Respiratory Flashcards

1
Q

What would be the best way to stop continuous sneezing in a dog?

A

Intranasal application of a topical anesthetic (Lidocaine)

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2
Q

Why do bronchodilators sometimes decrease coughing?

A

Mucosal irritation does not directly stimulate the cough reflex, but causes bronchoconstriction which serves as the primary stimulus to cough
Bronchodilators will then dilate the bronchi which will decrease the coughing

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3
Q

What is/are the limitation(s) in using dextromethorphan or antihistamines as cough suppressants in dogs?

A

They have a short half-life and limited bioavailability

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4
Q

How much evidence supports the use of hydrocodone as an antitussive?

A

Very effect cough suppressant

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5
Q

How much evidence supports the use of butorphanol as an antitussive?

A

Approved as a tablet and effective

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6
Q

How much evidence supports the use of maropitant as an antitussive?

A

Less established efficacy

In study, they didn’t see an anti-inflammatory effect but the dogs coughed less

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7
Q

How much evidence supports the use of diphenoxylate as an antitussive?

A

Less established efficacy

Hypothesis is that crosses BBB to affect opioid receptors in medullary cough center

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8
Q

What benefits does furosemide have in managing pulmonary edema in addition to its diuretic effect (that decreases preload)?

A

Decreases preload by diuretic action

Produces local vasodilatory prostaglandin in the lung

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9
Q

What benefit do opioids have in managing dyspnea besides sedation?

A

They desensitize CO2 receptors to conver rapid shallow respiration to more efficient slower and deeper respiration

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10
Q

What drug is best suited to decrease pulmonary hypertension without having prominent effects on systemic blood pressure?

A

Slidenafil (Viagra, Revatio)

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11
Q

What are the benefits of using a glucocorticoid inhaler versus systemic administration? Name one example of an inhaled steroid.

A

In order to control inflammation, we want the steroids to act locally rather than systemically
Example: Beclomethasone (Beconase) and Fluticasone (Flonase)

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12
Q

Are feline asthma and equine COPD primarily a problem involving inhalation or exhalation?

A

Exhalation

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13
Q

What is a “heave line” in a horse and why does it occur?

A

Heave line is a line that is made of a line of abdominal muscles that enlarge in a horse with heaves

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14
Q

What are the most common side-effects of beta-2 agonist bronchodilators?

A

Tachycardia
Slight muscle tremors in some patients
Lowers serum potassium
Airway inflammation induced with regular inhalation of racemic albuterol, but not with levalbuterol

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15
Q

Explain how to perform an atropine-challenge (or butylscopolamine-challenge) test in equine COPD

A

Give test dose of atropine IV to see if it improves respiratory effort (diminished heave line)
Response to atropine indicates horse may respond to other bronchodilators
Has been used nefariously by horse traders, Check pupils for dilation.
Primary side effect of concern is ileus

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16
Q

What are the major beta-2 agonists used as bronchodilators?

A

Albuterol
Levalbuterol
Clenbuterol
Terbutaline

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17
Q

What is albuterol’s route of administration?

A

Inhaled, oral, or parenteral

18
Q

What is the major side effect of albuterol?

A

Airway inflammation induced

19
Q

What are the major species that albuterol is used in?

A

Humans, approved in horses

20
Q

What is levalbuterol’s route of administration?

21
Q

What are the major species that levalbuterols in used in?

22
Q

What is clenbuterol’s route of administration?

23
Q

What are the major species that clenbuterol is used in?

24
Q

What is terbutaline’s route of administration?

A

Parenteral

25
What are the major species that terbutaline is used in?
Humans
26
Why are glucocorticoids often given to animals receiving chronic beta-2 bronchodilators?
Used to prevent (or return) responsiveness of receptors that have down-regulated from prior chronic use of β2 agonists
27
What major benefit does theophylline provide in respiratory disease beyond bronchodilation?
Increases the strength of respiratory muscles, especially the diaphragm
28
Name the three methylxanthine compounds
Caffeine, theobromine, theophylline
29
How does aminophylline differ from theophylline?
Aminophylline is a water-soluble salt of theophylline (81% theophylline)
30
What effect does oxygen have on the pulmonary vasculature?
It is a vasodilator
31
Name two toxic signs most commonly seen with a theophylline overdose
Seizures Cardiac arrhythmias Vomiting
32
For an animal on theophylline, what commonly used antibiotics requires a dosage reduction of the theophylline?
Fluoroquinolones Erythromycin Chloramphenicol
33
What is/are the best method(s) of promoting expectoration?
Stimulation of tubule-acinar glands Adding moisture: Humidify the air. In hospitals, nebulization or vaporization of the air is performed You can also hydrate the patient
34
What are the drugs used a expectorants?
``` Guaifenesin (glyceryl guaiacolate) Saline expectorants (ammonium chloride, potassium or calcium iodide, sodium or potassium citrate, ammonium carbonate) Volatile oils (eucalyptus and menthol) ```
35
What is the proposed MOA of expectorants?
Stimulation of tubule-acinar glands
36
How effective are drugs used as expectorants?
Not very | There is no effect in dogs. In cats, a dose of 1000 mg/kg po is required for a consistent change
37
Explain the benefit to an animal with respiratory foam due to pulmonary edema of bubbling oxygen through a 20% ethanol solution
This will act as a surfactant to break up the bubbles therefore improving ventilation
38
What is the only analeptic drug used in veterinary medicine and what toxicity is associated with its overdose?
Doxapram (Dopram) | It has a very small therapeutic index an repeated doses can cause seizures
39
What are the primary respiratory side effects associated with antihistamines in any species?
Drying of the respiratory tract
40
What are the primary respiratory side effects associated with bromide in cats?
Pneumonitis
41
What are the primary respiratory side effects associated with cisplatin in cats?
Pulmonary edema
42
What are the primary respiratory side effects associated with nebulized acetylcysteine in any species?
Bronchospasm