respiratory drugs Flashcards
1
Q
asthma is a complex disease characterised by what
A
airway inflammation
2
Q
what marks the inflammatory component of asthma
A
airway oedema, goblet-cell hyperplasia, mucus secretion and infiltration
3
Q
the newer name for COPD
A
RAO, recurrent airway obstruction
4
Q
COPD is caused by what
A
an abnormal inflammatory response to an inhaled environmental insult
5
Q
what are the two frequently overlapping diseases COPD can be divided into
A
emphysema and chronic bronchitis
6
Q
sympathetic effect on the airway causes what
A
bronchodilation
7
Q
parasympathetic effect on airway causes what
A
bronchoconstriction
8
Q
the two receptor types expressed by airway smooth muscle cells
A
beta2 adrenergic and muscarinic
9
Q
beta2 adrenergic receptors are activated by what
A
adrenaline
10
Q
muscarinic receptors cause what when stimulated
A
bronchoconstriction
11
Q
beta2 adrenergic receptors cause what when stimulated
A
bronchodilation
12
Q
what effect does mast cell degranulation produce
A
bronchoconstriction and airway inflammation
13
Q
what effect do cysteinyl leukotrienes induce
A
bronchoconstriction
14
Q
types of drugs acting on the respiratory system
A
- bronchodilators
- resp antiinflammatory drugs
- antitussives
- mucolytics, expectorants
15
Q
indications for bronchodilators
A
- anaphylaxis
- allergic bronchitis
- asthma
- pulmonary edema
- pneumonia
- pleural effusion
- pneumothorax
- tracheal collapse and hypoplasia
16
Q
groups of bronchodilators
A
- sympathomimetics
- anticholinergic substances
- xanthine derivatives
17
Q
sympathomimetics mechanism of action to cause bronchodilation
A
act on beta2 receptors - incr cAMP
18
Q
two groups of sympathomimetics
A
- non specific
- specific/beta2 receptor agonists
19
Q
non specific sympathomimetics
A
- adrenaline
- isoproterenol
- ephedrine
20
Q
specific sympathomimetics
A
- salbutamol
- terbutaline
- clenbuterole
- salmeterol
21
Q
adrenaline bronchodilation mechanism of action
A
at beta2 receptors
22
Q
indications adrenaline for bronchodilation
A
only in life threatening situations eg anaphylaxis
23
Q
which drug is isoproterenol similiar to
A
adrenaline
24
Q
ephedrine mechanism of action
A
directly and indirectly
25
ephedrine indications
- bronchodilator
| - tachyphylaxis
26
two types of beta2 agonists bronchodilators
- short acting
| - long acting
27
short acting beta2 agonists duration
1-4hrs
28
long acting beta2 agonists duration
6-12hrs
29
side effects beta2 agonists
tachycardia, restlessness, tremors, decr uterine contraction
30
beta2 agonists contraindications
congestive heart failure
31
duration salbutamol per os
30mins
32
duration salbutamol inhalation
5mins
33
long acting beta2 agonists
- terbutaline
- clenbuterole
- salmeterol
34
terbutaline duration
6-8hrs
35
terbutaline selectivity
less
36
clenbuterole selectivity
less
37
clenbuterole duration
6-8hrs
38
clebuterole target species
less effective in companion animals, frequently used in horse
39
clenbuterole is prohibited in what
racing and food production (horses)
40
salmeterol selectivity
most selective
41
salmeterol duration
longest, 10mins-2hrs
42
how do we minimise adverse effects of adrenergic agonists
by inhalant delivery
43
beta1 receptor activity causes what
cardiac effects - tachycardia, arrythmias
44
which drugs give us beta1 receptor activity
ephedrine, isoproterenol
45
beta2 adrenoreceptor agonists cause what
skeletal muscle tremor
46
alpha adrenoceptor activity causes what
vasoconstriction and hypertension
47
side effects of acetylcholine antagonists
tachycardia, mydriasis, decr mucociliary clearance
48
acetylcholine causes paralytic ileus in which species
equine
49
indications for acetycholine antagonists
- asthma in fe
- RAO in eq
- organophosphate toxicosis
50
parasympatholytic bronchodilators
- acetylcholine antagonists
- atropine
- glycopyrrolate
- ipratropium
51
when should we use atropine and glycoyrrolate in eq RAO
only in life threatening situation
52
glycopyrollate vs atropine
longer duration, much safer
53
what kind of amine is atropine
tertiary
54
what kind of amine is ipratropium
quaternary
55
does ipratropium cross the blood brain barrier
no
56
does ipratropium affect mucociliary clearance
no
57
methyl xanthine derivatives bronchodilators
- caffeine
- theophylline
- theobromine
58
derivatives of theophylline
- aminophylline
- propentophylline
- pentoxyphylline
59
methyl xanthine derivatives mechanism of action
phosphodiesterase inhibitor -> cAMP level incr -> bronchodilation
60
pharmacokinetics of methyl xanthine derivatives
- good absorption
| - enterohepatic circulation -> activated carbon
61
side effects of methyl xanthine derivatives
diuresis, palpatations, hyperacidity, CNS stimulation
62
methyl xanthine derivatives TI
small
63
methylxanthines indications
bronchitis, pneumonia
64
methyl xanthines dosage forms
iv, po, rectally
65
propentophyllin has a vasodilator effect in which organs
brain, muscles, kidney
66
therapeutic use of methyl xanthines
acute or chronic asthma thats unresponsive to beta-adrenoceptor agonists, COPD and emphysema
67
methyl xanthines adverse effects
arrythmias, nervousness, vomiting and GI bleeding
68
types of respiratory anti-inflammatories
- inhalational glucocorticoids
- chromones
- leukotriene antagonists
69
resp anti-inflammatories indication
asthma, RAO
70
inhalational GCs mechanism of action
inhibition of the expresssion of several genes -> decr cytokine production
71
what do inhalational GCs do to mucus production
decr
72
what do inhalational GCs do to diameter
increasing
73
is it possible to systemically apply inhalational GCs
yes, but several side effects
74
definition of an antitussive
any medicine used to suppress or relieve coughing
75
whats a mucolytic
destroying or dissolving mucus
76
whats an expectorant
drugs that loosen and clear mucus and phlegm from the resp tract
77
antitussives mechanism of action
they suppress the cough centre
78
types of peripheral antitussives
- mucolytics, expectorants
- bronchodilators
- coating substances
- local anaesthetics
79
types of central antitussives
morphine derivatives
80
codeine vs morphine
- better bioaval
- 10 times lower analgesic potency
- similiar antitussive
81
why shouldnt we use codeine in cats
excitation
82
possible rare side effects of codeine
convulsions, sedation, constipation
83
can dihydrocodeine be used in cats
no
84
is butorphanol safe for use in cats
yes
85
butorphanol features
most effective, but sedation
86
which receptor does dextrometorphan act on
sigma receptor
87
is dexmetorphan addictive
no
88
is dexmetorphan analgesic
no
89
dextrometorphan, can it be used in cats
yes
90
tramadol can it be used in cats
yes
91
mucolytics and expectorants indications
bronchitis, bronchopneumonia, tracheitis, rhinitis, sinusitis, RAO as adjunctive therapy
92
mucolytics and expectorants mechanism of action
dissolution of dense, sticky mucus inside the resp tract -> productive coughing
93
list of mucolytics
- N acetylcysteine
| - carbocystein
94
N acetylcysteine mechanism of action
breaking up disulphide bonds in mucoproteins -> dissolution of viscious mucus
95
N acetylcysteine administration route
per os, inhalation
96
for which type of toxicosis is N acetylcysteine an antidote
paracetamol toxicosis
97
carbocysteine vs N acetylcysteine
similiar action, oral absorption a little better
98
where do expectorants act directly
mucus membranes of airways
99
where do expectorants act indirectly
stimulating gastric mucus membranes
100
list of expectorants
- bromhexin
| - guaifenesin
101
bromihexin three actions
- breaking up mucopolysaccharides, dissolving mucus
- -incr secretion of serous glands
- enhancing ciliary movement
102
what does bromhexin do to the permeation of Igs and ABs
enhances it
103
what happens to iGa and IGg levels after bromhexin admin
increased
104
bromhexin indications
rhinitis, sinusitis, tracheobronchitis
105
ambroxol what is it
metabolite of bromhexin
106
in which species can we apply dembrexine
equine
107
can guafenesin be combined with other antitussives
yes
108
guafenesin mechanism of action
does not change amount of mucus secretion-> enhances ciliary movement
