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1. Pharmacology > Respiratory Pharmacology > Flashcards

Respiratory Pharmacology Flashcards

(60 cards)

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1
Q

Objectives of drugs affecting resp. system

A

Suppress protective reflexes
Control inflamm.
↓ pulmonary pressure
Dilate bronchioles
Alteration of resp. tract fluids
Control resp. rate
Control infection (antimicrobial therapy)

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2
Q

Resp. defence mechanism

A

Upper resp. tract = mucociliary apparatusl, cough and sneezing
Lower resp. tract = mononuclear phagocyte system

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3
Q

Coughing

A

Central and peripherally acting (chemoreceptor and stretch receptor→ constriction)

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4
Q

Goal for cough suppression

A

↓ frequency and severity without impairing mucocilary defenses

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5
Q

Cough suppression drug uses

A

Dissemination of infection to healthy tissue or other animals
Rupture fo lung abscesses
Interference with sleep

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6
Q

Cough suppression contraindication

A

Productive cough (mucous out lungs)
Symptomatic therapy without diagnosis (tracheo-esophageal fistula → aspiration)

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7
Q

Peripheral acting antitussives

A

Mucosal anesthetics (lidocaine, benzocaine)
Demulcents (soothing effects, syrups)
Bronchodilators (inhalers)

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8
Q

Centrally acting antitussives MOA

A

Suppression of medullary cough center at opiate receptors (mu and K receptors)

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9
Q

Non-narcotic centrally acting antitussives

A

Dextromethorphan: semisynthetic agents

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10
Q

Narcotic (opioid) centrally acting antitussives

A

Morphine, codeine, hydrocodone

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11
Q

Narcotic agonist/ antagonists centrally acting antitussives

A

Butorphanol

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12
Q

Drugs used as antitussives with less established efficacy

A

Maropitant (cerenia)
Diphenoxylate + atropine (Lomotil)

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13
Q

Maropitant

A

Neurokinin receptor (NK1-R) antagonist
Antiemetic in dogs and cats (+ motion sickness)

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14
Q

Diphenoxylate + atropine

A

Antitussive in chronic bronchitis and tracheal collapse
Enough concentration crosses BBB
Adverse: constipation

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15
Q

Respiratory mononuclear phagocyte system

A

In cats, cattle, pigs, sheep, goats
Pulmonary alveolar macros and pulmonary intravascular macros

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16
Q

Phagocytic properties

A

Release inflamm. mediators: histamine, serotonin, PG, leukotrines, PAF
↓ airway caliber size, edema, chemotaxis, ↑ mucous production, bronchospasm

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17
Q

Drugs that target inflammatory response

A

Glucocorticoids
Locally acting steroids
Drugs targeting leukotrienes
NSAIDs
Antihistamines

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18
Q

Glucocorticoids

A

Allergic resp. conditions
Good short- term effects

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19
Q

Locally acting steroids

A

Resp. inhaler using spacer
Beclomehtasone, fluticasone

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20
Q

Drugs that target leukotrienes

A

Zafirlukast, montelukast

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21
Q

NSAIDs

A

Aspirin: inhibits TXA2
Tepoxalin: Both PG2 and LTs

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22
Q

Antihistamines

A

H1R antagonists
Benadryl

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23
Q

Cromolyn

A

Target inflamm. mediators
Mast cell stabilizer
Inhibits calcium influx into mast cells (prevent degranulation)

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24
Q

Cyproheptadine

A

Targets inflamm. mediators
Antihistmine and antiserotonin
Binds to 5HT2 receptors
Appetite stimulant

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25
Pulmonary capillary pressure
Pulmonary edema due to fluid overload, left heart failure, mitral valve obstruction
26
Drugs that ↓ pulmonary capillary pressure
Morphine: ↓ preload via vasodilation Furosemide: ↓ preload, produce vasodilatory PG in lung Methyxanthines: bronchodilator
27
Pulmonary hypertension
Pulmonary vessel vasoconstriction: compensatory mechanism Complication from chronic lung disease (bronchitis, fibrosis)
28
Vasodilators
O2: emergency Sildenafil (viagra)
29
Peripherally acting antitussives
Mucolytics (breaks down mucous) Expectorants (pushes mucous out by liquifying lower resp. tract) Bronchodilators
30
Dilate bronchioles
Airway caliber changes: 1. Parasympath. sys (baseline tone, mild bronchoconstriction) 2. Sympathetic sys (B2 adrenergic receptor, bronchodilation) 3. Purinergic sys (adenosine, vagal stimulation, irritant receptor and astham)
31
Bronchodilators
B2 adrenergic receptor agonists Methylxanthines Cholinergic antagonists
32
Bronchodilator additional effects
↓ mucosal edema Anti-inflammatory effect
33
Bronchodilator MOA
Reverse contraction by ↑ cAMP, ↓ Ca2+
34
B- adrenergic agonists
Non-selective: adverse cardiac effects Selective: Inhaled (albuterol), oral (clenbuterol), parenteral (terbutaline)
35
B-adrenergic receptor agonists
Most effective bronchodilators ↓ fluid viscosity, ↑ mucocilary clearance
36
B-adrenergic receptor agonists adverse effects
Sympathetic response: tachycardia, hypertension, m. tremors Hyokalemia, hyperglycemia
37
Terbutaline
Tablet, elixir, injectable forms Not well absorption in horses >> parenteral route
38
Clenbuterol
Lower clinical efficacy FDA approved for use in horse
39
Methylxanthine
Relaxes bronchial smooth m. Stimulate CNS and heart Mild diuretic and anti-inflamm. effects ↑ strength of resp. m. (diaphragm)
40
Theophylline use
Longterm for bronchodilatory therapy
41
Theophylline MOA
Inhibits phoshodiesterases (PDE)- ↑ cAMP → smooth m. relaxation, anti-inflamm. effect Binding purinergic receptors
42
Theophylline adverse effects
CNS excitation, GI upset, diuresis, cardiac stimulation
43
Anticholinergic drugs
Atropine or butylscopolamine challenge test in equine COPD Chronic fibrosis in COPD
44
Alteration of resp. tract fluids
↓ viscosity ↑ surfactant production ↓ foam resp. tract
45
Mucocilliary apparatus function
Warming, humidifying air and trapping particles
46
Fluid blanket covering the mucoid apparatus
Mocoid/ gel layer: goblets, traps materials and transports, glycoprotein Water/ sol layer: tubular-acinar gland, parasympathetic control
47
↓ viscosity
Adding moisture/ hydration Stimulation of tubule-acinar gland Chemical cleavage Humidification of O2 Aerosolization
48
Aerosolization
Nebulization: local admin Enhances efficacy, minimize toxicity, rapid response
49
Factors influencing airway deposition
Diameter, shape, electrical charge, density, mass, prep type Method, devices, diseases, drugs
50
Expectorants
Stilumation of tubule-acinar glands MOA: irritation → reflex bronchial secretion Guaifenesin, iodide preps, volatile oils
51
Iodide preparations (potassium iodide)
Gastric mucosa irritation by iodide salts Contrain: hyperthyroid, pregnant, milk-producing animals
52
Decreasing viscosity of secretion
Hydration ↑ ionic strength: Na2CO3 and saline Rupturing sulfur linkages in mucus: N-acetylcysteine or iodine
53
N- acetylcysteine
Breakdown disulfide bonds Anti-inflamm. effects
54
Increasing surfactant production
Neonatal respiratory distress syndrome Suction airway if intubated Avoid humidification of air Nebulized 20-40% ethanol
55
Neonatal respiratory distress syndrome
Inadequate surfactant Premature born Resp. complication Dexamethasone or betamethasone
56
Resp. stimulants
Doxapram: CNS stimulant for anesthesia and neonatal animals Naloxone: Stimulates resp. in narcotic OD Yohimbine stimualtes resp. in xylazine OD
57
Resp. suppressants
Opioids Relieve fear and anxiety
58
Adverse effects of drugs on the lungs
Bronchospasm Drying resp. tract (anticholinergics and antihistamines) Pulmonary edema (cisplatin in cats, vol overload) Pneumonitis (bromide in cats)
59
Bronchospasm
Topical or aerosol (acetylcysteine) Cholinergic drugs Propranolol and aspirin Type 1 hypersensitivity
60

1. Pharmacology (29 decks)

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