1 Respiratory drugs and epidemiology Flashcards
How are respiratory drugs administered
- inhalation
- oral
- IV
What are the drugs which are used to improve ventilation
Brochodilators
- Beta2 agonist
- anticholinergic
Anti-inflammatory
- corticosteroid
What do the drugs which are used to improve ventilation do
improve airway patency (keeping it open)
prevent mast cell degranulation
What are drugs which impair ventilation
- beta-blockers
- respiratory depressants e.g. benzodiazepines, opioids
What drugs are used to improve gas exchange
- respiratory stimulants (e.g. theophyllines)
- oxygen
What are used to deliver inhaled drug delivery
- Meter dose inhaler (MDI)
- breath activated device (spinhaler, turbohaler)
What is the problem with an inhaler compared to a spinhaler/turbohaler?
high velocity suspension in inhaler can mean a lot of powder ends up in the mouth rather than in the lungs
What can be used for young children instead of an inhaler
nebuliser
What are the actions of beta agonists
- stimulate beta2 receptors
- lungs dilate
- airways wider
What different types of beta agonists do you get
Short acting
- salbutamol
- terbutaline
Long acting
- salmeterol
What is in a blue inhaler
Short acting beta2 agonists:
- salbutamol
- terbutaline
What is the onset of short acting beta agonists
2-3 minutes
how long do the effects of short acting beta agonists last
4-6 hours
What are short acting beta agonists used for
used treat acute bronchial constriction
what is the onset time for long acting beta agonists
1-2 hours
how long do the effects of long acting beta agoinsts last for?
12-15 hours
what are long acting beta agonists used for
used to prevent acute bronchial constriction
What are long acting beta agonists always used with? why is this important?
an inhaled steroid, to prevent cardiac arrest
what do anticholinergics do (Ipratropium = grey inhaler)
- inhibit muscarinic nerve transmission in autonomic nerves
- additive effect in bronchial dilation and reducing mucus secretion
What are the effects of corticosteroids
reduce inflammation in the bronchial walls
What corticosteroids have brown, orange and pink inhalers
Beclomethasone (brown)
Budesonide (brown)
Fluticosone (orange)
Mometasone (pink)
What are inside compound preparations (purple)
inhaled steroid with long acting beta agonist (mixture of green and brown as lots of patients will ignore brown one cause they don’t feel it makes much difference)
What does chromoglycate do
stops mast cells degranulating (‘like tasting sand’)
What do leukotriene inhibitors do
monotelukast
- inhibits one of the key inflammatory mediators
