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1. Pharmacology > Respiratory Pharmacology > Flashcards

Respiratory Pharmacology Flashcards

1
Q

Objectives of drugs affecting resp. system

A

Suppress protective reflexes
Control inflamm.
↓ pulmonary pressure
Dilate bronchioles
Alteration of resp. tract fluids
Control resp. rate
Control infection (antimicrobial therapy)

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2
Q

Resp. defence mechanism

A

Upper resp. tract = mucociliary apparatusl, cough and sneezing
Lower resp. tract = mononuclear phagocyte system

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3
Q

Coughing

A

Central and peripherally acting (chemoreceptor and stretch receptor→ constriction)

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4
Q

Goal for cough suppression

A

↓ frequency and severity without impairing mucocilary defenses

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5
Q

Cough suppression drug uses

A

Dissemination of infection to healthy tissue or other animals
Rupture fo lung abscesses
Interference with sleep

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6
Q

Cough suppression contraindication

A

Productive cough (mucous out lungs)
Symptomatic therapy without diagnosis (tracheo-esophageal fistula → aspiration)

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7
Q

Peripheral acting antitussives

A

Mucosal anesthetics (lidocaine, benzocaine)
Demulcents (soothing effects, syrups)
Bronchodilators (inhalers)

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8
Q

Centrally acting antitussives MOA

A

Suppression of medullary cough center at opiate receptors (mu and K receptors)

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9
Q

Non-narcotic centrally acting antitussives

A

Dextromethorphan: semisynthetic agents

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10
Q

Narcotic (opioid) centrally acting antitussives

A

Morphine, codeine, hydrocodone

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11
Q

Narcotic agonist/ antagonists centrally acting antitussives

A

Butorphanol

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12
Q

Drugs used as antitussives with less established efficacy

A

Maropitant (cerenia)
Diphenoxylate + atropine (Lomotil)

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13
Q

Maropitant

A

Neurokinin receptor (NK1-R) antagonist
Antiemetic in dogs and cats (+ motion sickness)

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14
Q

Diphenoxylate + atropine

A

Antitussive in chronic bronchitis and tracheal collapse
Enough concentration crosses BBB
Adverse: constipation

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15
Q

Respiratory mononuclear phagocyte system

A

In cats, cattle, pigs, sheep, goats
Pulmonary alveolar macros and pulmonary intravascular macros

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16
Q

Phagocytic properties

A

Release inflamm. mediators: histamine, serotonin, PG, leukotrines, PAF
↓ airway caliber size, edema, chemotaxis, ↑ mucous production, bronchospasm

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17
Q

Drugs that target inflammatory response

A

Glucocorticoids
Locally acting steroids
Drugs targeting leukotrienes
NSAIDs
Antihistamines

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18
Q

Glucocorticoids

A

Allergic resp. conditions
Good short- term effects

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19
Q

Locally acting steroids

A

Resp. inhaler using spacer
Beclomehtasone, fluticasone

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20
Q

Drugs that target leukotrienes

A

Zafirlukast, montelukast

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21
Q

NSAIDs

A

Aspirin: inhibits TXA2
Tepoxalin: Both PG2 and LTs

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22
Q

Antihistamines

A

H1R antagonists
Benadryl

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23
Q

Cromolyn

A

Target inflamm. mediators
Mast cell stabilizer
Inhibits calcium influx into mast cells (prevent degranulation)

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24
Q

Cyproheptadine

A

Targets inflamm. mediators
Antihistmine and antiserotonin
Binds to 5HT2 receptors
Appetite stimulant

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25
Q

Pulmonary capillary pressure

A

Pulmonary edema due to fluid overload, left heart failure, mitral valve obstruction

26
Q

Drugs that ↓ pulmonary capillary pressure

A

Morphine: ↓ preload via vasodilation
Furosemide: ↓ preload, produce vasodilatory PG in lung
Methyxanthines: bronchodilator

27
Q

Pulmonary hypertension

A

Pulmonary vessel vasoconstriction: compensatory mechanism
Complication from chronic lung disease (bronchitis, fibrosis)

28
Q

Vasodilators

A

O2: emergency
Sildenafil (viagra)

29
Q

Peripherally acting antitussives

A

Mucolytics (breaks down mucous)
Expectorants (pushes mucous out by liquifying lower resp. tract)
Bronchodilators

30
Q

Dilate bronchioles

A

Airway caliber changes:
1. Parasympath. sys (baseline tone, mild bronchoconstriction)
2. Sympathetic sys (B2 adrenergic receptor, bronchodilation)
3. Purinergic sys (adenosine, vagal stimulation, irritant receptor and astham)

31
Q

Bronchodilators

A

B2 adrenergic receptor agonists
Methylxanthines
Cholinergic antagonists

32
Q

Bronchodilator additional effects

A

↓ mucosal edema
Anti-inflammatory effect

33
Q

Bronchodilator MOA

A

Reverse contraction by ↑ cAMP, ↓ Ca2+

34
Q

B- adrenergic agonists

A

Non-selective: adverse cardiac effects
Selective: Inhaled (albuterol), oral (clenbuterol), parenteral (terbutaline)

35
Q

B-adrenergic receptor agonists

A

Most effective bronchodilators
↓ fluid viscosity, ↑ mucocilary clearance

36
Q

B-adrenergic receptor agonists adverse effects

A

Sympathetic response: tachycardia, hypertension, m. tremors
Hyokalemia, hyperglycemia

37
Q

Terbutaline

A

Tablet, elixir, injectable forms
Not well absorption in horses&raquo_space; parenteral route

38
Q

Clenbuterol

A

Lower clinical efficacy
FDA approved for use in horse

39
Q

Methylxanthine

A

Relaxes bronchial smooth m.
Stimulate CNS and heart
Mild diuretic and anti-inflamm. effects
↑ strength of resp. m. (diaphragm)

40
Q

Theophylline use

A

Longterm for bronchodilatory therapy

41
Q

Theophylline MOA

A

Inhibits phoshodiesterases (PDE)- ↑ cAMP → smooth m. relaxation, anti-inflamm. effect
Binding purinergic receptors

42
Q

Theophylline adverse effects

A

CNS excitation, GI upset, diuresis, cardiac stimulation

43
Q

Anticholinergic drugs

A

Atropine or butylscopolamine challenge test in equine COPD
Chronic fibrosis in COPD

44
Q

Alteration of resp. tract fluids

A

↓ viscosity
↑ surfactant production
↓ foam resp. tract

45
Q

Mucocilliary apparatus function

A

Warming, humidifying air and trapping particles

46
Q

Fluid blanket covering the mucoid apparatus

A

Mocoid/ gel layer: goblets, traps materials and transports, glycoprotein
Water/ sol layer: tubular-acinar gland, parasympathetic control

47
Q

↓ viscosity

A

Adding moisture/ hydration
Stimulation of tubule-acinar gland
Chemical cleavage
Humidification of O2
Aerosolization

48
Q

Aerosolization

A

Nebulization: local admin
Enhances efficacy, minimize toxicity, rapid response

49
Q

Factors influencing airway deposition

A

Diameter, shape, electrical charge, density, mass, prep type
Method, devices, diseases, drugs

50
Q

Expectorants

A

Stilumation of tubule-acinar glands
MOA: irritation → reflex bronchial secretion
Guaifenesin, iodide preps, volatile oils

51
Q

Iodide preparations (potassium iodide)

A

Gastric mucosa irritation by iodide salts
Contrain: hyperthyroid, pregnant, milk-producing animals

52
Q

Decreasing viscosity of secretion

A

Hydration
↑ ionic strength: Na2CO3 and saline
Rupturing sulfur linkages in mucus: N-acetylcysteine or iodine

53
Q

N- acetylcysteine

A

Breakdown disulfide bonds
Anti-inflamm. effects

54
Q

Increasing surfactant production

A

Neonatal respiratory distress syndrome
Suction airway if intubated
Avoid humidification of air
Nebulized 20-40% ethanol

55
Q

Neonatal respiratory distress syndrome

A

Inadequate surfactant
Premature born
Resp. complication
Dexamethasone or betamethasone

56
Q

Resp. stimulants

A

Doxapram: CNS stimulant for anesthesia and neonatal animals
Naloxone: Stimulates resp. in narcotic OD
Yohimbine stimualtes resp. in xylazine OD

57
Q

Resp. suppressants

A

Opioids
Relieve fear and anxiety

58
Q

Adverse effects of drugs on the lungs

A

Bronchospasm
Drying resp. tract (anticholinergics and antihistamines)
Pulmonary edema (cisplatin in cats, vol overload)
Pneumonitis (bromide in cats)

59
Q

Bronchospasm

A

Topical or aerosol (acetylcysteine)
Cholinergic drugs
Propranolol and aspirin
Type 1 hypersensitivity

60
Q
A

1. Pharmacology (29 decks)

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