respiratory pharm Flashcards
FDA-approved opioid anti-tussive
Butorphanol in dogs
lasts 4-10hrs, potent PO dose
Most commonly used/effective opioid anti-tussive
Hydrocodone. Active metabolite = hydromorphone
What do some hydrocodone formulations contain that make it a strict prohibit of use in cats?
Acetaminophen
Non-opioid anti-tussive that is found OTC but not used in veterinary patients
Dextromethorphan:
Where are beta-2 receptors located and what happens when stimulated?
in the airways -> when stimulated, get agonist effect = brochodilation
3 most commonly used beta-2 agonists
Terbutaline, Albuterol, Clenbuterol
What drugs would you use in ER situations where pt can’t breathe and is hypotensive?
non-specific beta-2 agonist like epinephrine
Which beta-2 agonist is prohibited for use in food animals?
Clenbuterol b/c it can linger in tissues for long time -> may affect people who consume the meat
Livestock: Adverse effect of beta-adrenergic agonists on repro system, and their use in tocolysis
Clenbuterol, Terbutaline, Albuterol:
Reproductive:
1. inhibits uterine motility
2. Tocolysis: obstretrical procedure where medicine is used delay labor presentation of pre-term contractions. Can also help with manipulations of a fetus in dystocia.
Methylxanthines MoA
What two methylxanthines are often used in dogs, cats and rarely horses?
Theophylline and Aminophyilline
What is the main adverse effect in HORSES of theophylline?
CNS stimulation
Why is there an overdose/toxicity concern with methylxanthines like theophylline?
Theophylline gets metabolized into theobromine (just like chocolate), which undergoes extensive enterohepatic recirculation
Advantages of inhalant drugs for respiratory disease
- high drug concentrations directly at disease site
- minimal systemic effects/toxicity
- therapeutic effect at fraction of systemic dose
Disadvantages of inhalation therapy for respiratory disease
- Respiratory defenses prevent particulates reaching the lower airways
- need adapter (animals won’t breath-hold to allow for distribution)
- drug delivery depends on Vt, RR
- not all drugs suitable for aerosol delivery (airway irritants from preservatives in drug formulation)
Describe importance of particle size of inhalant drug
small enough to get to bottom of lung, but big enough to stay there
MDIs
Metered Dose Inhalers = pressurized cartridge dispenser that delivers a set amount of drug per “puff (actuation)”
Identify / purpose
Spacers: keeps drug in chamber- allows for animal to get all of drug with multiple breaths
Nebulizers MoA
deliver drug as vaporized steam, spray or mist
What are the mainstay of treatment for inflammation in the airway, which is mediated by leukotrienes?
airway inflammation -> bronchoconstriction
Inhalant glucocorticoids
- fluticasone, beclomethasone, ciclesonide
Systemic dexamethasone and predniso[lo]ne are very effective as well, but they have a much greater risk of causing systemic adverse effects versus inhalant glucocorticoids
Fluticasone vs Beclomethasone
Ciclesonide
Aservo, Equihaler
FDA-approved glucocorticoid prodrug inhalant for horses, metabolized by lungs into active metabolite
Mast Cell Stabilizers
Chloride-channel blockers that modulate mast cell-mediator (histamine) release
Mast cell stabilizers inhibit histamine release from mast cells and reduce airway hyper-responsiveness. They are given by inhalation prophylactically to patients with exercise-induced or allergen-induced asthma.
Why are beta-2 adrenergic agonists often paired with a glucocortioid?
B/c beta-2 agonists have no anti-inflammatory properties, which is very important for controlling these inflamamtory upper airway diseases
e.g., albuterol
Ipratropium bromide
Anti-cholinergic, atropine-derivative bronchodilator.
Rule of thumb for URT
If still e/d/u/def but have URT signs (wheezing, conjunctivitis, etc.), wait 10 days
most cases of bronchopneumonia are located in the ___
Interstitial Fluid - most abx get here w/out issue
What abx will be used to treat LRT in horses?
macrolide +/- rifampin
