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Clinical Pharmacology and Therapeutics for Veterinary Technicians - E-Book

Clinical Pharmacology and Therapeutics for Veterinary Technicians - E-Book

Robert L. Bill

(2016)

Additional Information

Book Details

Abstract

Grasp complex concepts and develop fundamental knowledge in the rapidly changing field of veterinary pharmacology with Clinical Pharmacology and Therapeutics for Veterinary Technicians, 4th Edition. This accessible, comprehensive text explains how drugs work so you can confidently communicate with clients about current drug therapies. Featuring up-to-date drug information and a new full-color design with added illustrations, tables, and boxes, this thorough resource covers drug uses, abuses, calculation errors, and mistakes.

  • Covers complex principles of pharmacology in a manner appropriate for both veterinary technicians and students.
  • Provides strong introductory content on safety, terminology, pharmacy procedures, drug handling (including the latest OSHA requirements), dosage calculations, and pharmacokinetics.
  • Emphasizes the reasons behind drug properties, actions, and effects — not just lists of facts.
  • Valuable clinical applications are interspersed throughout every chapter, and concepts are linked to real-life situations to help reinforce learning.
  • Critical thinking and review questions at the end of every chapter help you test comprehension.
  • UPDATED and NEW! The most up-to-date information on all drug categories and new content on several drugs.
  • NEW! Full-color format with photos and line drawings helps visual learners understand concepts and enhances images’ educational value.
  • NEW! Myths and Misconceptions, Ask Dr. Bill, and You Need to Know boxes break up the narrative and spotlight interesting concepts to make information easier to understand.
  • NEW! Evolve site with instructor resources, including PowerPoint presentations, test bank questions and answers, an image collection, the answer keys to each chapter’s self-assessment questions, and drug calculation practice exercises.
  • NEW! Vet Tech Threads design includes key terms, chapter outlines, and learning objectives, as well as other pedagogical features, to help you grasp key content and navigate through the chapters.

Table of Contents

Section Title Page Action Price
Front Cover cover
IFC_Evolve AD IFC1
Clinical Pharmacology and Therapeutics for Veterinary Technicians i
Copyright Page ii
Dedication iii
Reviewers iv
Preface v
The Changing Role of Veterinary Technicians v
Table Of Contents vii
1 Veterinary Pharmacology and the Veterinary Technician 1
Chapter Outline 1
Objectives 1
Key Terms 2
Role and Responsibilities of Today’s Veterinary Technician and Technologist 2
Why Is Pharmacology Important for Veterinary Technicians? 2
Four Rules to Live by for Safe Drug Usage 3
2 Pharmacy Procedures and Dosage Calculations 20
Chapter Outline 20
Objectives 20
Key Terms 21
The Goal: The Correct Dose Administered in the Correct Way 21
Understanding the Prescription versus the Drug Order 22
The Drug Order 22
The Prescription 22
Controlled Substances Have Special Requirements 22
The Controlled Substances Log 23
Writing the Drug Order: The Dosage Regimen 23
Dose versus Dosage 23
Dosage Range 23
Abbreviations: The Language of the Drug Order 26
Common Medication Errors 27
The Next Step: Determining the Amount of Drug Needed 28
The Metric, Apothecary, and Household Measurement Systems 28
The Steps for Calculating the Drug Mass Needed 29
Pounds and Kilogram Conversion 30
Know Your Metrics and How to Convert to Different Equivalent Units 31
A Variation on the Dosage: mg of Drug per Square Meter (mg/m2) 31
Understanding the Language to Adjust the Dose 32
Calculating the Amount of Dosage Form Needed 32
Percentage Solutions: A Variation on the Typical Liquid Drug Concentration 33
Determining the Total Number of Dosage Units to Be Dispensed to Fill a Drug Order 34
The Dosage Regimen Calculation Short Cut: Using Long Equations 35
The Most Common Mistake when Calculating Total Tablets to be Dispensed 37
Volume of Liquid Dosage Forms to Be Dispensed 37
Determining the Cost of the Dispensed Medication 37
Compounding Drugs 38
The Dispensing Label and Container 39
Storage of Drugs in the Veterinary Facility 40
Environmental Concerns for Proper Storage 40
Storing and Handling Cytotoxic and Hazardous Drugs 40
As a Veterinary Technician, Set an Example for Staff 41
Training and the Material Safety Data Sheet (MSDS) Notebook 41
Accidental Exposure to Cytoxic Drugs and How to Reduce the Risk 41
References 42
Web Resources 42
www.osha.gov 42
www.fda.gov/search.html 42
www.usp.org 42
Self-Assessment 43
3 Pharmacokinetics and Pharmacodynamics 46
Chapter Outline 46
Objectives 46
Key Terms 47
The Therapeutic Goal: Drug Concentrations within the Therapeutic Range 48
Balancing Inflow with Outflow 49
The Dosage Regimen and Routes of Administration 50
Loading Dose and Maintenance Dose 50
Total Daily Dose 50
Parenteral Routes of Drug Administration 51
Nonparenteral Routes of Drug Administration 53
How Drugs Move in the Body 53
Passive Diffusion 53
Facilitated Diffusion 54
Active Transport 55
Pinocytosis and Phagocytosis 55
Factors That Affect Rate of Drug Molecule Movement 55
Effect of a Drug’s Lipophilic or Hydrophilic Nature on Drug Molecule Movement 56
Pharmacokinetics: Absorption—Getting Drugs into the Body 58
Drug Absorption and Bioavailability 58
Effect of Route of Administration on Absorption 58
Effect of the Drug’s Chemical Properties on Absorption: Lipophilic and Hydrophilic Drugs 60
Effect of pH of the Environment on Absorption 60
Acid Drugs versus Base Drugs 61
Using the Drug’s pKa to Predict Its Ionized or Nonionized State 62
Ion Trapping and Absorption of Drugs 63
P-Glycoprotein and Drug Absorption from the GI Tract 64
Cytochrome P-450 and Drug Absorption from the Gastrointestinal Tract 64
Effect of Dissolution and Gastrointestinal Motility on Absorption of Orally Administered Drugs 64
The First-Pass Effect 66
Effect of Perfusion on Absorption of Parenterally Administered Drugs 66
Pharmacokinetics: Drug Distribution 67
Barriers to Drug Distribution 67
Effect of Tissue Perfusion on Drug Distribution 68
Effect of Plasma Protein Binding on Drug Distribution 69
Volume of Distribution 70
Pharmacodynamics: The Way Drugs Exert Their Effects 71
The Drug Is the Key, the Receptor Is the Lock 71
Affinity, Intrinsic Activity, Agonists, Antagonists, Reversal Agents, and Blockers 72
Competitive and Noncompetitive Antagonists 72
Partial Agonists/Partial Antagonists 73
Nonreceptor-Mediated Reactions 73
Pharmacokinetics: Biotransformation and Drug Metabolism 74
Drug Interactions Affecting Biotransformation 74
Species and Age Differences in Drug Biotransformation 75
Pharmacokinetics: Drug Elimination or Excretion 76
Routes of Drug Elimination 76
Renal Elimination of Drugs 76
Hepatic Elimination of Drugs 78
Half-Life and Clearance: Measures of Drug Elimination Rates 78
Relation of Half-Life to Steady-State Concentrations 79
Drug Withdrawal Times 81
Using Concepts of Pharmacokinetics and Pharmacodynamics 82
References 82
Self-Assessment 82
4 Drugs Affecting the Gastrointestinal Tract 87
Chapter Outline 87
Objectives 87
Key Terms 87
Function and Control of the Gastrointestinal Tract 88
Autonomic Nervous System Control 88
Emetic Drugs 90
The Vomiting Reflex: The Emetic Center 90
Vomiting and the Chemoreceptor Trigger Zone 92
Motion Sickness and the Inner Ear 92
Vomiting from Stimulation Elsewhere in the Body 92
Emotional Vomiting 93
Appropriate Use of Emetic Drugs to Induce Vomiting 93
Centrally Acting Emetic Drugs 94
Locally Acting Emetic Drugs 95
Antiemetic Drugs 95
Phenothiazine Tranquilizers 95
Antihistamine Antiemetic Drugs 96
Anticholinergic Antiemetic Drugs 96
Prokinetic Drugs as Antiemetics: Metoclopramide 96
Serotonin Antagonist Antiemetic Drugs 97
Neurokinin-1 (NK-1) Receptor Antagonist Antiemetics 97
Newer Antiemetics Are Always Coming 98
Antidiarrheal Drugs 98
Intestinal Motility in Health and Disease 98
Antidiarrheal Drugs That Work by Modifying Motility 99
Narcotic (Opioid) Antidiarrheals 99
Anticholinergic Drugs as Diarrheals 100
Decreasing Diarrhea by Blocking Secretions 100
Adsorbents and Protectants as Antidiarrheal Agents 101
Laxatives, Cathartics, and Purgatives 102
Laxatives 102
Cathartics 102
Antacids and Antiulcer Drugs 103
Physiology of Stomach Acid Secretion 103
Mucus Production 104
Pepsin Production 104
Drugs Used to Counter Gastric Acidity and Ulcer Formation 104
Nonsystemic Antacids 105
Systemic Antacids 105
Drugs Used for Rumen Health 106
Ruminatorics: Prokinetic Drugs 106
Ionophores 106
Antibloat Medications 107
The Role of Antimicrobials in Gastrointestinal Tract Disease 107
Tylosin (Tylan) 107
Metronidazole (Flagyl) 107
Erythromycin 108
Sulfasalazine (Azulfidine) 108
Additional Drugs Used to Treat Gastrointestinal-Related Disease 108
Oral Electrolyte Replacements 108
Pancreatic Enzyme Supplements 109
Corticosteroids 110
References 110
Self-Assessment 111
5 Drugs Affecting the Cardiovascular System 115
Chapter Outline 115
Objectives 115
Key Terms 115
Normal Cardiac Function 116
Think of the Heart as Being Two Pumps 116
Electrical Conduction through the Heart 117
What Are Depolarization and Repolarization? 119
Conduction Cells Depolarize Differently From Cardiac Muscle Cells 121
The Refractory Period 122
Role of the Autonomic Nervous System in Cardiovascular Function 122
The Sympathetic Nervous System Control of the Cardiovascular System 122
The Parasympathetic Nervous System Control of the Cardiovascular System 125
The Autonomic Tug-of-War 125
Antiarrhythmic Drugs 125
Classify the Arrhythmia to Understand Which Drug to Use 126
Antiarrhythmic Drugs That Inhibit Sodium Influx: The Sodium Channel Blockers 127
β-Blocker Antiarrhythmic Drugs 128
Other Antiarrhythmic Drugs 129
Positive Inotropic Drugs and Inodilators 130
Catecholamines 130
Pimobendan 130
Digoxin 131
Vasodilator Drugs 132
How Does Vasoconstriction Come About in Heart Disease? 132
The Kidney’s Role in Heart Disease: The Renin–Angiotensin System 133
Vasoconstriction’s Role in Systemic Hypertension 134
Principles of Safe Vasodilator Drug Use 134
Arterial Vasodilators: Amlodipine and Hydralazine 134
Venous Vasodilator: Nitroglycerin 135
Mixed Vasodilators: Nitroprusside and Angiotensin-Converting Enzyme Inhibitors (ACE Inhibitors) 136
Diuretics 137
Loop Diuretics: Furosemide 137
Thiazide Diuretics: Chlorothiazide and Hydrochlorothiazide 138
Potassium-Sparing Diuretics: Spironolactone 138
Osmotic Diuretics 139
Carbonic Anhydrase Inhibitors 139
Other Drugs Used in Treating Cardiovascular Disease 139
Aspirin 139
Sedatives and Tranquilizers 140
References 140
Self-Assessment 141
6 Drugs Affecting the Respiratory System 144
Chapter Outline 144
Objectives 144
Key Terms 144
The Respiratory System’s Protective Mechanisms 144
Antitussives 145
Butorphanol 146
Hydrocodone 146
Codeine 146
Dextromethorphan 146
Mucolytics, Expectorants, and Decongestants 147
Mucolytics 147
Expectorants 148
Decongestants 148
Bronchodilators 148
What Causes Bronchoconstriction or Asthma? 148
Beta-Adrenergic Agonist Bronchodilators 149
Methylxanthine Bronchodilators 150
Other Drugs Used to Treat Respiratory Problems 150
Antimicrobials 150
Corticosteroids 152
Antihistamines 152
Diuretics 152
Oxygen 153
References 153
Self-Assessment 153
7 Drugs Affecting the Endocrine System 156
Chapter Outline 156
Objectives 156
Key Terms 156
The Negative Feedback System 157
Thyroid Disease and Drug Therapies 158
Normal Thyroid Control 158
Thyroid Disease 158
Drugs Used to Treat Hypothyroidism 159
Additional Clinical Considerations of Hypothyroid Therapy 159
Drugs Used to Treat Hyperthyroidism 161
Additional Clinical Considerations of Hyperthyroid Therapy 162
Endocrine Pancreatic Drugs 163
Types of Insulins 163
Insulin Syringes and Additional Considerations in Using Insulin 164
Other Drugs to Control Diabetes and Drugs to Avoid 165
Drugs Affecting Reproduction 165
Hormonal Control of the Estrous Cycle 165
Hormonal Changes during Pregnancy and Parturition 167
Types of Reproductive Drugs 167
Specific Uses for Reproductive Drugs 169
Drugs Used to Control Estrous Cycling 169
Drugs Used in Foal Heat 169
Drugs Used to Treat Anestrus 170
Drugs Used to Maintain Pregnancy 170
Drugs Used to Prevent Pregnancy 170
Drugs Used to Terminate Pregnancy 170
Other Uses of Reproductive Drugs 171
References 172
Self-Assessment 172
8 Drugs Affecting the Nervous System 176
Chapter Outline 176
Objectives 176
Key Terms 176
Analgesics 177
The Pain Pathway 177
Opioid Receptors and Their Actions 178
Opioid Analgesic Drugs 180
Opioid Antagonist Drugs 184
Tranquilizers and Sedatives 184
Acepromazine 184
Benzodiazepine Tranquilizers 185
Alpha-2 Agonists 186
Alpha-2 Antagonists 188
Anesthetics 189
Injectable Anesthetics 189
Inhalant Anesthetics 191
Isoflurane 192
Sevoflurane 192
Desflurane 193
Other Anesthetic Gas 193
Nitrous Oxide 193
Central Nervous System Stimulants 193
Methylxanthines 193
Doxapram 193
References 194
Self-Assessment 195
9 Drugs Affecting the Nervous System 199
Chapter Outline 199
Objectives 199
Key Terms 199
Anticonvulsants 199
Phenobarbital 200
Adverse Effects of Phenobarbital 201
Benzodiazepines 202
Bromides 203
Other Anticonvulsants 203
Zonisamide 203
Levetiracetam (Keppra) 203
Gabapentin 204
Primidone 204
Behavior-Modifying Drugs 204
What Are Behavior-Modifying Drugs? 204
Antipsychotic Drugs 205
Antidepressant Drugs 205
Anxiolytic Drugs 207
Other Behavior-Modifying Drugs 207
References 207
Self-Assessment 208
10 Antimicrobials 212
Chapter Outline 212
Objectives 212
Key Terms 212
Types of Antimicrobials 213
Goal of Antimicrobial Therapy 213
Susceptibility, Resistance, Intermediate, and Breakpoints 214
Resistance of Microorganisms to Antimicrobial Therapy 215
How Does Bacterial Resistance Occur? 216
Selective Pressure, Resistance, and Clinical Disease 216
Resistance and Drug Residues 217
Classification of Antimicrobials by Their Mechanism of Action 218
Classes of Antimicrobials 219
Penicillins 219
Penicillin Pharmacokinetics 220
Penicillin Group Spectra of Activity and Resistance 220
Precautions for Use of Penicillins 221
Considerations for Specific Penicillin Groups 221
Cephalosporins 223
Mechanism of Action for Cephalosporins 224
Precautions for Use of Cephalosporins 224
Aminoglycosides 224
Mechanism of Action 224
Pharmacokinetics of Aminoglycosides 225
Precautions for Use of Aminoglycosides 226
Fluoroquinolones or Quinolones 228
Mechanism of Action 228
Pharmacokinetics of Quinolones 228
Precautions for Use of Quinolones 229
Tetracyclines 230
Mechanism of Action 230
Pharmacokinetics of Tetracyclines 230
Precautions for Use of Tetracyclines 231
Sulfonamides and Potentiated Sulfonamides 232
Mechanism of Action 232
Pharmacokinetics of Sulfonamides 232
Precautions for Use of Sulfonamides 233
Other Antimicrobials Used in Veterinary Medicine 234
Lincosamides 234
Macrolides 234
Metronidazole 235
Chloramphenicol and Florfenicol 236
Rifampin 236
Bacitracin 236
Antifungals 237
Amphotericin B 237
Azoles: The Imidazole Derivatives 237
Griseofulvin 238
Terbinafine 240
Nystatin 240
References 240
Self-Assessment 241
11 Disinfectants and Antiseptics 246
Chapter Outline 246
Objectives 246
Key Terms 246
Terminology Describing Disinfecting Agents 247
Appropriate Use of Disinfecting Agents 249
Selecting an Appropriate Disinfecting Agent 249
Types of Disinfecting Agents 250
Alcohols 250
Halogens: Chlorine Compounds 250
Halogens: Iodine Compounds and Iodophors 251
Biguanides: Chlorhexidine (Nolvasan, Virosan, Hibistat) 252
Aldehydes: Glutaraldehyde 252
Oxidizing Compounds: Hydrogen Peroxide, Peroxymonosulfate 253
Phenols (Lysol) 253
Quaternary Ammonium Compounds 253
Other Disinfecting Agents 254
References 254
Self-Assessment 255
12 Antiparasitics 258
Chapter Outline 258
Objectives 258
Key Terms 259
Challenges With Veterinary Antiparasitic Compounds 259
Keeping Current With New Products 260
Principles and Terminology of Antiparasitic Use 261
Internal Antiparasitics 262
Terminology Used to Describe Internal Antiparasitics 262
Antinematodals 262
Avermectins and Milbemycins (the Macrolides) 262
Ivermectin 265
Selamectin 266
Livestock Macrolides: Doramectin and Eprinomectin 266
Milbemycin Oxime 266
Moxidectin 266
Benzimidazoles 267
Pyrantel 268
Other Antinematodals 268
Emodepside 268
Piperazines 269
Levamisole 269
Anticestodals 269
Praziquantel 269
Epsiprantel 270
Antiparasitics Used in Heartworm Treatment 270
Different Stages, Different Drugs 271
Heartworm Adulticides 271
Heartworm Microfilaricides 272
Heartworm Preventives 273
Doxycycline for Treating Wolbachia 274
Additional Drugs Used in Heartworm Treatment 274
American Heartworm Society 2014 Protocol Recommendation 275
Antiprotozoals 275
Sulfonamides 275
Amprolium 276
Benzimidazoles 276
Metronidazole 276
Clindamycin 277
Ionophores 277
Ponazuril 277
External Antiparasitics 277
Organophosphates and Carbamates 278
Pyrethrins and Pyrethroids 280
Amitraz 282
Macrolides 283
Fipronil 284
Neonicotinoids: Imidacloprid and Nitenpyram 284
Spinosyns: Spinosad and Spinetoram 285
Isoxazolines: Afoxolaner and Fluralaner 286
Indoxacarb 286
Insect Growth Regulators: the Insect Development Inhibitors and Juvenile Hormone Analogs 286
Insect Repellents 287
References 288
Self-Assessment 289
13 Antiinflammatory Drugs 295
Chapter Outline 295
Objectives 295
Key Terms 296
The Inflammation Pathway 297
Arachidonic Acid Pathway 297
Corticosteroids 297
Mineralocorticoids 297
Glucocorticoids 298
Glucocorticoid Drugs 299
Dosage Formulations of Glucocorticoids 299
Effects of Glucocorticoids and Glucocorticoid Drugs 299
Disease Caused by Excessive Glucocorticoid Hormone or Glucocorticoid Drugs 302
Safe Use of Glucocorticoids 302
Nonsteroidal Antiinflammatory Drugs 303
Nonsteroidal Antiinflammatory Drugs as Analgesics and Antipyretics 303
Nonsteroidal Antiinflammatory Drug Precautions and Side Effects 304
The Classic, Nonspecific Cyclooxygenase Inhibitor Nonsteroidal Antiinflammatory Drugs 306
The Selective Cyclooxygenase-2 Inhibitor Nonsteroidal Antiinflammatory Drugs 307
Other Antiinflammatory Drugs 309
References 311
Self-Assessment 312
Answers to Self Assessment 317
Chapter 1 317
Chapter 2 319
Chapter 3 322
Chapter 4 328
Chapter 5 331
Chapter 6 336
Chapter 7 338
Chapter 8 344
Chapter 9 348
Chapter 10 351
Chapter 11 356
Chapter 12 358
Chapter 13 362
Glossary 366
A 366
B 367
C 368
D 369
E 369
F 370
G 370
H 370
I 371
K 371
L 371
M 372
N 372
O 373
P 373
R 374
S 375
T 376
U 377
V 377
W 377
X 377
Index 378
A 378
B 380
C 380
D 382
E 383
F 384
G 384
H 385
I 385
J 386
K 386
L 386
M 386
N 387
O 388
P 388
Q 390
R 390
S 390
T 391
U 392
V 392
W 393
X 393
Y 393
Z 393