Resp drugs Flashcards
What is the Mx for newly diagnosed asthmatic patient?
1) SABA e.g. salbutamol
What is the step up therapy for asthmatic patients with symptoms >2 times a week or asthma uncontrolled with SABA alone?
2) Low dose ICS added on e.g. beclomethasone with SABA
What is the step up therapy if asthma uncontrolled with low dose ICS?
3) LTRA e.g montelukast added on with ICS and SABA
What is the step up therapy if asthma uncontrolled with low dose ICS and LTRA?
4) LABA e.g. salmeterol added on with ICS, LTRA, SABA
How do SABAs work?
It acts on the smooth muscles of the airways to cause relaxation. This results in dilatation of the bronchioles and improves the bronchoconstriction present in asthma. Works short term, used as reliever medication during acute exacerbations of asthma.
How do inhaled corticosteroids work?
Example e.g. beclometasone. These reduce mucosal inflammation. widens airways. These are used as “preventer” medications to help reduced likelihood of attacks.
What are the side effects of ICS?
Oral candida
What is the long term first line Mx for COPD?
1)Initial treatment: (SABA or SAMA as needed)
SABA – salbutamol, SAMA - ipratropium
What is second line Mx for COPD if pt showing asthmatic features?
Have asthmatic features: (LABA + ICS)
- LABA - salmeterol,
- Inhaled corticosteroid
What is second line Mx for COPD if pt not showing asthmatic features?
No asthma features, initial treatment did not work: (LAMA + LABA)
- LABA - salmeterol,
- LAMA - tiotropium
What is the third line Mx for COPD if pt still has daily symptoms after 2nd line?
Still has daily symptoms after step 2 or has 1-2 exacerbations a year (LABA+LAMA+ICS)
What is the Mx for acute exacerbation of COPD?
ICS e.g. prednisolone+ ABx e.g. Amoxicillin
What tests should be done before starting macrolides?
- ECG
- LFT’s
What are the warnings for macrolides?
Macrolides can cause prolongation of QT.
