Respiratory 1

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Respiratory 1
2012-02-29 20:38:25

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  1. List 4 defense mechanisms of the respiratory tract.
    • cough
    • sneeze
    • mucociliary apparatus
    • bronchoconstriction
  2. When is coughing helpful, and when is it harmful?
    • helpful: clears out foreign bodies, mucus, irritants in airways
    • harmful: excessive - continued irritation, lack of rest
  3. What is the mucociliary apparatus?
    consists of a layer of mucus secreted by cells lining the respiratory mucosa, and the cilia on the luminal surface of the cells lining the respiratory tract
  4. What is the function of the mucociliary apparatus?
    dirt and debris is trapped in the mucus, and the mucus and dirt is swept towards the pharynx by the cilia, to be spit out or swallowed prevents blockage of air passages
  5. What is the function of the macrophages in the respiratory system?
    help to phagocytize and remove foreign material from the respiratory tract
  6. What is the function of respiratory tract immunoglobulins?
    they are antibodies that help to protect the body against specific infections that the body has already been exposed to. immunoglobulins are present in mucus lining the respiratory tract
  7. What is bronchoconstriction?
    smooth muscle lining bronchioles close to the level of the alveoli, contract, decrease diameter of bronchioles.
  8. What is the function of bronchoconstriction?
    is supposed to protect the respiratory tract from aspirating foreign material down into the alveoli
  9. Which type of stimulation causes bronchoconstriction - sympathetic or parasympathetic?
  10. Which type of stimulation causes increased mucus secretion - sympathetic or parasympathetic?
  11. When is mucus production helpful, and under what conditions is it harmful?
    • helpful: normally traps debris for removal
    • harmful: mucus can be excessive, thin and watery, or thick and hard to remove - either can prevent gas exchange, cause blockages
  12. What does inspissated" mean?
    dried up
  13. When is bronchoconstriction helpful, and when is it harmful?
    • helpful: when it prevents aspiration of foreign bodies or fluid deep into terminal bronchioles and alveoli
    • harmful: when it is extreme enough to make ventilation difficult - dyspnea
  14. List at least 5 common general respiratory problems that may require medication.
    • inflammation
    • infection
    • pulmonary edema
    • allergies
    • asthma
    • toxins
    • aspiration
    • congenital defects
    • neoplasia
    • parasites
    • trauma
  15. Is it important to get a specific diagnosis before treating the patient with respiratory drugs? Why or why not?
    yes - a lot of different conditions can cause respiratory clinical signs, and a drug helpful for one type of problem may be harmful for another type of problem
  16. In general, are over-the-counter multiple-drug-combination human cold-type medications recommended for veterinary patients? Why or why not?
    no. extremely variable drugs and dosages, often contain drugs that are ineffective (decongestants) or toxic (acetaminophen) to small animals
  17. What do antitussive drugs do?
    block the cough reflex
  18. What is the difference between a productive and a non-productive cough?
    • productive: mucus is coughed up
    • non-productive: no mucus coughed up
  19. Do all types of coughs need to be prevented?
  20. Is it helpful to suppress very productive coughs? Why or why not?
    no. need to get excess fluid, mucus out of airways to prevent blockage
  21. Is it helpful to suppress non-productive coughs? Why or why not?
    yes - prevent chronic irritation - can cause changes in the respiratory lining. Let the patient get some rest.
  22. Do antitussive drugs cure the causes of coughs?
    no - they just relieve clinical signs
  23. What is the difference between centrally-acting and peripherally-acting antitussive drugs?
    • central acting: suppress the cough center of the brain. most commonly used in veterinary medicine.
    • peripheral acting: suppress local irritation in airways. usually not practical in animals - will not hold a "cough drop" in their mouths.
  24. List the 4 antitussive drugs discussed in class. These drugs all belong to or are derived from what classification of drug?
    • butorphanol, hydrocodone, codeine, dextromethorphan
    • opioid
  25. Since butorphanol and hydrocodone are also analgesic, they can mask signs of pain and worsening condition in the patient - true or false?
  26. Which of the 4 antitussive drugs discussed in this class are not especially effective in animals?
  27. What is the purpose of mucolytic drugs?
    thin out thick, dry mucus, and break down sticky mucus - so it can be removed by the mucociliary apparatus
  28. What is the first treatment we should give a dehydrated patient with thick, dry mucus in his respiratory system?
    rehydrate with IV fluids
  29. What is the main mucolytic drug discussed in class?
    acetylcysteine - Mucomyst
  30. Do not confuse "acetylcysteine" with "acetylcholine". What is acetylcholine?
    neurotransmitter found at the neuromuscular junction of skeletal muscle, and associated with the parasympathetic nervous system
  31. How does acetylcysteine act?
    sulfhydryl groups (-SH) break up disulfide (S-S) bonds in DNA of cellular debris that cucases the mucus to be sticky
  32. Does acetylcysteine help to remove blood clots from the respiratory system?
  33. How is acetylcysteine usually administered for mucolytic purposes?
    by nebulization or PO
  34. Can nebulization be stressful for a veterinary patient? Can nebulization stimulate bronchoconstriction? Can administration of a bronchodilator drug before nebulization be helpful?
    • yes
    • yes
    • yes
  35. What is an MDI? What is it used for?
    metered dose inhaler - used to administer drugs by inhalation/nebulization
  36. Are MDI's a relatively effective and well tolerated?
  37. If acetylcysteine is to be used PO, is there anything in particular we need to remember about this route of administration?
    yes - acetylcysteine tastes bad, and may have to be given by stomach tube.
  38. What toxin is acetylcysteine used to treat?
    acetaminophen - Tylenol - actually its toxic metabolite
  39. What is the purpose of expectorant drugs?
    make secretions more watery and increases volume of secretions, so the secretions are easier to remove
  40. How do expectorant drugs act?
    by stimulating receptors in the stomach and respiratory tract to cause increased secretions
  41. When can expectorant drugs be dangerous?
    if the volume is increased too much, and/or the cough reflex is suppressed - fluid may build up in airways and alveoli
  42. List the main expectorant drug discussed in class, and list 3 minor categories of expectorants
    • main: guaifenesin
    • minor caterories: saline expectorants, volatile oils, high humidity
  43. When used as an expectorant, is guaifenesin given PO, IV, or by nebulization?
    PO - by mouth
  44. For what purpose is guaifenesin given IV?
    muscle relaxant - for equine anesthesia