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Pharmacology > Respiratory pharmacology > Flashcards

Respiratory pharmacology Flashcards

1
Q

List four main causes of respiratory pathology

A

Trauma

Infection

Allergy

Toxin

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2
Q

List the three main aims of respiratory therapeutics

A
  1. to control aetiology
  2. to control inflammation
  3. to provide relief of symptoms
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3
Q

Name two classes of drugs that might be important in controlling respiratory aetiology

A

Chemotherapeutics

Diuretics

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4
Q

Name three drug classes that might be useful in controlling respiratory inflammation

A

Glucocorticosteroids

Antihistamines

Leukotriene antagonists

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5
Q

Name six classes of drugs that might provide relief of respiratory symptoms

A

Bronchodilators

Mucolytics

Antitussives

Expectorants

Surfactants

Decongestants

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6
Q

Which system stimulates the production of mucus from the respiratory system

A

Cholinergic innervation

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7
Q

Which cells produce mucous in the respiratory system?

A

Submucosal glands and goblet cells

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8
Q

Briefly describe the structure of mucous in the respiratory systems

A

Mucoproteins, DNA

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9
Q

What is the normal function of mucous in the respiratory system?

A

Protective coating from nasal cavity to large bronchioles

Humidifies air, protects from irritants and infection

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10
Q

What is the function of mucolytics?

A

Break up mucous

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11
Q

Name two mucolytics

A

Acetylcysteine (nebulisation)

Bromhexine

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12
Q

Describe the mechanism of action of acetylcysteine as a mucolytic

A

Breaks disulfide linkes in mucoproteins

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13
Q

Describe the mechanism of action of bromhexine as a mucolytic

A

Increased lysosome activity

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14
Q

What else can acetylcystein be used for besides being a mucolytic?

A

Paracetamol toxicity

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15
Q

Name an expectorant

A

Guaifenisin (glycerol guiacolate)

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16
Q

What is the aim of using an expectorant?

A

Designed to increase respiratory secretions and help clear airways

No real data to suggest effectiveness in dogs and cats

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17
Q

Which class of drugs can be used as a decongestant?

A

Selective alpha 1 agonists

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18
Q

Name 2 alpha1 agonists that might be used as decongestants

A

Pseudoephidrine, phenylephrine

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19
Q

What is the purpose of antitussives?

A

Reduce cough reflex through a reduction in sensitivity of irritant receptors

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20
Q

Name two classes of antitussive

A

Opioids

Non-opioid antitussives

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21
Q

Name three opioids that might be useful as antitussives

A

Hydrocodone, codiene, butorphanol

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22
Q

Name a non-opioid antitussive

A

Dextromethorphan hydrobromide

23
Q

When would you consider using a respiratory stimulant?

A

Caesarian puppies/kittens

Anaesthetic induced apnoea

24
Q

Name a respiratory stimulant

A

Doxapram

25
Q

What are contraindications for doxapram?

A

epilepsy, head trauma

26
Q

Which receptors are present on bronchial smooth muscle?

A

M1, M2, M3

Beta2

Histamine 1

Serotonin (cats)

NO (some species)

27
Q

What is the effect of M3 receptor agonists on bronchial smooth muscle

A

Bronchoconstriction and mucous secretion

28
Q

Which drugs might be useful in antagonising muscarinc receptors?

A

Atropine

Ipratropium bromide (doesn’t stop mucociliary clearance - advantage over atropine)

29
Q

List four pathophysiologic effects of asthma

A

Thicking of epithelium

Hypertrophy of goblet cells and submucosal glands

Bronchial smooth muscle spasms and hypertrophy

Cellular infiltration and oedema of mucosa and submucosa

30
Q

What three processes occur in the immediate phase of asthma?

A

Mast cell release

Bronchoconstriction

Chemotaxis

31
Q

What process occurs in the late phase of asthma?

A

Continuation of inflammation

32
Q

Name three anatomical/physiological differences between the airways of dogs and cats

A

Cats with greater broncho-motor tone at rest

Cats with smaller airway radius

Cats with additional receptor types

33
Q

Name four major categories of feline bronchial disease

A

Bronchial asthma

Acute bronchitis

Chronic bronchitis

Emphysema

34
Q

List some key features of bronchial asthma

A

Allergic component

Airway eosinophilia

Chronic inflammation even without clinical signs

Serotonin main mediator in cats

35
Q

List some key features of acute bronchitis

A

Short duration airway obstruction

neutrophilia and macrocytosis

36
Q

List some key features of chronic bronchitis

A

mixed cellular inflammation or mycoplasma infection

37
Q

List some key features of emphysema

A

destruction of bronchiolar and alveolar walls

38
Q

What are the clinical signs of feline bronchial disease?

A

Episodic, sub-acute or chronic:

Cough, wheeze, expiratory dyspnoea, tachypnoea

39
Q

What are some important diagnostic features of bronchial disease?

A

History: especially environmental

Physical exam/CSx

Thoracic radiographs (bronchial pattern)

Bronchalveolar lavage/tracheal ash

40
Q

List some anti-inflammatory actions of glucocorticosteroids

A

Inhibit formation of prostaglandins (stabilise cell walls)

Down-regulate fibroblast proliferation and collagen formation

reduce endothelial cell permeability

41
Q

List some immunomodulatory functions of glucocorticoids

A

Immunosuppression

Cytotoxic to T lymphocytes at high concentrations

Reduction in neutrophil movements

Reduction in dendritic cells (APC, link innate and adaptive immunity)

42
Q

List some first line drug classes in feline asthma?

A

Glucocorticosteroids

Bronchodilators

43
Q

List four glucocorticoids that might be useful in feline asthma

A

Prednisolone (oral: cheap but systemic effects)

Hydrocortisone or dexamethasone injection

Fluticasone (inhalation: $$ but no systemic effects)

44
Q

Name two classes of bronchodilators

A

B2 agonists

Methylxanthines

45
Q

List some B2 agonists and routes of administration that might be used as bronchodilators in feline asthma

A

Terbutaline (oral, IM, SC)

Salmeterol (inhalation)

Salbutamol (inhalation, IV)

Cluenbuterol

46
Q

List two methylxanthines

A

Aminophylline

Theophylline

47
Q

Name some naturally occuring xanthines

A

theophylline

theobromine

caffeine

48
Q

Name some effects of methylxanthines

A

anti-asthmatic:bronchodilators

CNS stimulant

positive chronotrope and inotrope

diuretic

49
Q

List the effects of theophylline (in people)

A

treating underlying inflammation

synergistic antiinflammatory effects with glucocorticosteroids

improve mucociliary clearance

decrease fatigue of respiratory muscles

inhibit release of mast cells

50
Q

Name an antileukotriene

A

Zafirlukast

51
Q

List two muscarinic antagonists

A

Ipratropium

atropine

52
Q

List a class of drugs that might be useful in allergic rhinitis

A

antihistamines

53
Q

Are antibiotics important in the treatment of respiratory disease?

A

Depends on cause:

primary therapy for many respiratory diseases of cattle and poultry

Not effective in feline bronchial disease unless caused by mycoplasma

Pharmacology (12 decks)

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