Respiratory Drugs Flashcards
how can respiratory drugs be administered
topically
inhalation
oral
intravenous
what are the two main classes of drugs used for ventilation that help improve airaway latency
bronchodilators
anti-inflammatory
what do bronchodilators do
these dilate the bronchioles, increasing the width of the airway and allowing for more airflow and the better you can ventilate your alveoli the better the gas exchange.
what are the bronchodilators
beta2 agonists
anticholinergic
what do the antiinflammatory drugs do
Inflammation causes the inner lining of the airway to swell and mucus to be produced making the airway more sensitive to asthma triggers.
Anti-inflammatory medicines help to stop this process and prevent asthma attacks.
what are the anti-inflammatory drugs
corticosteroids
how do we prevent mast cell degranulation
chromoglycate
leukotriene receptor antagonists
what drugs impair ventilation
beta blockers
respiratory depressants
what are the respiratory depressants
benzodiazepines
opioids
what do benzodiazepines do
these can make a person drowsy and so less keen to breathe
what do opioids do
these completely switch off respiratory drive in high doses
what are drugs used to improve gas exchange
Respiratory stimulates
oxygen
what is an example of a respiratory stimulant
• Theophyllines
what does theophylline do
these help in the problem of gas exchange as they tend to stimulate the respiratory drive which makes you ventilate more
when is oxygen prescribed
It is prescribed if it has a greater concentration in room temperature. The aim is increase the pressure gradient to try and improve gas exchange
what are the different types of inhaled drug delivery
Meter dose inhaler (MDI)
Breath activated devices include spinhaler or turbohaler.
Spacer devices
what is an MDI
this is a ‘puffer’. The drug is suspended in the air and the air gradually moves but as the air moves it slows down and the drug falls out of suspension
what is the problem with an MDI
The problem with this inhaler is that it produces a high velocity suspension so it does not make it all the way through the airway meaning that a lot of the powder which is sent out as an aerosol ends up settling in the mouth rather than inside the lungs. This can lead to oral fungus infections.
what are breathe activated devices
include spinhaler or turbohaler
These are activated by a click which opens a compartment of power and you breathe in causing the powder to be picked up by moving and is carried into the lungs which overcomes the issue of high velocity.
what do spacer devices do
Spacer devices take powder in an aerosol and hold the aerosol in a cannister until the patient is ready to suck it in. this takes away the issue of high velocity while also increasing the concentration
what do spacer devices improve
it improves drug delivery and uses a higher concentration of drug than with a puffer alone making it useful for small children and for acute asthma attacks.
what are the 2 types of beta agonist
short acting
long acting
what are short acting beta agonists
start working within a couple of minutes. Used for acute asthma attacks.
what are the names of the short acting beta agonists
salbutamol
terbatuline
what is the color of the salbutamol and terbutaline inhalers
blue
what are the long acting beat agonists
salmeterol
what color is salmeterol
green inhaler
what are the routes of administration for the short acting beta agonists
- Inhaled
- Oral
- Intravenous
what are short acting beta agonists used to treat
acute bronchial constriction (acute asthma attacks)
what are the long acting beta-agonists
They have a slow onset of around 1-2 hours
They last around 12-15 hours but you don’t need to use as often
what is the route of administration for long acting beta agonists
inhalation
what is the purpose of the long acting beta agonists
They are used to prevent acute bronchial constriction and they must always be used with an inhaled steroid
what is the purpose of anticholinergic
They inhibit muscarinic nerve transmission in autonomic nerves
The also have an additive effect in bronchial dilation and reducing mucus secretion
what is an example of an anticholinergic
ipratropium
what color is ipratropium
grey
what do corticosteroids do
They reduce inflammation in the bronchial walls- they are effective topically or systemically
what are examples of corticosteroids
- Beclomethasone (brown inhaler)
- Budesonide (brown inhaler)
- Fluticasone (orange inhaler)
- Mometasone (pink inhaler)
what color are beclometahsone and budesonide
brown
what color is fluticasone
orange
what color is mometasone
pink
what should always be taken with long acting beta agonists and why
steroids
avoid sudden cardiac death
what are compound preparations
where the inhaled steroid is prepared with the long acting B agonist in the same puffer
what is an example of compound preparations
Seretide contains both fluticasone and salmeterol
what is chromoglycate
drug that stops mast cells degranulating - help prevent asthma attacks.
Like inhaling sand
what is an example of a leukotriene inhibitor
Montelukast
what are montelukast
drugs that reduce inflammatory triggers within the airway walls. They inhibit specific inflammatory mediators meaning inflammation cannot proceed so they do not get oedema.
what are theophylline
used less now. An issue with it was that every manufacturer’s version has a different bioavailability. Need to use the same brand every week otherwise the effect will change.
how can oxygen be provided
through an oxygen concentrator or a cylinder.
what does an oxygen concentrator do
removes nitrogen from air. Someone requiring oxygen for a longer period of time would go through too many cylinders so the oxygen concentrator is a good option for them if they do not require that high a concentration of oxygen
what are mast cell stabisers
chromoglycate
