Respiratory Drugs Flashcards
What are respiratory diseases
Asthma, COPS, upper resp tract infection
Drug groups for treatment of RDs
Adrenergic drug for bronchodilation and corticosteroids for inflammation
What are the classifications of RDs
non-infectious (asthma and COPD), viral or bacterial respiratory infection
Difference between asthma and COPD (reversibility of airway obstruction)
A: reversible
C: irreversible
Causes of asthma attacks
Allergen, pollen, exercise, stress, or upper resp tract infection
What is status asthmaticus
Is the persistent life-threatening bronchospasm drug therapy
What are the signs of asthma
Wheezing and shortness of breath
What are the two main mechanisms of COPD
- chronic inflammation of the airway and excessive sputum production
- alveolar destruction with airway space enlargement and collapse
What controls respiration
Chemoreceptors, mechanoreceptors, behavioural
Chemoreceptors are the main stimulus for respiration. Breathing is stimulated by? And in COPD
By the increase of CO2 pressure.
By the decrease of O2 Pressure for COPD
Mechanorecptotes detect changes in
Flow, pressure or volume
Behavioural controls of receptors pertain to
Emotional affective condition of the client such as anxiety, pain, or general discomfort may cause ventilation that is excessive for the metabolic demand of the body
How are respiratory drugs delivered to the lungs? And what are they
Directly through inhalation devices.
Beta 2 agonists, anticholinergics/antimuscarinics, corticosteroids
Other resp drugs than direct
Leukotrine modifiers, methylxanthines, Anti-IgE antibodies
What is the difference between COPD and asthma drugs
When it is administered. As the same drugs are used for both
What are the advantages of inhalation devices
- directly to the bronchioles
- greater than oral dose
- accurate measurement
- rapid and predictable onset
- compact, portable and sterile
Beta agonists work by the stimulation of
Beta receptors in the lungs
The activation of beta receptors result in an accumulation of __________ in the smooth muscles, and causes ___________
Cyclic adenosine monophosphate (cAMP), relaxation of smooth muscles
This type of beta agonist produce fewer cardiac side effects
Selective
What are side effects of beta agonists
Nervousness, tachycardia, xerostomia
What are the two types of beta agonists
Short and long acting
Short acting beta agonists are used for the treatment of? What is the drug called
Both asthma and COPD. Salbutamol
What is the onset and duration time of short acting beta agonist
Within minutes and lasts up to 4-6 hours
What is the onset and duration of action for long acting beta agonist
Delayed but duration is sustained
Long acting beta agonist is used for the mgmt of
First line of COPD not for acute attacks
What is the MoA for anticholinergics
Inhibits cholinergic response > bronchodilation
Anticholinergics affect sputum by
The reduction in volume but not the viscosity
What are the side effects of anticholinergics
Xerostomia, bitter taste
What are the two types of anticholinergics and where are they used
Short - COPD reliever and controller
Long - first line COP
This is used for chronic therapy and what is its route
Corticosteroids through the inhaled route
Corticosteroids can be used through the oral route when
There is an acute exacerbation
What is the MoA of corticosteroids
- binds to glucocorticoid receptor on cytoplasm of cells
- reduced production of inflammatory mediators
- which decreases mucous production
Overall respiratory effect of corticosteroids
- improvement in pulmonary rxn, less wheezing, tightness and coughing
Uses of corticosteroids
- first line in asthma, in addition to COPD (severe)
Side effects of inhaled corticosteroids
- xerostomia, hoarseness, fungal infections on mouth and throat (ie. candidiasis)
What can be done to manage oral effects
Rinse mouth and through, use a spacer device with MDIs
What are prolonged effects of corticosteroid use
Adrenal suppression, impaired healing and immunosuppresion
What are leukotriene’s -
inflammatory cells byproduct - increase mucous secretion, bronchoconstriction, and bronchial hyperactivity
What are the overall result of leukotreine receptor agonists (LTRA)
Antiinflammaroty and bronchodilator activity
Uses of LTRA
2nd line for asthma not for COPD
What are the adverse reactions for LTRAs
Irritation of stomach mucosa, headache and alteration of liver function
What are the uses of methylxanthine
Add on therapy in asthma and COPD that is not controlled with other therapies
MoA of methylxanthine
- inhibits phosphodiesterase > increase in cAMP and relax sm. muscles
- inhibit contractile PGs, increase cathecolamines
What are the side effects of methylxanthine
CNS and cardia stimulation, Increased gastric secretion and diuresis
Methylxanthine has a narrow therapeutic index and interacts with these drugs
Benzodiazepines, and macrolide antibiotics
When is anti-IgE antibodies indicated
As an ADD On therapyin ALLERGIC asthmatics with elevated serum IgE who have inadequate response to other therapies
What is the MoA of anti -IgE abs
Recombinant DNA derived monoclonal abs
Prevent IgE from binding to mast cells and basophils, decreaseing release of allergic inflammatory mediator
When is the subcutaneous anti IgE injection given
Once or twice a month
What is. The side effect to anti-igE antibodies
Injection site rxn
Zafirkulast interacts with this common dent drug
Erythromycin lowers Z levels by 40% = may result in asthma exacerbation
Theophylline is respiratory drug interacts with this common Dent drug
Macrolide antibiotics - (erythromycin and clarithromycin) increase T levels > toxic effects.
T may diminish benzodiazepines
10-28% of asthmatics have a hypersensitivity to
aspirin and NSAID
LA with this should be avoided for those with RDs
Sulfite - hypersensitive
This analgesic can cause resp depression
Opiods
Consideration of N2O2 use
Use with caution dye to the precipitation of apnea (due to high O2 concentration)
