Lecture - Pharmacology (Bronchodilators) Flashcards
I know he told you not to worry about the doses but what should you know?
You should know that eg with asthma - you hv sliding scale. You increase doses within reason and consider using more than one drug when appropriate
Like dont just hv really high doses of beta agonist - wont solve the problem, might need more than one drug
Just tell me the names (spell them correctly) of the beta-2 agonists you are going to need to know?
SABA: salcutamol
LABA: salmeterol
So tha SABAs are known as the ‘relievers’ - why do they have to be selective beta-2 agonists?
Because if they are non-selective, they can go around and bind to eg beta-1 in the heart or other organs
So salbutamol is a selective b2 agonist that 200 fold selects for b2 than b1
How do B2 agonists work:
- What are the effects of B2 agonists and on which tissues?
- there are 3 things it has effects on (two actually but LABAs have effect on the third) - Why do you get variabilties in pateint responses to the B2 agonists?
Salbutamol
- So this is a SABA - do you use it in asthma or COPD?
- How do you take it in to counteract bronchospasm?
- How long is the onset and the how long is te effect?
- So when should you tell your pateint to use it?
- Why use the lowest dose possible?
- why not use frequently if it is so good? - Is it used for nocturnal asthma?
- What are some of the ADRs (red box!) that you should warn your pateint about?
- What should you beware about using concomitantly with salbutamol?
LABAs: Salmeterol
- Okay, so why arent these used for rapid relief?
- You couldnt use SABAs for nocturnal asthma, can you use them here?
- What part of the molecule makes them longer lasting?
- What is the onset of action, peak effect and bronchodilatory effect?
- When should you take it?
- Since these are so good, do you still need to use anti-inflammatories?
- What can LABAs potentiate?
Fixed dose combination inhaler:
- What are the benefits of using LABA with steroids?
- What is the adjunctive role?
- What is an example of a LABA + corticosteroid combination?
What is SMART therapy?
Muscuranic receptor blockers:
- What does parasym stimulation of M1,2,3,4 receptors lead to?
- what sort of drugs can you use to antagonise this? - Why are there presynaptic M2 receptors located on the neurons that release Ach on the broncho SM?
Muscuranic receptor blockers: Ipratropium
- Say that drug out loud
- What is the MOA?
- How do you take it in?
- Tell me about the onset and duration
- What do you use it with to give an additivie effect?
- What conditions is it used in?
Vagal component differences in COPD vs asthma
-explain this
ACh and eosinophils in airways sensitiation - what does this mean?
What are the ADRs of ipratropium? Not in a red box but still
Combination inhalers in COPD
- What is used as a combinatio inhaler for reversible bronchospasm in COPD?
- In repeat/severe exacerberations not controlled by LABAs - what do you use?
Why do you need to give Mg2+ in acute severe asthma?