Respiratory Flashcards
Beta-2 Agonists
Name and Mechanism
Salbutamol, terbutaline, salmeterol
GPCR relaxes smooth muscle to improve airflow and stimulates Na/K-ATPase pumps reducing hyperkalaemia
Beta-2 agonists
Indications
Asthma, COPD, hyperkalaemia
Beta-2 Agonists
Contraindications
CVD (tachycardia –> angina)
Beta-2 Agonists
Side effects
SNS stimulation (tremor, tachy, palps, anxiety, ^ glucose), increase serum lactate (cramps)
Beta-2 agonists
Interactions
Beta-blockers, theophylline, corticosteroids (hypoK)
Antimuscarinics
Name and mechanism
Tiotropium, ipratropium
Anticholinergics prevent PNS tone, relaxes smooth muscle, reduces secretions
Antimuscarinics
Indications
COPD, asthma (step 4)
Antimuscarinics
Contraindications
Angle closure glaucoma, arrhythmias
Antimuscarinics
Side effets
Dry mouth, little systemic absorption so minimal effects
Corticosteroid
Name and mechanism
Prednisolone
Glucocorticoid target receptors regulating gene transmission, anti-inflammatoru, catabolises muscle, retention of Na, loss of K
Prednisolone
Indications
Allergy/inflammatory asthma
Prednisolone
Contraindications
Infections, children
Prednisolone
Side effects
Immunosuppression
Cushings
ACTH suppression +/- WD addisonian crisis
Prednisolone
Interactions
Hypokalaemic increase, risk with NSAIDs, efficacy reduced by CYP450 inhibitors
Inhaled Corticosteroid
Name and Mechanism
Beclometasone, budesonide, fluticasone
Reduced inflammation local to AW
Beclometasone
Indications
Asthma, COPD
beclometasone
Contraindications
Pneumonia in COPD, children
Beclometasone
side effects
oral candidiasis, hoarse voice, ^pneumonia risk
Mucolytic
Name and mechanism
Carbocysteine Decreases viscosity (expectorant) by increasing sialomucin content of mucous
Carbocysteine
Indications
COPD
Carbocysteine
Contraindications
Allergy, breast-feeding, children
Carbocysteine
Side effects
GI, nausea, low BM, GI bleed
Theophylline
Mechanism of action
Non-selective PDE inhibitor, reduces inflammation and innate immune response (adenosine antagonist -> heart)
Theophyllines
Indications
Asthma, COPD, infant apnoea, adenosine reverse
Theophyllines
Contraindications
Allergy, high caffeine, dipyramidole IV
Theophylline
Side effects
Narrow TPI, N&D, tachy, arrhythmia, CNS excitation
Theophylline
Interactions
Cimetidine, phenytoin. eliminated CYP450
Oxygen
Mechanism
Increase Pa)2 to improve tissue delivery, increase nitrogen excretion and reduce half life of carboxyhaemoglobin
Oxygen
Indications
Hypoxaemia, pneumothorax, CO poisoning
Oxygen
Contraindications
Limit use in COPD with T2RF, near heat source/naked flame
Oxygen
Side effects
Dry throat/device discomfort
Oxygen
Prescription
Give target therapeutic range, may req venturi (start low and titrate up)
