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Pharmacology I > Lecture 28 - Respiratory Drugs > Flashcards

Lecture 28 - Respiratory Drugs Flashcards

1
Q

What are the changes seen in an asthmatics airway?

A

Epithelial damage
Mucus secretion
Mucosal inflammation + edema
Smooth muscle contraction

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2
Q

What is happening at the cellular level with allergies and the airway wall?

A

Allergen stimulates = Mast cell + DC
Mast cell = Stim. Neu + EOS
EOS = DC’s
DCs –> Th2 –> EOS

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3
Q

What molecule causes bronchodilation?

A

increase in cAMP

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4
Q

What two things affect the levels of cAMP?

A

AC + PDE

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5
Q

What occurs at the level of AC in regards to bronchial activity?

A

Beta agonists stimulate = Increase in AC = Increase cAMP

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6
Q

What occurs at the level of the PDE in regards to bronchial activity?

A

Theophylline inhibits = Increase cAMP

Also inhibits adenosine from causing constriction

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7
Q

What are B2 agonists really good at?

A

Bronchodialators

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8
Q

What is the mechanism in which B2 agonists are able to cause bronchodilation?

A

Increase cAMP = relax smooth muscle

Inhibit histamine release from mast cells

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9
Q

What are the respiratory drug families?

A 
Beta-2 agonists 
Muscarinic antagonists 
Phosphodieseterase Inhibitors 
Corticosteroids 
Leukotriene inhibitors 
Janus Kinase Inibitors 
Respiratory Stimulant 
Antihistamine
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10
Q

Drugs within family: Beta-2 agonists

A 
Albuterol 
Levalbuterol 
Clenbuterol 
Terbutaline 
Salmeterol
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11
Q

Drugs within family: Muscarinic Antagonists

A

Ipratopium

Tiotropium

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12
Q

Drugs within family: Phosphodiesterase inhibitors

A

Theophylline

Aminophylline

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13
Q

Drugs within family: Corticosteroids

A

Fluticasone
Budenoside
Prednisilone

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14
Q

Drugs within family: Leukotrine inhibitors

A

Zafirlukast

Montelukast

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15
Q

Drugs within family: JAK inhibitors

A

Oclacitinib

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16
Q

Drugs within family: Respiratory stimulants

A

Doxapram

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17
Q

Drugs within family: 1st gen. antihistamines

A

Diphenhydramine
Chlorpheniramine
Clemastine
Promethazine

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18
Q

Drugs within family: 2nd gen, antihistamines

A

Loratadine
Desloratadine
Fesofenadine
Cetirizine

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19
Q

What are the general characteristics of B2-agonists?

A

~4 to 6 hours of effect
Immediate action
Stops attacks

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20
Q

Which B2 agonist is NOT inhaled but rather oral?

A

Terbutoline

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21
Q

What is Salmeterol used for generally ?

A

Longer duration

Good for chronic use

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22
Q

What is Salmeterol NOT used for?

A

To stop attacks, doesn’t work for this

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23
Q

What is an adverse affect of Salmeterol?

A

Down-regulation of beta receptors

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24
Q

What can be given with Salmeterol to stop the down regulation of beta-receptors?

A

Corticosteroids

25
Q

What B2 agonists is thought to have the least amount of side effects?

A

Levoalbuterol

26
Q

What type (adminstration wise) of B2 agonist gives the most side effects?

A

Oral

27
Q

What are side effects of Beta-2 agonist use?

A

Tachycardia

Skeletal muscle tremors

28
Q

Why are the side effects so few and far between with the muscarinic antagonists used in the respiratory system?

A

Inhaled - very large compounds so they don’t get into the body

29
Q

What are the muscarinic antagonists used for most commonly?

A

RAO in horses

30
Q

How would Beta-2 agonists and corticosteroids be used together clinically?

A

Betas would be for rescue therapy

Given before inhaled corticosteroids to help increase the distribution when taken

31
Q

What syrup is used in horses with RAO?

A

Clenbuterol - DO NOT USE IN CATTLE

32
Q

What is the specific use of Salmeterol?

A

Improves signs of airway obstruction in horses with RAO

Use in mild to moderate cases

33
Q

What beta-2 agonist is NOT TO BE USED IN COWS?

A

CLENBUTEROL

34
Q

Which Beta 2 agonist can be injected into horses?

A

Terbutaline

35
Q

What do the phosphodiesterase inhibitors cause biochemically?

A

Increase cAMP – inhibit PDE

Block adenosine receptors

36
Q

What effects do phosphoesterase inhibitors have physiologically?

A

Relax smooth muscle
Stimulates CNS + Heart
May be anti-inflammatory

37
Q

Why is phosphodiesterase inhibitors the best to work against bronchocontriction?

A

beta and muscarinics are not responsible for the process

38
Q

Which phosphodiesterase inhibitor is injected?

A

Aminophylline

39
Q

What are phosphodiesterase inhibitors mostly used for?

A

Dogs + Cats for bronchitis

40
Q

What are side effects of PDE inhibtors?

A

SNS effects basically

CNS + Cardiac + Muscle

41
Q

What is important to note when using PDE inhibitors with other drugs?

A

Under go liver metabolism - can react with many other drugs

Low TI

42
Q

What is seen cellularly in inflammation of the airways?

A 
Inflammatory cell infiltrates 
Bronchocontriction 
Hypersecretion of mucous 
Epithelium permeability + destruction 
Edema
43
Q

What are corticosteroids used for?

A

Decrease inflammation
Reduce bronchial reactivity
Improve B agonist response

44
Q

What two steroids are inhaled?

A

Fluticasone
– and –
Budesonide

45
Q

What are inhaled steroids commonly used for?

A

RAO
– and –
Feline asthma

46
Q

What are the upsides of using Leukotriene inhibitors?

A

Decrease the need for steroids

Few side effects

47
Q

What is the down side to using Leukotriene inhibitors?

A

Not bronchodilators
No effect on in-progress attack
Cant be used alone - not strong enough

48
Q

When is a respiratory stimulant used? What is the drug called?

A

Doxapram
Emergency in anesthesia
Decrease respiratory depression with opioids
Hypoxic-iscehmia encephalopathy

49
Q

How does Doxapram work?

A

Works on chemoreceptors on carotid artery + aorta

Stimulate respiratory center

50
Q

What are the two major effects of Histamine? What receptors are involved?

A

Vasodilation = H1 + H2
– and –
Bronchospasm = H1

51
Q

What does H1 do for vasodilation?

A

Stimulates release of NO

52
Q

What are the effects of Anti-histamines?

A

Inhibit smooth muscle response
Inhibit vasodilation
Inhibit flare + itch

53
Q

Which type of anti-histamines have a CNS effect?

A

First generations

54
Q

What are the first generations used for due to their CNS effects?

A

Motion sickness

Nausea + Vomiting

55
Q

Which first generation antihistamine is used for nausea and vomiting?

A

Promethazine

56
Q

What type of action do first generation antihistamines have at the receptor site?

A

Competitive antagonists

57
Q

What are the different characteristics of second generation antihistamines?

A

No entrance into the brain
– and –
No anticholinergic effects

58
Q

What is a good second generation antihistamine to use in patients with liver disease or those on several drugs? Why?

A

Cetirizine

Excreted completely by the kidney

59
Q

What is the mechanism of Oclacitinib?

A

Decrease inflammatory mediators + Cytokines

Great for puritis + dermatitis

Pharmacology I (21 decks)

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