Respiratory drugs

Question 1

What ways can we administer respiratory drugs? (3 points)

Answer 1

• Inhalation (topical)
• Oral
• Intravenous

Question 2

What 2 types of drugs are used for ventilation to improve airway patency?

Answer 2

• Bronchodilators

- Anti-inflammatory

Question 3

What are 2 examples of bronchodilators used to improve airway patency?

Answer 3

• Beta2 agonists

- Anticholinergic

Question 4

What is an example of anti-inflammatory drugs used to improve airway patency?

Answer 4

• Corticosteroids - Switches off the inflammatory effect in the mucosa and the airway will be wider

Question 5

What 2 types of medication will prevent mast cell degranulation (will stop the process happening which leads to narrowing of the airways in the first place)?

Answer 5

• Chromoglycate

- Leukotriene receptor antagonist

Question 6

What are 3 examples of drugs that impair ventilation?

Answer 6

• Beta blockers

Respiratory depressants (drugs which slow down the brains desire to breath)

• Benzodiazepines (makes you drowsy)
• Opioids (stops you from breathing - switches off your respiratory drive - you can die from this)

Question 7

What is an example of a drug that is a respiratory stimulant and will improve gas exchange?

Answer 7

• Theophylline’s (often help when you have a gas exchange problem)

Question 8

What is the main drug used to improve gas exchange?

Answer 8

• OXYGEN

- It must be prescribed like any other drug (only a medicine when you give it in a higher concentration than room air)

Question 9

What are the 3 ways of giving inhaled drug delivery?

Answer 9

• Meter Dose Inhaler (MDI) (puffer)

Breath activated device

• Spinhaler
• Turboinhaler

Question 10

How does a meter dose inhaler work?

Answer 10

• Suspended drug which is then air - as the air moves gradually through the lungs it will slow down and deposit the droplets in the airways

Question 11

What is a problem with meter dose inhalers?

Answer 11

• It produces a high velocity suspension so doesn’t make it all the way through the airways
• A lot of the powder that is sent out ends up inside the mouth instead of making it to the lungs

Question 12

A nebuliser can be used to aid drug delivery, how does this work?

Answer 12

• Mask with liquid chamber and compressor, blows air up through the tube, the air has to make its way up through the liquid, inhaled from the mask
• If someone has an asthma attack then a nebuliser is a good way of giving the drug

Question 13

A spacer device can be used to aid drug delivery, how does this work?

Answer 13

• Spacer will take the powder from the inhaler in and hold it in the canister until the patient is ready to inhale the aerosol

Question 14

How do Beta agonists help with ventilation?

Answer 14

Stimulates B2 receptors in the lungs, lungs dilate, airways are wider, easier to breath

Question 15

What are 2 examples of short acting beta agonists used to increase ventilation?

Answer 15

• Salbutamol (blue inhaler - will kick in in a few minutes and will last for about 4 hours)
• Terbutaline (blue inhaler)

Question 16

What is an example of a long acting beta agonist used to improve ventilation?

Answer 16

• Salmeterol (green inhaler)
• Longer acting version of the short acting beta agonists
• Will work for about 8-12 hours but takes a while to make a difference

Question 17

What is the onset time for short acting beta agonists?

Answer 17

• 2-3 minutes

Question 18

How long do short acting beta agonists usually last for?

Answer 18

• 4-6 hours

Question 19

What are the routes of administration of short acting beta-agonists? (3 points)

Answer 19

• Inhaled
• Oral
• Intravenous

Question 20

What are short acting beta agonists used to treat?

Answer 20

• Acute bronchial constriction

Question 21

What is the onset time for long acting beta agonists?

Answer 21

• Sow onset - 1-2 hours

Question 22

How long do long acting beta agonists work for?

Answer 22

• Last 12-15 hours

Question 23

What is the route of administration of long acting beta agonists?

Answer 23

• Inhalation

Question 24

What are long acting beta agonists used for?

Answer 24

• To PREVENT acute bronchial constriction

Question 25

Why do you have to use an inhaled steroid with a long acting beta agonist?

Answer 25

• Because of ypu don’t then the risk of sudden cardiac death is higher
• Usually both are mixed together into a single device

Question 26

What do anticholinergics do?

Answer 26

• Inhibit muscarinic nerve transmission in autonomic nerves

- Additive effect in bronchial dilation and reducing mucous secretion

Question 27

What is an example of an anticholinergic and what colour of inhaler are these?

Answer 27

• Ipratropium

- Grey inhaler

Question 28

What do corticosteroids do?

Answer 28

• Reduce inflammation in the bronchial walls

- Effective topically or systemically

Question 29

What are 4 examples of corticosteroids and what colour of inhaler are they?

Answer 29

• Beclomethasone (brown inhaler)
• Budesonide (brown inhaler)
• Fluticosone (orange inhaler)
• Mometasone (pink inhaler)
• asthma significantly severe if using pink or orange

Question 30

Compound preparation inhalers can be given to patients who can’t be trusted to take both inhalers together (the inhaled steroid and long acting Beta agonist). What are 2 examples of these?

Answer 30

• Seretide (fluticasone/salmeterol)

Question 31

What is an example of a mast cell stabiliser?

Answer 31

• Chromoglycate
• (Drug which stops mast cells from bursting - it is the bursting (degranulation) of the mast cells which causes the asthma)

Question 32

Give an example of a leukotriene inhibitor and how does it work?

Answer 32

• Montelukast

- Reduces the inflammation triggers in the airway walls - blocks one of the inflammatory mediators

Question 33

What is an example of a respiratory drug?

Answer 33

• Theophylline’s