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MBChB 3 Drug Database > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

1
Q

What is an example of a Beta-Adrenergic Bronchodilator?

A

Salbutamol,

Salmeterol

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2
Q

What is the mechanism of action for salbutamol

A

Short-acting Beta-2 adrenoceptor agonists (SABA)
Relaxes bronchial smooth muscle, inducing bronchodilation.
Inhibit pro-inflammatory cytokine release from mast cells and TNF-α release from monocytes, reducing airway inflammation.
Increase mucus clearance from the airways by stimulating cilia action.

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3
Q

What are the main indications of salbutamol and salmeterol

A

asthma

COPD

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4
Q

List some side effects of salbutamol and salmeterol

A

Tremor
Tachycardia / cardiac dysrhythmia
Headache
Sleep disturbances

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5
Q

What is important clinically regarding Pharmacokinetics/dynamics for salbutamol

A

Only a small % of inhaled drug reaches target in the airways – a spacer may improve drug delivery

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6
Q

What information should you tell the patient before starting salbutamol

A

Check inhaler technique, review the need for spacer / nebuliser.
In exercise-induced-asthma, a dose immediately before exercise can reduce incidence of symptoms.
If required more than once daily, treatment needs reviewed.

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7
Q

What is the mechanism of action for salmeterol

A

Long-acting Beta-2 adrenoceptor agonist (LABA)
Relaxes bronchial smooth muscle, inducing bronchodilation.
Inhibit pro-inflammatory cytokine release from mast cells and TNF-α release from monocytes, reducing airway inflammation.
Increase mucus clearance from the airways by stimulating cilia action.

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8
Q

What is important clinically regarding Pharmacokinetics/dynamics for salmeterol

A

Not to be commenced in patients with rapidly deteriorating asthma – slower onset of action than SABA’s.

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9
Q

What information should you tell the patient before starting salmeterol

A

Report any deterioration in symptoms following initiation of LABA.
Do not exceed stated dose.
Seek medical advice when stated dose fails to control symptoms.

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10
Q

what are 2 examples of Anti-Muscarinic Bronchodilators?

A

Tiotropium

Ipratropium Bromide

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11
Q

What is the MoA for anti-muscarinic bronchodilators?

A 
Muscarinic receptor (M3) antagonists producing bronchodilatory effects.
Reduces mucus secretion and may increase bronchial mucus clearance by stimulating cilia.
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12
Q

What are the main indications for Tiotropium and Ipratropium Bromide

A

Asthma
COPD
Rhinitis

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13
Q

List some side effects of Tiotropium and Ipratropium Bromide

A

dry mouth
cough
constipation

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14
Q

What is important clinically regarding Pharmacokinetics/dynamics for anti-muscarinic bronchodilators

A

Inhaled and poorly absorbed into the circulation – unable to affect systemic muscarinic/cholinergic receptors
Nebulised Ipratropium Bromide should always be administered via a mouth piece to minimize the risk of acute angle closure glaucoma.

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15
Q

What information should you tell the patient before starting an anti-muscarinic bronchodilator

A

Good inhaler technique improves efficacy.

Cough may arise

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16
Q

what is an example of inhaled corticosteroids?

A

Beclomethasone

17
Q

what is the MoA for beclomethasone?

A

Anti-inflammatory effect on the airways.
Decrease formation of pro-inflammatory cytokines.
Up-regulates beta-2-adrenoreceptors in airways.

18
Q

what are the indications for inhaled corticosteroids?

A

treatment of COPD and asthma

19
Q

List some side effects of beclomethasone:

A

oral candidiasis
adrenal suppression
osteoporosis

20
Q

what is important clinically regarding Pharmacokinetics/dynamics for inhaled corticosteroids

A

Takes several weeks to months for full effects of therapy.

Spacer devices can reduce risk of thrush and improve drug delivery.

21
Q

What information should you tell the patient before starting beclomethasone

A

If on higher dose, carry a steroid card.

Increase dose during periods of illness.

22
Q

what are some examples of anti-histamines? (H1 receptor antagonists)

A

Chlorpheniramine
Desloratidine
Fexofenadine
Hydroxyzine

23
Q

what is the MoA of anti-histamines (H1 receptor antagonists)?

A

Antihistamine; H1 receptor antagonist.

Inhibits histamine-mediated contraction and vasodilation of the bronchial smooth muscle.

24
Q

what are the indications for anti-histamines? (H1 receptor antagonists)

A

anaphylaxis
hay fever
urticaria
sedation

25
Q

list some side effects of anti-histamines (H1 receptor antagonists)

A

drowsiness

tinnitus

26
Q

what is important clinically regarding Pharmacokinetics/dynamics for anti histamines (H1 receptor antagonists)?

A

Renally excreted
Sedation arises from central nervous system H1 antagonism (second generation H1 antagonists do not cross the blood brain barrier in therapeutic doses).

27
Q

What information should you tell the patient before starting anti histamines (H1 receptor antagonists)?

A

Do not operate heavy machinery.

Do not drive.

MBChB 3 Drug Database (10 decks)

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