Respiratory Drugs Flashcards
List the ways that respiratory drugs can be administered.
Inhalation
Oral
IV
Describe how inhaled respiratory drugs work.
Inhaled drugs are topical drugs.
The power falls and settles on airway linings as the speed of the air slows.
What drugs impair ventilation?
Beta blockers
Respiratory depressants;
Benzodiazepines (cause drowsiness)
Opioids (have an effect on the area of the brain which regulates respiratory rate)
What are the 2 main actions of respiratory drugs?
Improving ventilation
Improving gas exchange
How do respiratory drugs improve ventilation?
Improve ventilation via;
Increasing the airway diameter
Preventing mast cell degranulation
What drugs increase airway diameter and improve ventilation?
Bronchodilators - Beta2 agonists and anticholinergics
Anti-inflammatory drugs - corticosteroids.
What drugs improve ventilation by preventing mast cell degranulation?
Leukotriene receptor antagonists
What drugs improve gas exchange?
Theophyllines
Oxygen
Name the types of inhalers.
Meter dose inhaler (puffer)
Breath activated device (spinhaler and turbohaler)
How can we aid the delivery of respiratory drugs?
Nebuliser - Bubbles contain high concentrations of the drug.
Spacers - Increases the concentration of drug reaching the airways and reduced the effects of steroids in the oral cavity. = thrush
Name short acting b2 agonists that improve airway diameter (and therefore ventilation)
Salbutamol (blue)
Terbutaline (blue)
What is the onset of short acting b2 agonists?
2 - 3 mins
How long do the effects if short acting b2 agonists last?
4 - 6 hours
What do short acting b2 agonists treat?
Treat constriction of the airways in an acute attack.
Name a long acting b2 agonist used to improve airway diameter (and therefore ventilation)
Salmeterol (green)
What is the onset of long acting b2 agonists?
onset 1-2 hours
How long do long acting b2 agonists last?
12 -15 hours
What are long acting b2 agonists used for?
Used as a preventative measure - not used to treat an acute attack.
MUST BE USED ALONGSIDE INHALED STEROIDS.
Name an anticholinergic drug that improves airway diameter (and therefore ventilation)
Ipratropium (grey)
What are the actions of ipratropium?
(Anticholinergic drug that is used for bronchodilation and improving ventilation)
Inhibits muscarinic nerve transmission
Reduces mucus secretion
Name corticosteroids that improve airway diameter (and therefore ventilation)
Beclomethasone (brown)
Fluticasone (orange)
Mometasone (pink)
What are the actions of corticosteroids?
(Used for bronchodilation and improving ventilation)
Target all 3 mechanisms of asthma;
Reduce inflammation of the bronchial wall
Reduce contraction of smooth muscle
Reduce mucous secretion
What medication is the most effective way to treat asthma?
Corticosteroids
When would inhaled corticosteroids be used?
Used if short acting b2 agonists have to be taken > 3 times per week.
(used alongside long acting b2 agonists)
Not used to TREAT an acute attack however is taken as a preventative measure for latent attacks.
When would oral steroids be given to an asthmatic patient?
In a very severe asthma attack.
Describe the progression of treatment for asthma.
Starting point - salbutamol : inhaled short acting b2 agonist.
If this has to be taken > 3 x per week patient moves on to;
Beclamethasone : inhaled corticosteroid.
This is usually taken alongside a long acting b2 agonist - Salmeterol.
Leukotriene agonists - prevent mast cell degranulation.
In very severe asthma/asthma attacks patients have to take oral steroids and are regularly hospitalised.
What do b2 agonists (used in an acute attack) not have an effect on?
Oedema of the airways
Excessive mucous secretion
What are the side effects of steroid inhalers?
Commonly;
Oral candidiasis = fungal infection of the mouth.
When dosages are > 1500 ug
= Osteoporosis
= adrenal suppression.
What medications are taken to treat oral candidiasis?
Nystatin
Fluconazole
