Respiratory Week and Dream Street

Question 1

Theophylline trade name

Answer 1

Aminophylline

Question 2

Theophyline drug class

Answer 2

methylxanthine

Question 3

theophylline mechanism of action

Answer 3

not fully understood; possiblities:

• inhibit PDE which breaks down cAMP so when inhibit it
• > incrased cAMP -> stimulation of PKA which phosphorylates targets -> relaxes smooth muscle; overall potentiates effect of B2 agonists -> enhanced bronchodilation
• adenosine receptor antagonist (adenosine -> release histamine and leukotrienes from mast cells -> bronchoconstriction and therefore inhibits adenosine -> bronchodilation
• antiinflamatory effects on cells in airway

Question 4

theophylline fx

Answer 4

bronchodilation

Question 5

theophylline side effects

Answer 5

at high doses can -> CNS and cardiac stimulation and GI distress

Question 6

dexamethasone tarde name

Answer 6

Ozurdex, Maxidex, Decadron, Baycadron

Question 7

dexamethasone drug class

Answer 7

corticosteroid

Question 8

dexamethasone mechanism of action

Answer 8

• prevents transricption of genes of various inflamatory proteins (by inhibition of phospholipase A2 which converts phospholipids to arachadonic acid) this prevents transrciption of cytokines
• stimulates production of anti-inflamatory proteins which interact with inflamatory cells and structural cells in airways
• b/c effect transrcption effects are not immeduate usually take a few days to develop fully (full effect on bronchial hyper-responsiveness can require weeks or months of therpay)

Question 9

dexamethasone fx

Answer 9

anti-inflamatory drug; effective in treatment of inflamtory lung dxs (feline asthma, RAO, ect.)

Question 10

dexamethasone side effects

Answer 10

b/c anti-inflamtory and immunosupressive effects there are many side effects especially with long term use

GI ulceration/ performation and bleeding, hyperadrenocotricism, retard growth in young animals

Dogs

PU/ PD/ PP

Dull dry coat, weight gain, panting, V+, D+, elevated liver enzymes, pancreatitis, GI ulceration, lipemias, activation or worseing of diabetes mellitus, muslce wasting, behavioral changes

Cats

Hypergylcemia, less frequently PU/ PD/ PP/ weight gain, D+, depression, cushingoid effects

Horses

Laminitis

Question 11

albuterol trade name

Answer 11

proventil, accuneb

Question 12

albuterol drug class

Answer 12

beta 2 adrenergic agonist

Question 13

albuterol mechanism of action

Answer 13

stimulates production of cAMP by activation of adenyl cyclase via Gs -> relaxation bronchial, uterine, and vascular smooth muscle; beta 2 adrenergic agonist

Stim B2 receptor -> stim Gs -> Adenyl cyclase stimulated

• > ATP converted to cAMP -> stim PKA -> phosphorylated target proteins ->
• increase Ca2+-activated K+ channel activation
• decrease PLC-IP3-Ca2+ pathway activity
• increase Na+/Ca2+ exchange
• incrase Na+/Ca2+ ATPase
• decrease MLCK
• > smooth muscle

Question 14

albuterol fx

Answer 14

Bronchodilation ->

alleviate brochospasm or cough

Question 15

albuterol side effects

Answer 15

• inc HR - tremors - CNS excitement (nervousness) - dizziness - decreased serum K+ values possible

Question 16

epinephrine trade name

Answer 16

Adrenaclick, EpiPen, Twinject, Medihaler-Epi

Question 17

epinephrine drug class

Answer 17

hormone and adrenergic agonist

Question 18

epinephrine mechanism of action

Answer 18

endogenous adrenergic agent w/ alpha and beta activity -> - relaxation smooth muscle in bonchi and iris - antagonizes effects histamine - inc glycogenolysis - raise blood sugar - give rapidly IV -> inc systolic BP - give slow IV -> modest rise systolic pressure and dec diastolic pressure - dec TPR bc beta effects

Question 19

epinephrine fx

Answer 19

From notes: - cardiac arrest/ heart block - acute anaphylactic reactions (counteract hypotension and bronchospasm) - combine with local anesthetics to retard removal of anesthetics - control bleeding (apply topically) -treatment for anaphylaxis or cardiac resuscitation - can add to local anestetics to retard systemic absorption and prolong effect

• when treating shock B effects of epinephrine -> bronchodilation
• B1 effects on heart -> increase HR and force of contraction -> help restore BP
• vasoconstriction via EPI stim a1 receptors

Question 20

epinephrine side effects

Answer 20

• anxiety - tremor - excitablity - V+ - hypertension (overdose) - arrhythmias - hyperuricemia (excess of uric acid in blood) - lactic acidosis (buildup of lactate in body) - EPINEPHRINE REVERSAL IF GIVEN W/ ALPHA ADRENERGIC ANTAGONISTS (will -> dec BP not inc)

Question 21

atropine trade name

Answer 21

atropine

Question 22

atropine drug class

Answer 22

muscarinic antagonist

Question 23

atropine mechanism of action

Answer 23

-inhibits acetylcholine and other cholinergic stimulants at postganglionic parasympathetic neuroeffector sites - high dose can block nicotinic receptors at autonomic ganglia and NMJ

Ach binds M3 -> stimulation Gq -> activate phospholipase C -> produce IP3 -> intracellular Ca2+ -> smooth muscle contraction

Question 24

atropine side effects

Answer 24

• dry mount - increased viscosity of secretions - dysphagia - constipation - V+ - thirst - urinary retention or hesitancy - CNS effects (stimulation, drowsiness, ataxia, seizures, respiratory depression) - Opthamic effects (blurred vision, pupil dilation, cycloplegia, photophobia) - Cardiovascular effects (sinus tachycardia, increased myocardial work, O2 consumption, bradycardia, hypertension, hypotension, arrhythmias, circulatory failure)
• CNS effects GI, dryiing secretions ect

Question 25

atropine function

Answer 25

• antidote for organophosphate intoxication - preanesthetic prevent or reduce secretions of respiratory tract - treat sinus bradycardia, sinoatrial arrest, incomplete AV block - differentiate vagally-mediated bradycardia for other causes - antidote for OD cholinergic agents
• treatment of bronchoconstriction that isnt responding to other treatments because of all the side effects this is not suitable for long term use