Respiratory (Asthma) Drug Therapy Flashcards by Hafsa Fadl

What is the most leading chronic disease in developed coounties and its incidence is increasing ?

COPD ?
Asthma ?

Asthma

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Is asthma reversible or non-reversible ?

Reversible

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What is the main resaosn of obstruction in the lungs in an acute onset of Asthma ?

Bronchi constriction

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What cells are responsible for the release of cytokines and interleukin production & release that causes inflammation?

T - Lymphocytes
B - Lymphocytes

Bonus: What is the difference between Type 1 2 3 4 hypersensitivity reactions?

T lymphocytes

Type I: reaction mediated by IgE antibodies.

Type II: cytotoxic reaction mediated by IgG or IgM antibodies.

Type III: reaction mediated by immune complexes.

Type IV: delayed reaction mediated by cellular response.

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What other cells are involved in asthma

Neutrophils
Basophils
Eosinophils

Eosinophils

These cells are triggered by T cells activation & cause the release of a range of chemicals that’s involved in contraction of the bronchioles.

Also associated with production of toxic chemicals causing shedding of epithelial tissue

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True or false

Macrophages have a bad effect on pts with asthma by releasing pro-inflammatory cytokines

True

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What ar the 2 groups of drugs that are given to pts with asthma ?

Bronchodilators
Anti-inflammatory agents

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Are beta 2 adrenoreceptor agonists referred to be what type of drug?

Anti inflammatory drugs ?
Bronchodilatory drugs ?

Bronchodilatory drugs

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How do beta 2 adrenalinereceptors agonists (bronchodilators) work?
Are they available for short and long-term?

Open airways by directly activating the beta receptors relaxing the smooth muscle in the walls of the bronchioles that

Both short and long

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Give an exemplar of a short last asthma drug?

Salbutamol

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Give examples of long lasting beta 2 agonists ? Choose 2!

Salbutamol
Salmeterol
Ipatropium bromide
Formoterol

Salmeterol
Formoterol

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What are the 2 most common side effects of beta 2 agonists

Tachycardia
Tremors

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How does theophylline which is from the group of methylxanthines work on the bronchial

It’ relaxes the bronchial smooth muscle

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Does theophylline have inflammatory effects ??

Yes or no

Yes

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Does theophylline have a short or long half-life?

Short half-life

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When would theophylline be used?

Asthma
Chronic asthma
COPD
Chronic COPD

Chronic asthma and chronic copd

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What 3 systems are effected by theophyline?

Cardiac
Resp
Nervous
Urinary
Gastro
Endocrine
Lymphatic

Nervous - CNS (increased alertness @ interfere with sleep

Cardiac: increasing HR & contraction therefore BP increases

Gastric: indigestion due to increased gastric secretions & relaxation of cardiac sphincter leading to reflux

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Name a muscarinic receptor antagonists drug?

Ipatropium bromide
Glycopyronium

How long does it take IPB to have its bronchodilatory effects and how long does it last for in hours ?

20 mins ?
35 mins ?
45 mins ?

2-3 hours ?
3-5 hours ?
6-7 hours ?

45 mins
3-5 hours

How does corticosteroids reduce inflammation?

Prevention of what being produced ?

Arachidonic acid

This leads to the reduction of prostaglandins and leukotrienes = reduced inflammatory response

What’s dysphonia?

Change in voice

Can beclonetasone cause weakening of the bone ?

Yes or no

Yes (osteoporosis) & Blurred vision & Skin reactions

What are leukotriene receptor antagonists?

Leukotrienes are involved in the inflammatory pathway so these are drugs that blocks the effects of leukotrienes !!

Give 2 examples of leukotriene receptor antagonists?

Montelukast
Zafirlukast
Flutixasone
Ipatropium bromide

Montelukast
Zafirlukast

When corticosteroids are inspired what can be a problem ? What can they cause? Hint: Can—

Candidiasis

What are the 2 groups of meds used for asthma

Bronchiodilators & anti - inflammatory drugs

Explain Poiseuille’s Law of physics in relation to bronchospasm.

If thr radius of the of an airway decreases from 4mm - 3mm from bronchospasm or mucosal oedema the potential flow of gas decreases by almost 1/3 from that small reduction in the airways !!

Do non selective or selective bronchodialtors work for preferably on the bronchial smooth muscle ?

Selective bronchodilators

What receptors for beta 2 agonists target

Beta 2 receptors

Alpha & Beta 1 stimulation What symptoms will I see the patients have ?

Tachycardia and hypertension

What class does theophylline drug fall into ? Beta 2 adrenal receptor antagonist ? Methylxanthines? Leukotriene receptor antagonists ? Muscarinic receptor antagonists ?

Methylxanthines

What class does zafirlukast and montelukasts fall under ? Beta 2 adrenal receptor antagonist ? Methylxanthines? Leukotriene receptor antagonists ? Muscarinic receptor antagonists ?

Leukotriene receptor antagonists

What class does fluticasome fall under ? Beta 2 adrenal receptor antagonist ? Leukotriene receptor antagonists ? Muscarinic receptor antagonists ? Inhaled corticosteroids ?

Inhaled corticosteroids

Which class does Salmeterol fall into? Beta 2 adrenal receptor antagonist ? Methylxanthines? Leukotriene receptor antagonists ? Muscarinic receptor antagonists ?

Beta 2 adrenoreceptor agonists

What does montelukast do? Reduce inflammation Reduce secretions Reduce bronchospasm

Reduce secretions

What does inhaled saline do ? Saline nebuliser? Draws water into airways & thins mucus Reduces all types of inflammation Draws water out of the airways making clearer?

Draws water into airways & thins mucus

MOA: of corticosteroids Reduces swelling ? Relaxes muscles ? Acts on nerves, prevents the muscles tightening up and reduces muscus ?

Reduces swelling

MOA: of Long acting beta2 agonists Reduces swelling ? Relaxes muscles ? Acts on nerves, prevents the muscles tightening up and reduces muscus ?

Relaxes muscles - bronchodilator

MOA: of LAMA: Reduces swelling ? Relaxes muscles ? Acts on nerves, prevents the muscles tightening up and reduces muscus ?

Acts on nerves, prevents the muscles tightening up and reduces muscus ?

Which inhaler requires pt to take a slow deep breath in ? Pressurised metered dose inhaler (pDMI) Dry powder inhaler (DPI) Soft mist inhaler

pDMI

Which class of drugs can cause a patient to develop diabetes, and cataracts Steroids LABA/SABA LAMA

Steroids

COPD related: Give examples of some Long acting beta 2 agonists (LABAs) ? Formoterol Tiotropiun Salmeterol

Formeterol Salmeterol

How does long acting Beta 2 antagonists (LABA) help the patient?

Improves lung function Less breathlessness & easier to breath - pts will say they don’t get out of breath doing daily activities

What’s the durations of formeterol and salmeterol ? 12 hours 12-24hrs 6-8 hours 9-10 hours

12hours Salbutamol 6 hrs