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Pharmacology 1 choefsho > Respiratory drugs > Flashcards

Respiratory drugs Flashcards

1
Q

What do you call an array of antimicrobial drugs that improve the clearance of material from the airways by stimulating cough and breaking up mucus?

A

Expectorants, mucolytics, decongestants

  • For patients with large volumes of thick or tenacious mucous secretions
  • Not well documented in vetmed
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2
Q

Which of the following is an antimicrobial mucolytic administered via nebulization, but is also an irritant to the airways?

  1. 0.9% NaCl
  2. N-Acetylcysteine (NAC)
  3. Guaifenesin
  4. Phenylephrine
A
  1. N-Acetylcysteine (NAC)
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3
Q

Which of the following is a therapeutic strategy used to hydrate the airways to improve clearance (antimicrobial)?

  1. 0.9% NaCl
  2. N-Acetylcysteine (NAC)
  3. Guaifenesin
  4. Phenylephrine
A
  1. Nebulization of 0.9% NaCl with coupage
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4
Q

Which of the following has been used as an antimicrobial expectorant in equine?

  1. 0.9% NaCl
  2. N-Acetylcysteine (NAC)
  3. Guaifenesin
  4. Phenylephrine
A
  1. Guaifenesin
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5
Q

Which of the following is used as an antimicrobial decongestant in horses to relieve nasal congestion?

  1. 0.9% NaCl
  2. N-Acetylcysteine (NAC)
  3. Guaifenesin
  4. Phenylephrine
A
  1. Phenylephrine (causes local vasoconstriction in upper airways)
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6
Q

Which group of antibiotics have a good concentration in the epithelial lining fluid (ELF, fluid lining the alveoli) and accumulate in phagocytes? (pick 3)

  1. Aminoglycosides
  2. Macrolides
  3. Beta-lactams
  4. Tetracyclines
  5. Fluoroquinolones
A
  1. Macrolides, 4. Tetracyclines, 5. Fluoroquinolones

(also, some tulathromycin)

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7
Q

Which group of antibiotics may achieve effective concentrations in the interstitial space of lungs? (pick 2)

  1. Aminoglycosides
  2. Macrolides
  3. Beta-lactams
  4. Tetracyclines
  5. Fluoroquinolones
A
  1. Aminoglycosides and 3. Beta-lactams
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8
Q

T or F. Pleural space is harder to reach and may require surgical intervention.

A

True (ex. chest tube placement for flushing for pyothorax), don’t let drugs do all the work!

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9
Q

T or F. Sensitivity testing is required for antifungals because efficacy is unpredictable.

A

False, sensitivity testing is rarely done; efficacy is generally predictable once the etiology is known

  • Antifungal therapy may be needed for months
  • Adjunct anti-inflammatory therapy may be considered at the beginning of treatment
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10
Q

What do use to treat blastomycosis?

A

Itraconazole

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11
Q

What do you use to treat coccidioidomycosis?

A

Fluconazole

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12
Q

Which antivirals are used to treat a viral infection?

A

Antivirals are not commonly used; treatment generally consists of supportive care and control of secondary bacterial infections

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13
Q

Which oral anti-inflammatory drugs are commonly used for respiratory conditions?

  1. Prednisone/prednisolone
  2. Fluticasone
  3. NSAIDS
  4. Leukotriene inhibitors
  5. NK1 antagonists (Cerenia)
A
  1. Prednisone/prednisolone (glucocorticoids)
    * (3, 4, 5 not used much)*
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14
Q

Which topical/local anti-inflammatory drug is used in respiratory conditions, but has low bioavailability?

  1. Prednisone/prednisolone
  2. Fluticasone
  3. NSAIDS
  4. Leukotriene inhibitors
  5. NK1 antagonists (Cerenia)
A
  1. Fluticasone
    * Human approved, has been assessed in some vet cases
    * (3, 4, 5 not used much)*
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15
Q

Which drug is not used as an antitussive (cough suppressant)?

  1. Codeine and dextromethorphan
  2. Butorphanol
  3. Hydrocodone
  4. NSAIDs
A
  1. NSAIDs

Opioids are used to reduce the sensitivity of the cough-center to afferent stimuli (irritation, stretch, etc.) via opioid receptors

  • Hydrocodone: may be formulated with homatropine as an abuse deterrent for humans; sometimes formulated with acetaminophen
  • Butorphanol: high first-pass effect (lower oral bioavailability)
  • Codeine and dextromethorphan more commonly used in humans
  • Side effects: sedation, constipation, nausea
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16
Q

Which drugs are used as bronchodilators in the case of acute anaphylaxis?

  1. Terbutaline
  2. Clenbuterol
  3. Albuterol
  4. Epinephrine, Isoproterenol
A
  • Nonselective beta-adrenergic agonsits (urgent injectable)
    • 4. Epinephrine, Isoproterenol: short term treatment of life-threatening bronchoconstriction (ex. acute anaphylaxis)
      • Will have beta-1 effects (cardac)
17
Q

Which inhalant bronchodilator has a rapid response and can last for hours?

  1. Terbutaline
  2. Clenbuterol
  3. Albuterol
  4. Epinephrine, Isoproterenol
A
  1. Albuterol (Salmeterol + fluticasone = Advair)
    * Selective beta-2 agonist
18
Q

Which bronchodilator is used in small animals to manage asthma, but not really used in horses due to low oral absorption?

  1. Terbutaline
  2. Clenbuterol
  3. Albuterol
  4. Epinephrine, Isoproterenol
A
  1. Terbutaline
  • Selective beta-2 agonist
  • Human approved product
  • Tablet or injection
19
Q

Which bronchodilator is a veterinary approved oral syrup used in horses to manage COPD?

  1. Terbutaline
  2. Clenbuterol
  3. Albuterol
  4. Epinephrine, Isoproterenol
A
  1. Clenbuterol
  • Selective beta-2 agonist
  • NOT PERMITTED IN FOOD PRODUCING ANIMALS
20
Q

Bronchodilators in the form of metered-dose inhalers are available for which species?

A

Cats, horses, dogs

  • AeroKat, AeroHippus, AeroDawg
  • Spacer
  • Specialized mask
21
Q

Selective beta-2 agonists will primarily have bronchodilatory effects; what else can it do?

A

May also stabilize mast cells and increase mucociliary clearance

  • Other beta-2 effects and beta-1 effects are less apparent
  • Tolerance may be seen with chronic use (receptor down-regulation
22
Q

T or F. Beta-adrenergic agonists, methylxanthine derivatives, and anticholinergics are used as bronchodilators.

23
Q

What are the 2 main methylxanthines that are used as bronchodilators to manage respiratory disease?

A

Aminophylline (parenteral) and Theophylline (oral)

  • Phosphodiesterase inhibitors (block degradation of cAMP) and are adenosine receptor agonists
  • Also inhibit mast cell degranulation and improve mucociliary clearance
  • Stimulate catecholamine release from adrenals
  • Increase CNS sensitivity to PaCO2 (increased breathing)
24
Q

What are potential adverse effects of using methylxanthines (Aminophylline and theophylline) to manage respiratory disease?

A
  • Cardiac stimulation
  • GI irritation (salivation, nausea, vomiting)
  • Skeletal muscle stimulation (twitching)
  • Diuresis (PU/PD)
25
Q

Which drug is used for pulmonary hypertension by relaxing vascular smooth muscles?

  1. Doxapram
  2. Exogenous surfactants
  3. Sildenafil (Viagra)
A
  1. Sildenafil (Viagra)
26
Q

Which drug is a phospholipid/protein mixture that reduces surface tension in the alveoli and prevents collapse during expiration (allows the alveoli to stay expanded) in premature foals or calves?

  1. Doxapram
  2. Exogenous surfactants
  3. Sildenafil (Viagra)
A
  1. Exogenous surfactants
27
Q

Which drug is a short-term respiratory stimulant used to assist with laryngeal exams in dogs and cats and also stimulates respiration in newborn animals?

  1. Doxapram
  2. Exogenous surfactants
  3. Sildenafil (Viagra)
A
  1. Doxapram
    * Analeptic, central respiratory stimulant

Pharmacology 1 choefsho (13 decks)

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