Respiratory drugs Flashcards
What ways can we administer respiratory drugs? (3 points)
- Inhalation (topical)
- Oral
- Intravenous
What 2 types of drugs are used for ventilation to improve airway patency?
- Bronchodilators
- Anti-inflammatory
What are 2 examples of bronchodilators used to improve airway patency?
- Beta2 agonists
- Anticholinergic
What is an example of anti-inflammatory drugs used to improve airway patency?
- Corticosteroids - Switches off the inflammatory effect in the mucosa and the airway will be wider
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)?
- Chromoglycate
- Leukotriene receptor antagonist
What are 3 examples of drugs that impair ventilation?
- 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)
What is an example of a drug that is a respiratory stimulant and will improve gas exchange?
- Theophylline’s (often help when you have a gas exchange problem)
What is the main drug used to improve gas exchange?
- OXYGEN
- It must be prescribed like any other drug (only a medicine when you give it in a higher concentration than room air)
What are the 3 ways of giving inhaled drug delivery?
- Meter Dose Inhaler (MDI) (puffer)
Breath activated device
- Spinhaler
- Turboinhaler
How does a meter dose inhaler work?
- 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
What is a problem with meter dose inhalers?
- 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
A nebuliser can be used to aid drug delivery, how does this work?
- 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
A spacer device can be used to aid drug delivery, how does this work?
- Spacer will take the powder from the inhaler in and hold it in the canister until the patient is ready to inhale the aerosol
How do Beta agonists help with ventilation?
Stimulates B2 receptors in the lungs, lungs dilate, airways are wider, easier to breath
What are 2 examples of short acting beta agonists used to increase ventilation?
- Salbutamol (blue inhaler - will kick in in a few minutes and will last for about 4 hours)
- Terbutaline (blue inhaler)
What is an example of a long acting beta agonist used to improve ventilation?
- 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
What is the onset time for short acting beta agonists?
- 2-3 minutes
How long do short acting beta agonists usually last for?
- 4-6 hours
What are the routes of administration of short acting beta-agonists? (3 points)
- Inhaled
- Oral
- Intravenous
What are short acting beta agonists used to treat?
- Acute bronchial constriction
What is the onset time for long acting beta agonists?
- Sow onset - 1-2 hours
How long do long acting beta agonists work for?
- Last 12-15 hours
What is the route of administration of long acting beta agonists?
- Inhalation
What are long acting beta agonists used for?
- To PREVENT acute bronchial constriction
Why do you have to use an inhaled steroid with a long acting beta agonist?
- Because of ypu don’t then the risk of sudden cardiac death is higher
- Usually both are mixed together into a single device
What do anticholinergics do?
- Inhibit muscarinic nerve transmission in autonomic nerves
- Additive effect in bronchial dilation and reducing mucous secretion
What is an example of an anticholinergic and what colour of inhaler are these?
- Ipratropium
- Grey inhaler
What do corticosteroids do?
- Reduce inflammation in the bronchial walls
- Effective topically or systemically
What are 4 examples of corticosteroids and what colour of inhaler are they?
- Beclomethasone (brown inhaler)
- Budesonide (brown inhaler)
- Fluticosone (orange inhaler)
- Mometasone (pink inhaler)
- asthma significantly severe if using pink or orange
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?
- Seretide (fluticasone/salmeterol)
What is an example of a mast cell stabiliser?
- Chromoglycate
- (Drug which stops mast cells from bursting - it is the bursting (degranulation) of the mast cells which causes the asthma)
Give an example of a leukotriene inhibitor and how does it work?
- Montelukast
- Reduces the inflammation triggers in the airway walls - blocks one of the inflammatory mediators
What is an example of a respiratory drug?
- Theophylline’s
