Respiratory Drugs Flashcards
List different examples of suppressants
Codeine, dextromethorphan, pholcodine
What do antitussive drugs do?
- Supress cough reflex via CNS action
- Inhibit impulses to the muscles that are active during coughing
What are suppressants mainly?
Opioid based
What expectorant drugs are found in common cough syrups?
Ammonia, simple linctus, and guaifenesin
List the combining drugs that COPD is often treated with
Glucocorticoids
B2 agonists
Cromoglicate
Anticholinergics
Leukotriene antagonists
Methylxanthines
List some examples of Glucocorticoids
Budesonide, fluticasone, beclomethasone, mometasone
List some examples of B2 agonists
Short acting - salbutamol, feneoterol
Long acting - bambuterol, terbutaline, formoterol, salmerol
List some examples of Anticholinergics
Ipratropium, tiotropium
List some examples of Leukotriene antagonists
Montelukast
Zafirlukast
List some examples of Methylxanthines
Theophylline
Aminophylline
What do B2 agonists do?
Stimulates b2 receptors found in airway, vascular and uterine smooth muscle.
This results in relaxation.
Whats the typical route b2 agonists are given?
Mostly orally
What are some side effects of B2 agonists
Palpitations
Tachycardia due to stimulation of b1 receptors in heart tremor due to stimulation of CNS
What is a caution of B2 agonists?
These drugs stimulate the heart so should be cautious when administering to those with cardiac disorders
What are some other effects of B2 agonists?
Headache, tension, peripheral vasodilation, muscle cramps, rash
What condition are Glucocorticoids used for?
Prophylaxis of chronic asthma
What does Glucocorticoids decrease?
- Synthesis and release of inflammatory mediators
- Infiltration and activity of inflammatory mediators
- Oedema of the airway mucosa
- Airway mucus production
What do Glucocorticoids increase?
The number of bronchial beta2 receptors and their responsiveness to beta2 agonists
What do Antimuscarinic Bronchodilators do?
Block the action of acetylcholine in bronchial smooth muscle.
This reduces intracellular GMP (guanine monophosphate synthetase) a broncho constructive substance
What is an example of a Antimuscarinic Bronchodilator?
Ipratropium Bromide (atrovent)
What do cromoglicates do?
Stabilise mast cells and prevent release of broncho constructive and inflammatory substances (histamines)
What are cromoglicates used for?
- Primarily used as a preventive for exercises induced and allergic asthma
What do Cromoglicates not treat efficiently?
Treat an already manifested asthma attack
What are cromoglicates less effective than?
Glucocorticoids
How are cromoglicates administered?
Through inhalation
What do Leukotriene Receptor Antagonists (LTRAs) do?
Act by supressing the effects of leukotrienes, compounds that promote bronchoconstriction as well as mucus production and airway oedema
What do Leukotriene Receptor Antagonists (LTRAs) help prevent?
Acute asthma attacks induced by allergens or other stimuli
Leukotriene Receptor Antagonists (LTRAs) are indicated in what treatment plan?
Long-term treatment plan for Asthma
How are Leukotriene Receptor Antagonists (LTRAs) administered?
Orally
What are some side effects of Leukotriene Receptor Antagonists (LTRAs) ?
Fatigue, stomach pains, dizziness, headache, insomnia
Some may have allergic reaction
What are Methylxanthines and what do they do?
Provide mild to moderate relaxation of muscles in the airway to decrease bronchospasm
Methylxanthines are long lasting ____?
Bronchodilators
What receptor are antihistamines?
H1 receptor antagonists
What do Antihistamines do?
Inhibit smooth muscle constriction in blood vessels and respiratory and GI tract
What do antihistamines decrease?
Capillary permeability
Salvation and tear formation
Antihistamines bind to H1 receptors, what are they both called?
Central and peripheral
What can antihistamines cause negatively?
CNS stimulation - anxiety and agitation especially in children
What is a negative effect of Antihistamines?
Substantial anticholinergic (inhibits bronchoconstriction and reduction of mucus secretion) effects
What are the treatment steps?
- B2 receptors - for relief only
- Glucocorticoids - to prevent
- Regular B2 long lasting agonists
3a. Discontinue 3 and increase dose of glucocorticoids - Add a leukotriene antagonist or slow release theophylline plus a regular b2 agonist
- Add a single dose of prednisolone
What do you treat for Bronchiectasis and Cystic Fibrosis?
Treat with mucolytics (make mucus less thick) and antibiotics
What are blue inhalers?
Short acting B2 agonists like salbutamol
What are green inhalers used for?
Long acting B2 agonists like salmeterol
What are Brown/Beige/White/Red/Orange inhalers used for?
Steroid inhalers (like beclomethasone)
Usually preventers and the darker the colour, the stronger the dose
What are pink/purple inhalers used for?
Regular combination inhalers such as fluticasone/salmeterol
What does salbutamol do to the body?
- Selective B2 adrenoceptor agonist
- Stimulates the B2 receptors located in the airway smooth muscle of the lungs
- Bronchodilatory effect
Where are other receptors in relation to salbutamol located in?
Walls of the vascular smooth muscle - mile drop in BP
Uterus - causing relaxation of the uterine walls
- Also interferes with B1 receptors located in heart causing tachycardia
What does Ipratropium Bromide do to the body?
Works as an antagonist at muscarinic cholinergic receptors in the parasympathetic autonomic nervous system
What sort of bronchodilator is IB?
Anti-muscarinic
When IB muscarinic cholinergic receptors meet the parasympathetic autonomic nervous system, what happens next?
Effect of acetylcholine is therefore blocked on the muscarinic receptors in the bronchial mucosa
The parasympathic activity is inhibited allowing the sympathic nervous system to take over
What sort of drug is Hydrocortisone?
A glucocorticoid produce by the adrenal cortex (outer layer of the adrenal gland)
What happens in the body in relation to Hydrocortisone?
Lipocortin production is increased which inhibits phospholipase A2 so that the release of arachidonic acid from cell membranes is reduced
What is reduced when Hydrocortisone is administered?
Production of leukotrienes and prostaglandins
What is Adrenaline?
A sympathomimetic (mimics the sympathetic nervous system)
What does adrenaline do to the body?
Action upon B2 receptors causes relaxation of smooth muscle in the bronchi
What is O2 essential for?
Cell metabolism
What is GTN?
Potent vasodilator
What does GTN release?
Releasing nitric oxide which causes smooth muscle to relax
What does GTN relax?
Relaxing effects on the veins in muscles and reduce venous return to the heart
What is decreased when administering GTN?
Pre-load is decreased
Also the pressure in both the pulmonary and systemic circulation
In larger doses of GTN, what happens to the body?
Pressure in the entire systemic circulation is reduced
What is Furosemide?
Loop diuretic
What does Furosemide do?
Increases the blood flow to the kidneys and will therefore increase glomerular filtration
What is reabsorbed back into the blood once Furosemide is given?
Sodium potassium and chloride from this filtrate are inhabited for being reabsorbed back into the blood
What are sodium potassium and chloride held?
Lumen of the nephron with water so less water is reabsorbed this meaning more water is secreted in the urine therefore reducing systemic volume
