repsiratory Flashcards
salbutamol
beta-2-antagonist
mode of action of beta-2-antagonist/salbuatmol
act on beta 2 receptors on smooth muscle in bronchi,GI tract, uterus and blood vessels
= relax = improve airflow
indications for beta 2 antagonist
asthma
COPD
hyperkalaemia (nebulised as additional treatment)
contraindications of beta 2 antagonist
cardiovascular disease - tachycardia may provoke angina or arrhythmias
side effects of beta 2 antagonist
tachycardia palpitations anxiety tremor increased serum glucose
interactions of beta 2 antagonist
beta blockers (reduce effectiveness) \+ theophylien + corticositeroids = hypokalaemia
tiotropium
bronchodilatory antimuscarinic - anticholinergic
mode of action of tiotropium/bronchodilatory antimuscarinics
competitively inhibit acetylcholine = antiparasympathetic effects = increase heart rate and conduction , reduce smooth muscle tone and peristalitic contraction , pupillary dilation etc
indications for tiotropium
in COPD - used to releive breathlessness
asthma - asjuvant therapy for breathlessness in exacerbations. long acting in step 4
contraindications of tiotropium
patients susepctible to angle closure glaucoma
risk of arrhythmia
side effects of tiotropium
when inhaled, very little systemic absorption, so not many side fffects
- dry mouth
prednisolone
systemic corticosteoids
mode of action of corticosteroids
glucocorticoid effect
reduce inflammation
suppress immune system
indications of corticosteroids
treat allergic or inflammatory disorders - anaphylaxis and asthma
suppress autoimmune disease
treatment of cancers as part of chemo or to reudce tumour associated swelling
hormone replacment in adrenal insufficiency or hypopituitarism
contraindications of corticosteroids
infection
children (suppress growth)
side effects of corticosteroids
more liekly to get infected
DM
osteoporosis
increased catabolism - muscle weakness, skin thinning, easy brusing, gastritis
mood and behavioural change
hypertension hypokalaemia and oedema
interactions of corticosteoids
NSAIDs = increae peptic ulceration and GI bleeds
enhance hypokalaemia in beta 2 agonists, theophyline and diuretics
Efficacy reduced by cytochrome P450 inducers
carbocysteine
mucolytic
mode of action of mucolytics
faciliate expectoration by reducing sputum viscosity
prevent chest infections
indications of mucolytics
COPD and chronic productive cough
bronchiectasis
contraindications of mucolytics
active peptic ulcer disease
- can ditrupt gastric mucosal barrier
side effects of mucolytics
peptic ulcers
GI bleeding (rarely
steven-johnson syndrome
erythema multiforme
theophylline
xanthine
mode of action of xanthines
reduces inflammation and innate immnoty
to treat wheezing, chest tightness and SOB
indications of xanthines
bronchodilato in asthma and stable COPD
not sueful in exacerbations of COPD
contraindications of xanthines
cardiac arrhythmias or cardiac disease, HTN, hyperthyroidism, peptic ulcers, epilepsy, eldely, fever, hypokalaemia
side effects of xanthines
nausea, vomting, gastric irriation, diarrhoea
palpiations, tachycardia, arrhythmias,
headache, CNS stimulation, insomnia, convulsion
interactions of xanthines
additive effect with beta-2-agonists
- increase risk of side effects inc hypokalaemia
mode of action of oxygen
reduces fraction of nitrogen in alveolar gas = accellerate diffusion of nitrogen out of body = treat pneumothorax
in CO poisoning, competes with CO to bind to Hb = shortens half life
indications for oxygen
increase tissue oxygen delivery in hypoxaemia
accelerate reabsorption of pleural gas in pneumothroax
reduce half life of carboxyhaemoglobin in CO poisoning
contraindications of oxygen
chronic type 2 resp failure - severe COPD
= disturbs adapted state = rise in CO2 = repsirtroy acidosis = depressed consciousness + tissue hypoxia
naked flame
side effects of oxygen
delviery device - discomfort, dry throat (use humidification system
