lecture 16 - bronchodilators

Question 1

What are the 3 key classes of bronchodilators?

Answer 1

B2 agonists, muscarinic antagonists, leukotriene antagonist

Question 2

What are the 2 types of B2 agonists?

Answer 2

SABAs (short acting B2 agonists), LABAs (long acting B2 agonists)

Question 3

What are the 2 types of muscarinic antagonists used in asthma treatment?

Answer 3

SAMAs (short acting muscarinic antagonists), LAMAs (long acting muscarinic antagonists)

Question 4

What is a key example of a SABA?

Answer 4

salbutamol

Question 5

What is a key example of a LABA?

Answer 5

Formoterol

Question 6

Why must B2 agonist bronchoconstrictors have high selectivity?

Answer 6

If they agonise B1 it will cause tachycardia

Question 7

What is the mechanism of action of SABAs, such as salbutamol?

Answer 7

Stimulate Beta-2 adrenoreceptors in bronchial smooth muscle, which inhibits the entry of calcium ions into the muscle, resulting in bronchodilation

Question 8

What dosing regimen is recommended for SABAs, such as salbutomol?

Answer 8

Use inhaler as required when symptoms arise, use lowest dose possible, do not used at a fixed interval

Question 9

Whatare the adverse effects of SABAs?

Answer 9

tremor, tachycardia, paradoxical bronchospasm

Question 10

Which LABA is fast acting?

Answer 10

Formeterol

Question 11

What is the indication for LABAs?

Answer 11

nocturnal asthma, exercise-induced asthma, or when other therapies have failed to improve symptoms.

Question 12

What time of asthma Beta 2 agonists should be used for rapid/rescue relief?

Answer 12

SABAs

Question 13

What should LABAs be used with?

Answer 13

An asthma controller medication, such as an inhaled corticosteroid

Question 14

What are the advantages of a fixed dose combination inhaler?

Answer 14

Allow steroids to be delivered, but in lower doses as LABAs are used prophylactically

Question 15

What are the 2 drug classes combined in a fixed dose combination inhaler?

Answer 15

LABA, glucocorticoid

Question 16

What is the most commonly used fixed dose combination inhaler in NZ?

Answer 16

Symbicort - butesonide + formoterol

Question 17

What are the 2 drugs used in symbicort?

Answer 17

Formoterol (LABA) + budesonide (ICS)

Question 18

What respiratory condition are muscarinic receptor blockers most commonly used in treatment of?

Answer 18

COPD (can also be used in chronic/severe refractory asthma)

Question 19

What is an example of commonly used LAMA?

Answer 19

Tiotropium

Question 20

What are the core principles of initial pharmacological treatment for asthma?

Answer 20

• use inhaled corticosteroids
• use LABA and/or LAMA only with ICS
• avoid maintenance with oral corticosteroids