respiratory drugs Flashcards
asthma is a complex disease characterised by what
airway inflammation
what marks the inflammatory component of asthma
airway oedema, goblet-cell hyperplasia, mucus secretion and infiltration
the newer name for COPD
RAO, recurrent airway obstruction
COPD is caused by what
an abnormal inflammatory response to an inhaled environmental insult
what are the two frequently overlapping diseases COPD can be divided into
emphysema and chronic bronchitis
sympathetic effect on the airway causes what
bronchodilation
parasympathetic effect on airway causes what
bronchoconstriction
the two receptor types expressed by airway smooth muscle cells
beta2 adrenergic and muscarinic
beta2 adrenergic receptors are activated by what
adrenaline
muscarinic receptors cause what when stimulated
bronchoconstriction
beta2 adrenergic receptors cause what when stimulated
bronchodilation
what effect does mast cell degranulation produce
bronchoconstriction and airway inflammation
what effect do cysteinyl leukotrienes induce
bronchoconstriction
types of drugs acting on the respiratory system
- bronchodilators
- resp antiinflammatory drugs
- antitussives
- mucolytics, expectorants
indications for bronchodilators
- anaphylaxis
- allergic bronchitis
- asthma
- pulmonary edema
- pneumonia
- pleural effusion
- pneumothorax
- tracheal collapse and hypoplasia
groups of bronchodilators
- sympathomimetics
- anticholinergic substances
- xanthine derivatives
sympathomimetics mechanism of action to cause bronchodilation
act on beta2 receptors - incr cAMP
two groups of sympathomimetics
- non specific
- specific/beta2 receptor agonists
non specific sympathomimetics
- adrenaline
- isoproterenol
- ephedrine
specific sympathomimetics
- salbutamol
- terbutaline
- clenbuterole
- salmeterol
adrenaline bronchodilation mechanism of action
at beta2 receptors
indications adrenaline for bronchodilation
only in life threatening situations eg anaphylaxis
which drug is isoproterenol similiar to
adrenaline
ephedrine mechanism of action
directly and indirectly
ephedrine indications
- bronchodilator
- tachyphylaxis
two types of beta2 agonists bronchodilators
- short acting
- long acting
short acting beta2 agonists duration
1-4hrs
long acting beta2 agonists duration
6-12hrs
side effects beta2 agonists
tachycardia, restlessness, tremors, decr uterine contraction
beta2 agonists contraindications
congestive heart failure
duration salbutamol per os
30mins
duration salbutamol inhalation
5mins
long acting beta2 agonists
- terbutaline
- clenbuterole
- salmeterol
terbutaline duration
6-8hrs
terbutaline selectivity
less
clenbuterole selectivity
less
clenbuterole duration
6-8hrs
clebuterole target species
less effective in companion animals, frequently used in horse
clenbuterole is prohibited in what
racing and food production (horses)
salmeterol selectivity
most selective
salmeterol duration
longest, 10mins-2hrs
how do we minimise adverse effects of adrenergic agonists
by inhalant delivery
beta1 receptor activity causes what
cardiac effects - tachycardia, arrythmias