Respiratory Drugs Flashcards
3 ways of administering respiratory drugs
- inhalation (use the drug topically)
- oral
- intravenous
inhaler adminstration
drug use topically
- powder doesn’t make it to the alveoli, air flow gets slower, particles drop out of suspension and land on airway wall
drugs that are used to improve ventilation
improve airway patency
- bronchodilators
- anti-inflammatory
bronchodilators cause
airways to open more
(increase diameter)
can ventilate alveoli more
beta 2 agonist
bronchodilator
e. g. salbutamol
- stimulate beta receptors casing them to dilate
anticholinergic
bronchodilator
- prevent muscle constriction, opening airways
2 types of bronchodialtors
beta 2 agonists
anticholinergic
salbutamol is what type of drug?
beta 2 agonist (bronchodilators)
how do anti-inflammatories improve airway patency?
shrink the lining mucosa (increase diameter)
- corticosteroid
switch off inflammatory process so mucosa shrinks in size
how does preventing mast cell degranulation improve airway patentcy?
preventative therapy, stop processes happening which lead to narrowing of airways
e. g.
- Chromoglycate
- Leukotriene receptor antagonist
drugs that prevent mast cell degraulation
- Chromoglycate
- Leukotriene receptor antagonist
drug that acts as an anti-inflammatory
corticosteroid
what does ventilation allow?
important gas exchange to occur
- Allows more to be ventilated
Ventilation poor = compromised gas exchange = failure
Easier to ventilate – more gas exchange
basic function of lungs
gas exchange in alveoli and ventilate to allow gas exchange
3 ways in which ventilation can be compromised
Want wide dilating airways – patent
Inflammation on the alveoli constricts the airways
Inflammation and swelling of mucosa lining
3 types of drugs which can improve ventilation
bronchodilators
anti-inflammatory
prevent mast cell degranulation
ALL IMPROVE AIRWAY PATENCY
2 drugs types that impair ventilation
beta blockers
respiratory depressants
what and how do respiratory depressants work?
slow down the brains desire to breathe
- benzodiasepines
- opoids (high doses shut off respiratory drive, so die)
2 types of drug that improves gas exchange
respiratory stimulants
oxygen
respiratory stimulant example
theophyline
stimulates respiratory drive
oxygen as a drug
given in greater concentration than room air
e.g. if Disease of alveoli = more difficult for oxygen to get for gas exchange, give greater concentrations of oxygen
how is an inhaled drug delivered?
suspended drug in air, drug falls out of suspension and lands on airways
2 methods of inhaled drug delivery
meter dose inhaler (MDI) - puffer
breath activated devices
- spinhaler, turbohaler
meter dose inhaler (MDI)
a.k.a puffer
suspended drug in air, drug falls out of suspension and lands on airways
disadvantage of MDI
Very high velocity suspension,
- may not get round first bend in lungs, lots of the powder in aerosol ends up in mouth not in lungs
2 types of breath activated devices
- spinhaler
- turbohaler
advantage of breath activated devices
Slower rate of air so more of the powder reaches the lungs
Improve drug delivery to lungs, reduce drug delivery to the mouth
2 aids of respiratory drug delivery
nebuliser
spacers
nebuliser
aids drug delivery
- Mask with liquid chamber and connector
- Blow air up through tube, bubbles through liquid and inhale from mask an aerosol of bubbles
- Higher concentration than inhaler
- Acute asthma attack can deliver a large volume of oxygen quickly
spacer devices
aids drug delivery
Variety of sizes
- Take the powder in aerosol, aerosol is held in the cannister into the patient is ready to inhale the drug
- Can have multiple puffs in spacer before patient inhaled – increase concentration of drug delivered
- reduces high velocity issue
2 types of beta agonists
short acting (4 hours)
long acting (8-12 hours)
short acting beta agonists examples (2)
- salbutamol (blue inhaler)
- terbutaline (blue inhalers)
blue inhalers can be….
salbutamol or terbutaline
short acting beta agoinist
long acting beta agonist examples
salmeterol (green inhaler)
green inhalers contain
salmeterol
what do beta agonists do?
stimulate beta 2 receptors in lungs
lungs dilate - airways wider and easier to breathe
onset and duration of short acting beta agonists
quick onset (2-3mins) lasts 4-6 hours
3 routes of administration for short acting beta agonists
- inhaled
- oral
- intravenous
what are short acting beta agonists used to treat?
acute bronchial constriction
e.g. asthma attack, breathing issue in premature labour
onset and duration of long acting beta agonists
slow onset (1-2 hours) lasts 12-15 hours - need to be used less often
route of administration of long acting beta agonist
inhaled
use of long acting beta agonist
prevent acute bronchial constriction
ALWAYS use with an inhaled steroid
- cardiac death risk
role of anticholinergic
inhibit muscarinic nerve transmission in autonomic nerves
additive effect in bronchial dilation and reducing mucus secretion
example of anticholinergic
Ipratropium (grey inhaler)
grey inhaler contains
Ipratropium
role of corticosteroids
reduce inflammation in bronchial walls
effective topically or systemically
corticosteroid examples
Beclomethasone (Brown inhaler)
Budesonide (Brown inhaler)
Fluticosone (Orange inhaler)
Mometasone (pink inhaler)
brown inhalers contain
Beclomethasone or Budesonide
different shades indicate different concentrations
orange inhalers contain
Fluticosone
pink inhalers contain
Mometasone
whats is the strongest asthma medication?
Mometasone (pink inhaler)
what inhaler would mild asthma sufferers have?
blue and brown
salbutamol and inhaled steroid
what are compound preparations?
Inhaled steroid with long acting beta agonists
Mixed together into one device for patient ease
– not take both when they need to (usually neglect the brown one, feel no effect but it is important)
example of compound preparations?
Seretide (fluticasone/salmeterol)
how can compound preparations be taken?
puffer or disc inhaler
example of mast cell stabiliser
chromoglycate
role of mast cell stabiliser
Stop mast cell degranulating which triggers the asthma attack
Gritty to inhale – not pleasant
role of leukotriene inhibitors
Tablets that reduce the inflammatory triggers in airway walls
example of leukotriene inhibitor
Montelukast
- inhibits the one of key inflammatory mediators, blocks it, inflammation cannot proceed
why is it important to ensure patient receives the same respiratory drug brand?
Different drugs and drug brands have different bioavailability
Need to ensure that the patient has the same brand so same effect in lungs
role of theophylines
Prevents wheezing and shortness of breath
Relaxes airway muscles, opening up breathing passages and decreasing the lungs response to irritants
white oxygen cylinders
for emergency use
black oxygen cylinders
larger than emergency ones. Available in hospitals
oxygen concentrator function
Removes the nitrogen in air and leaves with concentrated oxygen
Allows raised oxygen concentration with less mechanical delivery
Cannot generate 100% but most patients do not need 100% all of the time
