Respiratory Flashcards
3 types of asthma drugs
short term relievers
long term controllers
antihistamines
albuterol
terbutaline
beta-2 agonist
bronchial smooth muscle relaxation
short term reliever
G-protein … cAMP
use:
acute episode
exercise / allergen-induced … prophylaxis
COPD
salmeterol
formoterol
beta-2 agonist
bronchial smooth muscle relaxation
short term reliever
use:
maintenance therapy asthma
COPD
exercise-induced
ADR: cross reaction beta-1 (cardiac stimulation) hyperglycemia hypoKalemia muscle tremor
ipatropium
competitive M blocker (AntiCholenergic)
blocks broncho-restriction and mucus secretion
short term reliever
use:
COPD first line
enhances beta-2 agonist Rx
ADR:
anti-BLUSHPADS BBC
Bradycardia Lacrimation Urination Salvation Hypotension Pinpoint pupils (miosis) Accommodation Defecation (GI motility) Sweating Bronchoconstriction Bronchosecretion CNS ataxia, confusion
theophylline
aminophylline
methylxanthines unclear - think it blocks adenosine receptors causes bronchodilation increases force of diaphragm contraction short term reliever
use:
2nd or 3rd line asthma
2nd or 3rd line COPD
ADR:
very narrow therapeutic index
CNS - headache. nervousness, seizures, insomnia
cardiac stim - palpitations, arrhythmias
GI irritation - abdominal pain, increases acid secretion, anorexia
name the options to manage emergent Sx of asthma
albuterol (DOC)
salmeterol (maintenace)
ipatropium (more about the mucus)
theophyline (very narrow therapeutic index)
beclomethasone
prednisone
fluticasone
corticosteroids
anti-inflammatory
promotes epithelial regeneration
long term controller
use:
chronic asthma therapy
rhinitis (allergic or non-allergic)
COPD
ADR: if used oral - candidiasis (thrush), hoarseness adrenal suppression - weakness, fatigue, muscle loss slow growth rate in kids cataracts, glaucoma skin thinning, bruising osteoporosis immunosupression
(inhaled less ADR than oral)
montelukast
zafirlukast
leukotriene pathway inhibitors
blocks D4 receptor (edema, smooth muscle constriction)
long term controller
use:
asthma
added to inhaled steroid Tx
aspirin-induced asthma
zileuton
leukotriene pathway inhibitor
5-Lipo-Oxygenase
long term controller
use: use: asthma added to inhaled steroid Tx aspirin-induced asthma
cromolyn
nedocromil
blocks activation of mast cells
long term controller
use:
asthma
exercise induced asthma
nasal spray/ eye drops for allergic rhinitis / conjunctivitis
what Rx are used to prevent asthma attacks
corticosteroids (beclomethaasone, prednisone)
leukotriene pathway block (montelukast, zafirlukast, zileuton)
cromolyn, nedocromolyn
where would you find lots of stored histamine granules
in tissue exposed to outside world (lots of mast / basophil cells) --> lung, skin, nose, GI (+enterochromafin-like cells in stomach fundus) mouth, feet, blood vessels
histamines negative feedback
histamine binding H2 receptor on mast cell
normal histamine release mechanism
IgE cross binding antigen
other methods to release histamine
Rx -
morphine,
muscle relaxants - depolarizing (blocks Nm receptors: succinylcholine (SUX suxamethonium), tubocurarine
x-ray contrast
venoms - bee, snake
radiation
