Drug treatment of asthma Flashcards
What is the therapeutical approach to sEA
glucocorticoids
bronchodilators
What is the therapeutical approach to mEA
glucocorticoids
bronchodilators
immune modulation (interpheron-alpha)
omega-3 supplementation
Glucocorticoids have impact on ……
Lung function
Airway inflammation
Bronchial remodeling
Describe the bioavailability of oral prednisolone
50%
Peak concentration 45m post-admin.
Pharmacologic effects 8h
poor in horses
What glucocorticoids are used to treat equine asthma
oral prednisolone
IV and oral dexamthasone
Isoflupredone: causes hypokalemia
How long does the pharmacological effect of prednisolone last after oral administration in horses
8hr
How long until peak concentration after administration of oral prednisolone in horses?
45 mins
How long does the pharmacological effect of IV and PO dexamethasone last in horses
24 hrs
How long post administration until IV and PO dexamethasone effects lung function
IV- 2hrs
PO- 6hrs
When is the systemic dexamethasone used in treatment of equine asthma?
Rescue therapy when exacerbation taking place
Initial treatment of mEA
How is a exacerbation of acute sEA treated?
IV dexamethasone followed by PO dexamethasone or preds
When resp effort and nasal discharge resolve use inhaled GC
How is mEA treated with corticosteroids?
Start PO dexamethasone or preds for 4weeks
Follow with inhaled GCs
What should bronchodilators be used alongside
glucocorticoids
What bronchodilators are commonly used in horses for treatment of equine asthma
Clembuterol (PO or inhaled)
Albuterol (inhaled)
Salbuterol (inhaled)
When is the use of systemic bronchodilators justified
severe forms of equine asthma
What drugs other than GCs and bronchodilators can be used in the treatment of equine asthma
Interferon-alpha
cromoglicate- mast cell mediated mEA
omega-3 fatty acids
List the possible adverse effects of glucocorticoids in horses
adrenal supression
adrenal gland atrophy
immune suppression
laminitis
List the adverse effects of systemic beta-adrenergic bronchodilators
Cardiovascular remodeling
Tachyphilaxis
What are regulatory considerations to take into account when administering asthma treatment to competition horses?
each drug and delivery has a detection time
treatment has to be discontinued before that time