respiratory drugs Flashcards
1
Q
how can respiratory drugs be administered
A
- variety of ways
- inhalation
- oral
- intravenous
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
3
Q
why is ventilation needed
A
- to make sure airways are opened more
- open more = more airflow
4
Q
what is seen as the only function of the lungs
A
gas exchange
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
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
7
Q
what do bronchodilators do
A
- open airway up
- opens diameter of tube
8
Q
what do anti-inflammatory do
A
- reduce swelling of lining, reducing oedema
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
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
11
Q
what are anti-inflammatories
A
- corticosteroids = switch off inflammatory process in mucosa so mucosa can shrink to airway is wider
12
Q
what prevents mast cell degranulation
A
- chromoglycate
- leukotriene receptor antagonists
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
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
15
Q
what are the 2 ways of inhaled drug delivery
A
- meter dose inhaled (MDI)
- breath activated device
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
why must long acting beta agonists be used with inhaled steroid
- risk of cardiac death of not
| - often are mixed together
26
what do beta agonists do
- 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
what do anticholinergics do
- inhibit muscarinic nerve transmission in autonomic nerves
- additive effect in bronchial dilation and reducing mucus secretion
- ipratropium (grey inhaler)
28
what do corticosteroids do
- reduce inflammation in bronchial walls = effective topically or systemically
- mainly brown coloured
29
what are different types of corticosteroids
- beclomethasone = brown inhaler
- budenoside = brown inhaler
- fluticasone = orange inhaler
- mometasone = pink inhaler
- fluticasone and mometasone are stronger so are different colours
30
what is betamethasone
- different shades of brown depending on amount of steroid
- cream coloured = 50mcg
- chocolate coloured = 100mcg
- chocolate milk coloured = 200mcg
31
what is mometasone
- top end steroid
- different shades of pink depending on amount
- light pink = 200mcg
- dark pink = 400mcg
32
what are compound preparations
- 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
what are mast cell degranulators
- chromoglycate
- stop mast cells degranulating as that causes asthma
- Vicrom and Tilade
34
what are leukotriene inhibitors
- reduce inflammatory triggers in airway walls
| - montelukast = inhibits key inflammatory mediator so inflammation can't proceed
35
what are respiratory drugs
- 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
