Respiratory Flashcards

1
Q

List the three nonselective beta agonists.

A

Epinephrine
Isoproterenol
Ephedrine

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2
Q

What is epinephrine used for (as a respiratory drug)?

A

Drug of choice for emergency life threatening bronchoconstriction and acute anaphylaxis response

*No long term use

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3
Q

What are the Beta-2 agonists?

A
Salmeterol (Human - long acting)
Albuterol
Terbutaline
Metaproterenol
Clenbuterol
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4
Q

How do you administer Terbutaline?

A

Oral or Inj. ONLY injection in horses bc of poor oral absorption
(lasts 6-8hr)

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5
Q

What species is albuterol used in?

A

Oral/Inhalent in cats and horses

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6
Q

How is Metaproteranol given?

A

Only oral, 4hr duration

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7
Q

What species is clenbuterol used for?

A

Horses.

Illegal in food animals.

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8
Q

How do the Beta-2 Agonists work?

A

Selective for Beta 2. Bronchodilation, stabilization of mast cells, and increased mucociliary clearance.

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9
Q

Adverse effects of Beta 2 agonists?

A

(Any beta 1 effect) Cardiac stimulation, vasodilation, and uterine relax

**Can be poison from causing hyperglycemia and hypokalemia

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10
Q

T/F Beta 2 agonists are often used to treat RAO?

A

True.

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11
Q

What are the anticholenergics that work on the respiratory system?

A

Ipratropium
Atropine
Glycopyrrolate

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12
Q

List the Methylxanthine derivative drugs.

A

Caffiene ** coffee, tea, chocolate
Theophylline
Aminophylline (soluble salt of theophylline)

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13
Q

MOA of Methylxanthine derivatives (Know this)

A
  1. Inhibition of phosphodiesterase

2. Antagonism of adenosine receptors

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14
Q

Effects of Methylxanthine derivatives on the CNS

A

Stimulation of sensory and motor areas (like when you drink too much coffee)

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15
Q

Effects of Methylxanthine derivatives on the Respiratory system

A

Bronchodilation, Antiinflammatory, prevention of microvascular leakage (treat pulmonary hypertension), mucociliary clearance, improve breathing.

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16
Q

Effects of methylxanthine derivatives on the Cardiovascular system

A

stimulation of cardiac contractility, increasing heart rate, systolic pressure, and vasodilation (can be adverse effect-tachyarrythmia)

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17
Q

Effects of Methylxanthine derivatives on the Kidney?

A

Diuresis secondary to increased cardiac output and glomerular filtration

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18
Q

How are methyxanthine derivatives given?

A

Oral or parenteral.
*Volume of distribution is lower in cats than other species

oh p.s its metabolized by the liver, didnt feel like making another card

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19
Q

What are the therapeutic uses of Methylxanthine derivatives?

A

Brinchoconstriction, bronchial asthma (resp dx), and chronic obstructive pulmonary disease (RAO)

*Aminophylline is also used in the treatment of congestive heart failure and anaphyllaxis

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20
Q

Contraindications of Methylxanthine derivatives?

A

Cardiac disease, Peptic ulcer disease (increases aciditiy), and seizure disorders (CNS stimulation)

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21
Q

T/F You need to be careful when using inhalation anesthetics and methylxanthine derivatives

A

True.

The cardiac depression from the anesthetics plus the stimulation from the MD could lead to tachycardia/arrhythmia

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22
Q

What are the 6 groups of Antiinflammatory drugs (in reference to respiratory)?

A
Cromolyn sodium
Leukotriene inhibitors
Glucocorticoids
NSAIDS
Beta adrenergic agonists
Methylxanthines
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23
Q

What is Cromolyn sodium used for?

A

Anti-inflammatory and Anti-bronchoconstrictor (Not a bronchdilator though)
*Treats RAO

24
Q

What glucocorticoids are used in the treatment of respiratory disease?

A

Dexamethasone injection sometimes (Anti-bronchoconstriction)
Fluticasone inhaler –> SA
Beclomethasone inhaler –> LA

25
Q

What is Flunixin used for in respiratory disease?

A

NSAID tx:

  • endotoxin release
  • colic antispasmotic in horses
  • bovine respiratory disease (BRD)
26
Q

What is aspirin used for in respiratory disease?

A

Pulmonary embolism

27
Q

What are the two leukotriene inhibitors that we know?

A

Zafirlukast and Zileuton

28
Q

How does Zafirlukast work?

A

Leukotriene receptor agonist (selective competitive agonist)

29
Q

How does Zileutron work?

A

5-lipoxygenase (5-LO) inhibitor (inhibits formation of leukotriene)

30
Q

What are the clinical uses of leukotriene inhibitors?

A

Given orally to PREVENT chronic bronchial asthma….. in humans….

31
Q

How do antihistamines help in regards to respiratory?

A

(competitive agonists of H1 receptors)

tx of chronic respiratory disease bc of their effect on bronchial secretions

32
Q

What are antitussives?

A

Drugs which decrease the frequency and severity of nonproductive cough without impairing mucociliary defenses

33
Q

What are the 3 centrally-acting, narcotic, antitussives?

A

Codeine, Hydrocodone, Morphine

34
Q

What are the three centrally-acting, nonnarcotic, antitussives?

A

Butorphenol, Dextromethophan, Noscapine

35
Q

What are the two peripherally-acting antitussives?

A

Bronchodilators, Mucokinetics

36
Q

What is codeine used for?

A

Antitussive.

Controlled drug with sedation and constipation as side effects

37
Q

What is Hydrocodone used for?

A

Drug of choice for cough in dogs!!

More potent than codeine

38
Q

What is tramadol used for?

A

Antitussive.

inexpensive, oral, and has opoid/seratonin/alpha2 activity

39
Q

What is Butorphenol used for?

A

Nonnarcotic antitussive.

Agonist/antagonist with a long duration of action

40
Q

What is Dextromethorphan used for?

A

Nonnarcotic antittussive.

NMDA antagonist with V/CNS side effects

41
Q

What is the difference between mucokinetic drugs and expectorants?

A

Mucokinetic drugs facilitate removal of secretions

Exoectorants increase volume/fluidity of secretions

42
Q

What is the mechanism of action for mucokinetic drugs?

A

Stimulating ciliary activity (Beta agonist/methylxanthines) and decreasing viscosity of bronchial secretions (saline/NaBicarb)

43
Q

What is the mechanism of action for expectorants?

A

Act reflexly by irritation of gastric mucosa (K+Iodide/NH4+salts)
OR
direct stimulation (Guaifenesin/Volatile oils)

44
Q

What is Guaifenesin used for?

A

works on glands of the respiratory system as an expectorant as well as a muscle relaxant when combined with ketamine in horses.

45
Q

What are the direct decongestants?

A

Direct Alpha Agonists - vasoconstrictors

  • Phyenylephrine
  • Ephedrine
  • Pseudoephedrine
  • phenylpropanolamine
46
Q

What are your indirect decongestants?

A
  • H1-antagonists (diphenhydramine, hydroxyzine)
  • Cromolyn sodium
  • GLucocorticoids
47
Q

What is the drug of choice to tx pulmonary edema?

A

Furosemide (diuretic)

*also could use digoxin/phophodiesterase inhibitors but more heart risk

48
Q

What are the two antifoaming agent?

A
  • Nebulization of ethyl alcohol

- Silicone Spray

49
Q

What are the three main categories of bronchodilator drugs?

A
  1. Beta adrenergic agonists
  2. Methylxanthine derivatives
  3. Anticholenergics - derivatives of atropine
50
Q

What can oxygen be used for?

A

Hypoxemia and respiratory acidosis

51
Q

When is oxygen contraindicated?

A

Paraquat toxicosis

52
Q

What is Doxapram used for?

A
Respiratory analeptic (stimulant)
Reverses respiratory depression due to inhalation/barbituate anesthesia or neonatal depression
53
Q

What is the M.O.A. for doxapram?

A

Stimulating the chemoreceptors (main mechanism) and directly acting on the respiratory center

54
Q

Adverse effects of Doxapram?

A

Pressor effect and seizures with large doses

55
Q

What can doxapram reverse in dogs?

A

Actions of acepromazine, xylazone, or droperidol-fentanyl

56
Q

What can doxapram reverse in cats?

A

Thiopental-acepromazine

57
Q

What can doxapram treat in foals?

A

Hypercapnia associated with hypoxic-ischemic encephalopathy