9. Respiratory Pharmacology Flashcards
Name some inhaled corticosteroids
Beclometasone
Budesonide
Fluticasone
How do ICS work?
Pass through plasma membrane, activate cytoplasmic receptors, activated receptor then passes into nucleus to modify transcription
Reduces mucosal inflammation, widens airways, reduces mucus
What are the adverse effects of ICS?
Can cause local immunosuppressive action - candidiasis, hoarse voice
What a re the contraindications for ICS?
Pneumonia risk possible in COPD at high doses
What are the adverse effects of beta2 agonists?
Adrenergic - fight or flight effects
Tachycardia, palpitations, anxiety and tremor
Increase glycogenolysis and increase renin
What are the contraindications of beta2 agonists?
LABA should only be prescribed alongside ICS
Tachycardia may provoke angina
What are the DDI of beta2 agonists?
Beta blockers may reduce effect
Name a leukotriene receptor antagonist (LTRA)
Montelukast
How do LTRA act?
Leukotrienes released by mast cells/eosinophils which increase bronchoconstriction, increase mucus and increase oedema through CysLT1
LTRA block CysLT1
What are the ADR of LTRA?
Headache
GI disturbance
Dry mouth
Hyperactivity
Name some long acting muscarinic antagonist (LAMA)
Tiotropium - main
Theophylline
How do LAMA work?
Relative selectivity for M3 receptors
Block vagally mediated contraction of airway smooth muscle
What are the ADR of LAMA?
Infrequent anticholinergic effects - dry mouth, urinalysis retention, dry eyes
What is the action of theophylline?
Adenosine receptor antagonist - decrease bronchoconstriction
What is a DDI for theophylline?
CYP450 inhibitors - increase concentrations of theophylline
