respiratory pharma

Question 1

respiratory treatements (9)

Answer 1

• high flow oxygen
• beta agonist drugs
• Anticholinergic drugs
• corticosteriods
• adreneline
• CPAP
• SaO2 and cardiac monitoring
• severe cases: sedation, intubation, mechaniacl ventilation
  -antibiotics or chemotheraputics

Question 2

Oxygen as treatment

Answer 2

• Hypoxia is primary casue of death from exacerbation, oxygen may help to decrease dyspnoea, aid bronchodilation and minimose risk of arrythima
• Should be used in patients where O2 sat below 92% in room air, weane off ehrn sat level exceeds 94%

Question 3

sympathomimetics

Answer 3

agonists at beta 2 adrenergic receptors on bronchiole smooth muscle

Question 4

sympathomimetics examples

Answer 4

• salbutomol: ventolin
• salmeterol
• trebutaline

Question 5

mechanism of B2 agonists on bronchiole muscle cells

Answer 5

-drug binds to B2 receptor
- adenylate cyclase activated
- increase cAMP concentration
- activation of protein kinase enzyme which attaches phosphate groups to other protiens
- myosin-light chained kinase enzyme is inactivated
- reduced interaction of actin and myosin -> smooth muscle relaxation and bronchodilation

Question 6

anticholineric drugs are used in…

Answer 6

moderate to severe cases
best used in combination with other therapies
- can be used in acute asthma, maintenence asthma and COPD

Question 7

anticholinergic drugs action

Answer 7

blocks musinaric acetylcholine receptos on bronchiole smooth muscle
smooth muscle bronchodilates

Question 8

corticosteroids

Answer 8

these drugs switch on/off specific genes that code for proteins involved in the inflammatory process or its regulation
- can take hours to exert full therapeutic effect

Question 9

corticosteriod examples

Answer 9

hydrocortisone- IV for asthma
methylprednisilone
predisnisone

Question 10

steriod recommendations

Answer 10

• used in moderate to severe cases
• decrease admission and relapse if given in first hour od exacerbation
• oral steriods are most convinents, least expensive
• IV given to patients that dont respond to oral

Question 11

methylxanthines

Answer 11

used for ashtma nd COPD
work by 2 mechainisms
- inhibition of enzyme phosphodiesterase
- block adenosine type 1 receptors that inhibit adenylate cyclase
=bronchodilation

Question 12

CPAP

Answer 12

-applies continuous positive airway pressure to keep airways open through breathing cycle

Question 13

sympathomimetics role

Answer 13

used to increase or decrease cardiac contractility

Question 14

sympathomimetics example

Answer 14

beta blockers

Question 15

beta blockers are a type of:

Answer 15

sympathomimetics

Question 16

beta blockers example

Answer 16

metoprolol, propanolol

Question 17

mechainsm of beta blockers

Answer 17

• cmpetitvely block beta 1 adrenic receptors in the SA and AV nodes od heart and ventricular muscles
• reduce heart rate and contractility, therefore reduce cardiac output and blood pressure
• becasue HR decreases, more time for blood to move from aorta to other areas if circulation
• aortic blood pressure therefore reaches lower levels during diastole so afterload is decreased

Question 18

advantages of beta blockers (3)

Answer 18

• reduction in rate and force of contraction, reduced cardiac output and BP
• decreases myocardial workload and oxygen consumption
• proven over 30 years to reduce Bp and incidence od fatal and non-fatal stroke

Question 19

disadvanatges of beta blockers

Answer 19

• fatigue/depression
• vivid or bad dreams
• cold peripheries
  -possible conduction block or heart failure
• may increase serum triglycerides
• casue asthma due to bronchoconstriction

Question 20

calcium channel blocker is a tpye of….

Answer 20

vasodilator

Question 21

calcium channel blocker examples

Answer 21

nifedipine, felodipine

Question 21

Verapamil is…

Answer 21

is a calcium channel blocker which binds more to calcium channels on cardiac muscle and pacemaker cells so may be more useful in treatinf one arrthymias

Question 22

calcium channel blockers function

Answer 22

• Vascular smooth muscle cells have only small amonuts of stored calcium ions, calcium ions are nessecary for muscle contraction because they permit interaction bectween actin and myosin
• Calcium ions enter through voltage gated calcium channels where the muscle cell is depoalrised
• Blocking these channels in vascular smooth muscle casues less calcium to be avaliable intracellulary so the force of the contration is decreases -> vasodialtion and reduced TPR

Question 23

calcium channel blockers unwanted effects

Answer 23

excessive vasodialtion, hypotension, dizziness, flushing, ankle oedema, calcium channel blockers may also worsen heart block and heart failure

Question 24

proton pump inhibitor examples

Answer 24

Omezaprole, pantoprazole and other prazole medicatrions

Question 25

what are proton pump inhibitors

Answer 25

- drugs that affect proton pimp inhibitors in stomach wall - most potent inhibitors in GI tract

Question 26

omezaprole function

Answer 26

-irreversibly inbibits the HKTpase in stomach - final step int he acid scretory pathway - reduces acid secretion by 99% - is neutral pH byt because it is a weak base, it accumulates in the caniculi of parietal cells where it is activated and has specific action on these cells

Question 27

unwated effects of omezaprole

Answer 27

are uncommon but may include; headache, diarhea, rashes, dizziness, pain in muscles and joints