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Basic Pharmacology > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

1
Q

what is the pleural cavity?

A

potential space existing around each lung
negatively pressurized at all times

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2
Q

what does narrowing of airway cause?

A

increased airflow and more irritation and reflex bronchoconstriction

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3
Q

what is the main active stimulator of bronchoconstriction and secretion?

A

parasympathetic input

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4
Q

what does sympathetic input cause?

A

bronchodilation
beta2

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5
Q

what are the positives of inhalation therapy?

A

achieves high local concentrations
may minimize systemic exposures and hence adverse effects

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6
Q

what are the main disadvantages of inhalation therapy?

A

ensuring accurate dose is delivered
knowing what the dose should be in the first place

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7
Q

what class of drugs is used as antitussives?

A

opiates

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8
Q

when should you not use an antitussive?

A

productive cough and/or bacterial pneumonia

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9
Q

how do opioid antitussives reduce the cough?

A

decrease responsiveness of cough center to afferent stimuli and may decrease peripheral response of sensory nerve endings
mu and kappa receptors

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10
Q

what opioid antitussives do we use?

A

butorphanol
hydrocodone
codeine
diphenoxylate and atropine

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11
Q

what effects does butorphanol have?

A

weak analgesic
effective cough suppressant

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12
Q

what receptors does butorphanol impact?

A

partial mu receptor agonist and full kappa receptor agonist

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13
Q

is dextromethorphan an opioid?

A

no: structurally related to but does not bind opioid receptors

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14
Q

what receptors does dexstromethorphan stimulate?

A

sigma-1 receptors

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15
Q

which antitussive do we use in cats?

A

dextromethorphan is safest

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16
Q

what is the mechanism of action for mucolytics?

A

breakdown mucous secretions

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17
Q

what is the mechanism of action for expectorants?

A

increase bronchial secretions
enhance mucociliary clearance
promote productive cough

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18
Q

what is one mucolytic?

A

acetylcysteine

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19
Q

how does acetylcysteine work?

A

interacts with disulfide bonds on mucoproteins to break down mucous
enhances mucous clearance
increases glutathione

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20
Q

why is acetylcysteine used as an anti-dote for some toxicants?

A

increases glutathione concentrations or reacts directly with toxic metabolites

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21
Q

what is the predominant system for control of bronchiole tone?

A

parasympathetic

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22
Q

what is the primary adrenergic receptor for control of bronchiole tone?

A

beta-2

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23
Q

what are the actions of beta-2 agonist bronchodilators?

A

smooth muscle relaxation
decrease release of inflammatory mediators from mast cells
decrease and thin secretions
increase mucociliary clearance (activate cilia)

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24
Q

what does chronic stimulation of beta-2 receptors result in?

A

down-regulation and de-sensitization of receptors

25
Q

what enhances response to beta-2 agonists?

A

corticosteroids

26
Q

what does down-regulation and de-sensitization of beta-2 receptors lead to?

A

variable response to beta-2 agonists

27
Q

what can peripheral beta-2 activation lead do?

A

vasodilation
hypotension
reflex tachycardia

28
Q

who is clenbuterol approved in?

A

horses
banned in food animals: was used as tocolytic and growth promotant

29
Q

which species is terbutaline preferred for?

A

cats
injectable

30
Q

what is the mechanism of action of theophylline?

A

adenosine receptor antagonist
inhibits phosphodiesterase (increase cAMP)
augments release of catecholamines

31
Q

what do methylxanthines cause?

A

airway smooth muscle relaxation
decreased release of inflammatory mediators from mast cells
increased mucociliary transport

32
Q

in what can methylxanthines be used?

A

occasionally feline asthma
cardiogenic cough in dogs: enlarged left atrium pushes on bronchi
collapsing trachea in dogs

33
Q

what are respiratory stimulants used for?

A

decrease respiratory depressant effects of opiates and barbituates
“dummy” foals to correct hypercapnea

34
Q

what does doxapram do?

A

stimulates respiratory center
activates aortic/carotid chemoreceptors

35
Q

what do mast cell stabilizers do?

A

stabilize mast cells and prevent release of inflammatory mediators
may inhibit platelet-activating factor (early and late phases of pulmonary inflammatory response)

36
Q

what do glucocorticoids do?

A

upregulate beta-adrenergic receptors and increase their sensitivity: increase synthesis of intermediary protein in second messenger system of receptors

37
Q

what is the clinical use of mast cell stabilizers?

A

must be administered prior to triggering exposure

38
Q

the lungs are found within the ___________ cavity, not the ______________________

A

thoracic
pleural cavities

39
Q

_____________________ can increase sensitivity to nociceptors, leading to bronchoconstriction, and increase secretions, thereby narrowing airways

A

inflammatory mediators
histamine, prostaglandins, leukotrienes

40
Q

what are the sites of action of drugs affecting the respiratory system?

A

lung tissue
alveoli/bronchioles/bronchi
pleural cavity/space
membranes
autonomic nervous system
CNS: cortex and cough center

41
Q

what must you use for aerosol drugs?

A

metered-dose inhaler products with an appropriate spacer

42
Q

what do we want to do with inflammatory/allergic airway diseases?

A

decrease inflammation/immune response
promote air exchange by increasing bronchi and bronchiole diameter
improve mucociliary clearance

43
Q

what classes of drugs do we use in inflammatory/allergic airway diseases?

A

anti-inflammatories
bronchodilators

44
Q

what do we use in exercise-induced pulmonary hemorrhage?

A

diuretics

45
Q

what are antitussives used for primarily in horses?

A

diagnostic procedures
equine asthma

46
Q

what is the cough reflex?

A

afferent nerve endings in bronchi and trachea: irritation and stretch, vagus nerve
activate cough center in medulla oblongata

47
Q

what is the response in opioid antitussives?

A

inconsistent
significant adverse effects

48
Q

what might hydrocodone come with?

A

homatropine: prevent human abuse
antimuscarinic effects

49
Q

which hydrocodone products should you not use?

A

those with acetaminophen in them

50
Q

what is the detailed mechanism of action for mucolytics (acetylcysteine)?

A

interacts with disulfide bonds on mucoproteins to break down mucous
enhances mucous clearance
increases glutathione

51
Q

with beta 2 agonists, what might non-selective agonists do?

A

activate beta 1 and cause tachycardia and arrhythmias

52
Q

what activity does terbutaline have?

A

beta 2 agonist
minimal beta 1 activity

53
Q

can you use terbutaline orally in horses?

A

no
low bioavailability

54
Q

can you use the racemic mixture of albuterol chronically in cats?

A

no
S-isomer pro-inflammatory

55
Q

what is theophylline/aminophylline?

A

adenosine receptor antagonist: bronchodilation, respiratory stimulation

56
Q

what do methylxanthines stimulate?

A

respiration centrally
diaphragmatic contractions
CNS excitement/toxicity

57
Q

what will happen if respiratory stimulants are over-used?

A

loss of stimulatory effect and loss of respiration

58
Q

what is cromolyn?

A

mast cell stabilizer
may inhibit platelet activating factor

59
Q

how long do glucocorticoids take in dogs to have an effect on upregulating beta-adrenergic receptors and increasing their sensitivity?

A

48 hours

Basic Pharmacology (37 decks)

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