Respiratory Drugs Flashcards
what drugs are central to the treatment of inflammatory airway disease?
glucocorticoids
what are some adverse effects of glucocorticoids?
adrenal suppression
immunosuppression
pu/pd
gastrointestinal ulceration
hyperglycemia
laminitis (horses)
what are the advantages of using inhaled steroids?
limits adverse effects of systemic glucocorticoids
more useful for prevention than treatment
how do adrenergics work with bronchodilation?
bind to beta2 receptors
what is the parenteral bronchodilator of choice in cats?
terbutaline
can you use albuterol as a chronic treatment in cats?
no
which beta2 agonist is not allowed in food animals?
clenbuterol
what do corticosteroids do with beta2 agonists?
enhance the response
what are some adverse effects associated with peripheral beta2 agonists?
vasodilation
hypotension
reflex tachycardia
what do methylxanthines cause?
airway smooth muscle relaxation
decreased release of inflammatory mediators from mast cells
increased mucociliary transport
stimulates respiration
what are the adverse effects of epinephrine?
tachycardia and arrythmias
hypertension
excitability
vomiting
sweating (horses)
tocolytic
what can inflammatory mediators do in the airways?
increase sensitivity
cause bronchoconstriction
increase secretions
what are the therapeutic goals of inflammatory respiratory disease?
decrease inflammation
decrease resistance
improve mucociliary clearance
promote gas exchange
what are the mechanisms of action of glucocorticoids?
inhibit release of inflammatory mediators from macrophages and eosinophils
decrease synthesis and release of cytokines important in immune response
decrease synthesis of prostaglandins, leukotrienes, platelet activating factor
enhance effects of adrenergic agonists on bronchial smooth muscle
which inhalers should and should not be used in veterinary medicine?
use: metered dose inhalers
do not use: breath actuated inhalers
what are the main classes of bronchodilators?
adrenergic agonists
anticholinergics
methylxanthines
what are some beta2 agonists in small animals?
terbutaline
albuterol
which beta2 agonist cannot be used as chronic treatment in cats?
albuterol
what are the beta2 agonists in equine?
clenbuterol
albuterol
salmeterol
which beta2 agonist cannot be used in food animals?
clenbuterol
what can non-selective agonists do that is adverse?
may activate beta1 and also cause tachycardia and arrhythmias
alpha1: vasoconstriction
what are some methylxanthines?
theophylline (most effective)
caffeine
theobromine (least effective)
what is important about albuterol in cats?
inhalant is racemic mixture
S-form is pro-inflammatory in cat
S-form accumulates with longer term treatment
why are bronchodilators rarely used in dogs?
minimal bronchoconstriction in chronic bronchitis
what is used for chronic bronchodilation?
theophylline
what is used for inflammation in canine chronic bronchitis?
prednisone
fluticasone (inhaled)
what anti-inflammatories are used in equine asthma?
dexamethasone
prednisolone
ciclesonide, fluticasone (inhaled)
what are the adverse effects of clenbuterol?
sweating
tachycardia
muscle tremors
inhibits uterine contractions
how can epinephrine cause acute bronchoconstriction?
alpha and beta adrenergic agonist
what are the mechanisms for pulmonary edema?
negative pressure pulmonary edema: post-anesthesia
pneumonia
cardiogenic
acute respiratory distress syndrome
what are the therapeutic principles for pulmonary edema?
address underlying cause
diuresis: reduce blood volume and pressure, increases oncotic pressure
what can be given to dogs with anxiety associated with dyspnea?
butorphanol
buprenorphine and acepromazine
what can be given in respiratory distress?
oxygen
acepromazine
butorphanol
glucocorticoids sometimes
what is terbutaline like?
minimal beta1 activity
longer lasting
parenteral bronchodilator of choice in cats
