Respiratory Flashcards
List the three nonselective beta agonists.
Epinephrine
Isoproterenol
Ephedrine
What is epinephrine used for (as a respiratory drug)?
Drug of choice for emergency life threatening bronchoconstriction and acute anaphylaxis response
*No long term use
What are the Beta-2 agonists?
Salmeterol (Human - long acting) Albuterol Terbutaline Metaproterenol Clenbuterol
How do you administer Terbutaline?
Oral or Inj. ONLY injection in horses bc of poor oral absorption
(lasts 6-8hr)
What species is albuterol used in?
Oral/Inhalent in cats and horses
How is Metaproteranol given?
Only oral, 4hr duration
What species is clenbuterol used for?
Horses.
Illegal in food animals.
How do the Beta-2 Agonists work?
Selective for Beta 2. Bronchodilation, stabilization of mast cells, and increased mucociliary clearance.
Adverse effects of Beta 2 agonists?
(Any beta 1 effect) Cardiac stimulation, vasodilation, and uterine relax
**Can be poison from causing hyperglycemia and hypokalemia
T/F Beta 2 agonists are often used to treat RAO?
True.
What are the anticholenergics that work on the respiratory system?
Ipratropium
Atropine
Glycopyrrolate
List the Methylxanthine derivative drugs.
Caffiene ** coffee, tea, chocolate
Theophylline
Aminophylline (soluble salt of theophylline)
MOA of Methylxanthine derivatives (Know this)
- Inhibition of phosphodiesterase
2. Antagonism of adenosine receptors
Effects of Methylxanthine derivatives on the CNS
Stimulation of sensory and motor areas (like when you drink too much coffee)
Effects of Methylxanthine derivatives on the Respiratory system
Bronchodilation, Antiinflammatory, prevention of microvascular leakage (treat pulmonary hypertension), mucociliary clearance, improve breathing.
Effects of methylxanthine derivatives on the Cardiovascular system
stimulation of cardiac contractility, increasing heart rate, systolic pressure, and vasodilation (can be adverse effect-tachyarrythmia)
Effects of Methylxanthine derivatives on the Kidney?
Diuresis secondary to increased cardiac output and glomerular filtration
How are methyxanthine derivatives given?
Oral or parenteral.
*Volume of distribution is lower in cats than other species
oh p.s its metabolized by the liver, didnt feel like making another card
What are the therapeutic uses of Methylxanthine derivatives?
Brinchoconstriction, bronchial asthma (resp dx), and chronic obstructive pulmonary disease (RAO)
*Aminophylline is also used in the treatment of congestive heart failure and anaphyllaxis
Contraindications of Methylxanthine derivatives?
Cardiac disease, Peptic ulcer disease (increases aciditiy), and seizure disorders (CNS stimulation)
T/F You need to be careful when using inhalation anesthetics and methylxanthine derivatives
True.
The cardiac depression from the anesthetics plus the stimulation from the MD could lead to tachycardia/arrhythmia
What are the 6 groups of Antiinflammatory drugs (in reference to respiratory)?
Cromolyn sodium Leukotriene inhibitors Glucocorticoids NSAIDS Beta adrenergic agonists Methylxanthines
What is Cromolyn sodium used for?
Anti-inflammatory and Anti-bronchoconstrictor (Not a bronchdilator though)
*Treats RAO
What glucocorticoids are used in the treatment of respiratory disease?
Dexamethasone injection sometimes (Anti-bronchoconstriction)
Fluticasone inhaler –> SA
Beclomethasone inhaler –> LA
What is Flunixin used for in respiratory disease?
NSAID tx:
- endotoxin release
- colic antispasmotic in horses
- bovine respiratory disease (BRD)
What is aspirin used for in respiratory disease?
Pulmonary embolism
What are the two leukotriene inhibitors that we know?
Zafirlukast and Zileuton
How does Zafirlukast work?
Leukotriene receptor agonist (selective competitive agonist)
How does Zileutron work?
5-lipoxygenase (5-LO) inhibitor (inhibits formation of leukotriene)
What are the clinical uses of leukotriene inhibitors?
Given orally to PREVENT chronic bronchial asthma….. in humans….
How do antihistamines help in regards to respiratory?
(competitive agonists of H1 receptors)
tx of chronic respiratory disease bc of their effect on bronchial secretions
What are antitussives?
Drugs which decrease the frequency and severity of nonproductive cough without impairing mucociliary defenses
What are the 3 centrally-acting, narcotic, antitussives?
Codeine, Hydrocodone, Morphine
What are the three centrally-acting, nonnarcotic, antitussives?
Butorphenol, Dextromethophan, Noscapine
What are the two peripherally-acting antitussives?
Bronchodilators, Mucokinetics
What is codeine used for?
Antitussive.
Controlled drug with sedation and constipation as side effects
What is Hydrocodone used for?
Drug of choice for cough in dogs!!
More potent than codeine
What is tramadol used for?
Antitussive.
inexpensive, oral, and has opoid/seratonin/alpha2 activity
What is Butorphenol used for?
Nonnarcotic antitussive.
Agonist/antagonist with a long duration of action
What is Dextromethorphan used for?
Nonnarcotic antittussive.
NMDA antagonist with V/CNS side effects
What is the difference between mucokinetic drugs and expectorants?
Mucokinetic drugs facilitate removal of secretions
Exoectorants increase volume/fluidity of secretions
What is the mechanism of action for mucokinetic drugs?
Stimulating ciliary activity (Beta agonist/methylxanthines) and decreasing viscosity of bronchial secretions (saline/NaBicarb)
What is the mechanism of action for expectorants?
Act reflexly by irritation of gastric mucosa (K+Iodide/NH4+salts)
OR
direct stimulation (Guaifenesin/Volatile oils)
What is Guaifenesin used for?
works on glands of the respiratory system as an expectorant as well as a muscle relaxant when combined with ketamine in horses.
What are the direct decongestants?
Direct Alpha Agonists - vasoconstrictors
- Phyenylephrine
- Ephedrine
- Pseudoephedrine
- phenylpropanolamine
What are your indirect decongestants?
- H1-antagonists (diphenhydramine, hydroxyzine)
- Cromolyn sodium
- GLucocorticoids
What is the drug of choice to tx pulmonary edema?
Furosemide (diuretic)
*also could use digoxin/phophodiesterase inhibitors but more heart risk
What are the two antifoaming agent?
- Nebulization of ethyl alcohol
- Silicone Spray
What are the three main categories of bronchodilator drugs?
- Beta adrenergic agonists
- Methylxanthine derivatives
- Anticholenergics - derivatives of atropine
What can oxygen be used for?
Hypoxemia and respiratory acidosis
When is oxygen contraindicated?
Paraquat toxicosis
What is Doxapram used for?
Respiratory analeptic (stimulant) Reverses respiratory depression due to inhalation/barbituate anesthesia or neonatal depression
What is the M.O.A. for doxapram?
Stimulating the chemoreceptors (main mechanism) and directly acting on the respiratory center
Adverse effects of Doxapram?
Pressor effect and seizures with large doses
What can doxapram reverse in dogs?
Actions of acepromazine, xylazone, or droperidol-fentanyl
What can doxapram reverse in cats?
Thiopental-acepromazine
What can doxapram treat in foals?
Hypercapnia associated with hypoxic-ischemic encephalopathy
