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Respiratory Drugs Study Guide

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Respiratory Drugs
Drug Class
Example Drug
MOA
Route of Administration / Indication
Toxicity / Adverse Effects
Indications
Non-selective
-Receptor
Agonists
Epinephrine
Direct stimulation of adrenergic
receptors
SQ, IV, IM or intratracheal
administration
Tachycardia
cardiac arrhythmias
hypertension
Used for acute or emergency control of
bronchoconstriction
Isoproterenol
Direct stimulation of adrenergic
receptors
Injectable for bronchodilation
Tachycardia
cardiac arrhythmias
hypertension
Used for acute or emergency control of
bronchoconstriction
Ephedrine
Direct stimulation of adrenergic
receptors
Oral for bronchodilation
Tachycardia
cardiac arrhythmias
hypertension
Used for chronic control of
bronchospasm
Selective
-Receptor
Agonists
Albuterol
Selective stimulation of beta-2
adrenergic receptors
Oral or nebulized
Short acting
Can be used as a rescue agent
Tocolytic decreases uterine contractions
Beta-1 effects at high doses: tachycardia,
tremors, CNS excitation, anxiety, sweating
Rescue agent
Clenbuterol
Selective stimulation of beta-2
adrenergic receptors
Oral administration
Given BID for 30 days max
Repartitioning agent and thus banned
for use in food animals
Tocolytic
Beta-1 effects at high doses: tachycardia,
tremors, CNS excitation, anxiety, sweating
Used primarily in horses with RAO &
should be used with an inhaled steroid
Terbutaline
Selective stimulation of beta-2
adrenergic receptors
Oral, SQ,IV, IM
Tocolytic
Beta-1 effects at high doses: tachycardia,
tremors, CNS excitation, anxiety, sweating
Small animal bronchitis and feline
asthma
Occasionally used in horses
Salmeterol
Selective stimulation of beta-2
adrenergic receptors
Long acting agent
Longer onset of action and duration
than albuterol due to increased
lipophilicity
Inhaled
Tocolytic
Beta-1 effects at high doses: tachycardia,
tremors, CNS excitation, anxiety, sweating
Used primarily in horses with RAO &
should be used with an inhaled steroid
Anticholinergic
Bronchodilators
Atropine
Block M3 receptor and
antagonize vagal-mediated
airway constriction
Injectable (IV, IM)
Anticholinergic effects (dry mouth,
mydriasis, urinary retention, constipation)
Ileus in horses
Tachycardia
Adjunct therapy for bronchoconstriction
Rescue agent for bronchoconstriction
Ipratropium bromide
Block M3 receptor and
antagonize vagal-mediated
airway constriction
Inhaled atropine salt
Minor local irritation (coughing)
Adjunct therapy of RAO of horses,
possibly other species
N-butylscopolammonium
bromide
Block M3 receptor and
antagonize vagal-mediated
airway constriction
Injectable (IV, IM)
Tachycardia
Decreased borborygmi
Minor anticholinergic effects
Adjunct therapy RAO of horses
Methylxanthine
Derivatives
Theophylline
Inhibit phosphodiesterase and
increase cAMP levels
Oral administration only
Metabolized by liver
Produce bronchodilation, tocolysis,
diuresis, and respiratory stimulation
CNS excitation
GI irritation
Cardiac stimulation (tachycardia,
arrhythmia)
Many drug interactions
Bronchodilator used in dogs, cats
(mostly second choice drugs)
Should be monitored due to narrow
therapeutic index
Aminophylline
Inhibit phosphodiesterase and
increase cAMP levels
Theophylline salt that can be given IM
or IV
Metabolized by liver
Produce bronchodilation, tocolysis,
diuresis, and respiratory stimulation
Just as theophylline
Rapid IV administration more likely to
cause adverse effects
Used in dogs, cats, horses
Should be monitored due to narrow
therapeutic index
Corticosteroids
Dexamethasone
Prednisone
Prednisolone
Inhibit PLA2 & chemotaxis
Stabilize lysosomal and
leukocyte membranes
Increase capillary selective
permeability
Inhibit fibroblast activity
Suppress T-lypmhocyte, &
macrophage activity Ig
production
Systemically administered
glucocorticoids
Oral administration for home therapy
ACTH depression with long term use
Sodium retention, edema, potassium loss,
and metabolic alkalosis
Muscle weakness & wasting
Depression of host defenses
Acute management of RAO/asthma
Chronic therapy of RAO/asthma
Fluticasone
Inhibit PLA2 & chemotaxis
Stabilize lysosomal and
leukocyte membranes
Increase capillary selective
permeability
Inhibit fibroblast activity
Lipophilic
Delayed onset of action with long
duration and little systemic absorption
Fewer adverse effects with inhaled
steroids
Cornerstone of treatment of
hyperreactive airway diseases in
humans
Most popular inhaled glucocorticoid in
veterinary patients

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Respiratory Drugs Drug Class Non-selective -Receptor Agonists Example Drug Epinephrine MOA • Direct stimulation of adrenergic receptors Route of Administration / Indication • SQ, IV, IM or intratracheal administration • Direct stimulation of adrenergic receptors • Injectable for bronchodilation Isoproterenol • Direct stimulation of adrenergic receptors • Oral for bronchodilation Ephedrine Albuterol • Selective stimulation of beta-2 adrenergic receptors • • • • • • Clenbuterol Selective -Receptor Agonists Terbutaline • Selective stimulation of b ...
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