side effect of oral glucocorticoid administration in dogs? a. Polyuria and polydipsia b. Polyphagia c. Hyperglycemia d. Vomiting

175. d Emesis is not a commonly reported side effect of steroid administration in dogs.

176. Glucocorticoids are often used to treat all but which of the following conditions? a. Autoimmune skin disease b. Asthma c. Lymphocytic neoplasias d. Hyperadrenocorticism

176. d Glucocorticoids are the primary treatment in autoimmune, allergic/inflammatory, and some neoplastic diseases. Iatrogenic hyperadrenocorticism can actually be caused by glucocorticoid administration.

177. An example of an anticholinergic drug is a. Acetylcholine b. Pilocarpine c. Atropine d. Nicotine

177. c All of the other drugs listed are cholinergic drugs.

178. The term drug compounding refers to which of the following activities? a. Diluting or combining drugs for ease of administration b. Delivering a drug via a different route than is directed on the label c. Delivering a drug at a different dose than is directed on the label d. Delivering the drug to a different species than is directed on the label

178. a A veterinarian may alter a drug or medication for ease of administration by diluting, mixing drugs, and mixing drugs in a more palatable solution; this is referred to as compounding. Choices b to d define extra label drug use.

179. Which of the following drugs is most commonly used to treat urinary incontinence in dogs? a. Phenylpropanolamine b. Diethylcarbamazine c. Acepromazine d. Bethanechol

179. a

18. The benzodiazepine derivative diazepam is often administered in combination with a. Droperidol b. Morphine c. Ketamine d. Xylazine

18. c "KetVal," ketamine and Valium (diazepam), is a commonly used drug combination.

180. Which of the following drugs is classified as an osmotic diuretic and is often used to reduce intracranial pressure or treat oliguric renal failure? a. Furosemide b. Propranolol c. Mannitol d. Bethanechol

180. c Mannitol is osmotically active and is therefore effective at pulling fluid into the intravascular space.

181. Which of the following drugs does not have an antiemetic action? a. Phenothiazines (Chlorpromazine) b. Metoclopramide (Reglan) c. Antihistamines (Meclizine) d. Apomorphine

181. d Choices a to c all have antiemetic action; apomorphine is used as an emetic agent in dogs.

182. An animal that demonstrates an allergic response to penicillin administration should not be given which of the following antibiotics? a. Clindamycin b. Cephalosporins c. Sulfonamides d. Fluoroquinolones

182. b Animals that have an allergic reaction to penicillin often cross-react with cephalosporins as well.

183. Griseofulvin (Fulvicin) is used in cats, dogs, and horses to treat which of the following disorders? a. Dermatophytosis b. Staphylococcus pyoderma c. Rickettsial disease d. Nematode infection

183. a With nonlocalized or refractory infections, oral griseofulvin is used to treat dermatophytosis in addition to topical therapy with an antifungal agent.

184. Which of the following drugs provides analgesic relief to a patient who undergoes a painful procedure? a. Acepromazine b. Diazepam c. Thiopental d. Fentanyl

184. d The only drug in this list that provides analgesia is the opioid fentanyl. The other drugs (acepromazine, diazepam, and thiopental) may be used as preinduction or induction agents but do not provide analgesia.

188. The number of species of bacteria that are affected by an antibiotic is known as the antibiotic's a. Effectiveness b. Efficacy c. Spectrum d. Sphere

188. c An antibiotic with a broad spectrum will be useful against a large number of microorganisms.

189. Which of the following statements correctly describes multidrug chemotherapeutic protocols? a. Drugs are usually selected that work in the same part of the cell cycle. b. Drugs are usually selected that work in different parts of the cell cycle. c. Drugs are selected that produce similar adverse side effects. d. Most chemotherapy drugs are dosed on a milligram/kilogram basis.

189. b Ideally a multidrug chemotherapy protocol aims to provide an array of drugs that attack the neoplasm in different parts of the cell cycle. There is also an attempt to select drugs that do not all result in the same adverse effects (e.g., bone marrow suppression). Most chemotherapy drugs are based on body surface area (meters squared) to achieve more accurate dosing because of the narrow margin of safety.

19. If using a regular disposable-type syringe, which of the following drugs should not be preloaded and left for a time? a. Acepromazine b. Atropine c. Diazepam d. Ketamine

19. c Diazepam has a potential to react with plastic. Prolonged exposure should be avoided.

190. Which of the following drugs does not have an immunosuppressive effect? a. Cyclosporine b. Azathioprine (Imuran) c. Prednisone d. Ivermectin

190. d Cyclosporine, azathioprine (Imuran), and prednisone are all used for their immunosuppressive effects.

191. An example of an aminoglycoside antibiotic is a. Erythromycin b. Ampicillin c. Neomycin d. Doxycycline

191. c Erythromycin is a macrolide antibiotic, ampicillin is a penicillin, and doxycycline is a tetracycline.

192. A recently reported side effect of fluoroquinolone administration (Baytril) in cats given SID dosing at a higher dosing schedule is a. Retinal damage b. Hypertension c. Renal failure d. Hepatic failure

192. a Retinal damage was reported in cats receiving SID dosing using the high end of the labeled dose range. Divided (BID) or using the lower end of the dosing range has been recommended.

193. Which of the following clinical signs may indicate that an animal is experiencing lidocaine toxicity? a. CNS signs: drowsiness, ataxia, muscle tremors b. Renal signs: oliguria c. Hepatic signs: jaundice, clotting problems d. Respiratory signs: labored respirations, bronchoconstriction

193. a Cats are especially sensitive to lidocaine and may develop central nervous system (CNS) signs indicating toxicity. All animals, especially those receiving a constant rate infusion, should be carefully monitored for these signs.

194. An asthmatic cat may receive which of the following drugs for its bronchodilatory effect? a. Histamine b. Digoxin c. Prednisone d. Theophylline

194. d Theophylline and aminophylline are methylxanthines that demonstrate a bronchodilatory effect in addition to cardiac stimulation. Prednisone is used to treat asthmatics, but it is used primarily for its antiinflammatory properties and alone does not directly stimulate bronchodilation.

195. The class of antibiotics most commonly prescribed to treat rickettsial infections, such as Rocky Mountain spotted fever, is a. Tetracyclines b. Penicillins c. Aminoglycosides d. Sulfonamides

195. a Tetracyclines (oxytetracycline, doxycycline) are most commonly used as a first-line approach to treating rickettsial infections.

196. What drug will not cause nephrotoxicity? a. Aminoglycosides b. Banamine (Flunixin Meglumine) c. Cisplatin (Platinol) d. Oxymorphone

196. d Choices a to c are drugs that can potentially result in renal damage if used inappropriately.

197. Why is it an accepted practice for cats receiving aspirin therapy to be dosed on a 2-day interval schedule only (i.e., a minimal dose every 2 days)? a. Liver metabolism of salicylates occurs at a very slow rate in comparison to other species, thereby making cats extremely susceptible to overdose in comparison to dogs. b. Salicylates cause severe respiratory depression in cats. c. Salicylates often result in severe hypertension. d. Salicylates may result in hypercoagulable states in cats.

197. a Cats can metabolize aspirin but do so at a very slow rate and thus must be dosed accordingly. It is best to avoid salicylates in cats when alternative drug choices exist.

198. A cat diagnosed with hyperthyroidism may be offered a number of treatment options, including all but which of the following? a. Radioactive iodine-131 treatment b. Methimazole (Tapazole) medical management c. Thyroidectomy surgery d. Fenbendazole medical management

198. d Hyperthyroid cats may receive radioactive iodine therapy (especially cats with ectopic thyroid tissue) or thyroidectomy surgery, or they may be managed medically with Tapazole. Fenbendazole is an antiparasitic drug.

199. Butorphanol is an opioid that is often used for its analgesic properties but is also used in other clinical scenarios as a. An antidiarrheal agent b. An antitussive agent c. An antiemetic d. A bronchodilator

199. b Butorphanol can be used to inhibit a nonproductive cough.

212. Antimicrobial drugs that work against bacterial deoxyribonucleic acid (DNA) have the potential for causing birth defects or other problems in the host animal if they also alter mammalian DNA. One group of antimicrobial agents known for this tendency is a. Antifungals b. Antibacterials c. Antivirals d. Antiprotozoals

212. a Antifungal agents (e.g., griseofulvin) can cause birth defects if given to pregnant animals.

2. Decreased function of what organ would have the greatest effect on biotransformation of most drugs? a. Kidney b. Liver c. Pancreas d. Spleen

2. b The majority of the biotransformation of most drugs occurs in the liver.

20. A 10-kg dog has inadvertently been administered a dose of xylazine hydrochloride intended for a 30-kg dog. The correct reversal agent for this overdose is a. Yohimbine b. Atipamezole c. Noradrenalin d. Atropine

20. a Xylazine hydrochloride is an α2-adrenergic receptor agonist that is antagonized by Yohimbine.

200. Triple sulfas were developed to the avert __ that was/were seen with single sulfonamide toxicity. a. Diarrhea b. Crystalluria c. Bronchospasms d. Seizures

200. b The solubility of one sulfa in a triple sulfa is not dependent on the solubility of the other sulfas, so a smaller amount of each sulfa is used, thereby reducing the possibility of toxicity.

201. A dog diagnosed with a mast cell tumor is scheduled for surgery. The veterinarian chooses to pretreat the dog with an H1 blocker to prevent the negative effects of histamine release when the tumor is manipulated. Which of the following drugs may be chosen? a. Diphenhydramine b. Methimazole c. Vincristine d. Sulfasalazine

201. a An antihistamine such as diphenhydramine (Benadryl) or hydroxyzine (Atarax) is given to prevent histamine from binding to receptors and causing a detrimental histamine response (bronchoconstriction, tachycardia, etc.).

202. Which of the following drugs is used for its sedative, antiseizure, and appetite stimulant effects? a. Diazepam (Valium) b. Cyproheptadine c. Ketamine d. Potassium bromide

202. a Diazepam is used for the properties listed in the question. Cyproheptadine is an appetite stimulant often used in cats. Potassium bromide is an antiseizure medication used in refractory cases in conjunction with oral phenobarbital therapy. Ketamine is a dissociative anesthetic agent.

203. A cat is given a drug (methionine) to alter the pH of his urine in an effort to dissolve his struvite stones. The drug has which of the following intended effects? a. Acidification of the urine b. Alkalinization of the urine c. Dilution of urine d. Concentration of the urine

203. a Methionine (Methigel) is prescribed to promote the production of low pH (acidified) urine; this should assist with prevention and dissolution of struvite uroliths.

204. Which of the following types of insulin provides the longest duration of action? a. NPH insulin b. Regular insulin c. Ultralente insulin d. Semilente insulin

204. c Ultralente is the longest acting insulin product. NPH and Lente insulin demonstrate intermediate duration of action with regular and Semilente insulins providing the shortest duration of activity in patients.

205. It is essential for veterinary technicians to educate clients expected to treat their pets with insulin. Which of the following statements is true? a. Insulin can be stored at room temperature in between uses. b. The bottle of insulin should be shaken before use. c. The injection is given in the same site each time. d. Insulin should be given with a meal.

205. d Insulin should be given around the time of a meal to prevent hypoglycemia.

206. Antimicrobial (antibiotic) drugs are classified according to the type of organisms they affect. Which type of antimicrobial drug would be effective against organisms like Giardia or Eimeria? a. Bactericidal b. Virucidal c. Antiprotozoal d. Fungistatic

206. c Giardia and Eimeria are protozoa.

207. Many antibiotic drug inserts (information included in packages of drugs) make reference to the MIC at which the antibiotic is effective. What is the MIC? a. Minimum inflammatory concentration b. Maximum infusion concentration c. Minimum inhibitory concentration d. Maximum inhalation concentration

207. c The minimum inhibitory concentration (MIC) for each pathologic organism can give an idea as to how high an antibiotic concentration will be necessary for it to be effective.

208. Antimicrobial drugs like neomycin, gentamicin, and amikacin each belong to what group of antibiotics? a. Penicillins b. Cephalosporins c. Quinolines d. Aminoglycosides

208. d Aminoglycosides are a diverse and commonly used group of antimicrobial drugs.

209. Aminoglycosides, if given at high dosages or by continuous IV infusion, cause damage to the a. Lungs and liver b. Liver and inner ear c. Kidney and liver d. Inner ear and kidney

209. d Aminoglycosides are nephrotoxic (toxic to the kidney) and ototoxic (toxic to the ear).

21. Griseofulvin acts on a. Gram-positive bacteria b. Gram-negative bacteria c. Gram-negative and gram-positive bacteria d. Dermatophytes

21. d Griseofulvin is a superficial antifungal agent.

210. Bacterial resistance to antibiotics is a significant problem in veterinary medicine. What factor is not considered to be a significant contributor to development of bacterial resistance? a. Prolonged levels of higher-than-recommended dosages of antibiotics b. Normal dosages of antibiotics for half the recommended duration c. Low dosages of antibiotics in the feed for prolonged periods d. Antibiotics that do not reach the infection site in concentrations that exceed MIC

210. a High dosages may increase the risk of toxicity, but they usually are sufficient to kill bacteria and prevent the selection for resistant strains of bacteria that occurs when low dosages or ineffective antibiotics are used.

211. Which of the following drug groups is most likely to provoke an allergic reaction in treated animals? a. Aminoglycosides b. Quinolines c. Penicillins d. Tetracyclines

211. c The most common adverse reaction to penicillin administration in most species is allergy (usually urticaria).

213. Unlike many other penicillins, penicillin G is not recommended for use by mouth (po). Why? a. It upsets the stomach. b. It is destroyed by gastric acid. c. It causes severe diarrhea and intestinal cramping. d. It is ineffectively absorbed from the gastrointestinal tract.

213. b Penicillin G is readily destroyed by the acidic environment in the stomach.

214. Which type of adverse reaction is most commonly observed when penicillins are administered to rabbits? a. Kidney damage and subsequent change in urine production b. Hives and swelling of the face from allergic reaction c. High fever and severe depression d. Severe diarrhea

214. d Penicillins destroy the normal flora in the gut of rabbits, which may result in fatal diarrhea.

215. Certain bacteria, especially Staphylococcus, produce an enzyme (β-lactamase) that destroys many penicillin drugs. Which is one of the penicillins not destroyed by β-lactamase? a. Penicillin G b. Cloxacillin c. Amoxicillin d. Hetacillin

215. b Cloxacillin, dicloxacillin, and oxacillin are types of penicillin used in veterinary medicine that are effective against β-lactamase-producing bacteria.

216. What is added to amoxicillin to make it resistant to the penicillin-destroying β-lactamase enzymes produced by some bacteria? a. Trimethoprim b. Clavulanic acid c. Piperonyl butoxide d. Ormetoprim

216. b Penicillins with an added compound that destroys β-lactamase are called potentiated penicillins.

217. Some penicillin G injectable products contain procaine or benzathine, and some penicillin G products contain neither. What effect do procaine and benzathine have on penicillin G? a. They act as a local anesthetic to decrease the pain of injection. b. They prolong absorption of penicillin G from the injection site. c. They increase the rate at which penicillin G enters the bloodstream. d. They enhance the bacterial killing activity of the penicillin.

217. b Procaine penicillin G may be dosed less frequently than penicillin G. Whereas procaine is indeed a weak local anesthetic, its addition to penicillin G is for the repository effect and not for its anesthetic quality.

218. Ceftiofur is classified on the package insert as a third-generation cephalosporin antibiotic; cefadroxil is classified as a first-generation cephalosporin. How do third-generation cephalosporins differ from first-generation cephalosporins? a. Third-generation drugs are better absorbed when given orally. b. Third-generation drugs have better gram-negative activity. c. Third-generation drugs last longer in the body; they are given once daily only. d. Third-generation drugs have fewer side effects and adverse reactions.

218. b The latter generations tended to shift their spectrum of activity to a greater extent against gram-negative bacteria and slightly away from gram-positive bacteria. In severe infections with gram-negative bacteria, the concept of generation when selecting a cephalosporin becomes very important.

219. Aminoglycoside antibiotics (e.g., amikacin and gentamicin) are powerful agents against bacteria. Unfortunately, they do not seem to work well in deep puncture wounds or in the lumen of the colon. Why? a. These are anaerobic sites, and bacteria require oxygen to take up aminoglycosides. b. These sites often have enzymes that inactivate aminoglycosides. c. Gram-positive bacteria commonly infect these sites, and aminoglycosides are ineffective against gram-positive bacteria. d. The DNA of bacteria at these sites is resistant to aminoglycosides.

219. a It is important to remember that aminoglycosides are largely ineffective against anaerobic bacteria.

22. What is not true of sulfonamides? a. They can cause renal failure. b. They can cause skin eruptions. c. They can cause keratoconjunctivitis sicca. d. They can cause hepatitis.

22. d Potential for renal disease but no adverse effects on liver

220. How can a drug like neomycin, which has severe risk of nephrotoxicity when administered by injection, have little risk when administered topically or orally? a. Some species are resistant to kidney damage that may result from the drug. b. Little of the drug is absorbed through the skin. c. Absorbed drug is excreted so quickly that it does not have time to damage the kidneys. d. Subcutaneous enzymes inactivate the drug.

220. b Aminoglycoside molecules are very hydrophilic, which means they do not effectively penetrate intact cellular membranes, such as those lining the gastrointestinal tract. Thus, neomycin, for the most part, remains in the bowel lumen and does not reach the kidneys.

221. What antibiotic is most likely to cause damage to the ear? a. Amoxicillin b. Gentamicin c. Tetracycline d. Enrofloxacin

221. b Aminoglycosides tend to accumulate in the fluid of the inner ear. If these concentrations rise high enough, they can damage the cells involved with hearing and balance.

222. What route of administration of amikacin or gentamicin causes the highest risk for nephrotoxicity (kidney toxicity)? a. Per os b. Intramuscular c. Continuous intravenous infusion d. Intravenous bolus

222. c The risk of nephrotoxicity is diminished by ensuring that during the time between doses, the concentration of aminoglycoside in the body decreases below a certain critical level. A continuous intravenous infusion (drip) would not allow the concentrations to drop below this critical level.

223. What can a technician do to recognize early signs of nephrotoxicity in an animal that receives aminoglycosides? a. Monitor blood urea nitrogen (BUN) and creatinine levels b. Monitor the CBC and total protein level c. Monitor feces for change in consistency d. Monitor urine for casts and protein

223. d Casts and protein appear in the urine during the early stages of kidney insult. BUN and creatinine levels do not increase until 66% to 75% of the kidney have already been severely damaged.

224. Why is it important that pus-filled wounds or ear canals with purulent debris be thoroughly cleaned before applying a topical aminoglycoside (e.g., gentamicin)? a. Purulent material shields bacteria from the antibiotic. b. The alkaline nature of the purulent material reduces bacterial uptake of the drug. c. Nucleic acids in the cellular debris (pus) bind the aminoglycoside. d. Irritation from the purulent material causes the tissue to produce enzymes against the aminoglycoside.

224. c Aminoglycosides work by binding to ribosomes (made from ribonucleic acid or RNA). If there are lysed white blood cells (WBCs) present, the nucleic acid from the cellular debris binds to the aminoglycosides and prevents them from acting against the bacteria.

225. What drugs are considered fluoroquinolones? a. Oxytetracycline, doxycycline b. Danofloxacin, enrofloxacin c. Sulfadimethoxine, sulfamethazine d. Chloramphenicol, lincomycin

225. b Fluoroquinolone drug names typically end with -floxacin.

226. What organ blocks entrance of many drugs because of a barrier similar to the blood-brain barrier? a. Prostate gland b. Thyroid gland c. Pancreas d. Spleen

226. a The prostate has a blood-tissue barrier that blocks entrance of many antibiotics in a way similar to the way in which the blood-brain barrier prevents many substances from entering the brain.

227. In what animal is use of enrofloxacin safest? a. 1-year-old Dutch rabbit b. 3-month-old Doberman puppy c. 6-month-old quarter horse colt d. 2-year-old Siamese cat

227. a Enrofloxacin may adversely affect developing joint cartilage in dogs and horses. It has been associated with retinal blindness in cats. It is a good choice for rabbits because it does not destroy normal gut flora.

228. What is the drug group of choice for treating Lyme disease (borreliosis)? a. Antifungal b. Antiviral c. Antibiotic d. Antiprotozoal

228. c Antibiotics, particularly tetracyclines, are effective against the spirochete bacterium Borrelia,which causes Lyme disease. Penicillins are also effective against this organism.

229. With what type of diet should oral tetracyclines not be administered? a. High fat b. Low sodium c. High calcium d. Low potassium

229. c Calcium and other minerals in the gastrointestinal tract chelates (combines with) tetracycline in such a way that the drug cannot be absorbed and is rendered ineffective. This is the reason oral tetracycline should not be given with milk products.

23. What antiinfective compounds, when given to juvenile animals, can impair cartilage development? a. Cephalosporins b. Fluoroquinolones c. Penicillins d. Macrolides

23. b Fluoroquinolones have been associated with cartilage damage in young horses and puppies.

230. Why should tetracycline use be avoided in pregnant bitches? a. It may cause changes in the joint cartilage that may result in arthritis at an older age in the pup. b. It may be deposited in dental enamel and give the pup's teeth a mottled yellow appearance. c. It may impair normal central nervous system development in the pups that may show up as behavioral changes later in life. d. It may damage the developing pups and may result in liver impairment later in life.

230. b The same attraction that chelates calcium to tetracycline binds tetracycline to bone and enamel in the developing fetus. The yellow mottling of otherwise white dental enamel can be unsightly.

231. What is the effect of prostaglandin F2 alpha on the reproductive system? a. Ovulation b. Luteolysis c. Follicle stimulation d. Corpus luteum formation

231. b Luteolysis in polyestrus animals, such as cattle, can be used to synchronize breeding.

232. What drug readily penetrates the blood-brain barrier and achieves therapeutic concentrations of antibiotic in the central nervous system? a. Amoxicillin b. Enrofloxacin c. Oxytetracycline d. Chloramphenicol

232. d Chloramphenicol exists largely in a non-ionized (lipophilic) form that can readily cross membranes. Most other antibiotics exist in an ionized (hydrophilic) form at normal body pH. Thus, they are prevented from readily crossing lipid membranes.

233. Chloramphenicol is metabolized by specific enzymes in the liver. Consequently, it interferes with or influences how rapidly other drugs metabolized by the same liver enzymes are eliminated from the body. This is important to remember to prevent accidental overdose of a simultaneously administered drug. Metabolism of what drug is affected by simultaneous use of chloramphenicol? a. Phenobarbital b. Aspirin c. Sulfadimethoxine d. Enrofloxacin

233. a Barbiturates rely heavily on the liver for their removal from the body. Any alteration in liver enzyme function is likely to affect barbiturate elimination and duration of action (e.g., prolongation of barbiturate anesthesia).

234. Why is chloramphenicol used with extreme caution in cats and neonates? a. It can bind with dietary calcium (milk) and become deactivated. b. The liver is unable to metabolize chloramphenicol effectively in these animals. c. It can alter developing bone, enamel, and cartilage. d. It may drastically alter gut bacterial flora, resulting in fatal diarrhea.

234. b The neonatal liver is not fully capable of functioning for several weeks. Thus, the neonate is unable to metabolize chloramphenicol very readily. The same is true for cats of any age.

235. What fatal reaction to chloramphenicol has been reported in cats and people? a. Kidney failure b. Aplastic anemia c. Pulmonary edema d. Liver failure

235. b Chloramphenicol attaches to mitochondrial ribosomes in the bone marrow and can result in suppression of marrow blood cell formation. The result is severe anemia.

236. What antimicrobial is banned from use in any food animal because of the risk to human health? a. Oxytetracycline b. Dicloxacillin c. Chloramphenicol d. Sulfadimethoxine

236. c The Food and Drug Administration (FDA) has banned use of chloramphenicol in any animal to be used for food production due to the risk of bone marrow toxicity with consumption of drug residues in foods of animal origin.

d. Sulfadimethoxine 237. When are drugs like sulfadimethoxine, sulfadiazine, and other sulfa drugs most likely to cause kidney problems? a. When an animal is receiving intravenous fluids and they have a diuretic effect on the kidneys b. When an animal is dehydrated c. When an animal has only one functional kidney d. When an animal has a bladder infection

237. b When an animal is dehydrated, there is less water passing through the kidneys, resulting in possible precipitation of sulfate crystals that, in turn, can damage the kidneys.

238. What are trimethoprim and ormetoprim? a. Agents that are growth regulators b. Agents that enhance bactericidal activity of sulfa drugs c. Agents that enhance the spectrum of activity of penicillins d. Agents that reduce the risk of liver damage from hepatotoxic drugs

238. b Ormetoprim and trimethoprim enhance the bactericidal effects of killing by sulfa drugs.

239. Within the past few years there have been reports of dogs having adverse reactions to sulfadiazine, a very commonly used sulfonamide. What reaction should clients and veterinary professionals watch for? a. Cardiac arrest b. Sudden liver failure c. Decreased tear production d. Increased urination

239. c Keratoconjunctivitis sicca, or dry eye, has been reported.

24. Potentiated penicillins a. Have a narrow spectrum of action relative to regular penicillins b. Include cephalosporins c. Are active against b-lactamase-producing bacteria d. Are not used in treating mastitis

24. c Potentiated penicillins are resistant to inactivation by β-lactamase.

240. What antibacterial drug is also effective against protozoa such as Giardia? a. Clindamycin b. Griseofulvin c. Metronidazole d. Sulfasalazine

240. c Metronidazole is commonly prescribed as a therapeutic trial for suspected giardiasis, even if the organism cannot be demonstrated on fecal examinations.

241. Ketoconazole, miconazole, and griseofulvin are effective against a. Viruses b. Flukes c. Intestinal nematodes d. Fungi

241. d These drugs are used to treat dermatophyte infections such as ringworm.

242. What drug is used intravenously to treat status epilepticus? a. Primidone b. Phenytoin c. Diazepam d. Phenobarbital

242. c Diazepam (Valium) is not very effective when given PO, but it is commonly used via IV to stop ongoing seizure activity.

243. What anticonvulsant drug is converted by the liver primarily to phenobarbital, which accounts for most of its anticonvulsant activity? a. Diazepam b. Primidone c. Phenytoin d. Clonazepam

243. b Approximately 85% of primidone is converted to phenobarbital, which, in turn, constitutes the major drug-controlling seizure activity.

244. What traditional anticonvulsant is now being used simultaneously with phenobarbital in dogs that are nonresponsive to phenobarbital alone? a. Diazepam b. Potassium bromide c. Phenytoin d. Strychnine

244. b This was the first anticonvulsant used in the late 1800s in people. Much of its mechanism of action is still unknown.

245. What drug is a respiratory stimulant? a. Oxytocin b. Dobutamine c. Propranolol d. Doxapram

245. d Doxapram stimulates the brainstem respiratory centers.

246. Drugs that effectively block the cough reflex are called a. Mucolytics b. Expectorants c. Antitussives d. Antihistamines

246. c

247. Drugs that reduce the viscosity of secretions in the respiratory tract are called a. Antiinflammatories b. Expectorants c. Antitussives d. Antihistamines

247. b

248. Drugs used to increase airflow through respiratory passageways narrowed by the contraction of smooth muscle around them are called a. Bronchodilators b. Expectorants c. Antitussives d. Antihistamines

248. a Bronchodilators are often used in the treatment of asthma.

249. Butorphanol and hydrocodone are examples of a. Mucolytics b. Expectorants c. Antitussives d. Antihistamines

249. c Butorphanol and hydrocodone are opioid drugs with antitussive properties.

25. If you are instructed to give a medication IP, you inject the medication a. Into the jugular vein b. Into the popliteal artery c. Into the abdominal cavity d. Into a major muscle mass

25. c IP is the abbreviation for "intraperitoneal."

250. Drugs that are described as β2-adrenergic receptor stimulators have what effect on the respiratory tree? a. Increase the volume of watery secretions b. Increase the volume of sticky mucoid secretions c. Cause bronchoconstriction d. Cause bronchodilatation

250. d β2-adrenergic receptors relax the smooth muscles that encircle the bronchioles.

251. Terbutaline, albuterol, and metaproterenol are described as selective β2-adrenergic agonists. They are used in veterinary medicine to a. Treat feline asthma or other bronchoconstrictive diseases b. Treat low blood pressure caused by shock c. Suppress a productive cough, such as in bronchopneumonia d. Stimulate secretions within the respiratory tree to aid the mucociliary apparatus

251. a These drugs quickly reverse the bronchoconstriction caused by allergic insult, such as occurs in asthma.

252. Methylxanthines are often used to improve breathing in cardiac patients and patients with respiratory disease. What drugs are methylxanthines used for this purpose? a. Theophylline and aminophylline b. Codeine and dextromethorphan c. Hydrocodone and butorphanol d. Guaifenesin and propranolol

252. a Aminophylline is actually made of 80% theophylline and 20% salt to decrease the gastrointestinal irritation when given PO.

253. Most drugs that control arrhythmias of the heart are said to be "negative inotropes." What does this mean? a. They increase the heart rate. b. They decrease the heart rate. c. They increase the force of contractions. d. They decrease the force of contractions.

253. d Many antiarrhythmic drugs may decrease the heart rate.

254. What drug reduces tachyarrhythmias by decreasing conduction of the impulse that causes cardiac contraction through the heart? a. Propranolol b. Lidocaine c. Procainamide d. Digoxin

254. b Lidocaine blocks nervous conduction; this is also the reason for its local anesthetic effects.

255. Hyperthyroid cats have heart rates of over 200 beats per minute because of large numbers of β1-sympathetic receptors in their heart that make the heart more sensitive to epinephrine and norepinephrine. This high heart rate is an anesthetic risk. What drug is used to slow the heart rate and decrease arrhythmias associated with β1-receptor stimulation? a. Lidocaine b. Propranolol c. Quinidine d. Digoxin

255. b Propranolol is a rather nonspecific beta blocker (it blocks both β1- and β2-receptors). Blocking the receptors prevents the sympathetic nervous system from stimulating the heart and allows the parasympathetic system to naturally slow the heart rate.

256. Digoxin has a narrow therapeutic index. What does this mean? a. Plasma drug concentrations that produce toxicity are very low. b. Plasma drug concentrations required to achieve a beneficial effect are very high. c. Plasma drug concentrations that produce toxicity are very close to the minimum concentration at which a beneficial effect occurs. d. Plasma drug concentrations are extremely variable from animal to animal.

256. c The therapeutic index measures how close toxic concentrations are to minimal therapeutic concentrations. If there is not much difference between the toxic dose and the beneficial dose, the therapeutic index is narrow or small.

257. Because digoxin has a narrow therapeutic index, veterinary technicians and owners of animals that receive digoxin must be able to detect early signs of digoxin toxicity, such as a. Increased urination and increased water consumption b. Increased coughing and difficulty breathing c. Decreased appetite, anorexia, diarrhea, and vomiting d. Wobbly gait, fainting (syncope), and disorientation

257. c The gastrointestinal tract usually shows the first signs of digoxin toxicity.

258. Some drugs commonly used to treat veterinary patients with cardiovascular disease alter the electrolyte levels (Na+, K+, Cl−) within the body. Which electrolyte change greatly enhances the risk of digoxin toxicity? a. Increased sodium (hypernatremia) b. Increased potassium (hyperkalemia) c. Decreased chloride (hypochloremia) d. Decreased potassium (hypokalemia)

258. d Hypokalemia, which may be caused by some diuretics used in patients with cardiovascular disease, increases the risk of digoxin toxicity. Low magnesium concentrations also do this. Sometimes patients that receive diuretics plus digoxin are given potassium supplementation to reduce the risk of digoxin toxicity.

259. What drug would be most effective against dermatophytes? a. Tylosin b. Enrofloxacin c. Sulfadimethoxine d. Itraconazole

259. d Dermatophytes are fungi. Choices a, b, and c are antibacterial drugs.

26. Xylazine a. Is safe in all dogs b. Can be reversed with naloxone c. Provides some analgesia d. Can cause priapism in stallions

26. c Xylazine is an α2-adrenergic receptor agonist.

260. Drugs classified as ACE inhibitors have what effect on the body? a. Increase the strength of heart contractions b. Cause vasodilatation c. Cause bronchodilatation d. Increase the heart rate

260. b ACE inhibitors block the angiotensin-converting enzyme, which is an enzyme that normally produces angiotensin II, a very potent vasoconstrictor. By blocking formation of the vasoconstrictor, the ACE inhibitor allows vasodilation.

261. Captopril is an example of a(n) a. Positive inotrope b. Antiarrhythmic c. Bronchodilator d. Vasodilator

261. d Captopril dilates arterioles and venules.

262. Nitroglycerin is sometimes used as a paste applied to the pinna or to the abdominal skin in dogs with cardiovascular disease. Nitroglycerin has what therapeutic effect? a. Increases strength of heart contractions b. Causes vasodilation c. Causes bronchodilation d. Decreases the heart rate

262. b Nitroglycerin is a venodilator, and, perhaps more importantly, it also dilates cardiac arterioles, providing improved blood supply to the cardiac muscle.

263. Spironolactone, chlorothiazide, and furosemide are classified as a. Diuretics b. Positive inotropes c. Antiarrhythmics d. Vasodilators

263. a These three diuretics work on different parts of the renal nephron to promote diuresis (increased urine production).

264. Dogs with heartworm disease are treated with aspirin because it a. Increases the diuretic effect of drugs like furosemide b. Decreases the risk of clot formation and proliferation of the pulmonary arterial lining c. Increases the ability of vasodilators to keep the coronary arterioles fully dilated d. Decreases oxygen consumption by the weakened cardiac muscle

264. b Aspirin is used in heartworm disease to decrease clot formation and proliferation of the pulmonary arterial lining, both of which can significantly narrow the pulmonary arteries in dogs with heartworm disease.

265. What controlled substance rating indicates the drug with the greatest potential for abuse? a. C-III b. C-II c. C-V d. C-IV

265. b C-II are drugs with the highest potential for abuse that can be prescribed without special permission. C-I drugs have no proven or accepted medical application (heroin, marijuana, cocaine). C-V drugs have the lowest potential for abuse.

266. For what reason is apomorphine used in canine patients in emergency veterinary medicine? a. To keep blood pressure elevated in animals in shock b. To alleviate pain c. To produce emesis after ingestion of a toxin d. To maintain kidney function during periods of reduced blood flow to the kidneys

266. c Apomorphine is a potent emetic (stimulator of vomiting). It is usually administered via drops (crushed tablet in saline or water) or by placing the tablet directly into the conjunctival sac of the eye.

267. What drug is most likely to be prescribed to prevent motion sickness? a. Apomorphine b. Syrup of ipecac c. Atropine d. Diphenhydramine

267. d Dimenhydrinate (Dramamine) and diphenhydramine (Benadryl) are antihistamines. Because histamine release is involved with vestibular stimulation of vomiting (vestibular function controls balance, sense of motion), blocking histamine receptors decreases vomiting caused by motion sickness. Acepromazine and other phenothiazine tranquilizers are also prescribed.

268. For what is syrup of ipecac used? a. To stimulate defecation to flush out poisons from the distal bowel b. To induce vomiting c. To stimulate duodenal movement to overcome constipation d. To increase blood supply to the gastrointestinal tract

268. b Syrup of ipecac is an emetic. It is important to remember that syrup of ipecac takes up to 20 minutes to work, because it has to move into the duodenum to stimulate the gastrointestinal tract and be absorbed. Once absorbed it stimulates the chemoreceptor-trigger zone.

269. Why should syrup of ipecac and activated charcoal (the universal antidote) not be given simultaneously? a. The resultant vomiting is too severe and too prolonged. b. They cancel out the beneficial effects of each other. c. Neither is absorbed in sufficient quantity to be of any benefit. d. Severe diarrhea and intestinal cramping result.

269. b Syrup of ipecac tends to coat the charcoal, preventing the toxicant from being absorbed by the charcoal. The charcoal tends to keep the syrup of ipecac away from the gastrointestinal wall, thus preventing it from irritating the gastrointestinal tract and inducing the desired emetic effect.

27. Propofol a. Is a potent analgesic b. Can be given via the IM and IV routes c. Is best administered as a single bolus d. Can be given in incremental doses

27. d Propofol has a wide margin of safety and may be used as continuous infusion or as repeated boluses.

270. Anticholinergic drugs like atropine, aminopentamide (Centrine), or isopropamide (Darbazine) are expected to have what effect on the gastrointestinal tract? a. Increase secretions by the bowel b. Increase movement of feces through the bowel c. Decrease ability of compounds to irritate the bowel wall d. Decrease bowel motility

270. d These drugs are anticholinergic; that is, they work against acetylcholine. Acetylcholine is the neurotransmitter heavily involved with the parasympathetic nervous system. Blocking acetylcholine impairs the parasympathetic nervous system, which stimulates gastrointestinal movement, secretion, and blood flow.

271. Opioid drugs such as paregoric and loperamide are often used as antidiarrheals. What is their main effect on the gastrointestinal tract? a. Decrease diarrhea by decreasing peristaltic waves b. Decrease diarrhea by relaxing segmental mixing contractions c. Decrease diarrhea by increasing segmental mixing contractions d. Decrease constipation by increasing intestinal secretions

271. c Opioid drugs (narcotics) are used to treat diarrhea by increasing segmental contractions of the bowel, thus increasing the resistance to feces flow.

272. Bismuth subsalicylate is the active ingredient in a common over-the-counter (OTC) preparation used for some types of gastrointestinal disease for what effect? a. Mild laxative b. Antiemetic c. Antidiarrheic d. Emetic

272. c Pepto-Bismol contains this ingredient. The salicylate blocks prostaglandin formation in the gastrointestinal tract. Prostaglandins normally stimulate fluid secretions; therefore, blocking prostaglandin formation decreases the fluid consistency of the feces.

273. Drugs like flunixin meglumine, ibuprofen, and other NSAIDs often produce side effects in the gastrointestinal tract with long-term use or high-dosage use, especially in dogs. What are the side effects? a. Increased bowel motility, resulting in fluid diarrhea b. Decreased ability to digest fat, resulting in fatty stool (steatorrhea) c. Ulcers or gastritis from decreased mucus production d. Decreased bowel motility, resulting in constipation

273. c Naturally occurring prostaglandins have a protective effect on the gastrointestinal tract. They increase intestinal secretions (including gastric mucus) and maintain normal perfusion of tissues. NSAIDs block prostaglandin formation, including the good prostaglandins that normally protect the stomach and intestinal tract.

274. Cimetidine and ranitidine are often called H 2 blockers, traditionally referred to as histamine receptors. For what effect are they used? a. Antidiarrheal b. Laxative c. Rumen stimulant d. Antacid

274. d H2 receptors are located on the cells that secrete hydrochloric acid into the stomach. When these receptors are blocked, the amount of acid dumped into the stomach is reduced.

275. What type of medication is sucralfate (Carafate)? a. Antiulcer b. Antidiarrheal c. Antibloat d. Anticonstipation

275. a This drug forms a sticky paste when exposed to the acidic pH of the stomach. The paste adheres to ulcer sites and covers them like a Band-Aid, protecting the ulcer from the acidic environment of the stomach.

276. The drug most commonly used in treating animals with hypothyroidism is a. Thyroid-stimulating hormone (TSH) b. Thyroid extract c. Synthetic levothyroxine (T4) d. Synthetic liothyronine (T3)

276. c TSH is available in injectable form only. Thyroid extract is made from pulverized thyroid glands, and its potency is somewhat inconsistent from dose to dose. T3 is the active hormone, but using it as a supplement bypasses the normal regulatory mechanism that tissues have for converting just enough T4 to T3 to meet their metabolic needs. Therefore, T4 is the best drug to use.

277. For what disease are methimazole and propylthiouracil used? a. Hypothyroidism in dogs b. Cushings disease (hyperadrenocorticism) in dogs c. Hyperthyroidism in cats d. Addisons disease (hypoadrenocorticism) in dogs

277. c These drugs prevent formation of new thyroid hormone, thus allowing concentrations of T3 and T4 to drop to normal levels.

278. What drug is used to return a mare to proestrus from diestrus through lysis of the corpus luteum? a. Progesterone b. Estrogen c. Prostaglandin d. Gonadotropin

278. c Prostaglandins are used to promote luteolysis in cows and mares.

279. What hormone is given to mares or cows for several days to mimic diestrus and then withdrawn to mimic natural lysis of the corpus luteum and a return to proestrus? a. Estradiol cypionate (ECP) b. Prostaglandin-F2-alpha (dinoprost tromethamine) c. Human chorionic gonadotropin (HCG) d. Progestin (Altrenogest)

279. d

28. Butorphanol a. Is an antibiotic b. Is an antitussive c. Can be reversed using yohimbine d. Is contraindicated in the cat

28. b Butorphanol's original use was as a cough suppressant.

280. What reproductive hormone can produce pyometra in dogs? It is also used in the pregnant mare in an attempt to keep it from prematurely aborting its fetus. a. Estrogen b. Progesterone c. Gonadotropin d. Prostaglandin

280. b Progesterone increases uterine secretions and causes the endometrium to become a better incubation site for bacteria, which can lead to pyometra.

281. What reproductive hormone can cause severe (and sometimes fatal) aplastic anemia or open-cervix pyometra several weeks after it has been given? a. Estradiol cypionate b. Prostaglandin-F2-alpha (dinoprost tromethamine) c. Human chorionic gonadotropin d. Progestin (Altrenogest)

281. a Pyometra occurs because high levels of estrogens, such as estradiol cypionate, cause the uterine cells to produce more receptors to progesterone, essentially making the uterus more susceptible to pyometra.

282. What drug is used as a contraceptive in dogs and sometimes for correction of behavioral problems in cats (e.g., inappropriate urination)? a. Altrenogest b. Megestrol acetate c. Estradiol cypionate d. Dinoprost tromethamine

282. b This is known by the trade name Ovaban.

283. What drug does not cause the adverse gastrointestinal effects associated with most NSAIDs? a. Aspirin (salicylate) b. Flunixin meglumine c. Acetaminophen d. Phenylbutazone

283. c Acetaminophen is not an NSAID drug, so its mechanism of action and adverse-effect risks differ from the NSAID drugs.

284. The glucocorticoid drug commonly used orally to treat inflammatory conditions in dogs and cats is a. Hydrocortisone b. Prednisone c. Triamcinolone d. Dexamethasone

284. b Prednisone is commonly administered orally to cats and dogs.

285. Predictable, short-term side effects of glucocorticoid therapy of which every client should be aware are a. Polyuria and polydipsia b. Cough and nasal discharge c. Anorexia and diarrhea d. Dry skin and skin irritations

285. a Increased water consumption necessitates that the owner make accommodations for greater urinary frequency if the pet is an indoor animal.

286. Commonly used glucocorticoids affect the CBC. What are the effects of glucocorticoid use on the CBC? a. Neutrophils decreased, eosinophils increased, lymphocytes decreased b. Neutrophils increased, eosinophils increased, lymphocytes increased c. Neutrophils increased, eosinophils decreased, lymphocytes decreased d. Neutrophils decreased, eosinophils decreased, lymphocytes increased

286. c Glucocorticoids cause eosinophils and lymphocytes to be sequestered (taken up or hidden) from the general circulation; as a result, their numbers in the CBC decrease. Neutrophils, by contrast, come off the walls of the blood vessels and reenter the general circulation, causing neutrophilia. This pattern is commonly called a stress leukogram.

287. Chronic administration of high doses of glucocorticoids can cause iatrogenic a. Renal failure b. Addisons disease c. Cushings disease d. Johnes disease

287. c Iatrogenic means "caused by the treatment itself." Cushings disease is hyperadrenocorticism, or the condition caused by excessive glucocorticoids.

288. In what species might glucocorticoid administration lead to abortion during the last few weeks of gestation? a. Horses and cattle b. Pigs and dogs c. Dogs and cats d. Horses and cats

288. a Dexamethasone is used to induce parturition in late-term or overdue cows.

289. NSAIDs are most likely to cause side effects in what two organ systems? a. Renal and pulmonary b. Renal and gastrointestinal c. Pulmonary and cardiac d. Cardiac and hepatic

289. b NSAIDs block prostaglandins; blocked prostaglandin formation predisposes an animal to gastritis, potential ulcer formation, and renal damage from inadequate blood and oxygen supplies.

29. An iodophor a. Has a longer action than basic iodine compounds b. Is not inactivated by organic materials c. Is not an irritant at concentrations generally used d. Provides adequate disinfection with a single application

29. a Iodophors are iodine combined with a carrier molecule; the effect is that the iodine is released over time, so there is a prolonged effect.

290. Which NSAID, when given perivascularly in horses, can cause skin necrosis and sloughing? a. Phenylbutazone b. Etodolac c. Ketoprofen d. Meclofenamic acid

290. a Phenylbutazone injection outside the vein can cause severe skin sloughing in horses.

291. One of the following antiinflammatory drugs is sometimes applied topically. Care must be taken to clean the area where it is applied because it readily penetrates the skin and can carry bacterial toxins or other chemicals with it into the body. What drug is this? a. Dexamethasone b. Dimethyl sulfoxide c. Flunixin meglumine d. Hydrocortisone

291. b Dimethyl sulfoxide (DMSO) is also known for its potent garlic or raw oyster odor.

292. Which of these opioid drugs is not a controlled substance? a. Butorphanol b. Loperamide c. Buprenorphine d. Fentanyl

292. b Loperamide is the active ingredient in the over-the-counter antidiarrheal drug Imodium.

293. A drug's package insert states that the drug is an anticestodal. Against what type of parasite will this drug be effective? a. Ascarids (Toxocara, Toxascaris) b. Tapeworms (Taenia) c. Protozoa (Eimeria, Giardia) d. Flukes (liver fluke, lung fluke)

293. b Anticestodals are also sometimes referred to as cestocides.

294. What breed of dog has a blood-brain barrier that allows ivermectin to reach toxic concentrations within the brain more readily than in other breeds? a. German shepherd b. Collie c. Schnauzer d. Cocker spaniel

294. b Collies, collie mixes, and collie-type dogs such as Australian shepherds are more susceptible to CNS toxicity after administration of avermectin drugs such as ivermectin.

295. What drug is used most commonly as a microfilaricide in treatment of heartworm disease? a. Thiacetarsemide b. Diethylcarbamazine c. Ivermectin d. Piperazine

295. c Although not officially approved for this use, ivermectin is the drug of choice for clearing Dirofilaria microfilariae from the blood of dogs.

296. If an animal receives an overdose of organophosphate insecticide (from dips, powders, sprays), what is the treatment of choice? a. Diphenhydramine (Benadryl) b. Corticosteroids (glucocorticoids) c. Intravenous fluids to aid elimination of the compound through the urine d. Atropine

296. d Organophosphates stimulate the parasympathetic nervous system, producing gastrointestinal hyperactivity (vomiting and diarrhea), bronchoconstriction, increased urination, and constricted pupils. Atropine blocks the parasympathetic nervous system receptor sites and therefore counteracts the parasympathetic effects.

297. What insecticide is effective in treating demodectic mange? a. Fenoxycarb b. Amitraz c. Pyrethrin d. Allethrin

297. b Amitraz (Mitaban) was developed to treat demodectic mange, a traditionally difficult condition to manage. Fenoxycarb is an insect growth regulator. Pyrethrin and allethrin are pyrethroid insecticides.

298. Methoprene and fenoxycarb are ingredients found increasingly in flea and other insect products. What are they? a. Insecticides b. Repellents c. Insect growth regulators d. Synergists

298. c Insect growth regulators prevent growth of the insect, which results in the death of the insect. Synergists (piperonyl butoxide) are compounds added to insecticides (like pyrethrins) to improve their insecticidal activity. Repellents used in veterinary products include butoxypolypropylene glycol (Butox PPG) and diethyltoluamide (DEET).

299. The following information was provided for a prescription written by a veterinarian: Dr. Pete Bill, Veterinary Associates, Inc., 325 Sentry Highway West Lafayette, IN 47907. Indiana License Number #4xxx. (317) 555-8636. For: Mr. R. K. Jones, 111, Melrose Place, Loomisville, IN 47905. Canine patient, Amoxicillin 100 mg tablets, Sig: 1 tab q8h po prn 2 refills. Date: 1/5/96. Signature: Pete Bill. What vital information is missing from this prescription? a. Veterinarian's Drug Enforcement Administration (DEA) license number b. Pet's name c. Owner's telephone number d. Number of tablets

299. d The pharmacist is not likely to know how many tablets must be dispensed. The DEA number is not required except for prescriptions for controlled substances (barbiturates, tranquilizers), in which case some states require that a different prescription form be submitted.

312. When a drug is used by a route, in a species, or for another indication other than that specified by the manufacturer, this use is a. A felony offense b. An extra label use c. Prohibited by the AVMA d. An implied consent from the manufacturer

312. b Any manner of use other than that specified on the drug label is termed extra label.

59. A drug given by which of the following routes reaches its peak plasma concentration the fastest? a. Orally b. Intramuscularly c. Subcutaneously d. Intravenously

59. d Drugs administered intravenously, directly into the bloodstream, reach their peak plasma concentration virtually instantaneously as compared to those administered and absorbed through other routes.

3. The generic name for a drug is also called the a. Trade name b. Chemical name c. Proprietary name d. Nonproprietary name

3. d Generic and nonproprietary names are interchangeable; no single company owns the rights to these types of names.

30. Heartgard contains ivermectin, which a. Prevents dogs from developing congestive heart failure b. Is also effective in treating tapeworms c. Is used to prevent heartworm infection d. Can be administered orally only

30. c Ivermectin is a proven preventive for Dirofilaria immitis.

300. The following information was provided for a prescription written by a veterinarian: Canine patient, Amoxicillin 100 mg tablets, Sig: 1 tab q8h po prn 2 refills. Date: 1/5/96. In the prescription what does po mean? a. Administer every other day b. Administer by mouth c. Administer as needed d. Administer on an empty stomach

300. b PO stands for the Latin per os, which means "by mouth."

301. The following information was provided for a prescription written by a veterinarian: Canine patient, Amoxicillin 100 mg tablets, Sig: 1 tab q8h po prn 2 refills. Date: 1/5/96. How many times a day is this medication to be given? a. Once b. Twice c. Three times d. Four times

301. c q8h = every 8 hours or three times daily (tid).

302. The following information was provided for a prescription written by a veterinarian: Canine patient, Amoxicillin 100 mg tablets, Sig: 1 tab q8h po prn 2 refills. Date: 1/5/96. What does prn mean? a. Administer every other day b. Administer by mouth c. Administer as needed d. Administer on an empty stomach

302. c PRN stands for the Latin pro re nata, which means "as needed."

303. The abbreviations od and os on a prescription refer to a. Administer by mouth and by rectum b. Administer every other day and every 3 days c. Right eye and left eye d. Administer with food and without food

303. c OD = oculus dexter (dexter means "right") and OS = oculus sinister (sinister means "left").

304. What do 15 gr and 10 g mean on a prescription? a. 15 grains and 10 grams b. 15 grains and 10 grains c. 15 grams and 10 grams d. 15 grams and 10 grains

304. a The abbreviation gr is grain, and g is gram.

305. Most pharmaceutical agents that are measured in grains have how many milligrams per grain? a. 30 b. 60 c. 100 d. 120

305. b Although traditionally 65 mg = 1 grain, many products (phenobarbital, aspirin) that are measured in grains use the conversion 60 mg = 1 grain.

306. Which of the following is a concentration of a drug solution? a. 15 mg/kg b. 1000 U/ml c. 20 gr/mg d. 250 g/lb

306. b The concentration of a solution is a weight (mg, kg, g, gr, IU, u) per volume (ml, L, cc); units per ml (sometimes expressed as IU/ml) is commonly used for penicillin and insulin.

307. How many milliliters are in a teaspoon? a. 1 b. 3 c. 5 d. 10

307. c

308. How many cubic centimeters are in a tablespoon? a. 5 b. 15 c. 25 d. 30

308. b 1 cc = 1 ml, so there are 15 milliliters in a tablespoon.

309. Which equivalent is correct? a. q12h = QD b. q6h = QID c. q4h = TID d. q8h = BID

309. b Every 6 hours = 4 times daily (or per 24 hr); the abbreviation for four times daily (QID) should not be confused with the abbreviation for every day (QD).

31. The active drug in ProHeart is moxidectin, a member of the drug class a. Arsenical b. Organophosphate c. Avermectin d. Pyrantel

31. c Moxidectin is a member of the avermectin drug class.

310. A 10-kg animal weighs how many pounds? a. 2 b. 15 c. 18 d. 22

310. d There are 2.2 lb in each kg (10 × 2.2 = 22).

311. What dosage form must be shaken before administration to an animal? a. Solution b. Ointment c. Gel d. Suspension

311. d A suspension must be stirred up or shaken before dispensing to ensure uniform distribution of the drug throughout the liquid vehicle.

313. Each drug approved for use in food-producing animals has a time period given on the label between the last dose and when the animal can be slaughtered for food or when the milk can be sold. What is this period called? a. Elimination half-life b. Secretion period c. Refractory period d. Withdrawal time

313. d Any time a medication is administered to food animals, the withdrawal time must be clearly indicated on the label and to the livestock owner.

314. Sometimes drugs are first administered in a large dose and then given as a series of smaller doses. What is the first dose called? a. Initial dose b. Loading dose c. Distribution dose d. Bolus dose

314. b The loading dose establishes adequate initial concentrations of the drug in the body. The smaller maintenance doses are then designed to keep the concentrations within the therapeutic range.

315. Many drugs do not have X mg/ml listed on their labels but instead have their concentrations listed as a percent (e.g., X% solution). Which of the following most accurately reflects the conversion of a percentage of a solution to a weight per volume format? a. X% = X g/ml b. X% = X g/10 ml c. X% = X g/100 ml d. X% = X mg/10 ml

315. c A 5% solution contains 5 g/100 ml.

316. How many milligrams are in each milliliter of a 24% solution? a. 24 b. 2.4 c. 240 d. 0.24

316. c There are 24 grams per 100 milliliters, which is 0.24 g per ml; 0.24 g = 240 mg.

317. What class of drugs generally poses the greatest potential health threat to those handling the medication? a. Antibiotics b. Antineoplastics c. Antinematodals d. Antiprotozoals

317. b Antineoplastic drugs are cancer-fighting agents. They are potent and lethal to rapidly dividing cells, regardless of what animal (including the technician) they contact.

318. What effect does renal failure or compromised liver function have on the pharmacokinetics of many drugs? a. Decreased absorption of drugs given orally b. Increased elimination rate of drugs from the body c. Decreased volume of distribution of drugs d. Increased half-life of drugs

318. d Because many drugs leave the body through the kidneys and/or liver, a decrease in the function of these organs decreases the rate at which the drugs leave the body. Elimination rate is decreased, and half-life (the time it takes for half of the drug to leave the body) is prolonged or increased.

319. Controlled substances are drugs that a. Cannot be used in any animal intended for use as human food b. Have a high potential for abuse c. Are very hazardous to anyone handling them d. Are environmentally hazardous

319. b Drugs are rated from C-I (most potential for abuse) to C-V (least potential for abuse).

32. A risk to veterinary technicians who administer prostaglandins is a. Acne b. Liver failure c. Kidney damage d. Inducing an asthma attack

32. d Prostaglandins cause smooth-muscle contraction and may be absorbed across the skin. Asthmatics should wear gloves when administering prostaglandins or avoid them entirely.

320. Drugs that are administered intra articularly are injected into a. The abdominal cavity b. The globe of the eye c. The ear canal d. A joint

320. d

321. If a drug that is very irritating to tissues is accidentally given outside of the cephalic vein (perivascularly), you should immediately a. Apply a tourniquet to prevent movement of the drug up the leg b. Infiltrate the area with sterile saline or other sterile isotonic fluid c. Aspirate the area with a needle and syringe to remove as much drug as possible d. Inject epinephrine into the area to constrict the capillaries and decrease drug absorption

321. b Diluting the agent is most important. Sometimes lidocaine is added to the infiltrate. Massaging the area and applying heat are also sometimes suggested.

322. Generally 1 fluid ounce is equal to approximately how many milliliters of liquid? a. 1 b. 15 c. 30 d. 60

322. c

33. Loop diuretics such as furosemide a. Cause dehydration in normal animals b. Cannot be used simultaneously with ACE inhibitors c. Are unsafe for use in animals with pulmonary edema d. May cause hypokalemia with chronic use

33. d Long-term loop diuretics may often lead to hypokalemia; potassium supplements are often administered. They increase the excretion of water by increasing the excretion of the electrolytes (salts), especially potassium.

34. Pain receptors are called a. Nociceptors b. C fibers c. Proprioceptors d. Prostaglandins

34. a

35. If it is accidentally administered as an IV bolus, lidocaine may cause a. Full body numbness b. Seizures c. Bradyarrhythmia d. Polyuria

35. c Lidocaine diminishes nerve conduction; when given as an IV bolus, it may slow nerve conduction through the heart and cause bradyarrhythmia.

36. Which of these opioids is an agonist/antagonist? a. Oxymorphone b. Meperidine c. Butorphanol d. Fentanyl

36. c Butorphanol is used alone and can be used to reverse the depressant effects of other opioid drugs.

37. Acepromazine maleate causes a. Respiratory depression b. Tachycardia c. Hypotension d. Reduced salivation

37. c Acepromazine is a phenothiazine derivative that has the effect of vasodilation; therefore the blood pressure falls, resulting in hypotension.

38. What is the ratio between the toxic dose and therapeutic dose of a drug used as a measure of the relative safety of the drug for a particular treatment? a. Toxic index b. LD50 c. ED50 d. Therapeutic index

38. d

39. Aspirin may be safely used in cats as an NSAID, but it should be noted that its half-life in this species approximates a. 2 hours b. 8 hours c. 15 hours d. 30 hours

39. d Aspirin has a long half-life in cats, 30 hours, because it is excreted by the liver (albeit slowly).

81. The most common side effect of drugs that cause vasodilation is a. Cardiac arrhythmias b. Anorexia, vomiting, and diarrhea c. Hypotension d. Bradycardia

81. c Vasodilators relax blood vessels, allowing blood to flow more freely out of the congested heart. Because these vascular walls dilate, the pressure of the blood within may drop, resulting in hypotension.

92. Glucocorticoids have different durations of activity, a fact that plays an important role in their risk of side effects with long-term use. Which of the following glucocorticoids has the shortest duration of activity? a. Hydrocortisone b. Prednisone c. Dexamethasone d. Triamcinolone

92. a

4. You are asked to administer a drug that is supplied as an enteric-coated tablet at 100 mg, 50 mg, and 25 mg; you require 25 mg but have available 50-mg tablets only. You should a. Use a pill splitter to divide the 100-mg tablet into quarters to have the smallest piece. b. Use a pill splitter to divide the 50-mg tablet into halves to have the most accurate dose. c. Administer the 50-mg tablet but then skip the next scheduled dosing. d. Order or purchase 25-mg tablets for the dosing schedule.

4. d Sustained-release and enteric-coated medicines should not be divided, because they are meant to dissolve at a specified rate and in a uniform manner; this dissolution is dependent on the outer surface of the tablet being intact.

40. Which statement is most accurate pertaining to insect growth regulators? a. They prevent the female from laying eggs. b. They effectively kill all adult stages. c. They are insecticidal with very low risk of toxic effects in mammals. d. They are neurotoxic to mammals.

40. c Insect growth regulators (IGRs) affect immature stages and are generally considered safe.

41. What drug is approved for the treatment of old dog dementia? a. Clomicalm b. Metacam c. Diazepam d. Anipryl

41. d Anipryl administration allows dopamine levels to increase; reduced dopamine levels are associated with canine cognitive dysfunction.

42. What is not a short-term effect of corticosteroid therapy? a. Polyuria b. Polyphagia c. Delayed healing d. Osteoporosis

42. d Osteoporosis is a long-term effect.

43. A common side effect of antihistamine drugs such as diphenhydramine is a. Polyuria b. Sedation c. Pruritus d. Panting

43. b Mild sedation or drowsiness is a common side effect of most antihistamine drugs.

44. The H2 receptors are found in the a. Gastric mucosa b. Saliva c. Carotid arteries d. Aortic arch

44. a

45. Thiobarbiturates should be administered with great care or not at all to a. Collies b. Greyhounds c. Rottweilers d. Spaniels

45. b Sight hounds such as greyhounds, have minimal fat, so the thiobarbiturates will remain in the circulation at high concentrations.

46. What drug is contraindicated in the treatment of glaucoma? a. Atropine sulfate b. Carbachol c. Miotics d. Pilocarpine

46. a Atropine is a mydriatic and cycloplegic and is used to facilitate examination of the eye.

47. A chronotropic agent affects the a. Force of a contraction b. Rate of a contraction c. Rhythm of a contraction d. Rate of relaxation

47. b Chronotropic relates to rate; inotropic relates to force.

48. Puppies born via cesarean section that are not breathing well may benefit from __ drops administered sublingually. a. Dobutamine b. Digitalis c. Doxapram d. Diazepam

48. c Doxapram is a respiratory stimulant.

49. Parenteral administration of phenylbutazone should be via __ only. a. Subcutaneous injection b. Intramuscular injection c. Subcutaneous or intramuscular injection d. Intravenous injection

49. d Subcutaneous and intramuscular injections may lead to sloughing of tissue.

93. Which of the following statements about glucocorticoids is true? a. If adverse effects are seen after long-term administration, treatment should be discontinued immediately. b. They are generally considered safer to use than NSAIDs. c. They are a type of NSAID.

93. d Glucocorticoids may cause immune suppression.

94. What drug is not an NSAID? a. Prednisone b. Flunixin c. Phenylbutazone d. Aspirin

94. a Prednisone is a steroid drug of the glucocorticoid type.

56. When a drug is said to have a narrow therapeutic range, it means that a. Its effective and toxic doses are close to each other. b. It may be used for treatment of a few disorders only. c. It must be dosed frequently. d. It must be given in greater concentrations to be effective.

56. a Therapeutic range is the plasma concentration of drug considered to provide the most beneficial results. If this range is narrow, the difference between a therapeutic dose and a potentially toxic dose is very small.

57. The regulatory agency that oversees the development and approval of animal topical pesticides is the a. FDA b. EPA c. USDA d. DEA

57. b The Environmental Protection Agency (EPA) is the regulatory agency that oversees the development and approval of animal topical pesticides, and the Food and Drug Administration (FDA) oversees the development and approval of new animal drugs and feed additives. The United States Department of Agriculture (USDA) regulates the development and approval of vaccines and sera. The Drug Enforcement Administration (DEA) strictly enforces the regulations for the prescribing, handling, and storing of controlled substances.

58. A drug that has extreme potential for abuse and no approved medicinal purpose in the United States is classified as a. C-I b. C-II c. C-IV d. C-V

58. a

5. A prescription reads "2 tab q4h po prn until gone." The translation of these instructions is a. Two tablets are to be taken four times per day for pain until all tablets are gone. b. Two tablets are to be taken four times per day under supervision by the veterinarian until all tablets are gone. c. Two tablets are to be taken every 4 hours with food and water until all tablets are gone. d. Two tablets are to be taken every 4 hours by mouth as needed until all tablets are gone.

5. d Sig, instructions; q4h, every 4 hours; po, by mouth; and prn, as needed.

50. Intradermal injections are used primarily for a. Insulin injections b. Antibiotic injections c. Vaccinations d. Allergy testing

50. d

51. Most biotransformation of drugs occurs in the a. Liver b. Kidney c. Lungs d. Spleen

51. a Biotransformation, or drug metabolism, is the altering of a drug before its elimination from the body. The liver is the primary organ involved in biotransformation.

52. The main reason that generic forms of drugs are less expensive than trademark name drugs is because generic brands a. Use less expensive ingredients b. Are not advertised heavily c. Do not incur the expense of developing a new drug d. Do not work as well as trademark name drugs

52. c The federal government requires rigorous testing of any new animal health product before its marketing. This is a very time-consuming and expensive process, taking anywhere from 7 to 10 years at a cost ranging from $15 to $20 million. Generic drugs are often chemically identical to trademark name drugs.

53. Repository forms of parenteral drugs a. Contain a special coating that protects the drug from the harsh, acidic environment of the stomach b. Are formulated to prolong absorption of the drug from the site of administration c. Are composed of specially prepared plant or animal parts rather than being manufactured from chemicals d. Are extremely irritating to the tissues

53. b Repository forms of injectable drugs are not necessarily irritating to tissues and are formulated specifically to prolong absorption from the site of administration. Enteric coatings protect drugs from the acidic environment of the stomach.

54. All of the following organs may facilitate the elimination of drugs except the a. Kidneys b. Liver c. Lungs d. Spleen

54. d The two major routes of drug elimination are via the kidney into the urine and via the liver into the bile and subsequently into the feces. Certain drugs, for example, inhalant anesthetics, are mostly eliminated via the lungs.

55. What liquid form of drug is most commonly administered intravenously? a. Emulsion b. Solution c. Suspension d. Elixir

55. b Drugs administered intravenously are generally clear, rather than cloudy or thick, and they contain suspended particles. Elixirs are intended for oral administration.

6. Ten milliliters of a 2.5% solution of thiopentone contains a. 250 mg of thiopentone b. 25 mg of thiopentone c. 100 mg of thiopentone d. 2.5 mg of thiopentone

6. a 2.5% = 25 mg/ml; therefore in 10 ml there is 250 mg of thiopentone.

60. Which of these drugs is not an antifungal drug? a. Griseofulvin (Fulvicin) b. Clotrimazole (Otomax) c. Ketoconazole (Nizoral) d. Sulfadimethoxine (Albon)

60. d Albon is a coccidiostat and antibacterial drug. All other drugs listed have antifungal activity.

61. An example of an antibiotic that is considered to be a β-lactamase inhibitor is a. Amoxicillin b. Clavamox c. Tetracycline d. Penicillin

61. b Clavulanic acid is added to penicillin drugs such as amoxicillin, producing a potentiated compound. This combination drug is active against a wider spectrum of bacteria, including those that produce enzymes called β-lactamase, which attack and break down penicillin's β-lactam ring, rendering it inactive.

62. In what class of antibiotic drugs are nephrotoxicity and ototoxicity potential side effects? a. Barbiturates b. Aminoglycosides c. Phenothiazine tranquilizers d. Dissociative anesthetics

62. b The aminoglycoside group of antibiotics is successfully used in the treatment of severe bacterial infections, although a great deal of care must be taken because of their potential to cause serious side effects.

63. The best means of assuring that a particular antibiotic treatment will be successful is to a. Treat for no less than a full 2-week course. b. Collect a sample from the infected area for culture and sensitivity. c. Use the highest dose that is considered nontoxic. d. Use a broad-spectrum antibiotic.

63. b By collecting a sample for bacterial culture and sensitivity and sending it to the laboratory, a veterinarian will be able to determine the causative agent for the infection, as well as the specific antibiotics that will be most successful in eradicating that infection.

64. Dr. Blackman prescribed a particular antibiotic for a rabbit with a Pasteurella infection and asked you to educate the client regarding special instructions for administration of the drug. You told the client that she should wear gloves when handling this medication, because it has been associated with a rare adverse reaction in humans: aplastic anemia. Based on this information, the drug that you dispensed was most likely a. Gentamicin b. Tetracycline c. Erythromycin d. Chloramphenicol

64. d Chloramphenicol is a broad-spectrum antibiotic often used for the treatment of infections in rabbits and pocket pets, because penicillins and cephalosporins are potentially toxic in these species. Chloramphenicol has been found to cause myelosuppression in mammals, including humans, resulting in nonregenerative anemia and leukopenia. Care must be taken in handling this drug to minimize repeated contact with or inhalation of the powder.

65. The term anaphylaxis refers to a. A severe, life-threatening hypersensitivity reaction b. The development of resistance to a particular antimicrobial drug c. The disruption of bacteria's normal metabolic activity, causing cell death d. Bacterial cell death as a result of impaired production of nucleic acids

65. a Anaphylactic reactions may occur in response to a variety of substances, including drugs, vaccines, diagnostic agents such as radiographic contrast media, protein foods, and insect venom.

66. A very useful group of broad-spectrum drugs, whose popularity has more recently declined because of numerous potential side effects, including keratoconjunctivitis sicca, polyarthritis (especially in Doberman pinschers), hematuria, photosensitivity, and hypothyroidism, is the a. Sulfonamides b. Macrolides c. Tetracyclines d. Fluoroquinolones

66. a Sulfonamides—including Tribrissen, Primor, and Albon—are still often used for treatment of infections, although it is important that veterinary professionals be able to recognize the potentially serious side effects of these drugs.

67. Which of the following statements about tetracyclines is true? a. Tetracyclines are bacteriocidal. b. Oral absorption of tetracyclines is increased in the presence of food. c. Tetracyclines are potentially nephrotoxic and ototoxic. d. Tetracyclines may lead to bone or teeth problems if given to young animals.

67. d

68. A 50-lb dog is to be given 1 mg/kg dose of diazepam. How many milligrams will he be given? a. 50 mg b. 22.7 mg c. 500 mg d. 2.27 mg

68. b

69. Amoxicillin (Amoxi-Drop) was prescribed for Tallulah, a 4-year-old female Chihuahua, who was being discharged after a hospitalization. Dr. Segal asks you to give her owner discharge instructions. You advise the client of all of the following except a. She should call if she notices any adverse side effects as a result of the medication. b. She should complete all the medication dispensed, even if Tallulah is feeling well and her symptoms have resolved. c. She should administer the medication on an empty stomach. d. The medication should be refrigerated.

69. c Although the bioavailability of most penicillins is decreased in the presence of food, amoxicillin is an exception to this rule and need not be administered on an empty stomach.

7. The percentage of the total dose that ultimately reaches the bloodstream is called a. Absorption b. Distribution c. Bioavailability d. Clearance

7. c Bioavailability is the percentage of administered drug that gains access to the systemic circulation

70. Antimicrobial drugs like enrofloxacin (Baytril), marbofloxacin (Zeniquin), and orbifloxacin (Orbax) all belong to which group of antibiotics? a. Penicillins b. Cephalosporins c. Fluoroquinolones d. Aminoglycosides

70. c

71. Which of the following drugs is least likely to kill the normal flora in the gut of a rabbit, causing severe diarrhea? a. Sulfonamide (Tribrissen) b. Amoxicillin with clavulanic acid (Clavamox) c. Cephalothin (Keflin) d. Enrofloxacin

71. d Enrofloxacin is commonly used in pocket pets, because it is not active against the anaerobic flora of the gut.

72. Guaifenesin is an example of a(n) a. Expectorant b. Antitussive c. Bronchodilator d. Mucolytic agent

72. a Guaifenesin is also administered intravenously for muscle relaxation in equine anesthesia.

73. Which of these drugs is available over the counter as an antitussive? a. Codeine b. Dextromethorphan c. Hydrocodone d. Butorphanol

73. b Dextromethorphan is generally not as effective as prescription antitussives.

80. Epinephrine a. Increases the heart rate b. Decreases the heart rate c. Decreases the blood pressure d. Should be used to reverse the effects of acepromazine

80. a Epinephrine or adrenalin is an adrenergic (sympathomimetic) agent that stimulates all receptors to cause an increase in heart rate and cardiac output.

74. Dr. Charles is performing a C-section on Sadie, a 3-year-old Dalmatian. The smallest pup was not breathing spontaneously, so the doctor asked you give the following respiratory stimulant. a. Theophylline (Theo-Dur) b. Albuterol c. Doxapram HCl (Dopram) d. Terbutaline

74. c Acute respiratory failure is generally best managed by intubation and mechanical support of respiration. In certain instances, however, it may be desirable to stimulate respiration with drugs. One indication for use of a respiratory stimulant drug is when the respiratory efforts of neonates are adversely affected by general anesthesia of the bitch during cesarean section.

75. Butorphanol tartrate is an example of a drug that functions on more than one body system. It is both an a. Antitussive and narcotic analgesic b. Expectorant and narcotic analgesic c. Analgesic and expectorant d. Analgesic and barbiturate

75. a Butorphanol is a narcotic analgesic drug used in preanesthetic protocols and to control pain, as well as an antitussive.

76. The type of drug that would be most helpful for a patient with a productive cough is a. Antitussive b. Antihistamine c. Expectorant d. Analgesic

76. c An expectorant helps loosen phlegm and thin bronchial secretions associated with a cough that is producing mucus. It is best not to suppress a productive cough with an antitussive, because coughing helps the body clear its airways.

77. The anticoagulant diluted in saline or sterile water for injection to form a flush solution for preventing blood clots in intravenous catheters is a. Heparin b. EDTA c. Coumarin d. Acid citrate dextrose (ACD)

77. a

78. Sox, a 10-year-old M/C Siamese X, was brought to the emergency hospital, crying in pain and unable to walk. He was diagnosed with an arterial thromboembolism secondary to cardiomyopathy. The treatment for this condition is a(n) a. Hematinic drug b. Anticoagulant drug c. Hemostatic drug d. Fibrinolytic drug

78. d Fibrinolysis is the dissolution of a fibrin clot or thromboembolus. The fibrinolytic drug used most often in the treatment of thromboembolism is streptokinase.

79. The diuretic drug used most commonly in patients with congestive heart failure is a. Mannitol b. Spironolactone c. Chlorothiazide d. Furosemide

79. d By definition, congestive heart failure involves fluid congestion or accumulation in the body. This usually occurs in the abdominal cavity in the form of ascites or in the thoracic cavity or lungs in the form of pulmonary edema. Diuretics are indicated to rid the body of this excess fluid. Furosemide (Lasix) is the treatment of choice in both the acute and chronic forms of cardiac failure.

8. Cholinergic agents do all of the following except a. Slow heart rate b. Increase blood flow to intestinal tract c. Decrease diameter of bronchioles d. Cause peripheral vasodilation

8. d Cholinergic agents mimic the effects of the parasympathetic nervous system; sometimes it is referred to as the "rest and restore" system; it has minimal effect on peripheral vessels.

82. Cosmo, an 11-year-old M/C pug, has recently been diagnosed with mitral insufficiency and was referred to a veterinary cardiologist. The specialist decided to initiate treatment with digoxin, a positive inotrope and negative chronotrope. This means that it a. Increases the blood pressure and decreases the cardiac output b. Increases the peripheral vascular resistance and decreases the cardiac output c. Increases the force of contraction and decreases the heart rate d. Increases the heart rate and decreases the blood pressure

82. c Inotropy is the force of cardiac contraction, and chronotropy is the frequency of cardiac contraction.

83. Scooter, a 13-year-old miniature schnauzer, has arrested under anesthesia for routine dentistry. You run to the crash cart and grab what you know to be the drug of choice for cardiac arrest, which is a. Epinephrine b. Lidocaine c. Digoxin d. Dobutamine

83. a Epinephrine is the initial drug of choice for treating bronchoconstriction and hypotension resulting from anaphylaxis, as well as all forms of cardiac arrest.

84. A 3-month-old chow chow is presented to the pet emergency clinic because it has eaten a box of warfarin-based rat poison. Which of the following would be most useful to treat this toxicity? a. Protamine sulfate b. Coumarin c. Streptokinase d. Vitamin K

84. d Warfarin is an oral anticoagulant that binds vitamin K and is used in many rodenticides. Vitamin K is essential in the synthesis of several clotting factors, and so the management of this toxicity involves the administration of vitamin K.

85. Which of the following statements about drugs used for cancer chemotherapy is true? a. They are usually given by mouth. b. They usually have relatively low margins of safety. c. They are available over the counter. d. They are all nephrotoxic.

85. b Chemotherapeutic agents usually have low margins of safety; consequently, doses must be calculated with care, and treatment must be closely monitored.

86. Which of the following side effects is commonly seen with many cancer chemotherapeutic drugs? a. Hyperglycemia b. Immunosuppression c. Constipation d. Hyperphagia

86. b Most cancer chemotherapeutic drugs suppress components of the immune system.

87. Which of the following would be the least common side effect expected with common cancer chemotherapeutic drugs? a. Myelosuppression b. Vomiting and diarrhea c. Pruritus d. Alopecia

87. c Antineoplastic compounds produce characteristic toxicity to various body tissues that are related to tissue growth rate. Lymphocytes and bone marrow cells are most profoundly affected, followed by the mucosal cells of the gastrointestinal tract and cells of the hair follicles. Pruritus is a less frequently anticipated side effect of chemotherapy.

88. Common drugs of plant origin, such as digoxin and atropine, are ineffective in a cow when administered orally because of a. Eructation b. The large size of the rumen c. Methane gas d. Digestive microorganisms

88. d Drugs of plant origin may be inactivated by the digestive microorganisms in the rumen.

89. Which of these tissues is not a normal site for drugs to accumulate to be released later, thereby prolonging the effect of the drug? a. Pancreas b. Fat c. Muscle d. Liver

89. a

9. The nonsteroidal antiinflammatory drug (NSAID) that is extremely toxic to cats is a. Aspirin b. Acetaminophen c. Carprofen d. Flunixin

9. b Administration of even small doses of acetaminophen (Tylenol) to cats may be fatal.

90. Chronic use of moderate-to-high doses of glucocorticoids may result in the development of a. Addisons disease b. Cushings disease c. Diabetes mellitus d. Insulinoma

90. b High levels of glucocorticoids cause Cushings disease. When the glucocorticoids are exogenous, the disease is called iatrogenic.

91. Glucocorticoids are often used in veterinary medicine for treatment of all of the following conditions except a. Allergies b. Musculoskeletal problems c. Infections d. Immune-mediated disease

91. c Glucocorticoids are contraindicated in patients with infections, because they are potentially immune-suppressive.

95. Two relatively new NSAIDs used frequently in dogs for the relief of pain and inflammation, especially those associated with osteoarthritis, are a. Meclofenamic acid (Arquel) and dimethyl sulfoxide (DMSO) b. Orgotein (superoxide dismutase) and phenylbutazone c. Carprofen (Rimadyl) and etodolac (EtoGesic) d. Dipyrone and acetaminophen (Tylenol)

95. c Carprofen and etodolac selectively target inhibition of the enzyme cyclooxygenase-2 (COX-2), thereby reducing inflammation without blocking the prostaglandins associated with protection of the gastrointestinal tract and renal vascularity and blood flow.

96. Flunixin meglumine (Banamine) is an NSAID most commonly used a. In dogs for the treatment of chronic osteoarthritis b. In horses for treatment of colic c. In horses for reducing fever d. In dogs for its anticoagulant activity

96. b Flunixin meglumine is primarily used in equine patients with colic for its antiinflammatory, analgesic, and antiendotoxin effects.

97. The species that generally clears NSAIDs most slowly is a. Dog b. Cat c. Horse d. Ruminant

97. b Most NSAIDs have a long half-life in cats compared to other species.

98. What NSAID is administered to cats with a dosing interval of 2 days or more? a. Aspirin b. Ibuprofen (Advil) c. Carprofen (Rimadyl) d. Naproxen (Naprosyn)

98. a Cats are deficient in the liver enzyme glucuronyl transferase and thus metabolize aspirin very slowly.

99. The most common side effect of NSAIDs is a. Polyuria b. Gastrointestinal ulceration c. Diarrhea d. Constipation

99. b Most NSAIDs inhibit the enzyme cyclooxygenase, which leads to a reduction in the synthesis of both inflammatory prostaglandins and those prostaglandins that act to protect the mucosa of the gastrointestinal tract.