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Drugs > respiratory drugs > Flashcards

respiratory drugs Flashcards

1
Q

Beta-Adrenergic Bronchodilators

Examples of drugs

A

salbutamol

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2
Q

Beta-Adrenergic Bronchodilators

Mechanism of action

A
  • Short-acting Beta-2 adrenoceptor agonists (SABA)
  • Relaxes bronchial smooth muscle, inducing bronchodilation.
  • Inhibit pro-inflammatory cytokine release from mast cells and TNF-α release from monocytes, reducing airway inflammation.
  • Increase mucus clearance from the airways by stimulating cilia action.
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3
Q

Beta-Adrenergic Bronchodilators

Indication

A

Asthma

COPD

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4
Q

Beta-Adrenergic Bronchodilators

Side Effects

A

Tremor
Tachycardia / cardiac dysrhythmia
Headache
Sleep disturbances

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5
Q

Beta-Adrenergic Bronchodilators

Important pharmacokinetics / pharmacodynamics

A

Only a small percentage of inhaled drug reaches target in the airways – a spacer may improve drug delivery

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6
Q

Beta-Adrenergic Bronchodilators

Patienet Information

A
  • Check inhaler technique, review the need for spacer / nebuliser.
  • In exercise-induced-asthma, a dose immediately before exercise can reduce incidence of symptoms.
  • If required more than once daily, treatment needs reviewed.
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7
Q

Beta-Adrenergic Bronchodilators

Examples of drugs

A

Salmetrol

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8
Q

Beta-Adrenergic Bronchodilators

Mechanism of action

A
  • Long-acting Beta-2 adrenoceptor agonist (LABA)
  • Relaxes bronchial smooth muscle, inducing bronchodilation.
  • Inhibit pro-inflammatory cytokine release from mast cells and TNF-α release from monocytes, reducing airway inflammation.
  • Increase mucus clearance from the airways by stimulating cilia action.
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9
Q

Beta-Adrenergic Bronchodilators

Indication(s):

A

Asthma
COPD

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10
Q

Beta-Adrenergic Bronchodilators

Side effects:

A

Tremor
Tachycardia / cardiac dysrhythmia
Headache
Sleep disturbances

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11
Q

Beta-Adrenergic Bronchodilators

Important pharmacokinetics / pharmacodynamics:

A

Not to be commenced in patients with rapidly deteriorating asthma – slower onset of action than SABA’s.

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12
Q

Beta-Adrenergic Bronchodilators

Patient information:

A
  • Report any deterioration in symptoms following initiation of LABA.
  • Do not exceed stated dose.
  • Seek medical advice when stated dose fails to control symptoms.
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13
Q

Anti-Muscarinic Bronchodilators

Example(s) of drugs:

A

Tiotropium
Ipratropium Bromide

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14
Q

Anti-Muscarinic Bronchodilators

Mechanism of action:

A
  • Muscarinic receptor (M3) antagonists producing bronchodilatory effects.
  • Reduces mucus secretion and may increase bronchial mucus clearance by stimulating cilia.
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15
Q

Anti-Muscarinic Bronchodilators

Indication

A

Asthma
COPD
Rhinitis

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16
Q

Anti-Muscarinic Bronchodilators

Side effects:

A

Dry mouth
Cough
Constipation

17
Q

Anti-Muscarinic Bronchodilators

Important pharmacokinetics / pharmacodynamics:

A
  • Inhaled and poorly absorbed into the circulation – unable to affect systemic muscarinic/cholinergic receptors
  • Nebulised Ipratropium Bromide should always be administered via a mouth piece to minimize the risk of acute angle closure glaucoma.
18
Q

Anti-Muscarinic Bronchodilators

Patient information

A

Good inhaler technique improves efficacy.
Cough may arise.

19
Q

Inhaled Corticosteroids

Example(s) of drugs:

A

Beclomethasone

Note that some inhaled preparations used in COPD and asthma contain both inhaled steroids and long acting bronchodilators (examples are Seretide and Symbicort).

20
Q

Inhaled Corticosteroids

Mechanism of action:

A
  • Anti-inflammatory effect on the airways.
  • Decrease formation of pro-inflammatory cytokines.
  • Up-regulates beta-2-adrenoreceptors in airways.
21
Q

Inhaled Corticosteroids

Indication(s):

A
  • Treatrment of COPD
  • Treatment of asthma
22
Q

Inhaled Corticosteroids

Side Effects

A
  • Oral Candidiasis (thrush)
  • Adrenal suppression
  • Osteoporosis
23
Q

Inhaled Corticosteroids

Important pharmacokinetics / pharmacodynamics:

A
  • Takes several weeks to months for full effects of therapy.
  • Spacer devices can reduce risk of thrush and improve drug delivery.
24
Q

Inhaled Corticosteroids

Patient information:

A

If on higher dose, carry a steroid card.
Increase dose during periods of illness.

25
Q

Anti-Histamines (H1 receptor antagonists)

Example(s) of drugs:

A

Chlorpheniramine
Desloratidine
Fexofenadine
Hydroxyzine

Note that a number of other drugs such as anti-emetics and anti-psychotics have anti-histamine activity. H2 antagonists are discussed seperately.

26
Q

Anti-Histamines (H1 receptor antagonists)

Mechanism of action:

A

Antihistamine; H1 receptor antagonist.
Inhibits histamine-mediated contraction and vasodilation of the bronchial smooth muscle.

27
Q

Anti-Histamines (H1 receptor antagonists)

Indication(s):

A

Anaphylaxis
Hay fever
Urticaria
Sedation

28
Q

Anti-Histamines (H1 receptor antagonists)

Side effects:

A

Drowsiness
Tinnitus

29
Q

Anti-Histamines (H1 receptor antagonists)

Important pharmacokinetics / pharmacodynamics:

A

Renally excreted
Sedation arises from central nervous system H1 antagonism (second generation H1 antagonists do not cross the blood brain barrier in therapeutic doses).

30
Q

Anti-Histamines (H1 receptor antagonists)

Patient information:

A

Do not operate heavy machinery.
Do not drive.

31
Q
A

Drugs (8 decks)

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