asthma Flashcards
name some antimuscarinic bronchodilators
ipratropium, triotropium, glycopyrronium, aclidinium
indications of antimuscarinic bronchodilators
- in COPD - LAMA
2. Asthma - SAMA. or LAMA
MOA antimuscarinic bronchodialtors
- competitive inhibitors of ach
= stimulating receptors = rest and digest effects. when blocked by these drugs = increase HR and conduction but reduce SM tone and reduce secretions from resp glands and GI tract - in eye - relaxation of pupillary constrictor and ciliary muscles = dilatation and stops accomodation
SE antimuscarinic bronchodialtors
- irritation of resp tract = nasopharyngitis, sinusitis and cough
- GI disturbance - dry mouth, consitpated, urine retention, blurry vision, headache
Cautionary use of antimuscarinic bronchodilators in which patients
- angle closure glaucoma = increase IOP
- pt with arrhythmua risk
- pt with urianry retention
B2 agonists examples
- salbutomol
- terbutaline
- salmeterol
- formeterol
- indaceterol
b2 agonist indications
- asthma
- COPD
- hyperkalaemia
MOA b2 agonists
- smooth msucle relaxation.
- stimulat na+/k+ atpase = intracellular shift of k+
SE b2 agonists
- fight or flight; palpitations, tachycardia, anxiety, tremor
- promote glycogenolysis = increase glucose.
- increase lactate at high doses
- laba = muscle cramps
warnings for LABA use in asthma
- do not use alone. must be with steroid therapy or icnreased risk of death
caution use of b2 agonists in which patients
- CVD
what shouldr drive nebs in asthma
oxygen
what should drive nebs in copd
air
inhaled steroids name some
beclometasone
budesonide
fluticasone
indications doe inhaled steroids
- asthma
2. COPD
MOA inhaled steroids
downregulate pro inflammatory cytokines. reduced mucosal inflammation, widened airways and reduced mucus
SE of inhaled steroids
- olar thrush
- hoarse voice
- in COPD - increased risk of pneumonia
- v high dose = systemic SE e.g. adrenal supression, growth issues and osteoporosis
fluticasone and high dose steroids should be used carefully in whom
- COPD with hx of pneumonia and in kids
LTRA - indications
- asthma
MOA of LTRA
- reduce inflammation and bronchocosntriction bu blocking cyslt1 receptor which is a gpcr.
SE of LTRA
- headache
- abdominal pain
- increased rate of URTI
uncommon
0 hyerpactivity and reduced ability to concentrate
0 churg strauss
can you continue LTRA in pregnancy
if already initiated then yes
what dose of monteluakst is prescribed
10mg OD
what forms can you get monteulkast in
granules, tbalet or chewable tablet.
