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Pharmacology > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

1
Q

What are 4 common respiratory conditions?

A
  1. Asthma
  2. COPD (chronic bronchitis and emphysema)
  3. Cystic fibrosis (CF)
  4. Acute respiratory distress syndrome (ARDS)
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2
Q

What is Bronchial Asthma?

A

Recurrent and reversible shortness of breath

- Happens when airways of the lungs become narrow due to Bronchospasms or inflammation of the bronchial mucosa (edema)

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3
Q

What is Chronic Bronchitis?

A

A continuous inflammation of the bronchi and bronchioles

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4
Q

What is Emphysema?

A

Occurs when air spaces enlarge as a result of the destruction of alveolar walls.
- This decreases gas exchange surface area

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5
Q

What are 2 examples of Bronchodilators

A
  1. Salbutamol (Ventalin)
    - B2-adrenergic agonist
  2. Ipratropium bromide (Atrovent)
    - Anticholinergics
  3. Theophylline/aminophylline
    - Xanthine derivatives
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6
Q

What are 2 Anti inflammatory Drugs associated with the respiratory system?

A
  1. Budesonide (Pulmicort)
    - Glucocorticoids
  2. Montelukast (Singulair)
    - Leukotriene modifiers
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7
Q

When are B-Agonists Bronchodilators used?

A

During the acute phase of asthmatic attacks

  • It quickly reduces airway constriction and restores normal airflow
  • Also used in chronic management
  • A large group - sympathomimetics bronchodilators
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8
Q

What are the three types of B-Agonists Bronchodilators?

A
  1. Nonselective adrenergics (a and B)
    - Stimulates a, B1 (cardiac) and B2 (SM)
    - Eg. Epinephrine (Adrenalin)
  2. Nonselective B-adrenergics
    - Stimulates B1 and B2 receptors
    - Isoproterenol
  3. Selective B2 drugs
    - Activate airways smooth muscle B2 receptors
    - *Salbutamol (short acting)
    - Salmeterol (long acting)
    - Formoterol (long acting)
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9
Q

B-Agonist - Mechanism of Action

A

Dilation of airways

  • Activation of B2 receptors increase cAMP
  • Relaxes smooth muscles of airway and results in bronchial dilation and increased airflow
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10
Q

When is the best time to use B-Agonists?

A

During acute attacks and as well as preventative

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11
Q

B-Agonists - Common Adverse Effects

A
  • Tachycardia due to B1 receptors being stimulated
  • Tremors
  • Restlessness, insomnia (CNS stimulation)
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12
Q

What are side effects specific to Salbutamol?

A
  • B2 effects - muscle tremors, CNS (anxiety and nausea)
  • B1 effects - incrased HR, palpitations, chest pains, angina

Occurs when inhaled too frequently

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13
Q

What are two important factors to be aware of when using Bronchodilators?

A
  1. Presence of smoking

2. *Adequate fluid intake

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14
Q

What therapeutic effects should you be monitoring for when using Bronchodilators?

A
  1. Decreased dyspnea
  2. Decreased wheezing, restlessness, and anxiety
  3. Improved respiratory patterns with return to normal rate and quality
  4. Improved activity tolerance
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15
Q

Anticholinergics - What is the mechanism of action, purpose, adverse effects and an example?

A

Ipratropium bromide (Atrovent)

Slower and prolonged action compared to salbutamol

Used to prevent bronchoconstriction

  • COPD
  • Long-term maintenance

*Not to be used alone for acute exacerbations

Can cause dry mouth or throat (cough). Minimal systemic effects

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16
Q

What are 2 examples of Xanthine Derivatives?

A
  1. Theophylline
    - Oral
  2. Aminophylline
    - More water soluble form of theophylline. IV admin
17
Q

Which group of Bronchodilators are similar to caffeine?

A

Xanthine derivative

18
Q

When should you use Xanthine Derivatives?

A

In cases of chronic bronchitis, emphysema, mild-moderate cases of acute asthma, and in COPD management.

  • Quick relief of bronchospasm
19
Q

What are the 3 adverse effects of Xanthine Derivatives?

A
  1. CNS stimulation (anxiety, insomnia, seizures)
  2. CV stimulation
    - Palpitations (increased force of contraction)
    - Sinus tachycardia
    - Ventricular dysrhythmias
    - Diuresis
  3. GI distress (nausea and vomiting)
20
Q

Contradictions for Xanthine Derivatives?

A
  • Allergy
  • Cardiac dysrhythmias
  • High risk of stroke
  • Seizure disorders
  • Peptic ulcers
21
Q

What are the two main drug interactions to be aware of with Xanthine Derivatives?

A

Ciprofloxacin - inhibits liver CYP metabolism

Large amounts of caffeine can have deleterious effects

22
Q

Xanthine Derivatives - Care implications

A

Patients should be aware of palpitations, nausea/vomiting, weakness/dizziness, chest pain, convulsions.

St. John’s Wort

  • Increases metabolism of Xanthines
  • Cigarette smoke also causes the above

Diets high in protein and low in carbohydrates lowers blood levels of xanthines

23
Q

In what scenarios should you use Glucocorticoids?

A

When patients have chronic asthma and COPD
- Oral or IV for severe/short-term treatment

For prophylaxis treatment of asthma

Inhaled forms reduce systemic effects
- Takes several weeks for full therapeutic effect

24
Q

What are 2 examples of inhaled Glucocorticoids

A

Budesonide (pulmicort)
Fluticasone (flovent)
- used in combination with B2-agonist salmeterol to make Advair diskus

25
Q

What is a prominent adverse effect of Inhaled Glucocorticoids

A

Oral fungus infections like candida albicans

26
Q

How can patients avoid oral fungal infections?

A

Gargle and rinse mouth with water after inhalation

27
Q

What are 4 functions of Leukotriene Modulators?

A
  1. Prevent smooth muscle contraction of the bronchial airways
  2. Decrease mucus secretion
  3. Prevent vascular permeability
  4. Decrease neutrophil and other leukocyte infiltration to the lungs, preventing inflammation
28
Q

What is an example of a Leukotriene receptor antagonist? (LRTAs)

A

Montelukast

29
Q

When should you use Leukotriene Modulators

A

For the prophylactic and chronic treatment of asthma

- Not acute

Pharmacology (29 decks)

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