Skin acts as a barrier 

TWO compartment system - osmotic gradient flow 

Electrical characteristics 

Skin factors: hydration, physical damage, anatomic site, skin metabolism 

Mixture of a hydrophobic and hydrophilic agent

these would not normally mixed and this is done by an emulsifying agent

Sodium lauryl sulfate (ionic) 

polysorbates, sorbitan esters (nonionic) 

This are not inert - can have adverse effects 

Glucocorticoids are absorbed when applied topically.

True or false?

VASODILATION - increased dermal blood flow!

Can be done by adding heat

you need to hydrate the skin by COVERING IT 

occlusive bath oils 

Which would penetrate the skin best:

A) Lotion 

B) Ointment 

C) Cream 

D) Rinse

B) Ointment 

these are the most lipid based products so can penetrate the skin the most

Genetic (familial) 

Environmental factors 

- physical factors (radiation)

- Biological factors (infectious agents) 

Hormones (women are screwed!) 

Gastroenteritis 

Gingival hyperplasia 

nephrotoxicosis 

Papillomatosis 

Hepatoxicosis 

Side effects of drug treatments 

TREAT AGGRESSIVELY!!

When old lesions have healed and no lesions have developed. 

Then switch the drug with the most side effects to every other day - usually prednisone

-Concentration and solubility of the drug in the carrier

-Concentration of drug in barrier 

-Diffusion coefficient (movement across gradient)

-pH

A dispersion of hydrophilic and hydrophobic

unstable and will separate without emulsifying agent 

Surfactants

Sodium lauryl sulfate (ionic) 

Polysorbates, sorbitan esters (non ionic)

Increased blood flow (heat) increases absorption 

Vasoconstriction - decreases absorption

What is the purpose of using a wet dressing?

- hydrate the skin 

- debride necrotic or devitalize tissue

*replaced with hydrotherapy

Rinses are medications in a water soluble form. Both rinses and shampoos deliver medication to the skin, but rinses are applied with a sponge/poured on and left to dry on the coat. Shampoos must be throughly rinsed off. 

Rinses also require pre-bathing.

Promote drying 

most commonly contain talc or starches

Animals have fur 

animals like to lick topical medications off

Client compliance 

Many derm problems are diffuse/multifocal 

 Which one of the statements below is most UNTRUE about the spectrum of action of albendazole?

a.       Albendazole can be effective against adult parasitic nematodes

b.      Albendazole can be effective against adult fluke

c.       Albendazole can be effective against adult heartworm

d.      Albendazole can be effective against hypobiotic (encysted) larvae

  Which one of the following antinematodal drugs causes hyperpolarization of the postsynaptic membrane of  neurons or muscles of the nematode parasite, causing paralysis?

a.       Pyrantel

b.      Levamisole

c.       Ivermectin

d.      Dichlorvos

e.      Albendazole 

Answer: C) Ivermectin (Avermectin)

target s GluCls on the nematode nerve and pharyngeal muscle - causing paralysis and immobilization

   Which one of the following antinematodal drugs could cause liver toxicity and bone marrow depression if used in dogs?

a.       Pyrantel

b.      Biperazine

c.       Moxidectin

d.      Ivermectin

e.      Albendazole 

        For the administration of fenbendazole as a nematocide to a dog, which one of the procedures is most correct?

a.       Administer once after a full meal

b.      Administer 3 times over 5 days after full meals

c.       Administer once on an empty stomach

d.      Administer 3 times over 5 days on an empty stomach 

       Despite the fact that ivermectin is usually a very safe drug, overdose of this drug can cause:

a.       Aplastic anemia

b.      Abortion during late pregnancy

c.       CNS depression

d.      Jaundice

e.      Ventricular fibrillation

      Which one of the following statements regarding the mechanism of action of the antiparasitic is FALSE?

a.       Emodepside – activation of lactrophillin receptors

b.      Levamisole – activation of nicotinic receptors

c.       Oxfendazole – inhibition of microtubule formulation

d.      Piperazine – activation of glutamate-gated chloride channels 

Answer: piperazine - which is a GABA receptor agonist

(GluCl channels are acted on by ivermectin) 

         Which one of the following benzimidazoles nematocides is used in dogs?

a.       Albendazole

b.      Febantel

c.       Oxibendazole

d.  Thiabendazole

Answer: Febantel 

This is a what is in DRONTAL!!

      Which one of the following drugs, at the clinical doses, is LEAST effective against canine whipworms (Trichuris vulpis) ?

a.       Febendazole

b.      Milbemycin

c.       Pyrantel 

Answer: C) Pyrantel (cholinergic agonist) 

Pyrantel is only effective against ascarids (tapeworms) and hookworms but NOT WHIPS in cats and dogs 

===strongid t 

(horses- strongyles, ascarids, pinworms

pigs - ascarids, nodular worms, stomach worms) 

      Which one of the following statements about praziquantel is most TRUE ?

a.       Praziquantel selectively activates nicotinic receptor channels of cestodes

b.      Espsiprantel is better absorbed than praziquantel

c.       Praziquantel does not have activity against hydatid cysts

d.      Praziquantel is teratogenic 

C) no activity against hydatid cysts (or ova)

(in drontal plus) 

it is not teratogenic (which is why you can deworm bitches with drontal plus before whelping) 

- works against calcium channels (binds to Beta subunit) inhibits movement and digestion

      Which one of the following compounds is NOT recognized for its activity against cestodes?

a.       Pyrantel

b.      Doramectin

c.       Dichlorophene

d.      Albendazole 

Answer: DORAMECTIN not effective against tapeworms

it is effective against roundworms, lungworms, grubs sucking lice, microfilaria

cestodes= tapeworms

pyrantel - tapes, hooks, pinworms, nodular worms, stomach worms

Dichlorophene is effective against cestodes 

albendazole is effective against roundworms, tapeworms, and flukes

      Which of the following statements is MOST CORRECT?

a.       Clorsulon is more effect against immature F. hepatica than mature F. hepatica

b.      Clorsulon is more effect against mature F. hepatica then immature F. hepatica

c.       Clorsulon is effective against immature F. hepatica and mature F. hepatica

d.      Clorsulon is combined in a single preparation with moxidectin to treat nematodes 

      Which one of the following statements is MOST TRUE when referring to anthelmintic resistance?

a.       Anthelmintic resistance is present id there is less than 95% reduction in fecal egg counts following anthelmintic treatement

b.      Cross-resistance occurs between albendazole and ivermectin

c.       Ivermectin resistance can be overcome by increasing the dose of the anthelmintic

d.      Benzimidazole resistance is not widespread in cyanthostomes of horses 

   What is the meaning of the term REFUGIA?

a.       Refugia is the cellulose in the diet that inhibits the growth of nematode parasites

b.      Refugia are host animals carrying resistant nematode parasites

c.       Refugia are host animals carrying sensitive nematode patasites

d.      Refugia are a group of sensitive nematode parasites in a protected environment that are not exposed during anthelmintic treatment 

  Which one of the following actions does not reduce the development of anthelmintic resistance?

a.       Use of mixed species grazing

b.      Use of planned and timed anthelmintic doses and management to reduce the survival of free living resistant stages in the environment

c.       Removal of feces on horse paddocks

d.      Use of anthelmintic drugs with long half-lives 

Todlophophamide intravenously over 5 minutes to a 35 lbs female spayed wheaten terrier with multicentric lymphoma. Which one of the following is a potential adverse drug reaction to cyclophosphamide?

a.       Neutropenia

b.      Diarrhea

c.       Anemia

d.      Hemorrhagic cystitis

e.      Thrombocytopenia 

      Which one of the following drugs causes fatal pulmonary toxicity when administered to cats at therapeutic doses?

a.       Cisplatin

b.      Prednisone

c.       Cyclophosphamide

d.      Doxorubicin

e.      Vincristine

Answer: A) Cisplatin 

No beuno en el gato

    Which one of the following drugs causes dose-dependent cardiotoxicity when given to dogs?

a.       5-fluorouracil

b.      Doxorubicin

c.       Cisplatin

d.      Cyclophosphamide

                  e.     Vincristine 

Answer: B) Doxorubricin 

 A 6-year-old neutered female Scottish terrier has Clinical stage III lymphoma. You treated her with a cyclophosphamide intravenously last week, but her lymph node decreased in size about 15%. You would like to treat her today with another cytotoxic drug. However, her neutrophil count is low. Her physical examination is otherwise normal including biochem panel, except enlarged lymph nodes. Which one of the following drugs could be used to treat her safely without further decreasing her neutrophil count?

a.       Cyclophosphamide

b.      L-asparaginase

c.       Doxorubricin

d.      Cisplatin

e.      5-fluorouracil 

Answer: B) L-asparaginase - which is not myelosupressive unless you combine it with vancristine 

this is actually one of the safer drugs - can cause pancreatitis, hypersensitivity or hemorrhagic (which is rare) 

    If administered outside of the vein (perivascularly), which one of the following drugs causes severe tissue necrosis resulting in a skin slough?

 a.       Cisplatin

b.      Vincristine

c.       5-fluorouracil

d.      Dexamethasone

e.      Cyclophosphamide

      Which one of the following statements is FALSE about cancer chemotherapy?

a.       Most chemotherapeutic agents used to treat oncology patients kill normal and neoplastic cells by interrupting the cell cycle either directly or indirectly

b.      Theoretically, a tumor is usually clinically apparent when it is 1 cm³ volume or has undergone about 30 doublings

c.       Most tumor cells are susceptible to the cell killing effects of chemotherapy when the tumor is 2 cm³

d.      Cancer cells are most vulnerable to the cytotoxic effects of chemotherapeutic agents during the period of exponential growth

e.      Hair loss is uncommon in cats and dogs treated with chemotherapeutic agents

      A semi-solid preparation that is considered occlusive and consists of an oil-solid mixed with an oil base, is:

a.       A gel

b.      A cream

c.       A lotion

d.      A paste

e.      An ointment 

answer: E) OINTMENT 

NOT GEL - gel is alcohol based and non occulsive, where ointment is OIL (OIntment) based and occulsive 

    Emollients are hydrating agents that increase cutaneous water content by:

a.       Attracting water into the skin by osmotic mechanisms

b.      Acting as occlusive agents that reduce water evaporation from the skin

c.       Acting as hygroscopic agents that chemically bind water to keratinocytes

d.      Removing lipids that block water movement into the skin

e.      Restoring natural moisturizing agents, such as cerumides, in the skin 

      Which one of the following shampoo ingredients has strong degreasing properties and has anti-yeast activity (with minimal antibacterial properties)?

a.       Selenium sulfide

b.      Coal tar

c.       Salicyclic acid

d.      Benzoyl peroxide

e.      Sulfur 

Answer:A) Selenium sulfide - the wonder solution!!!

it is: Antifungal (esp Malassezia), degreaser, keratolytic and has some antibacterial 

      The most important consideration to reduce serious, long-term, adverse effect of glucocorticoid therapy for autoimmune disease is:

a.       The choice between prednisone and prednisolone

b.      Dropping the daily dose of prednisone/prednisolone to levels below “immunosuppressive” doses

c.       Concurrent administration of H2 blockers and GI protectants

d.      Use of non-flourinated glucocorticoids

e.      Switching the dose to alternate days as soon as possible 

    The drug listed below that is an antimetabolite used commonly in conjunction with something to treat auto immune skin diseases in the dog, is:

a.       Cyclosphosphamide

b.      Chlorambucil

c.       Prednisone

d.      Cyclosporine

e.      Azathioprine

Answer: E) Azathioprine 

seriously the only thing he said to know about azathioprine is that it is the only anti-metabolite 

      Which of the following drugs is primarily used topically (for management of perianal fistulas or discoid lupus) and works by blocking cytokine (IL 2)

a.       Prednisolone

b.      Cyclosporine

c.       Tacrolimus

d.      Azothiaprine

e.      Niacinamide

Answer: Tacrolimus - inhibits IL2 and blocks T cells 

much more potent than cyclosporine 

=inhibits macrophage activation

(applied topically = wear gloves) 

      Which one of the following anticoccidial drugs is the best choice for treating the sulfonamide-resistant coccidian outbreak in animals?

a.       Ponazuril

b.      Monensin

c.       Decoquinate

d.      Amprolium

      The use of all the following anticoccidial drugs does not require a preslaughter withdrawal period when used in food animals except:

a.       Amprolim

b.      Decoquinate

c.       Lasalocid

d.      Sulfadimethoxine

     Toxic effects of monensin in mammals include:

a.       Asphyxia

b.      Cardiomyopathy

c.       Hepatotoxicity

d.      Nephrotoxicity

e.      Teratogenicity 

Answer: B) cardiomyopathy 

degeration of myocardium from increase contractility 

      The following drugs have been used or have been suggested for the treatment of cryptosporidiosis except:

a.       Azithromycin

b.      Metronidazole

c.       Nitazoxanide

d.      Paromomycin 

      The following drugs have be used or been suggested for the treatment of giardia except:

a.       Fenbendazole

b.      Metronidazole

c.       Sulfadimethoxine 

     Which of the following antiprotozoal drugs is well known for its stimulatory effects of the parasympathetic nervous system due to its anti-cholinesterase activity?

a.       Ponazuril

b.      Paromomycin

c.       Ormetoprim

d.      Monensin

e.      Imidocarb 

Answer: E) imidocarb - used for babesia because it binds to its DNA and denatures it. It decreases AChE so it can cause SLUDD<- use atropine to reverse 

no cholinergic stimulants!! can be teratogenic and carcinogenic, irriatating and painful

    Which of the following ectoparasiticides may most likely cause CNS depression, bradycardia, and GI stasis in animals?

a.       Amitraz

b.      Fipronil

c.       Ivermectin

d.      Permethrin

e.      Rotenone

Answer: A) Amitraz

Octopamine receptor agonist- HAS Alpha2 agonism!!!! 

Causes CNS depression, bradycardia, GI stasis-> colic

treats demodex, mites, ticks

      The following are nicotinic receptor agonists that are used as flea adulticides. At the clinical doses, which one of them has the shortest duration of action?

a.       Dinotefuran

b.      Imidacloprid

c.       Nitenpyram

d.      Spnosad 

Answer: C) Nitenpyram (nicotinic R agonist) 

This is CAPSTAR - which is awesome, safe, fast but really SUPER short acting (like 24-48 hours max for flea killing) 

    Which of the following is a true statement about cholinesterase inhibitors as ectoparasiticides?

a.       Cattle are more resistant to organophosphate poisoning than swine

b.      Pralidoxime (2-PAM) is still effective in reactivating cholinesterase 48 hours after onset of organophosphate poisoning

c.       When using 2-PAM, it always has to be administered concurrently with atropine sulfate

d.      2-PAM is a useful antidote for both carbamate and organophosphate poisonings

Answer: C) give 2-pam with atropine sulfate 

Organophosphates are anti-cholinesterase agents, can cause SLUDD. Reverse with atropine and AChE reactivator pralidoxime (2-pam)

= use this within 24 hours of exposure to organophosphate

      Which of the following is a correct statement regarding ectoparasiticides?

a.       Macrocyclic lactones have knockdown effects on arthropods

b.      Amitraz is an approved miticide for horses

c.       Thio-organophosphates directly and potently inhibit cholinesterases

d.      Piperonyl butoxide increases the activity of a pyrethroid by inhibiting its degradation

      Which of the following anti-flea products also is effective against ticks?

a.       Fipronil

b.      Imidacloprid

c.       Lufenuron

d.      Metaflumizone

e.      Methoprene

Answer: Fipronil 

FRONTLINE baby

      Which of the following should not be used concurrently with metaflumazone?

a.       Amitraz

b.      Ivermectin

c.       Lufenuron

d.      Permethrin

e.      Pyriproxyfen 

Answer: 

Metaflumizone is a Na+ channel blocker, shouldn't be used with permethrin because it is an AGONIST of Na+ channels

    Which of the following is a true statement regarding the use of alkalinizing and acidifying agents to treat acid-base disturbances?

a.       Na acetate can only form HCO3- in the liver, whereas Na lactate can form in liver and skeletal muscle

b.      NH4Cl acidifies the body by releaseing HCl from NH4Cl

c.       Na gluconate may induce vomiting in dogs and cats

d.      NaCl acidifies the body by decreasing HCO3- reabsorption from the renal tubules 

      Which of the following should serve as the most appropriate plasma expander, if homologous plasma is not available?

a.       Plasma from another species

b.      Lactated ringers solution

c.       6% hetastarch

d.      10% dextran40 

Which of the following is a correct statement regarding route of administration for fluids?

a.       Oral route is practical in animals with severe diarrhea-induced dehydration and acidosis

b.      Intravenous route causes fewer side effects than other routes

c.       Subcutaneous route is the safest for administering >30 mEq/L of KCl if parental administration is necessary

d.      Subcutaneous route is versatile because it can be used for administration of large isotonic, hypertonic, and hypotonic solution

1    How much of a 50% glucose solution would be needed to meet the daily maintenance required for a 25 kg dog?

a.       13 ml

b.      65 ml

c.       130 ml

d.      650 ml

e.      1300ml

Answer: dog needs 1300 Kcal,
glucose = 4g/kcal = 325 g

50g/100ml solution SO =325g

325 X 100 = 32,000/50 = 650 mL

ahhhh..stoichiometry 

Which of the following solutions of sodium gluconate (m.w.= 218) is considered isotonic?

a.       6.6%

b.      3.3%

c.       1.6%

d.      0.8%

e.      0.4%

How would you measure Bicarb to give a 35 kg dog with base deficit of 23 mEq/L?

Body weight X 0.3 X Base deficit 

35 X 0.3 X 23 = 241.5 mEq

BIcarb MW = 84; 

241.5mEq = 1mg/84

(241.5X84) = 20,286mg = 20.3g

      Consider the patient in question 18 (35 kg ) the animal needs rehydration therapy. The ongoing loss of body water was estimated at 500 ml. From what you have learned, the total fluid that should be administered during the first 24 hours is approximately:

a.       1800 ml

b.      2300 ml

c.       3600 ml

d.      5300 ml 

e.  6700 ml

Answer: D) 

Maintanence + Ongoing loss + Deficit

      Which of the following is a true statement regarding fluid therapy?

a.       When using amino acids to induce positive nitrogen balance, one does not need to add glucose to provide calories to the animal

b.      5% dextrose solution is a good choice for supplying calories for total nutritional therapy

c.       Dextran and hetastarch may interfere with fibrin clot formation

d.      Ringers solution contains 147 mEq/L Na+ , 4 mEq/L K+, 151 mEq/L Cl-, and no Ca+

  Which of the following is a true statement regarding hypokalemia ?

a.       In acute hypokalemia, K+ should be administered when the plasma K+ level drops to 3.5 mEq/L

b.      Hypokalemia may be seen in patients with hypoadrenocorticism

c.       ECG lead II recording in a hypokalemia patient may show high T waves

d.      Hypokalemia may induce an increase in myocardial Ca2+ levels 

      Which of the following is a true statement regarding special problems in fluid therapy ?

a.       Severe K+ deficit may be seen in anorectic cattle

b.      In horses, severe hypernatremia is usually associated with dehydration

c.       Metabolic alkalosis is usually associated with grain overload in cattle

d.      Vasoconstriction is usually seen during general anesthesia 

Answer: A) anorexic cattle will have hypokalemia and can cause alkalosis 

this can cause cardiac arrhythmias

      Which of the following is a false statement regarding the administration of hypertonic solution?

a.       Its main use is for resuscitation of animals suffering from shock

b.      It may cause an increase in afterload because it may induce vasoconstriction

c.       It may cause volume overload and edema

d.      It is recommended in patients with blood coagulation problems 

      Which of the following is a false statement regarding the administration of lipid therapy ?

a.       It is not needed unless the animal is on prolonged parental nutrition

b.      Each gram of lipid generates 4 Kcal

c.       The recommended dose is not more than 2 g/kg/day

d.      Dysfunction of granulocytes is an adverse effect of the therapy

e.      It is contraindicated in patients with high plasma concentration of triglycerides 

Answer: B) because each gram of lipid generates 9Kcal

(its glucose that is 4Kcal/g)

   An aqueous solution of an antibiotic is applied to the conjunctiva and cornea. The most significant barrier to its penetration into the anterior chamber is:

a.       The tear-film

b.      Corneal epithelium

c.       Corneal stroma

d.      Corneal endothelium 

      The best choice for topical treatment of one of the sources of pain accompanying a corneal ulcer is:

a.       Pilocarpine

b.      Prednisolone acetate

c.       Atropine

d.  phenylephrine

      In order to treat uveitis (no corneal ulceration) the best topical drug is:

a.       Dexamethasone phosphate

b.      Prednisolone acetate

c.       Flurbuprophen sodium

d. Hydrocortisone sodium

      The two most useful drugs to keep in your exam room to facilitate examination of dogs and cats’ eyes would be:

a.       Acepromazine and lidocaine

b.      Tropicamide and proparacaine

c.       Phenylephrine and atropine

d.      “eye wash” and methylcellulose 

     Which topically applied drug would you treat a cat with high intraocular pressure?

a.       Latanoprost

b.      Dorsolamide

c.       Brinzolamide

d.      Phenylephrine 

      In order to treat keratomalacia (‘melting cornea”) you should chose a topical drug that is :

a.       Antiprotease

b.      Carbonic anhydrase inhibitor

c.       Beta bocker

d.      Cox 2 inhibitor