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Pharm II
Respiratory Drugs
27
Pharmacology
Professional
04/05/2014

Additional Pharmacology Flashcards

 


 

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Term
Feline Asthma
Corticosteroids
Definition
-multi faceted MOA
-injectable, oral, inhalation
-Side effects include suppression of the immune system and of the HPA axis
Term
Feline Asthma
Inj Corticosteroids
Definition
-Short term in SEVERE cases
-Start with IV Dex
-Inhaled Albuterol q30min
-supplement oxygen
-LAST RESORT for chronic therapy: Methylprednisolone (IM once every 4-8 weeks)
Term
Feline Asthma
Oral Corticosteroids
Definition
-use if symptoms occur more than once/wk
-Prednisolone (start @ high dose and then taper over 2-3mths)
-Ideally, switch to an inhaled steroid (Albuterol)
Term
Feline Asthma
Inhaled Corticosteroids
Definition
Fluticasone proprionate
-reduces eosinophilic airway inflammation
-min systemic immune effects
-can also supress HPA axis
-maintenance dose not well defined
Term
Question:
When is parenteral Dexamethasone indicated for feline asthma cases?
Definition
For short term tx of severe cases
Term
Question:
Which of the following drugs is preferred for inhaled therapy of feline asthma?
Definition
-Fluticasone
Term
Question:
In feline asthma, oral corticosteroid therapy is more appropriate
Definition
-When symptoms occur several times/wk
Term
Bronchodilators
Factoids
Definition
Beta-adrenergic agonists
-stabilize mast cells
-increase mucociliary clearance
Term
Bronchodilators
Terbutamine Sulfate
Definition
-Oral and inj preps
-emergency tx of resp distress (when Albuterol is not possible)
-min cardio stimulation
-hypokalemia possible but RARE
Term
Bronchodilators
Albuterol Sulfate
Definition
-inhalant
-side effects rare (caution in patients with pre-existing cardiac issues)
-use as needed (tolerance may develop)
-paradox: causes bronchospasms
Term
Bronchodilators
Anticholinergic Drugs
MOA
Definition
Block Ach by competing for muscarinic receptors
Term
Bronchodilators
Anticholinergics
Atropine
Definition
-Aerosolized or IV
-NONSPECIFIC MUSCARINIC RECEPTOR ANTAGONIST
-side effects: tachycardia, mydriasis, ileus, colic in horses, reduced ciliary beat freq, reduced mucus secretion
Indications:
-horses: emergency relief
-SA: organophosphate toxicity, unresponsive to asthmatics
Term
Bronchodilators
Anticholinergics
Glycopyrrolate
Definition
-less toxic than atropine
-quaternary amine
-more polar
-does not cross BBB
Term
Bronchodilators
Anticholinergics
Ipratropium Bromide
Definition
-more polar
-same properties as Atropine except:
*no CNS signs
*No effect on mucociliary apparatus
*little cardiovascular properties
-use in horses and possibly cats
Term
Question:
How often should B-agonists generally be used in feline asthma?
Definition
-as needed for acute flare-ups
Term
Other Drugs Affecting Bronchospasm and Inflammation
3 of them
Definition
Zafirlukast (Leukotriene receptor antagonist; block bronchorestrictve cysteinyl leukotrienes)

Cyproheptadine (Serotonin and H1 agonist; mediator in Type I hypersensitivity in cats)

Cetirizine (H1 receptor antagonist; histamine increased in BALF of asthma cats)
Term
Inhaled therapy in Horses
Definition
-reduction in side effects
Admin of:
-glucocorticoids (short lived)
-B-receptor agonists (fast-acting)
-Anticholinergics (Ipratropium bromide)
-Cromolyn (prophylactic)
Term
Cromolyn (Intal)
Definition
-HORSES
-stabilizes mast cells
-inhibits PAF synthesis
-administered by nebulization prophylactically
Term
PHT reducers
Sildenafil (Viagara)
Definition
-PHT associated with chronic obstructive pulmonary disease
-reduces pulmonary arterial pressure in dogs
-acts as a phosphodiesterase inhibitor --> vasodilation
-given TID in dogs
Term
Cough Suppressants
Definition
Indications: prevent coughing due to tracheal collapse, canine bronchitis or when a painful, nonprod, exhausting cough exists with the potential for exacerbating lung damage

Contraindications: when the animal has a PRODUCTIVE cough; may prevent infectious fluids and secretions from exiting the body
Term
Cough Suppressants
Centrally Active
Dextromethorpan
Definition
-codeine derivative; NON-NARCOTIC
-elevates the threshold for coughing
-onset in ~30 min; lasts 4-6 hrs
Term
Cough Suppressants
Centrally Active
Diphenoxylate
Definition
-NARCOTIC
-used in combo with Atropine (Lomotil)
Term
Cough Suppressants
Centrally Active
Codeine
Definition
-oral
-NARCOTIC, CONTROLLED
-binds to opioid receptors in the cough center and depresses sensitivity to afferent stimuli
-side effects: constipation, sedation
-Onset ~30 min; lasts 4-6 hrs
Term
Cough Suppressants
Centrally Active
Butorphanol
Definition
-parenteral and oral admin
-NARCOTIC, CONTROLLED
-MOA similar to codeine
-onset: 5 min; lasts 90 min
Term
Expectorants and Mucolytics
Definition
Goal:increase the fluidity of the secretions and facilitate their removal

Systemic physiological fluid therapy: SINGLE MOST IMPORTANT THERAPY- MAINTAIN HYDRATION

Saline expectorants: Iodide Salts
-MOA: irritates mucous glands of the respiratory tract to produce a productive cough
-Contraindications: hypotyroid patients, pregnant/lactating
-Drugs: K+ Iodide salt soln, ethylenediamine dihydroiodide

Acetylcysteine
-decrease viscosity of mucous secretions
-require an intact mucociliary apparatus
-reduces disulfide bonds in mucoproteins
-increase levels of glutathione (scavengers of free radicals)
Term
Respiratory Stimulants
Doxapram
Definition
-stimulate chemoreceptors of carotid artery and aorta

Indications:
-drug-induced medullar depression
-apnea in neonates
-detection of laryngeal paralysis
Term
Question:
Which of the following cough supressants is a non-narcotic?
Definition
Dextromethorpan
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