Steven Berkowitz, DVM Chief, Emergency and Critical Care Saint Francis Veterinary Center
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1 Steven Berkowitz, DVM Chief, Emergency and Critical Care Saint Francis Veterinary Center
2 Outline Anatomy Common Diseases Interventions Oxygen Therapy Medications Nebulization Coupage
3 Respiratory Tract
4 Lower Respiratory Tract
5 Airways
6 Common Diseases of Lower Airways Pneumonia Infectious Aspiration Infiltrative Neoplasia Asthma Chronic Obstructive Pulmonary Disease
7 Common Diseases of Lower Airways Allergic/Anaphylaxis Pulmonary Contusions Smoke Inhalation Pulmonary Bullae Pulmonary Blebs Acute Respiratory Distress Syndrome ARDS
8 Outline Anatomy Common Diseases Interventions Oxygen Therapy Medications Nebulization Coupage
9 Interventions Oxygen Therapy Room air = 21% O2 Flow by Oxygen Oxygen Cage O2 Tent Nasal Oxygen Intubation
10 Medications Classes of Medications Bronchodilators Mucinolytics Expectorants Anti-tussives Anti-Inflammatories Pulmonary Arterial Vasodilator
11 Medications- Bronchodilators Drugs: Aminophylline and Theophylline Doses: Dogs: Aminophylline 7-10mg/kg q8-12hr Theophylline 20mg/kg q12-24hrs Cats: Aminophylline 7-10mg/kg q8-12hr Theophylline mg/cat q12-24hrs Onset of Action: approx minutes if injected Side effects: (think chocolate toxicity- increased heart rate, anxiousness, increased gastric acid secretions)
12 Medications- Bronchodilators Drug: Albuterol Doses: Dogs: 0.05mg/kg q8-12hr or mcg (2 puffs) total dose Cats: same Onset of Action: approx. 5 minutes if inhaled Side effects: CNS excitement, increased heart rate, hypokalemia (low potassium)
13 Inhalers
14 Medications- Bronchodilators Drug: Terbutaline Doses: Dogs: 0.01mg/kg q4hr IM, 0.03mg/kg q8hr PO Cats: 0.01mg/kg q4hr IM, mg per cat q8-12hr PO Onset of Action: approx minutes if injected Side effects: CNS excitement, increased heart rate, hypokalemia (low potassium)
15 Medications Drug: Epinephrine Doses: relaxes bronchial smooth muscle inhibits histamine release Dogs: mg/kg, CRI 0.1-1mcg/kg/min Cats: same Onset of Action: almost immediate Side effects: increased heart rate, increased blood pressure, arrhythmias
16 Medications- Mucinolytics Drug: N-Acetylcysteine (Mucomyst) Doses: Dogs: 140mg/kg, then 70mg/kg q6-8hrs for 7 treatments(po/iv) Cats: same Nebulized: 50mL/hr for 30-60mins q6-12hr Onset of Action: approx minutes if inhaled, 1-2 hours if injected Side effects: nausea, vomiting, can cause bronchospasms if sensitive and inhaled
17 Medications- Expectorant Drug: Guaifenesin Doses: Dogs: mg/kg q8-12hr Cats: not labeled for cats Onset of Action: within hours Side effects: nausea, vomiting, gagging
18 Medications- Anti-Tussives NOT ALWAYS OK TO USE!!!! Drug: Narcotics (Codeine, butorphanol, etc.) Doses: depends on choice Onset of Action: depends on choice Side effects: CNS depression, nausea, ileus, respiratory depression
19 Medications- Anti-Inflammatories Drug: Prednisone/Prednisolone Doses: Dogs: 0.5-1mg/kg q24hr Cats: 1-2mg/kg q24hr Onset of Action: several hours Side effects: PU/PD/PP, weight loss, water retention, immune suppression, bone marrow suppression, GI bleeding
20 Medications- Anti-Inflammatories Drug: Dexamethasone Doses: Dogs: mg/kg q24hr Cats: mg/kg q24hr Onset of Action: minutes to hours Side effects: PU/PD/PP, weight loss, water retention, immune suppression, bone marrow suppression, GI bleeding
21 Medications- Anti-Inflammatories Drug: Fluticasone (Flovent ) Doses: Dogs: 110mcg q12-24hr Cats: same Onset of Action: approx. 2 weeks to reach peak effects Side effects: very little systemic absorption, may increase potential for local infections
22 Medications- Pulmonary Arterial Hypotensive Agent Drug: Viagra (Sildenafil) Doses: Dogs: 1-3mg/kg q8-12hr Cats: no documented dosing Onset of Action: within 30minutes- several hours Side effects: systemic hypotension, headaches, weakness, sinusitis
23 Outline Anatomy Common Diseases Interventions Oxygen Therapy Medications Nebulization Coupage
24 Interventions Nebulization
25 Nebulizer Saline Mucomyst Antibiotics (Gentamicin)
26 Coupage Percussion of the thorax to aid in the removal of secretions
27 Summary Lower Airway Disease is a Common Problem Oxygen Therapy can be Life Saving Multiple Types of Medications Used for Treatment Nebulization and Coupage are Often Quite Helpful Limit stress!!!
28 Any Questions??? Works cited available on request
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