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What is a drug?
A substance used for diagnosis, treatment, prevention, pain relief, or to control or improve any condition.
What routes can be used for drugs?
ingestion, inhalation, absorbtion, application, injection, or it can be developed within the body such as prednisone, which is converted into a usable drug by the liver.
What year did regulation of drugs begin and why?
1938 -people were experimenting in trying to get sulfa drugs to taste better so that kids would take them.  An elixer was made using diethylene glycol (antifreeze) which tasted sweet and kids liked.  Over 100 deaths were reported and new regulations were put into place to require testing, etc.
What government body regulates drugs?
The FDA, the USDA, and the EPA.
Is off-label drug usage legal?  Why is it done?
It was made legal by the AMDUCA (Animal Medical Drug Use Clarificaiton Act), but it only applies to non-food producing animals. 

Drugs are used off label because manufacturers often don't want to spend the time and money developing or adding or changing the label for their drug.
What are the 5 rights?
Right:  Drug, Dose, Route, Patient, and Time.
What is the role of a Vet Tech?
To properly dispense medication, educate the clients on the use of the medication, recognise side effects and adverse reactions, and act as a safety net for the Veterinarian (recognize mistakes).
Drugs have several different names. Name the different types and describe each.
*  Chemical name -not used much  (N-(4-hydroxyphenyl)acetamide)
*  Generic/non-proprietary name (acetaminophen)
*  Brand/Proprietary name -(Tylenol)
What information is always found on drug labels?
*  Drug name
*  Concentration
*  Quantity
*  Name & address of manufacturer
*  If a controlled substance, "CIV"
*  Expiration date
*  Lot number
Define "indication".
Who and what the drug is for.
What information can be found on drug inserts?
Storage and handling instructions, withdrawl time, etc.
What does antineoplastic mean?
Describe the different levels of controlled substances.
* CI = illegal drugs ie heroin, LSD
* CII = highly addictive drugs ie morphine
* CIII = drugs with abuse potential like ketamine
* CIV = diazapam, butorphanol
* CV = couph syrup with codine
What are the different drug classifications?
Veterinary use only
What exposure risks are associated with antineoplastic drugs and what care should be taken with them?
Spill, aerosolization, food/beverage contamination.

OSHA guidelines for safe storage, disposal and use.

Spill kit should include: gown, mask, bag, absorbant, scooper.

Cytotoxic agents are expelled in urine as well, so it should be treated with care as well -gloves used, etc.
What are some examples of compounding?
anesthetic cocktails, dilutions, mixing drugs in a syringe
What is the difference between a scored and an unscored tablet?
Scored tablets indicate the drug is evenly distributed throughout the pill while unscored tablets may have a greater concentration in one area and therefore must not be divided.
Which liquid medication must be shaken before use, suspensions or solutions?
suspensions because they contain undissolved medication while solutions contain dissolved drugs.
Injectable medicaitons exist in what forms?
multidose vials, single dose vials, ampules, and implants
What information does a drug regimen include?
Information on it's route, dosage, frequency, and duration.
What is the "first pass effect"?
A phenomenon of drug metabolism whereby the concentration of a drug is greatly reduced before it reaches the systemic circulation. It is the fraction of lost drug during the process of absorption which is generally related to the liver and gut wall. Notable drugs that experience a significant first-pass effect are Imipramine, Propranolol, and Lidocaine. After a drug is swallowed, it is absorbed by the digestive system and enters the hepatic portal system. It is carried through the portal vein into the liver before it reaches the rest of the body. The liver metabolizes many drugs, sometimes to such an extent that only a small amount of active drug emerges from the liver to the rest of the circulatory system. This first pass through the liver thus greatly reduces the bioavailability of the drug. Alternative routes of administration like suppository, intravenous, intramuscular, inhalational aerosol and sublingual avoid the first-pass effect because they allow drugs to be absorbed directly into the systemic circulation. The four primary systems that affect the first pass effect of a drug are the enzymes of the gastrointestinal lumen, gut wall enzymes, bacterial enzymes, and hepatic enzymes.
What is a "loading dose"?
A higher first dose to raise plasma concentration levels to a therapeutic range more rapidly.
What is "therapeutiic range"?
The ideal range of drug concentration in the body.  It is balanced by the rate of administration and rate of excretion.  A loading dose can help reach this range faster.
What is pharmacokinetics?
The study of drug absorbtion or movement from the route of administration to the site of action.
What traits may indicate higher risks for drug administration?
*  Age  -young and old.  Young animals do not have fully functioning livers which could cause them to OD.
*  Health status  -kidney or liver disease, heart issues.
*  Body condition  -very thin animals are often more sensitive to drugs because body fat slows drug absorbtion and helps store the drug as well)
What is "bioavailability"?
the quantity of drug that enters systemic circulation.
What factors determine bioavailability?
*  Route of administration -orally is lower than IV
*  Lipid solubility
*  pH of drug vs body (similar pH's absorb more quickly)
What are some anatomical barriers to drugs?
*  Blood/brain
*  Placenta
*  Renal portal system of reptiles
What is biotransformation?
Changes in the chemical form of the drug from what was administered to a form that can be excreted.

What factors effect biotransformation?
age, genetics, nutrition, species, metabolism
Where does biotransformation occur?
liver, kidneys
How are drugs eliminated from the body?
renal, liver, milk, lungs
Describe the term "half life" for drugs.
Time it takes to eliminate 1/2 of the drug from the body.
Describe the term "clearance" for drugs.
Time it takes to eliminate the drug from the body completely.
Define "adverse drug reaction".
An undesirable response to a drug by a patient.  It may vary in severity from mild to fatal.
Define "agonist".
A drug that brings about a specific action by binding with a particular receptor.
Define "antagonist".
A drug that inhibits a specific action by binding with a particular receptor.
Define "compounding".
Any manipulation peformed to produce a dosage-form drug, other than the manipulations described in nthe directions for use on the labeling of an approved drug product such as diluting or combining.
Define "drug".
A substance used to diagnose, prevent, or treat disease.
Define "efficacy".
The extent to which a drug causes the intended effects in a patient.
Define "extralabel use".
The use of a drug that is not specifically listed on the US Food and Drug Administration (FDA)-approved lable.
Define "half-life".
The amount of time (usually expressed in hours) that it takes for the quantity of a drug in teh body to be reduced by 50%.
Define "manufacturing".
The bulk production of drugs for resale outside of the veterinarian-client-patient relationship.
Define "biotransformation".
AKA "metabolism".  The biochemical process that alters a drug from an active form to a form that is inactive or that can be eliminated from the body.
Define "parenteral".
The route of administration of injectable drugs.
Define "partition coefficient".
The ratio of the solubility of substances (eg gas anesthetics) between two states in which they may be found (eg blood and gas, gas and rubber goods).
Define "legend drug".
AKA "prescription drug" -a drug that is limited to use under the supervision of a veterinarian because of potential danger, difficulty of administration, or other considerations. 

The legend that designates  a prescription drug states the following:  "Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian."
Define "regimen".
A program for administration of a drug that includes:
* route
* dose
* frequency
* duration
Define "residue".
An amount of a drug still present in animal tissue or products (eg meat, milk, eggs) at a particular point (slaughter or collection).
Define "Veterinarian-client-patient relationship".
The set of circumstances that must exist between the veterinarian, the client, and the patient before the dispensing of prescription drugs is appropriate.
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