Bronchodilators Flashcards
Classes
- Beta-Adrenergic Agonists
- Anticholinergics
- Xanthine Derivates (Methylxanthines)
Bronchodilators MOA
- relax smooth muscle
- dilates bronchi + bronchioles
what are Adrenergic Agonists?
drugs that stimulate + mimic actions of the SNS
(aka sympathomimetics)
Beta1-adrenergic receptors
- primarily in the heart
- stimulted by specific autonomic nerve fibers
Beta2-adrenergic receptors
- stimulated by anutonomic nerve fibers
- located in smooth muscle of bronchioles, arterioles, and visceral organs
Beta-Adrenergic Agonists
SABA
Short Acting Beta2 Agonist
Albuterol (Proventil)
Beta-Adrenergic Agonists
LABA
Long Acting Beta2 Agonist
Salmeterol (Serverent)
Beta-Adrenergic Agonists MOA
- specific receptor stimulation
- dilated airways
- activation of beta2 receptors = cAMP to relax smooth muscle of airway
Beta-Adrenergic Agonists Therepeutic effects
- bronchospasm relief
- treatment and prevention of acute attacks
- tx of hypotn and shock
Beta-Adrenergic Agonists Contraindications
- uncontrolled hypertn
- dysrhythmias
Beta-Adrenergic Agonists
Alpha and Beta AE
epinephrine
- insomnia
- restlessness
- anorexia
- vascular headache
- hyperglycemia
- tremor
- cardiac stimulation
Alpha adrenergic agonists
sympathomimetic
Epinephrine
regulates BP
Beta-Adrenergic Agonists
Beta1 and Beta2 AE
metaproterenol
- cardiac stimulation
- tremor
- angina
- vascular headache (migraine)
- hypotn
Beta-Adrenergic Agonists
Beta2 AE
albuterol
- hypotn/hypertn
- vascular headache
- tremor
Inhalation drug therapy
advantages
- direct
- few systemic SE
- rapid relief of acute attacks
Inhalation drug therapy
types
- metered-dose inhalers (MDI)
- dry powder inhalers
- nebulizers
- use of spacers
Inhalation drug therapy
disadvantages
- high impact on oropharynx
- optimal use low %*
*idk
Inhalation drug therapy
Considerations
- patients ability to use MDI/dry powder inhaler
- 1-2 minute between each puff
- 2-5 minute before each med
- steroid last
- nebulizers may take longer but may be more effective
Inhalation drug therapy
education
- encourage fluids
- peak flow meters
Albuterol AE
and why?
- Nausea
- Anxiety
- Palpitations
- tremors
- tachycardia
receptor specificity is lost
Salmeterol uses
- maintenance treatment
- combined with corticosteroid (fluticasone) = Advair
- 2x/day
- inhaled powder
Anticholinergic bronchodilator examples
- Ipratropium (Atrovent)
- Tiotropium (Spiriva)
Anticholinergic bronchodilator MOA
- block acetylcholine receptors on bronchial tree
- slow, prolonged action
Anticholinergic bronchodilator contraindications
- allergies
- caution with glaucoma
- caution with prosate enlargement
Anticholinergic bronchodilator SE
- dry mouth
- nasal congestion
- palpitations
- GI distress
- retention
- increased intraocular pressure
- headache
- coughing
- anxiety
Bronchodilator: Xanthine derivative examples
- caffeine
- thebromine
- theophylline
natural xanthines
Bronchodilator: Xanthine derivative MOA
- metabolized into caffeine
- stimulates CNS to enhance respir drive
- can stimulate cardiovasc response in large doses
- dilates kidney blood vessels = diuretic effect
