pharmacology Flashcards
bronchodilator mechanism
stimulate bronchial smooth muscle B2 ADR
- inc cAMP, inc PKA = relax
what does one use for nocturnal asthma
LABA
bronchodilator side effect
fine tremor, tachycardia, arrhythmias, hypokalaemia
bronchodilator contraindications
use with cautioning hyperthyroidism, CVS disease, arrhythmias and hypertension
CysLt receptor antagonist examples
montelukast, zafirlukast
CysLt receptor antagonist mechanism
CysLTs (LTD4, LTC4) derived from inflammatory cells cause contraction of airway SM, oedema inc in mucus and eosinophils
they block these
what is the therapeutic ratio like for oral steroids
low
oral steroid mechanism
signal via nuclear receptors
bind to GRE
oral steroid AE oral
oral candidiasis
oral steroid AE GI
peptic ulcer
oral steroid AE MSK
myopathy
oral steroid AE endocrine
cushing
NOTE: what is cushings
excess corticosteroids (causes hypertension)
name an inhaled steroid
beclomethasone
inhaled steroid AE
fever systemic effects than oral steroids
anti inflammatory anti-IgE monoclonal antibody
omalizumab
expensive
omalizumab administration
injection every 2 weeks
omalizumab use
prophylaxis in asthma
when raised IgE and severe persistent allergic asthma despite max therapy
omalizumab AE
abdominal pain
headache
pyrexia
omalizumab contraindications
caution in autoimmune disease
methylxanthine example
theophylline
methylxanthine mechanism
non selective inhibitor of PDE
- inc cAMP and relaxes ASM
theophylline route
oral
aminophylline route
IV
methylxanthine AE
narrow therapeutic ration
arrhythmias, seizures, hypotension
SAMA
ipratropium and oxitroprium
SAMA mechanism
non selectively block M 123
LAMA
tiotropium and aclindium
tiotropium mechanism
selectively blocks M3
longer half life than ipatropium
PDE4 inhibitor
rofimulast
PDE4 inhibitor use
to reduce COPD exacerbations
PDE4 inhibitor AE
nausea, diarrhoea, headache, weight loss
Mucolytics
oral carbocisteine and oral erdosteine
carbocisteine mechanisms
reduce sputum viscosity
carbocisteine AE
rarely GI bleeding
Mucolytics contraindications
caution with those with history of peptic ulcer
erdosteine mechanism
symptomatic treatment of acute exacerbation chronic bronchitis
erdosteine AE
nausea, vomiting, diarrhoea and abomdinal pain
what do M1 ACH receptors do
facilitate fast neurotransmission by Ach acting on nicotinic receptors
what do M2 ACH receptors do
inhibit Ach release
what do M3 ACH receptors do
mediate SM contraction and inc mucus secretion
what is indacaterol
ultra LABA - rapid onset of action and only daily dose required
what is the best combination for reducing FEV1
LAMA + LABA
what are the effects of antihistamines
antagonists of H1 receptors
- dec vasodilatation and inc capillary permeability
- dec activation of sensory nerves
- dec mucus secretion from submucosal glands
what is used for aspirin induced asthma
CYsLt antagonist
what is symbicort
budesonide and formoterol
what is seretide
fluticasone and salmeterol
