Resp misc Flashcards
B2 agonist side effects
tremour, trachycardia, hypokalemia, hypoglycemia, LABA: increased mortality by asthma
Anti-cholinergic inhaled side effects
dry mouth, cardiovascular effects?
Inhaled corticosteroids side effects
cataracts, osteoporosis, oropharyngeal thrush, increased risk of pneumonia in COPD patients
Treatments of COPD (medical)
SABA, LABA, Anticholinergics, combination, corticosteroids, phosphodiesterase-4 inhibitor
What do corticosteroids do?
produce anti-inflammatory effects and increase binding of LABA to the B receptor
how do SAMAs and LAMAs work?
M3 receptors stimulated by Ach in the smooth muscle of bronschioles caused to stimulate G protein and then contraction. SABA is an antagonists that blocks ACh
How to SABAs work?
B receptors on smooth muscle in bronchioles. Adrenaline or noradrenaline - adenylate cyclase (converts ATP to cAMP) - increase in cAMP causes muscle relaxation - bronchodilation. agonists promote this
what does PD4 inhibition do? (phospodiesterase 4)
interferes with the breakdown of cAMP. accumulation of cAMP causes the release of protein kinase A which can produce anti-inflammatory effects.
Name a methylxanthine and how does it work?
theophilline and aminophyilline. These inhibit the PD4, this icnreases cAMP and causes bronchodilation
what are methylxanthines metabolised by?
CYP450
Name 3 inhaled corticosteroids (ICS)
beclomethasone, budesonide and fluticasone
WHat would you prescribe if a patient had exacerbations and persistent breathlessness?
FEV1 more than 50% - LABA or LAMA
FEV1 less than 50% - LABA+ ICS or LAMA
if patient has PERSISTENT exacerbations and persistancet breathlessness what would you prescribe?
ICS+ LABA if only LABA taken. if LAMA taken before, give LAMA+LABA+ICS
When would you prescribe LABA+ICS?
FEV1<50% or persistent exacerbations and breathlessness
When would you prescibe antibiotics to manage an exacerbation?
increased dyspnea, increased sputum volume, and increased sputum purulence.
Who require mechanical ventilation.
