Esa3 Flashcards
Ipratropium.
Anticholinergics
Affect nicotinic and Muscurinic receptors and oreganglionic nerve terminal: reduced parasympathetic stimulation
E.g. In COPD, reduce smooth muscle contraction
Lots of side effects so not that great
Tiotropium
Anticholinergics
Affect nicotinic and Muscurinic receptors and oreganglionic nerve terminal: reduced parasympathetic stimulation
E.g. In COPD, reduce smooth muscle contraction
Lots of side effects so not that great
Theophylline and aminophylline
Methylxanthines
Anti IgE: mast cell stabilisers. Anti Inflammatory =
Also Bronchodilaton: inhibit phosphodiesterases (normally break down cAMP. Increased cAMP = bronchodilaton.
COPD and asthma
Hydrocortisone
Short term corticosteroid-
Asthma
Also prednisone
Flunisolide, triamicinolone, mometasone
Preventer corticosteroid
Asthma and COPD
Aformeterol, salmeterol
Long acting B2 agonists-
ASTHMA
Montelukast- leukotriene inhibitor
Oral medication.
Asthma
Carbocysteine,
Mucolytics
Break down and reduce thickness of sputum
COPD
Metaproterenol
b2 agonist
Avoid as loads of side effects
Asthma
Treat acute exacerbation of COPD
Nebulisers (bronchodilaton)
Oral steroids
Antibiotics if needed
Give O2 (only in acute, long term just makes it worse unless in long term oxygen therapy) Repeat ABG
Treat pneumonia
Depends on curb 65
Supportive: fluids,oxygen and analgesics as appropriate
Antipyretic: reduce fever and malaise e.g. Paracetamol
Antibiotic:
CAP: pneumococcus: amoxicillin
HAP: Gram negative: co amoxiclav (IV)
Amoxicillin
CAPneumonia- mild Of normal causative organisms: - strep pneumoniae -Haemophilus influenzae - klebsiella pneumoniae
Doxycycline
Tetracycline
Mild CAP
other infections…….
Tetracyclins so Target:
Erythromycin/clarithromycin
Mild CAP if allergy
Other uses: …….
Macrolides : target ….
Co amoxiclav
Used with clarithromycin and erythromycin –> CAP (moderate to severe - need admission)
Salbutamol
B2 agonist
Activates adenyl cyclase –> cAMP –> PKA –> phosphorylation of myosin light chain kinase –> relax SM = bronchodilaton
Asthma, and symptomatic relief in COPD
SE: tachycardia, tremor, palpating, hypokalaemia, anxiety
Cahmpix- varenicline
Gum/patch in nicotine replacement therapy
- reduce withdrawal discomfort
- partial agonist, binds to nicotinic Ach receptors
Rifampicin
Tb (4mths) as part of multi drug therapy
SE: Hepatitis, rash, flu like, shock, elevated serum tramsaminases, elevate metabolism of other drugs
Can be TB resistance.
Isoniazid
TB treatment: 4 mths
SE
Rash, hepatitis, peripheral neuropathy
Pyeazinamide
TB- 2months
Ethambutol
TB : 2 months
SE: optic neuritis, visual disturbances, affect those with renal impairments
Alternative TB treatments : 2nd line drugs
If resistance: e.g. multi drug resistant TB(no rifamycin or isoniazid) or
extremely drug resistant TB (no fluoroquinolones and >1 injectable)
- use 4/5 drugs but for longer
Quinolones (MDR): moxifloxacin, levofloxacin
injectables: caoreomycin, kanamycin, macrolides (azithrromycin, clarithromycin),
Pifenidone
Can be used to treat fibrosising alveolitis.
High dose oral steroids help initially
Nintedanib= new therapy
Omeprazole
PPI
GORD
Cimetidine
Ranitidine
H2 antagonists
- reduce HCL production
GORD
Alignates
Antacids e,g, gaviscon
GORD treatment
Calcium carbonate
Antacid: GORD treatment
H pylori treatment
Amoxicillin/clarithromycin
If peptic ulcers then triple therapy
- PPI, Omeprazole
- H2 antagonist , cimetidine
- antibiotic
- stop/review NSAID treatment
- endoscopy if bleeding- cancer?
Sulphasalazine
Amino salicylates:
Long term management for ulcerative colitis (or crohns)
Cephalosporin
Broad spectrum antibiotic
- good for anaerobes: so anything colon related normally
Prophylaxis in gut surgery (dirty surgery)
Metroniadozole
Anaerobic infection: colon surgery
