respiratory drugs Flashcards

1
Q

how can respiratory drugs be administered

A
  • variety of ways
  • inhalation
  • oral
  • intravenous
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2
Q

what type of administration is asthma

A
  • topical
  • inhaler powder doesn’t make it to the alveoli so not inhalation
  • air flow slows and particles stick on airway wall instead
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3
Q

why is ventilation needed

A
  • to make sure airways are opened more

- open more = more airflow

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4
Q

what is seen as the only function of the lungs

A

gas exchange

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5
Q

if ventilation doesn’t work what does that mean

A
  • gas exchange won’t work either

- want to ventilate CO2 out and O2 in

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6
Q

what do muscles on chest wall do

A
  • create a negative pressure in the lungs

- if you have narrowed airways then its difficult for gas to get in

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7
Q

what do bronchodilators do

A
  • open airway up

- opens diameter of tube

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8
Q

what do anti-inflammatory do

A
  • reduce swelling of lining, reducing oedema
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9
Q

what happens in most of respiratory disease

A
  • inflammation of bronchi which is like atherosclerosis

- makes bronchi narrower so gas exchange is harder

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10
Q

what are bronchodilators

A
  • beta2 agonists widens airways = beta 2 receptors are avoided in asthma as it makes ventilation harder
  • anticholinergic = prevents muscle constriction to open airways
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11
Q

what are anti-inflammatories

A
  • corticosteroids = switch off inflammatory process in mucosa so mucosa can shrink to airway is wider
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12
Q

what prevents mast cell degranulation

A
  • chromoglycate

- leukotriene receptor antagonists

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13
Q

what drugs impart ventilation

A
  • beta blockers
  • respiratory depressants = benzodiazepines make you drowse so can’t breathe as well, opioids in a high dose can completely switch off respiratory drive
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14
Q

what drugs improve gas exchange

A
  • only way to improve gas exchange is to improve ventilation
  • respiratory stimulants = theophyllines
  • oxygen = this is a drug, only a medicine if you give it in a higher concentration than in air, must be prescribed like any other drug (if have a disease of the alveoli it is more difficult for O2 to get through from blood to alveoli
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15
Q

what are the 2 ways of inhaled drug delivery

A
  • meter dose inhaled (MDI)

- breath activated device

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16
Q

what is a meter dose inhaled

A
  • puffer inhaler
  • produced high velocity suspension = suspended drug in air
  • a lot of the drug will sit in the mouth as it won’t make it ti the lungs
  • press down and breath in at the same time
  • patients can get infection in mouth = will go away if use the other kind
17
Q

what is a breath activated device

A
  • open by clicking to release powder
  • more goes into the lungs
  • spinhaler ad turbohaler
18
Q

what aids are there for drug delivery

A
  • nebuliser

- spacers

19
Q

what is a nebuliser

A
  • mask with micro chamber and compressor
  • connects to oxygen or the air
  • good for asthma attacks
  • good for children who can’t use an inhaler
20
Q

what are spacer devices

A
  • come in different sizes
  • take powder in aerosol and hold in canister until patient is able to breath it in
  • can have more puffs than normal
  • increases concentration
  • is better for asthma attacks as gives higher concentration and improves drug delivery
21
Q

what types of beta agonists can you get

A
  • short acting

- long acting

22
Q

what are short acting beta agonists

A
  • salbutamol (blue inhaler)
  • terbutaline (blue inhaler)
  • quick onset = 2-3 minutes
  • use in emergency
  • used as infusion if someone goes into premature labour to stop it
  • stop asthma attacks that are happening now
  • lasts 4-6 hours
  • route of administration = inhaled, oral, intravenous
  • used to TREAT acute bronchial constriction
23
Q

what is the most commonly used short acting beta agonist

A
  • salbutamol
24
Q

what are long acting beta agonists

A
  • salmeterol (green inhaler)
  • slow onset = 1-2 hours
  • last 12 -15 hours
  • not used often
  • route of administration = inhaled
  • used to PREVENT acute bronchial constriction
  • always used with inhaled steroid
25
Q

why must long acting beta agonists be used with inhaled steroid

A
  • risk of cardiac death of not

- often are mixed together

26
Q

what do beta agonists do

A
  • stimulate beta receptors in lungs so they dilate so airway is wider for airflow
  • someone with asthma attack won’t use salmeterol as it will take time to kick in, use salbutamol instead
27
Q

what do anticholinergics do

A
  • inhibit muscarinic nerve transmission in autonomic nerves
  • additive effect in bronchial dilation and reducing mucus secretion
  • ipratropium (grey inhaler)
28
Q

what do corticosteroids do

A
  • reduce inflammation in bronchial walls = effective topically or systemically
  • mainly brown coloured
29
Q

what are different types of corticosteroids

A
  • beclomethasone = brown inhaler
  • budenoside = brown inhaler
  • fluticasone = orange inhaler
  • mometasone = pink inhaler
  • fluticasone and mometasone are stronger so are different colours
30
Q

what is betamethasone

A
  • different shades of brown depending on amount of steroid
  • cream coloured = 50mcg
  • chocolate coloured = 100mcg
  • chocolate milk coloured = 200mcg
31
Q

what is mometasone

A
  • top end steroid
  • different shades of pink depending on amount
  • light pink = 200mcg
  • dark pink = 400mcg
32
Q

what are compound preparations

A
  • patient is not trusted to take both as they think brown doesn’t do anything so only take green which causes problems
  • now give a purple premixed of green and brown
  • it is an inhaled steroid with long acting beta agonist
  • Seretide = fluticasone and salmeterol
33
Q

what are mast cell degranulators

A
  • chromoglycate
  • stop mast cells degranulating as that causes asthma
  • Vicrom and Tilade
34
Q

what are leukotriene inhibitors

A
  • reduce inflammatory triggers in airway walls

- montelukast = inhibits key inflammatory mediator so inflammation can’t proceed

35
Q

what are respiratory drugs

A
  • theophylline = if given different brands can have an effect, need to stick to same brand to have same effect on lungs
  • oxygen
    = black canister with white lid in hospitals
    = O2 concentrator machine concentrates the air and removes nitrogen leaving O2
    = smaller and heart nowadays
    = allow patient high concentration without too much mechanical delivery
    = might only need 35% O2 and machine can generate this, can’t generate 100%
  • only the cylinder can generate 100% oxygen