Term
| When do we intubate & ventilate? |
|
Definition
-cardiopulmonary arrest
-severe hypoventilation
-severe hypozemia |
|
|
Term
| What is the emergent tx for resp dz? |
|
Definition
-minimal handling
-oxygen
-mild sedation: butorphanol or ace
-fast-acting bronchodilator
-short-acting corticosteroid
-diuretc
-thoracocentesis |
|
|
Term
| What is the goal of O2 supplementation? |
|
Definition
| -inc FiO2 => inc PaO2 & SaO2 => inc O2 delivery |
|
|
Term
| What factors affect O2 delivery to tissue? |
|
Definition
-oxygenation of blood
-Hemoglobin content of blood
-peripheral vasculatur
-CO |
|
|
Term
| What are some common indications for O2 supplementation? |
|
Definition
-hypoxemia
-resp distress
-cardiac/resp arrst
-hypotension
-shock
-metabolic acidosis
-major surgery
-ead and spinal cord injury |
|
|
Term
| What are the methods of O2 supplementation? |
|
Definition
-flow-by or face mask
-O2 cage
-nasal insufflation |
|
|
Term
| What are the advantages & disadvantages of flow-by or face mask O2? |
|
Definition
-A: best for very short term use
-D: not accepted by all petients |
|
|
Term
| What are the advantages & disadvantages of O2 cage? |
|
Definition
-A: control O2 level, temp, humidity
-D: not practical for too large of dogs |
|
|
Term
| What are the advantages of O2 supplementation? |
|
Definition
-works for any size of patient
-usually well accepted |
|
|
Term
| What is an oxygen hood? Disadvantages? |
|
Definition
-contructed E-collar & cellophange wrap
-D: become very hot & not accepted |
|
|
Term
| What are the general guidelines for oxygen supplementation? |
|
Definition
-humidify O2 (exception is O2 hood)
-provide flow rates: 50-200 ml/kg/min
-w/ nasal insufflation do NOT exceed flow rates of 6L/min |
|
|
Term
| What are some complications of O2 supplementation? |
|
Definition
| -O2 toxicity: formation of O2 free radicals, lipidperoxidation, resp failure |
|
|
Term
| What O2 levels should we keep to avoid complications? |
|
Definition
| -long-term O2 mainained at less than or equal to 50% FiO2 |
|
|
Term
| What are some resp indications for abx? |
|
Definition
-bacterial rhinitis
-infectious tracheitis
-bacterial bronchopneumonia
-pyothorax |
|
|
Term
| When is parental admin of abx best? |
|
Definition
-critically ill
-concurrent GI dz |
|
|
Term
| When is oral admin of abx best? |
|
Definition
-stable
-healthy GI tract
-out-patient |
|
|
Term
| What are our empiric first choice abx for bacterial rhinits? |
|
Definition
-Doxy
-Azithromycin
-Amoxicillin/clavulanic acid |
|
|
Term
| What is the common name for infectious tracheobronchitis? Etiology? |
|
Definition
-kennel cough
-B. conrhiseptica, Mycoplasma sp, viral |
|
|
Term
| What are the empiric first choice abx for kennel cough? |
|
Definition
|
|
Term
| How do we treat a mild, stable bacterial pneumonia? |
|
Definition
-first gen cephalosporin
-Amoxicillin |
|
|
Term
| How do we treat a moderate, stable bacterial pneumonia? |
|
Definition
-second gen cephalosporin
-amoxi/sulbactam +/- fluoroquinolone |
|
|
Term
| How do we treat a severe, unstable bacterial pneumonia? |
|
Definition
-amoxi/sulbactam & fluoroquinolone
-2nd/3rd gen cephalosporin & fluoroquinolone
-meropenem or imepenem |
|
|
Term
| What abx do we empirically use to treat pyothorax? |
|
Definition
-Filamentous and/or sulfr granules: actinomyces = penicillins OR nocardia = TMS, azithromycin, aminoglycosides, tetracylcines
-BS: potentiated penicillins, clindamycin + fluoroquinolones |
|
|
Term
| What are some commonly used antifungals? |
|
Definition
-Itraconazole: oral
-Fluconazole: oral
-Terbinafine: oral
-amphotericin B: IV
-clotrimazole: topical |
|
|
Term
| What are some common etiologies of fungal rhinitis? Do they affect dogs or cats more frequently? |
|
Definition
-Aspergillus or penicillium: dog >> cat
-Crypto: cat >> dog |
|
|
Term
| What are the common etiologies of fungal pneumonia? Do they affect dogs or cats more frequently? |
|
Definition
-Histo: cat > dog
-Blasto: dog ? cat
-Coccidiosis: dog >> cat
-Crypto: cat > dog
-Aspergillus, systemic: dog >> cat |
|
|
Term
| Which abx do we use to treat fungal rhinitis? |
|
Definition
=topical clotrimazole or enilconazole
+/- oral terbinafine |
|
|
Term
| How do we treat fungal rhinitis? |
|
Definition
| -oral itraconazole or fluconazole |
|
|
Term
| How do we treat fungal pneumonia? |
|
Definition
-normally: oral itraconazole or fluconazole
-life-threatening: IV amphotericin B |
|
|
Term
| Which animals cannot use enilconazole for fungal rhinitis? |
|
Definition
|
|
Term
| When is topical therapy contraindicated w/ fungal rhinitis? |
|
Definition
| -erosion of cribiform plate = access to brain |
|
|
Term
| What are the cure rates w/ topical therapy of fungal rhinitis? |
|
Definition
-60-70% w/ first tx
-about 90% w/ multiple tx |
|
|
Term
| True or False: Absence of nasal discharge indicates cure of fungal rhinitis. |
|
Definition
|
|
Term
| What are some indications for corticosteroid tx of resp dz? |
|
Definition
-feline asthma
-chronic bronchitis
-eosinophilic bronchopneumopathy
-lymphoplasmacytic rhinitis
-HW dz |
|
|
Term
| What are the two classes of bronchodilators? Examples of each? |
|
Definition
-Methylxanthines: Theophylline, Aminophylline
-Beta-rc agonist: terbutaline, albuterol, epinephrine |
|
|
Term
| What are some common indications of bronchodilators? |
|
Definition
-feline asthma
-chronic bronchitis
-bronchial collapse
-bronchopneumonia |
|
|
Term
| How do methylxanthines work? |
|
Definition
-inh phosphodiesterase: relax smooth mm
-inh mobilization of Ca: inh smooth m contraction
-inh adenosine: inh bronchoconstrition |
|
|
Term
| What are the physiologic effects of methylxanthine? |
|
Definition
-bronchodilation
-anti-inflam: inh mast cell degranulation
-improves mucociliary clearance
-strengthens resp mm: helps prevent m fatigue |
|
|
Term
| HOw do beta-rx agonists work? |
|
Definition
| -activate adenyl cyclace => smooth m relaxation = bronchodilation |
|
|
Term
| What are the physiologic effects of beta-rc agonists? |
|
Definition
-bronchodilation
-anti-inflam: inh inflamm mediator release
-improves mucociliary clearance by dec secretion viscosity |
|
|
Term
| What are some side effects of beta agonsits & methylxanthines? |
|
Definition
-CNS excitation
-GI distress
-tachycardia
-cardiac arrhythmia
-Beta-rc agonists: hypokalemia |
|
|
Term
| What are some contraindications for beta agonists & methylxanthines? |
|
Definition
-cardiac dz
-seizure disorder
-hypertension
-hyperthyroid
-renal dz
-liver dz
-knwon hypersensitivity |
|
|
Term
| What are the two classes of antitussives? Give examples of each. |
|
Definition
-Narcotics: hydrocodone, butorphanol, codeine
-Non-narcotic: dextromethorphan |
|
|
Term
| What are some indications for antitussives? |
|
Definition
-tracheal/bronchial collapse
-tracheitis
-chronic bronchitis
-pulmonary fibrosis |
|
|
Term
| What is the best cough suppression? |
|
Definition
|
|
Term
| What are the contraindications of antitussives? |
|
Definition
-any productive cough: important physical defense
-bronchopneumonia |
|
|
Term
| What is our major mucolytic protussive? How does it work? |
|
Definition
-N0acetyl-L-cystine (NAC)
-breaks mucoprotein disulfide bonds = improves mucociliary clearance and cough
-also a direct antioxidant |
|
|
Term
| How do we administer NAC? |
|
Definition
-IV slowly
-PO is neutraceutical
-nebulization causes bronchoconstriction |
|
|
Term
| What are some common indications for NAC? |
|
Definition
-bronchopneumonia
-chronic bronchitis
-non-cardiogenic pulmonary edema
-ARDS |
|
|
Term
| What are the advantages of inhalant therapy? |
|
Definition
-deliver moisture or drug directly to airway
-quicker onset of action
-lower required doses: dec systemic SE |
|
|
Term
| What are the two delivery methods of inhalant therapy? |
|
Definition
-nebulizer
-metered dose inhaler |
|
|
Term
| What does the final destination depend on? |
|
Definition
-partical size: smaller size = deeper delivery
-breath characteristics: deeper breath = deeper drug deliver |
|
|
Term
| How do we maintain airway hydration? |
|
Definition
|
|
Term
| What happens w/ airway dehydration? |
|
Definition
|
|
Term
| What are the indications for airway hydration? |
|
Definition
-excess tracheal & bronchial secretions
-bronchopneumonia |
|
|
Term
| What is coupage? When do we do it? |
|
Definition
-repeated, firm, thoracic percussion to improve clearance of debris
-done after nebulization |
|
|
Term
| What are the indications for coupage? |
|
Definition
|
|
Term
| What are contraindications for coupage? |
|
Definition
| -pulmonary abscess or bullae |
|
|
Term
| What are the various drugs we use for nebulization? |
|
Definition
-abx
-bronhcodilators
-mycolytics |
|
|
Term
| Briefly describe the method of drug nebulization. |
|
Definition
-use systemic dose
-dilute w/ sterile saline
-give over 20-30min |
|
|
Term
|
Definition
-suspension of drug in propellent w/ speciic amt of drug w/ eac actuation
-spacers are required |
|
|
Term
| What is the most commonly used MDI? |
|
Definition
-fluticasone proprionate (corticosteroid): three different doses
-also use albuterol (can be repeated) |
|
|
