Block 3 respiratory slides+ SG Flashcards
Respiratory disease includes:
Asthma COPD Lung cancer Obstructive sleep apnoea Bronchiectasis Childhood bronchiolitis Childhood pneumonia
Asthma in New Zealand
- 1 in 9 adults and 1 in 7 children
- Māori are 3.4 times and Pacific peoples 3.9 times more likely to be hospitalised
COPD in New Zealand
-4th leading cause of death in NZ
-3.7 times higher for Māori and 2.8 times higher for
Pacific people
What is Asthma?
a chronic lung condition. a condition in which the airways are more sensitive than normal and tend to narrow in response to certain triggers
the narrowing of airways is due to?
swelling of the lining of the airway
• increased mucous in the airway
• ‘Bronchospasm’
what is bronchospasm?
contraction of the muscle layer surrounding the airway
COPD refers to?
chronic bronchitis and emphysema. co-existing diseases of the lungs result in narrowing of the airways and potential loss of viable lung tissue
what happens when you have COPD?
limitation of the flow of air to and from the lungs and
poor gaseous exchange.progressive lung disease.
Pharmacological therapy 2 main groups
Bronchodilators and Anti-inflammatory agents
-aims to improve air flow in and out of lungs, improve gaseous exchange in alveoli, provide o2 & removal of co2
Routes of administration
Inhaled (aerosols, nebules), oral (liquid, tablets), IV (injections)
what does bronchodilators do?
relieve the constriction of the bronchi allowing air into the lungs for gaseous exchange
when do you use bronchodilators?
used in acute situations
when rapid response is required (short acting) and as long-term symptom
controllers/maintenance treatment (long-acting)
what are the types of bronchodilators used?
B-adrenergic agonists, antimuscarinics, and
methylxanthines.
what is B2-adrenergic agonists?
selectively bind to B2-adrenergic receptors and
stimulate a sympathetic nervous system response leading to bronchodilation.
SABA (Short-acting beta-2 agonist) available in inh,nebs,inj
fast acting bronchodilators and are known as relievers. These are used for quick relief of bronchospasm.
- salbutamol
- terbutaline
LABA (Long-acting beta-2 agonist)available in inh,nebs,inj
have t½ of 6-12 hours and are administered once or twice daily. They are known as symptom controllers / maintenance
treatment and are to be used in conjunction with inhaled corticosteroids
for asthma
-salmeterol
-formeterol
how to use inhalers
pressing down on inhaler, breathing in deeply as soon as medication is released,
holding your breath, exhaling
Advantages of Using Spacer
Avoids timing issue • More drug gets into lungs • Less drug needed for effective dose • Fewer adverse effects • Easier to deliver medication
Antimuscarinics- Onset of action slower than b-agonists
drugs block the muscarinic
receptors involved in the parasympathetic stimulation of the
bronchioles
Antimuscarinics drugs
Short Acting: ipratropium (Atrovent)
• Long Acting: tiotropium (Spiriva); glycopyrronium (Seebri)
Therapeutic Action:
bronchodilation and decreased mucous secretion
Adverse effects
dry mouth/throat irritation, blurred vision, tachycardia, urinary retention, constipation
Methylxanthines drugs & MOA
-caffeine
- theophylline (Nuelin) (oral) and aminophylline (injection)
- a complex mechanism by inhibiting the enzyme that degrades cAMP (second messenger system)
Adverse effects
insomnia, anxiety, tremors,
tachycardia, epigastric pain, nausea (due to lack of specificity, the drugs ↑ cAMP levels in other cells)
