Treatment without drugs

-room ventilation

-O2 supplement

-Mask, nasal canula, E-Collar with plastic

-"wet" cough, moving things out of the lungs vs

dry cough, not doing anything to help situation

Collapsing Trachea

WHAT KIND OF COUGH COMES WITH THIS?

Acquired defect of the cartilage rings in the trachea generally affects toy and miniature breeds.

--Non productive cough

CHF! What causes coughing?

Clinical signs?

Congestive Heart Failure

-accumulation of fluid in lungs, pressure on trachea from enlarged heart

-Moist cough that's worse after rest or in the AM.

Heartworm Disease from?

-Adult worms live where?

-Clinical sings in k9's?

-Clinical signs in Felines?

Dirofilaria immitis --

live in the caudal pulmonary arteries --Coughing dt PA enlargement, dead worms in lungs, pulmonary edema 

--Coughing, vomiting, pulmonary damage

-Bronchitis in cats

-Airway obstruction dt allergens

-Mild to severe, wax and wane

-Coughing

-Sternal recumbency, open-mouth breathing, cyanosis, end-expiratory push

Depends on severity of clinical signs

-O2 cage

-Bronchodilators

-Glucocorticoids (prednisone)'

-Cyproheptadine 

What happens in COPD of Horses?

Why?

Hypertrophy of smooth muscles surrounding terminal bronchioles. 

--Dusty mold environments and allergens. Happens a lot to indoor stalled horses

Toxocara canis

ROUNDWORMS

Cough suppressants

Block the cough reflex

Cough receptors throughout the respiratory tract>cough center>respiratory muscle contraction>cough

Central 

V

Local 

Antitussives

--Suppress cough center in brain

--soothe mucosal irritation that is initiating the cough

ie throat spray, lozenges

1. Butorphanol

2. Hydrocodone

3. Codeine

4. Dextromethorphan

Butorphanol

• What is it?
• Controlled substance?
• Administration methods and names?

• Central acting opoid, antitussive
• CIV controlled substance
• Oral: Torbutrol
• Parental: Torbugesic, Dolorex

Hydrocodone

• Brand names?
• What is it?
• Controlled substance?
• Side effects?

• Hycodan, Tussigon
• Central acting opioid, antitussive
• CIII controlled substance
• sedation, long term use may cause constipation

Codeine

• What is it?
• Controlled substance?
• Available in what forms?
• Popular in veterinary medicine?

• Antitussive, central-acting opiod
• A controlled substance, but lower class
• Available in some cough syrups
• Not very common in Vet Med

Dextromethorpan

• What is it?
• Commonly found where?
• Controlled substance?
• Cautions?

• An antitussive, derivative of an opioid
• Commonly found in OTC cough/cold meds
• Not a controlled substance
• Mixed with other ingredients during preparation that

• Mucolytics
• Expectorants
• Decongestants

What exactly a mucolytic do?

Common in veterinary medication?

It breaks up mucus to make it thinner and more easily moved out by cilia or coughed up.

Rarely used in veterinary medicine

• What is Acetylcysteine? 
• Used how?
• How does it work?
• Common in practice?

• A mucolytic, also known as Mucomyst
• Generally used in a nebulization or PO
• Works by chemically changing the mucus' viscosity (decreases it)
• Not commonly used for this purpose, but in tylenol toxicity

What exactly do expectorants do?

Different kind of expectorants?

• Increase fluidity of mucus by stimulating the respiratory tract cells to produce more liquid, thinner and easier to cough up. 
• Parasympathetic stimulants
• Local-acting, 

• Guaifenesin?
• Also known as?
• What does it do for respiratory?
• Also does what for horses?

• It is a parasympathetic stimulant, it increase mucus production via gastric irritant
• Glycerol guaiacolate, GG
• Muscle relaxant used IV in horses for anesthetic reasons

• Local acting expectorants do what?
• They are also ______
• Some are toxic to cats, known as?
• Examples:

• They directly stimulate respiratory secretions
• Also known as volatile oils, aromatic
• Pine oil is toxic to cats
• Vicks vapor rub, etc

• Decongestants do what by being an _______________?
• Common in Vet Med?
• Why?

• Alpha-1 agonists, vasoconstriction of periphery, decrease mucus membrane swelling/production
• Not common in vet med
• OTC preparations non-acceptable bc dangerous dt differences in animals

• Bronchonstriction is caused by what?
• Receptors for what?

• Terminal bronchioles are surrounded by smooth muscle, when they contract it constricts the airways. 
• They have receptors for Acetylcholine, Histamine and Epinephrine (B-2)
• CONTRACTS DUE TO
• PSN response, ACh
• Mast cell response, histamine
• Beta blockers, antagonist

ACh?

Stimulate what?

• Acetylcholine receptor, it's a parasympathetic neurotransmitter
• Constricts bronchioles as a defense mechanism

• Produced by mast cells/basophils
• Released with inflammation, hypersensitivity reactions

Sympathetic Nervous System

Stimulation DILATES

Serotonin blocker in cats does what?

An example of a blocker?

Selective B2

v 

Non-selective 

Beta Agonists

BRONCHODILATORS

Has B2 activity only

ie Albuterol, Terbutaline

vs

Has affinity for B1 and B2

tachycardia, peripheral vasocontriction

ie Ephedrine, Epinephrine, Isoproterenol

Methylxanthines?

BRONCHODILATOR

Causes bronchodilation by relaxing smooth muscle via cAMP

ie Theophylline, Aminophylline (80% Theo, 20% salt)

• Antimicrobial?
• Administration?
• Problems?

• Respiratory drug
• Admin via nebulization
• Need to reach site of infection, most of the time don't so kill weak bacteria and resistance is formed.

Corticosteroids?

What do they do?

What are they used for?

• RESPIRATORY DRUG
• Decrease inflammation but stabilizing mast cells and capillary walls
• Used in acute respiratory distress due to allergic response
• ie Anaphylaxis, feline asthma, FHWD

• Antihistamines?
• What do they do?
• Examples?  
• Side effects?

• RESPIRATORY DRUG
• Blocks histamine that causes bronchioconstriction by competing for receptor
• IE Chlorpheniramine, Hydroxyzine, Diphenhydramine, Cyproheptadine
• Cause drowsiness, and excitement in felines

Diuretics role in respiratory care?

How

Used to remove fluid that has accumulated in the lungs. 

Like furosemide(Salix) pulls water out of blood into urine so blood is thicker