Respiratory Drugs

Question 1

Epinephrine

Answer 1

• stimulates Alpha and Beta
• emergency treatment of life threatening bronchocontriction (anaphylaxis)
• not chronic
• not specific
• short acting

Question 2

Clenbuterol (ventipulmin)

Answer 2

• B2 agonist (“ol”)
• approved for RAO in horses (IV or syrup)
• increase efficacy when inflammation is controlled as well
• low doses (bronchodilation)
• B2 selectivity is lost at higher dose (lipolysis, increased blood flow to muscles)
• banned in food animal
• don’t give to pregnancy mares ( tocolysis - uterine relaxation)

Question 3

Salbutamol/Albuterol (ventolin - human form)

Answer 3

B2 agonist
Blue inhaler for acute asthma attacks
- aerosol route
- cats and horses
- chronic use not recommended (beta down regulation)

Question 4

Salmeterol (human - advair, serevent)

Answer 4

• longer acting B2 agonist

- nebulization with mask for animals

Question 5

What is a methylxanthine drug MOA?

Answer 5

• PDE inhibitor that relaxes the bronchial smooth muscle
• increase intracellular cAMP
• antagonize adenosine
• minor inflammatory effects (lower gene expression, lower degranulation)

Question 6

Theophylline

Answer 6

• methylxanthines
• human formulations (injectable, Aq solutions, elixirs, tablets, capsules)
• enzymes inhibited by erthromycin, cimetidine, propranolol and fluoroquinolones (toxicity)
• enzymes induced by rifampin and phenobarbital (need to increase dose)

Question 7

What are the mechanisms of action of anticholinergic drugs?

Answer 7

• inhibit vagally mediated smooth muscle tone (bronchodilation)

Question 8

Name 3 anticholinergics used for resp?

Answer 8

Atropine
- anticholinergic
- test dose for RAO hores
- may cause colic or ileus
- increase HR, mydriasis
Glycopyrrolate
- mostly used during anesthesia
Ipratropium
- inhalent

Question 9

How do glucocorticoids prevent resp disease symptoms?

Answer 9

• attenuates the inflammatory response (suppress cytokines, lower recruitment of airway eosinophils)

Question 10

glucocorticoid airway efffects?

Answer 10

• decrease inflammation
• decrease response to allergens
• prevent wall remodelling
  NET: increase radius

Question 11

Name 2 systemic glucocorticoids used for resp disease?

Answer 11

Prednisolone/Prednisone (dogs)
Prednisolone (cats/horses)
Dexamethazone (power or injectable for horses)

Question 12

Name 3 inhalant glucocorticoid used for resp?

Answer 12

Fluticasome (flovent)
- potent and long acting
- expensive
Bevlomethasome (rivenase)
Budesonide (pulmicort)

Question 13

What are antileukotriene drugs? Name 2.

Answer 13

• leukotreiene receptor antagonist and or 5-lipooxygenase inhibitor drugs for chronic asthma use in humans
• not bronchodilators
• for chronic inflammation
• ineffective in cats?

Zafirlukast (Accolate)
Montelukast (Singulair)

Question 14

What is serotonin and cyproheptadine used for and what does it do?

Answer 14

cats are sensitive to serotonin induced resp inflammation

• blocks H1 receptor and serotonin recpetor
• used for headshaking in horses
• just stick with steroids

Question 15

How can opioids be used for antitussive?

Answer 15

Supress cough center in medulla

- u & K receptors

Question 16

What 3 U agonists can we use for antitussive?

Answer 16

Morphine
Codeine (methylmorphine)
- increase F
- decrease analgesic compared to morphine but equal antitussive
Hydrocodone (hycodan)

Question 17

What K agonist is used for antitussive?

Answer 17

Butorphanol

• poor F, so higher dose used
• dogs dont absorb well

Question 18

What multiple opioid receptor agonist can be used for antitussive?

Answer 18

Tramadol

• multiple opioid receptor types + A2 and 5HT receptor
• antitussive activity of M1 and M2
• not as effective as butorphanol

Question 19

What non true opioid can be used for antitussive?

Answer 19

Dextromethorphan

• D-isomer of levorpthan
• NMDA (glutamate) antagonist
• more of a placebo

Question 20

What herbal ingredients can be used?

Answer 20

Camphor, Menthol, Canada Balsam, Pine needle oil, Tincture of capsicum

Question 21

What is a resp stim used and what does it do?

Answer 21

Doxapram (repiram)

• direct stimulation of resp center
• neonatal or anesthetic use

Question 22

What are 3 phlegm drugs and their effects?

Answer 22

Guaigenesin
- expectorant (mucous hydration for expelling)
Ambroxol
- mucokinetics - increase transportability)
N-acetlycycsteine
- mucolytics (reduce viscousity)