Respiratory therapeutics Flashcards

1
Q

Symptomatic treatment of influenza

A

Rest

Decrease stress

Ensure adequate hydration

NSAIDs +/- paracetamol

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2
Q

When should antimicrobials be considered for equine influenza?

A

If a horse shows signs of respiratory disease > 10 days (high risk of escondary bacterial infection)

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3
Q

When are antiviral treatments used for equine influenza?

A

For very large outbreaks with severe morbidity

(drugs are limited and very expensive)

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4
Q

EHV-1,-4 treatment

A

Symptomatic treatment

Antiviral drugs occasionally used if neurological disease (valacyclovir)

Biosecurity is critical

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5
Q

Guttural pouch mycosis location

A

commonly located on the caudo-dorsal aspect of the medial compartment, over the internal carotid artery

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6
Q

Most common causative agent of guttural pouch mycosis

A

Aspegillus spp.

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7
Q

Most common clinical signs of guttural pouch mycosis

A

Due to cranial nerve and arterial damage within mucosal lining

Epistaxis (arterial wall erosion) - can lead to fatal haemorrhagic event

Dysphagia

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8
Q

Diangosis of guttural pouch mycosis

A

Endoscopic examination

Care not to dislodge any plaques that may lead to haemorrhage

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9
Q

Most common medical therapy for guttural pouch mycosis

A

Azoles
- inhibit fungal mediated synthesis of ergosterol via inhibition of cytochrome P-450 enzyme

Enilconazole

Administered via the biopsy channel of an endoscope

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10
Q

Antimicrobials for Strepequi var, equi (strangles)

A

Immunity impeded by antimicrobials so not for every case

Useful for
- acutely affected animals
- severe lymphadenopathy causing resp distress
- metastatic abscessation
- purpura haemorrhagica

Never use prophylactically

Penicillin is drug of choice

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11
Q

Treatment of metastatic abscessatio of strangles

A

may require long term (<6mo in some cases) antimicrobial therapy

Base treatment duration on re-examination and serial assessments of acute phase protein concentrations

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12
Q

Therapy of carrier status strangles

A

Chondroids need endoscopic or surgical removal

Gelatin/penicillin formulations to topically treat

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13
Q

Systemic antimicrobial therapy for bacterial pneumonia

A

Transtracheal or triple lumen catheter tracheal aspirate samples should be submitted for bacteriology

Initiate antimicrobial treatment whilst waiting

Penicillin/gentamycin/metronidazole are first line treatments

Usually require parenteral antibiotics for 4-10 days then oral can be used

Total duration of antibiotic administration is often 4-6 weeks

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14
Q

Inhaled therapies for bacterial pneumonia

A

Nebulised saline

Some antibiotics can be nebulised (gentamycin/cefquinome)

Unlikely in case of animals with significant lung pathology

Bronchodilators may be beneficial in some cases but not commonly used

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15
Q

Pleural effusion management

A

May need chest drains

Fibrinous adhesions could be problematic - inhibit effective drug penetration, and precede abscess formation

Recombinant tissue plasminogen activator (rTPA) can be used to break down fibrin

NSAIDs may be needed to minimise inflammation, control fever, and provide analgesia

Adequate hydration

Laminitis prophylaxis

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16
Q

Treatment of fungal pneumonia

A

Azoles
- itraconazole
- fluconazole
- vericonizole

Amphotericin B
- irritant, may cause phlebitis

17
Q

Medical treatment of equine asthma

A

Corticosteroids reduce pulmonary inflammation
- fewer side effects if inhaled

Inhaled beta-2 agonists act on airway relief of airway obstruction

Oral and IV clenbutarol (ventipulmin)

Anticholinergics

Buscopan

Methylxanthines

18
Q

Rescue therapy for respiratory distress at rest due to equine asthma

A

IV atropine/buscopan

IV dexamethasone

19
Q

Maintenance therapy for equine asthma

A

Oral prednisolone +/- oral clenbutarol, until stable

Inhaled corticosteroid +/- inhaled bronchodilator for medium term maintenance and during times of challenge

Fix environmental triggers

20
Q

Corticosteroid options for equine asthma

A

Tapering course of oral prednisolone

IV dexamethasone for acute distress

MDI: inhaled ciclesonide (licensed) fluticasone or beclomethasone (cascade)

Nebuliser: dexamethasone

21
Q

Inhaled beta-2 agonists for equine asthma

A

Salmeterol: effective up to 12h

Salbuterol/albuterol: effective up to 1-2h

Adverse effects include sweating, tachycardia, muscle temors

22
Q

Anticholinergics for equine asthma

A

E.g. glycopyrollate, ipratopium, atropine

Adverse effects include reduced GI tract motility/colic

23
Q

Buscopan for equine asthma

A

Muscarinic recepto agonist

Shown to be an effective bronchodilator

Causes transient tachycardia but very minimal side effects and very safe/readily available