Podcast
Questions and Answers
Which of the following is a known side effect of Beta agonists at higher doses?
Which of the following is a known side effect of Beta agonists at higher doses?
What is the primary mechanism by which methylxanthines exert their bronchodilatory effects?
What is the primary mechanism by which methylxanthines exert their bronchodilatory effects?
What is the difference between Albuterol and Terbutaline?
What is the difference between Albuterol and Terbutaline?
Which of the following anticholinergic drugs is most commonly used for its bronchodilatory effects?
Which of the following anticholinergic drugs is most commonly used for its bronchodilatory effects?
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What is the primary mechanism by which anticholinergic drugs like Ipratropium exert their bronchodilatory effects?
What is the primary mechanism by which anticholinergic drugs like Ipratropium exert their bronchodilatory effects?
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What is the primary reason for the variable absorption of oral theophylline?
What is the primary reason for the variable absorption of oral theophylline?
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Which of the following is a potential side effect of methylxanthines?
Which of the following is a potential side effect of methylxanthines?
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Which of the following drugs is considered an indirect beta agonist?
Which of the following drugs is considered an indirect beta agonist?
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What stimulates bronchoconstriction in response to pulmonary irritation?
What stimulates bronchoconstriction in response to pulmonary irritation?
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Which class of drugs primarily targets respiratory smooth muscle contraction?
Which class of drugs primarily targets respiratory smooth muscle contraction?
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What is the mechanism of action of beta agonist drugs in bronchoconstriction?
What is the mechanism of action of beta agonist drugs in bronchoconstriction?
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What is the typical onset time for beta agonist drugs when used for acute bronchoconstriction?
What is the typical onset time for beta agonist drugs when used for acute bronchoconstriction?
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Which of the following is NOT a type of bronchodilatory drug?
Which of the following is NOT a type of bronchodilatory drug?
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What effect does the activation of adenyl cyclase have in relation to beta agonists?
What effect does the activation of adenyl cyclase have in relation to beta agonists?
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Which of the following compounds has a rapid onset and is used as emergent therapy for bronchoconstriction?
Which of the following compounds has a rapid onset and is used as emergent therapy for bronchoconstriction?
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Which receptor type is primarily targeted by beta agonists in the respiratory system?
Which receptor type is primarily targeted by beta agonists in the respiratory system?
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Which side effect is NOT associated with ß2 agonist drugs?
Which side effect is NOT associated with ß2 agonist drugs?
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What is the main advantage of using Ipatropium over Atropine?
What is the main advantage of using Ipatropium over Atropine?
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Which drug is contraindicated with asthma due to its bronchoconstrictive properties?
Which drug is contraindicated with asthma due to its bronchoconstrictive properties?
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What characterizes large aerosols greater than 10 μm in size when used in inhalational therapies?
What characterizes large aerosols greater than 10 μm in size when used in inhalational therapies?
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Which of the following corticosteroids can be administered via inhalation?
Which of the following corticosteroids can be administered via inhalation?
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What is a potential side effect of corticosteroid use?
What is a potential side effect of corticosteroid use?
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What is a primary use of physiologic saline in respiratory treatments?
What is a primary use of physiologic saline in respiratory treatments?
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What is the mechanism of action of dextromethorphan in cough suppression?
What is the mechanism of action of dextromethorphan in cough suppression?
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Corticosteroids inhibit the release of which inflammatory mediator?
Corticosteroids inhibit the release of which inflammatory mediator?
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Which agent is noted to be 300 times more lipophilic than other steroids?
Which agent is noted to be 300 times more lipophilic than other steroids?
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Which corticosteroid has the longest duration of action when inhaled?
Which corticosteroid has the longest duration of action when inhaled?
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Which type of cough suppressant is categorized as a peripheral cough suppressant?
Which type of cough suppressant is categorized as a peripheral cough suppressant?
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What is a common use for N-Butylscopolammonium Bromide in equine medicine?
What is a common use for N-Butylscopolammonium Bromide in equine medicine?
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Which of the following statements about corticosteroids is FALSE?
Which of the following statements about corticosteroids is FALSE?
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What is the principal effect of the substance P antagonist Maropitant in respiratory conditions?
What is the principal effect of the substance P antagonist Maropitant in respiratory conditions?
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Which of the following types of agents is gentamycin classified under?
Which of the following types of agents is gentamycin classified under?
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Study Notes
Drugs for the Respiratory System
- Drugs for the respiratory system are discussed, including bronchodilatory drugs, anticholinergics, beta agonists, methylxanthines, and corticosteroids.
Pulmonary Response to Irritation
- Stretch receptors, irritant receptors, and J receptors are involved in the pulmonary response to irritation.
- Stimulation of these receptors leads to inflammatory cell infiltrates, histamine release, and afferent nerve stimulation.
- These stimuli ultimately cause bronchoconstriction, mucus hypersecretion, and increased airway permeability.
Bronchodilatory Drugs
-
Sympathomimetics (Beta Agonists):
- Albuterol, a non-specific beta agonist, is primarily used.
- Epinephrine is another example..
- Beta agonists act by increasing intracellular cAMP, decreasing intracellular calcium, and inhibiting smooth muscle contraction leading to bronchodilation.
-
Methylxanthines:
- Aminophylline and theophylline are examples.
- These drugs inhibit phosphodiesterase, increasing cAMP and thus decreasing calcium levels, resulting in bronchodilation.
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Anticholinergics:
- These drugs block muscarinic receptors, reducing the parasympathetic nervous system's influence on the airways, leading to bronchodilation.
Beta Agonist Drugs
- B1 receptors primarily affect the heart, while B2 receptors primarily affect the respiratory, uterine, and vascular smooth muscles.
- Beta agonists increase intracellular cAMP, decrease calcium release, and thus result in bronchodilation.
- Beta agonists have rapid onset but shorter duration of action.
- Some beta agonists are specific for B2 receptors, while others affect both B1 and B2 receptors.
Beta Agonist Side Effects
- At higher doses, beta agonists may lose their beta-2 specificity, leading to adverse effects such as tachycardia and hypertension.
- Pharmacokinetics can affect bioavailability, including first-pass effects.
- Oral administration is often less effective than intravenous administration.
Methylxanthines (Side Effects)
- Increased mental awareness and heart rate.
- Can be used for patients with diaphragmatic fatigue and hypoventilation.
Methylxanthines (Available Drugs)
- Theophylline (in various forms including immediate-release and sustained release), Aminophylline, and Caffeine.
- Dosage adjustments may be necessary for different species, especially horses, due to variable absorption and metabolism.
- Side effects may include decreased appetite, nausea, vomiting, agitation, tremors, and diuresis.
Anticholinergic Drugs
- Anticholinergics block M3 muscarinic receptors, reducing parasympathetic nervous system activation, thus leading to bronchodilation.
- Side effects may include decreased salivation, tachycardia, decreased gastrointestinal motility, decreased mucociliary clearance, and mydriasis.
- Anticholinergics are less effective in humans compared to B2 agonists.
Corticosteroids (Anti-inflammatory)
- Corticosteroids function by inhibiting nuclear factor-κβ.
- They decrease inflammatory mediator production.
- Corticosteroids are effective anti-inflammatory agents, suppressing the immune response.
- Inhalational administration is preferred to systemic administration (oral/IV) due to fewer side effects but slower onset of action.
Corticosteroids (Administration)
- Inhalational corticosteroids provide localized treatment, minimizing systemic side effects.
- Injectable and oral corticosteroids provide systemic action with rapid onset but may be associated with pronounced side effects like hyperglycemia, suppression of the HPA axis, etc..
Nebulization
- Nebulization is a method of administering drugs in the respiratory tract.
- Increased mucus secretions can be reduced by mucolytic drugs (saline, etc), allowing for mucociliary clearance.
Inhalational Therapies
- Inhalational therapies provide targeted drug delivery.
- Particle size affects site of deposition, with smaller particles reaching deep lung tissues.
- Patient factors like depth of breathing and airway patency influence drug delivery. Inhalant drug administration is designed such that the drug is deposited in the specific area of the respiratory system.
Delivery of Inhalational Drugs
- Spacers are used to aid in administering inhalants by allowing for controlled inhalation and timing.
- Certain species, like horses, must inhale through the nostrils.
Cough
- Coughing is triggered by various factors, including mechanical stimuli (mucus or foreign bodies).
- Cough is a physiological reflex to remove irritants from the respiratory tract.
- Chemical stimuli (substance P released by nerve endings on the resp tract) can trigger a cough response.
Antitussives
- Antitussives are drugs that reduce or stop coughing.
- Centrally acting antitussives may have some side effects; but have an effect on the cough center in the medulla
- Peripherally acting antitussives may act through the peripheral (nerves) aspects of the respiratory system.
- It is important to treat underlying causes (infection) instead of just suppressing coughing in general.
Peripheral Cough Suppressants
- Guaifenesin (glyceryl guaiacolate) acts as an expectorant, decreasing mucus viscosity.
- Lidocaine is a local anesthetic that can be used topically to suppress cough at the larynx.
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Description
This quiz explores essential drugs for the respiratory system, focusing on bronchodilatory medications such as beta agonists and corticosteroids. It also covers the pulmonary response mechanisms including the roles of various receptors in irritation. Test your knowledge on these critical pharmacological agents and their effects on respiratory function.
