Lecture 15 - Asthma Treatment Flashcards
(19 cards)
Relievers?
provide relief from asthma symptoms, rapid onset short duration, smooth muscle relaxation, use as required e.g. asthma attack, exercise
Preventers?
long-term control, anti-inflammatory to prevent attacks, taken daily
three types of bronchodilators?
inhaled beta-adrenergic agonists, anticholinergic agents, xanthine drugs
Beta-adrenergic agonist asthma management?
relaxation of smooth muscle (bronchodilation), reduced vascular permeability & edema
Beat-adrenergic agonist mechanism?
beta receptor -> AC -> ATP into cAMP -> PKA -> Ca activated K+ channel -> smooth muscle relaxation and inhibition of mediator release
Alternate routes of administration?
oral, direct endotracheal instillation
Problems with toddler inhalation?
small tidal volume, small airways, rapid respiration, aversion to masks
Why use spacer?
More direct entry to the lung rather than stomach
Rapid action long duration b-adr asthma treatment?
Formoterol
Adverse effects of b-adr?
tremor, tolerance, hypokalemia, tachycardia
Prescription of LABA?
not as first base, only if all other therapies fail, does not relief
Anticholinergic effects?
reduce mucus secretion, bronchoconstriction and inflammatory response
Ach drug?
Ipratropium Bromide
Ipratropium Bromide characteristics?
slow onset, short duration, regular basis, low side effects (less tachyphylaxis)
Ipratropium Bromide problem?
reduced mucociliary clearance
Xanthine drug effects?
non-selective inhibition of phosphodiesterase (bronchodilation), activate HDAC (anti-inflammatory), adenosine antagonist
Effects of adenosine antagonism?
arrhythmia, CNS stimulation, gastric acid hypersecretion, diuresis
Theophylline positive effects?
bronchodilation, increased diaphragm strength, increase mucociliary clearance, decreased dyspnea, CV performance, dec. pulmonary artery pressure, diuresis
Theophylline side effects?
toxicity risk due to narrow therapeutic range - monitored by serum monitoring; nausea etc, seizure, hyperglycaemia
