respiratory drugs Flashcards

1
Q

asthma is a complex disease characterised by what

A

airway inflammation

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2
Q

what marks the inflammatory component of asthma

A

airway oedema, goblet-cell hyperplasia, mucus secretion and infiltration

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3
Q

the newer name for COPD

A

RAO, recurrent airway obstruction

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4
Q

COPD is caused by what

A

an abnormal inflammatory response to an inhaled environmental insult

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5
Q

what are the two frequently overlapping diseases COPD can be divided into

A

emphysema and chronic bronchitis

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6
Q

sympathetic effect on the airway causes what

A

bronchodilation

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7
Q

parasympathetic effect on airway causes what

A

bronchoconstriction

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8
Q

the two receptor types expressed by airway smooth muscle cells

A

beta2 adrenergic and muscarinic

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9
Q

beta2 adrenergic receptors are activated by what

A

adrenaline

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10
Q

muscarinic receptors cause what when stimulated

A

bronchoconstriction

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11
Q

beta2 adrenergic receptors cause what when stimulated

A

bronchodilation

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12
Q

what effect does mast cell degranulation produce

A

bronchoconstriction and airway inflammation

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13
Q

what effect do cysteinyl leukotrienes induce

A

bronchoconstriction

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14
Q

types of drugs acting on the respiratory system

A
  • bronchodilators
  • resp antiinflammatory drugs
  • antitussives
  • mucolytics, expectorants
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15
Q

indications for bronchodilators

A
  • anaphylaxis
  • allergic bronchitis
  • asthma
  • pulmonary edema
  • pneumonia
  • pleural effusion
  • pneumothorax
  • tracheal collapse and hypoplasia
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16
Q

groups of bronchodilators

A
  • sympathomimetics
  • anticholinergic substances
  • xanthine derivatives
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17
Q

sympathomimetics mechanism of action to cause bronchodilation

A

act on beta2 receptors - incr cAMP

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18
Q

two groups of sympathomimetics

A
  • non specific

- specific/beta2 receptor agonists

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19
Q

non specific sympathomimetics

A
  • adrenaline
  • isoproterenol
  • ephedrine
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20
Q

specific sympathomimetics

A
  • salbutamol
  • terbutaline
  • clenbuterole
  • salmeterol
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21
Q

adrenaline bronchodilation mechanism of action

A

at beta2 receptors

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22
Q

indications adrenaline for bronchodilation

A

only in life threatening situations eg anaphylaxis

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23
Q

which drug is isoproterenol similiar to

A

adrenaline

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24
Q

ephedrine mechanism of action

A

directly and indirectly

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25
Q

ephedrine indications

A
  • bronchodilator

- tachyphylaxis

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26
Q

two types of beta2 agonists bronchodilators

A
  • short acting

- long acting

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27
Q

short acting beta2 agonists duration

A

1-4hrs

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28
Q

long acting beta2 agonists duration

A

6-12hrs

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29
Q

side effects beta2 agonists

A

tachycardia, restlessness, tremors, decr uterine contraction

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30
Q

beta2 agonists contraindications

A

congestive heart failure

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31
Q

duration salbutamol per os

A

30mins

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32
Q

duration salbutamol inhalation

A

5mins

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33
Q

long acting beta2 agonists

A
  • terbutaline
  • clenbuterole
  • salmeterol
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34
Q

terbutaline duration

A

6-8hrs

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35
Q

terbutaline selectivity

A

less

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36
Q

clenbuterole selectivity

A

less

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37
Q

clenbuterole duration

A

6-8hrs

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38
Q

clebuterole target species

A

less effective in companion animals, frequently used in horse

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39
Q

clenbuterole is prohibited in what

A

racing and food production (horses)

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40
Q

salmeterol selectivity

A

most selective

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41
Q

salmeterol duration

A

longest, 10mins-2hrs

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42
Q

how do we minimise adverse effects of adrenergic agonists

A

by inhalant delivery

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43
Q

beta1 receptor activity causes what

A

cardiac effects - tachycardia, arrythmias

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44
Q

which drugs give us beta1 receptor activity

A

ephedrine, isoproterenol

45
Q

beta2 adrenoreceptor agonists cause what

A

skeletal muscle tremor

46
Q

alpha adrenoceptor activity causes what

A

vasoconstriction and hypertension

47
Q

side effects of acetylcholine antagonists

A

tachycardia, mydriasis, decr mucociliary clearance

48
Q

acetylcholine causes paralytic ileus in which species

A

equine

49
Q

indications for acetycholine antagonists

A
  • asthma in fe
  • RAO in eq
  • organophosphate toxicosis
50
Q

parasympatholytic bronchodilators

A
  • acetylcholine antagonists
  • atropine
  • glycopyrrolate
  • ipratropium
51
Q

when should we use atropine and glycoyrrolate in eq RAO

A

only in life threatening situation

52
Q

glycopyrollate vs atropine

A

longer duration, much safer

53
Q

what kind of amine is atropine

A

tertiary

54
Q

what kind of amine is ipratropium

A

quaternary

55
Q

does ipratropium cross the blood brain barrier

A

no

56
Q

does ipratropium affect mucociliary clearance

A

no

57
Q

methyl xanthine derivatives bronchodilators

A
  • caffeine
  • theophylline
  • theobromine
58
Q

derivatives of theophylline

A
  • aminophylline
  • propentophylline
  • pentoxyphylline
59
Q

methyl xanthine derivatives mechanism of action

A

phosphodiesterase inhibitor -> cAMP level incr -> bronchodilation

60
Q

pharmacokinetics of methyl xanthine derivatives

A
  • good absorption

- enterohepatic circulation -> activated carbon

61
Q

side effects of methyl xanthine derivatives

A

diuresis, palpatations, hyperacidity, CNS stimulation

62
Q

methyl xanthine derivatives TI

A

small

63
Q

methylxanthines indications

A

bronchitis, pneumonia

64
Q

methyl xanthines dosage forms

A

iv, po, rectally

65
Q

propentophyllin has a vasodilator effect in which organs

A

brain, muscles, kidney

66
Q

therapeutic use of methyl xanthines

A

acute or chronic asthma thats unresponsive to beta-adrenoceptor agonists, COPD and emphysema

67
Q

methyl xanthines adverse effects

A

arrythmias, nervousness, vomiting and GI bleeding

68
Q

types of respiratory anti-inflammatories

A
  • inhalational glucocorticoids
  • chromones
  • leukotriene antagonists
69
Q

resp anti-inflammatories indication

A

asthma, RAO

70
Q

inhalational GCs mechanism of action

A

inhibition of the expresssion of several genes -> decr cytokine production

71
Q

what do inhalational GCs do to mucus production

A

decr

72
Q

what do inhalational GCs do to diameter

A

increasing

73
Q

is it possible to systemically apply inhalational GCs

A

yes, but several side effects

74
Q

definition of an antitussive

A

any medicine used to suppress or relieve coughing

75
Q

whats a mucolytic

A

destroying or dissolving mucus

76
Q

whats an expectorant

A

drugs that loosen and clear mucus and phlegm from the resp tract

77
Q

antitussives mechanism of action

A

they suppress the cough centre

78
Q

types of peripheral antitussives

A
  • mucolytics, expectorants
  • bronchodilators
  • coating substances
  • local anaesthetics
79
Q

types of central antitussives

A

morphine derivatives

80
Q

codeine vs morphine

A
  • better bioaval
  • 10 times lower analgesic potency
  • similiar antitussive
81
Q

why shouldnt we use codeine in cats

A

excitation

82
Q

possible rare side effects of codeine

A

convulsions, sedation, constipation

83
Q

can dihydrocodeine be used in cats

A

no

84
Q

is butorphanol safe for use in cats

A

yes

85
Q

butorphanol features

A

most effective, but sedation

86
Q

which receptor does dextrometorphan act on

A

sigma receptor

87
Q

is dexmetorphan addictive

A

no

88
Q

is dexmetorphan analgesic

A

no

89
Q

dextrometorphan, can it be used in cats

A

yes

90
Q

tramadol can it be used in cats

A

yes

91
Q

mucolytics and expectorants indications

A

bronchitis, bronchopneumonia, tracheitis, rhinitis, sinusitis, RAO as adjunctive therapy

92
Q

mucolytics and expectorants mechanism of action

A

dissolution of dense, sticky mucus inside the resp tract -> productive coughing

93
Q

list of mucolytics

A
  • N acetylcysteine

- carbocystein

94
Q

N acetylcysteine mechanism of action

A

breaking up disulphide bonds in mucoproteins -> dissolution of viscious mucus

95
Q

N acetylcysteine administration route

A

per os, inhalation

96
Q

for which type of toxicosis is N acetylcysteine an antidote

A

paracetamol toxicosis

97
Q

carbocysteine vs N acetylcysteine

A

similiar action, oral absorption a little better

98
Q

where do expectorants act directly

A

mucus membranes of airways

99
Q

where do expectorants act indirectly

A

stimulating gastric mucus membranes

100
Q

list of expectorants

A
  • bromhexin

- guaifenesin

101
Q

bromihexin three actions

A
  • breaking up mucopolysaccharides, dissolving mucus
  • -incr secretion of serous glands
  • enhancing ciliary movement
102
Q

what does bromhexin do to the permeation of Igs and ABs

A

enhances it

103
Q

what happens to iGa and IGg levels after bromhexin admin

A

increased

104
Q

bromhexin indications

A

rhinitis, sinusitis, tracheobronchitis

105
Q

ambroxol what is it

A

metabolite of bromhexin

106
Q

in which species can we apply dembrexine

A

equine

107
Q

can guafenesin be combined with other antitussives

A

yes

108
Q

guafenesin mechanism of action

A

does not change amount of mucus secretion-> enhances ciliary movement