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Pharm > Respiratory system drugs > Flashcards

Respiratory system drugs Flashcards

1
Q

Antitussive drugs

A

-mostly opioids (or derivatives of) that directly suppress cough centre in the medulla oblongata
-anti tussive effect not related to normal opiate receptors (mu and kappa)
COUGH SUPPRESSANTS

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2
Q

Morphine

A
  • antitussive drug
  • effective antitussive at low doses
  • not common for this tho due to SEs and abuse potential
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3
Q

Codeine (methylmorphine)

A
  • antitussive drug
  • equal antitussive effect as morphine but less analgesic (methylated morphine )
  • used in SAs
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4
Q

Hydrocodone

A
  • antitussive drug
  • similar to codeine but more potent
  • not for use with productive coughs and caution with cats
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5
Q

Hycodan

A
  • antitussive

- hydrocodone combined with anticholingeric drug (homatropine) to prevent abuse

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6
Q

Dextromethorphan (DXM)

A

Robitussin

  • antitussive drug
  • opioid derivative but doesn’t act at normal opioid receptors and not analgesic or addictive
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7
Q

Butorphanol (Torbutrol, Torbugesic)

A
  • analgesic and antitussive drug!
  • more potent than morphine as analgesic and more potent than codeine/DXM as antitussive
  • sedation
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8
Q

Beneficial effects of beta adrenergic receptor agonists in tx of airway diseases

A
  1. Bronchodilation
  2. Decreased release of mast cell inflammatory mediators
  3. Increased mucociliary clearance
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9
Q

Epinephrine (adrenaline)

A
  • used in therapy of inflammatory airway diseases (IAD)
  • stimulates alpha and beta receptors (alpha and beta adrengeric agonist)
  • used only for emergency life threatening bronchoconstriction (anaphylaxis)
  • short duration use only!
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10
Q

Isoproterenol (Isuprel)

A
  • therapy of IAD
  • potent beta receptor agonist–>bronchodilation
  • emergency relief in horses
  • inhalation/ injection
  • short duration of action
  • not long term suitable
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11
Q

Terbutaline (Brethine, Bricanyl)

A
  • therapy of IAD
  • potent beta 2 activity
  • oral forms only in canada
  • longer acting than isoproterenol
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12
Q

Salbutamol

A
  • therapy of IAD
  • potent beta 2 activity
  • used systemically in dogs and horses
  • metered dose inhaler most common administration form
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13
Q

Clenbuterol (ventipulmin)

A
  • therapy of IAD
  • commonly used for tx of recurrent airway obstruction (RAO) and heaves
  • Beta 2 agonist
  • injectable and oral form
  • banned in food animals
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14
Q

Methylxanthines

A

-therapy of IAD
-includes theophylline, theobromine and caffeine.
-CNS stimulants
-resp effects: bronchodilation, decreased release of inflam mediators from mast cells, increase diaphragmatic contraction and increased mucociliary transport
(theophylline>caffeine>theobromine)

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15
Q

Anticholinergic drugs for therapy of IAD

A
  • effective bronchodilators by inhibiting vagally mediated cholinergic sm. muscle tone in the resp tract (parasympatholytic)
  • useful for asthma tx
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16
Q

Atropine

A
  • anticholinergic drug for IAD therapy

- used for acute bronchodilation in horses,used to determine prognosis in RAO in horses

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17
Q

Glycopyrrolate

A
  • anticholinergic drug for IAD therapy

- very potent, doesn’t cross BBB

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18
Q

Hyoscine Butylbromide

A

Buscopan

  • anticholinergic drug for IAD therapy
  • antispasmodic and anticholinergic that relaxes smooth muscle
  • safer than atropine to determine prognosis of RAO in horses
  • short term/emergency situations
19
Q

Glucocorticoids for IAD therapy

A
  • inhibit release of inflam mediators from macrophages and eosinophils (not mast cells)
  • decrease synthesis of PGs, LKTs, and platelet activating factor
  • enhance the action of beta 2 receptors in bronchial sm. muscle
  • reduce severity of symptoms, improve peak expiratory flow, diminish airway hyper responsiveness, prevent exacerbations and prevent airway wall remodelling
20
Q

Prednisolone/prednisone

A

-glucocorticoid for IAD therapy

21
Q

Dexamethasone

A
  • glucocorticoid for IAD therapy

- effective in RAO therapy in horses (fast)

22
Q

Rapid acting and repositrol glucocorticoids

A
  • IAD therapy
  • used in emergency treatment of dyspneic cats (shock dose IV- pred or dex)
  • long acting methylprednisolone acetate (depo-medrol) used for cats with bad owners
23
Q

Cyproheptadine

A
  • -IAD therapy
  • serotonin antagonist (serotonin has role in allergen induced bronchoconstriction in cats)
  • used as adjunct to glucocorticoids and bronchodilators to block bronchoconstriction in chronically asthmatic cats
24
Q

Antimicrobial therapys for IAD therapy

A

-only necessary sometimes
in IAD therapy
-ex. cats where trachea-bronchial culture showed mycoplasma
-secondary bacterial infection from strep zooepidemicus can exacerbate IAD in horses (penicillin, ceftiofur, trimethoprim/sulfonamide)

25
Q

Using inhalant therapy for IAD

A
  • via metered dose inhalers (MDIs)
  • high drug []s get directly delivered to the lungs and avoids systemic SEs
  • shorter onset of action
  • Nebulizers older and less efficacious that MDIs
26
Q

Inhalational Salbutamol

A

-short acting beta 2 agonist for IAD therapy
-tx of choice for acute exacerbations of bronchoconstriction
-relaxes sm. m. and increases airflow in 5 min
-racemic mixture (R enant ->bronchodilation and anti inflam …S opposite!)
-

27
Q

Inhalational Salmeterol (Serevent)

A
  • long acting beta 2 agonist (IAD therapy)
  • slow onset and long duration
  • not recommend for acute bronchodilation but improves system control when used daily
28
Q

Inhalational Glucocorticoids

A
  • IAD therapy
  • most potent inhaled anti inflam drugs available
  • improves asthma control and normalizes lung function and prevent irreversible airway damage
29
Q

Fluticasone(Flovent)

A

-inhaled corticosteroid for IAD therapy

30
Q

Beclomethasone (Beclovent, Vanceril)

A
  • inhaled corticosteroid for IAD therapy
31
Q

Flunisolide (Aerobid)

A
  • inhaled corticosteroid for IAD therapy

- severely affected cats must have this every day with prednisone

32
Q

Triamcinolone (Azmacort)

A

-inhaled corticosteroid for IAD therapy

33
Q

Ipratropium bromide (Atrovent)

A
  • inhalant anticholingergic used for IAD therapy
  • -derivative of atropine (less SEs)
  • relieves bronchoconstriction and reduces mucous secretions
  • efficacy with RAO in horses
34
Q

Cromolyn sodium (Intal)

A
  • inhalant mast cell stabilizers used in IAD therapy
  • chloride channel blocker that modulates mast cell mediator release and eosinophil recruitment
  • attenuation of viral induced airway inflam
35
Q

Nedocromil sodium (Tilade)

A
  • inhalant mast cell stabilizer used in IAD therapy
  • chloride channel blocker that modules mast cell mediator release and eosinophil recruitment
  • leads to attenuation of viral induced airway inflam
  • broader spectrum of efficacy
36
Q

Goals of expectorant and mucolytic drugs

A
  • increase output of bronchial secretions
  • enhance the clearance of bronchial exudate
  • promote a productive cough
  • drugs include: saline expectorants, direct stimulants, guaifenesin, acetylcystein and dembrexine
37
Q

Saline expectorants

A
  • stimulate bronchial mucous secretions via vagally-mediated reflex action on gastric mucosa.
  • ex: ammonium chloride, ammonium carbonate, potassium iodide, calcium iodide and ethylenediamine dihydroiodide.
38
Q

Volatile oils (eucalyptus/lemon oil)

A
  • expectorant and mucolytic drugs

- DIRECTLY increase respiratory tract secretions

39
Q

Guaifenesin (glyceryl guaiacolate)

A
  • expectorant drug
  • centrally acting muscle relaxant with expectorant effect (stimulate bronchial secretions via vagal paths)
  • just changes particle clearance from the airways (speeds it up)
40
Q

N-acetylcysteine (mucomyst)

A
  • mucolytic drug
  • mucolytic effect due t othe exposed sulfhydral group on cmpd, which interacts with the disulphide bonds on mucoprotein
  • helps break down mucus and enhance clearance
  • increase levels of glutathione also (scavenge free radicals)
  • in aerosol form can cause bronchocontriction by reflex
41
Q

Dembrexine (sputolysin)

A
  • expectorant/mucolytic drug
  • used for respiratory disease in horses
  • alters constituents and viscosity of abnormal respiratory mucous and improves efficacy of resp clearance mechanisms
  • also antitussive action and enhances [] of antibiotics in lung secretions
  • powder form for feed
42
Q

Alpha adrenergic agonists used as decongestants

A
  • alpha adrenergic agonists cause local vasoconstriction of mm (decreasing swelling and edema)
  • used topically as nasal decongestants for allergic and viral rhinitis (or systemically with antihistamines)
43
Q

Doxapram

A
  • stimulates medullary respiratory center and chemoreceptors of carotid artery and aorta to increase tidal volume.
  • used in emergencies during anesthesia or to decrease the respiratory depressant effects of opiates and barbiturates.
  • Used to stimulate respiration in newborns after difficult birth (under tongue)

Pharm (6 decks)

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