RESPIRATORY PHARMACOLOGY Flashcards
1
Q
MAIN DISORDERS OF THE RESPIRATORY SYSTEM
A
- asthma
- COPD
- allergic rhinitis
- cough
2
Q
PATHOPHYSIOLOGY OF ASTHMA
A
HYPERRESPONSIVENESS TO STIMULI ( allergens, infection, stress, cold air, exercise)→ release of mediators→ inflammation of airway (mucus production) and bronchoconstriction
3
Q
DRUG TREATMENT FOR ASTHMA
A
- block inflammatory mediators release, omalizumab
- prevent inflammation, leukotriene antagonists
- reduce inflammation, glucocorticoids
- bronchodilators, beta 2 agonists.
4
Q
TYPES OF BRONCHODILATORS
A
- beta 2 agonists
- anticholinergics
- Xanthine drugs
5
Q
BATA 2 AGONISTS CHARACTERISTICS
A
- first-line drugs
- moa, beta 2 adrenoreceptors agonists, relax smooth muscle directly, no effect on hyperreactivity or inflammation
- route, aerosol inhalation, PO/IV
- S/E tremor, tachycardia, hypokalaemia
- CAUTIONS/CONTRAINDICATION, hyperthyroidism, CV disease, arrhythmia, hypertension, diabetes
- SEVERAL DRUG INTERACTION
- SHORT ACTING SABA, salbutamol, terbutaline
- LONG ACTING LABA, salmeterol, formoterol
6
Q
ANTICHOLINERGIC CHARACTERISTICS
A
- ipratropium, tiotropiumum
- muscarinic receptor antagonists
- second-line drugs may be used for COPD
- weak bronchodilators
- route inhalation
- s/e dry mouth, GI upset
- cautions, prostatic hyperplasia, glaucoma
- interaction, reduced absorption of ketoconazole
7
Q
XANTHINE DRUGS CHARACTERISTICS
A
- theophylline, aminophylline
- moa, inhibit phosphodiesterase, increase level of cAMP, relax directly smooth muscle, no effect on inflammation
- route slow IV, slow-release oral
- narrow TI, rate of elimination can vary, long-acting only
- s/e nausea, anxiety, tachycardia, convulsions
- cautions, cardiac disease, hypertension, epilepsy, elderly
- common drugs interactions
8
Q
LIST OF ANTIINFLAMMATORY MEDS IN ASTHMA TREATMENT
A
- glucocorticoids
- leukotriene antagonists
- mast cell stabilizers
9
Q
MOA and characteristics of glucocorticoids
A
- nature, glucocorticoid receptor antagonists, modify gene transcription, increase anti-inflammatory mediators and reduce pro-inflammatory mediators
- treat moderate to severe asthma, beclomethasone, budesonide
- route, inhalation, oral, iv
- s/e generally mild, prolonged use cause suppression of HPA (HYPOTHALAMIC-PITYITARY-ADRENAL AXIS)→ Cushing’s syndrome, loss of bone density
- cautions, pulmonary TB, pregnancy
- interactions, CPY3A4 inhibitor, ketoconazole.
10
Q
LEUKOTRIENE ANTAGONISTS CHARACTERISTICs
A
- moa, block bronchoconstriction action of leukotriene released from inflammatory cells, reduce hyperreactivity and inflammation
- route, orally, 24h action on asthma release
- s/e minimal headache and GI upset
- caution in pregnancy and breastfeeding, elderly
- interactions, plasma concentration reduced by enzymes inducers and increased by enzymes inhibitors.
11
Q
MAST CELL STABILIZERS CHARACTERISTICS
A
- cromolyn sodium used prophylactically no acute attack
- MOA, prevents release of mediators from mast cells but mechanism in asthma is unclear
- route, inhalation
- s/e minimal cough, wheeze, transient bronchospasm
- caution may cause allergy
12
Q
SUMMARY OF ASTHMA TREATMENT STRATEGIES
A
- _long term asthma contro_l: inhaled steroids, leukotriene antagonists, long-acting beta-agonists, combination inhalers, theophylline
- quick relief meds, short-acting beta-agonists, muscarinic antagonists, oral iv steroids
- allergy meds, immunotherapy, omalizumab
13
Q
A
14
Q
TREATMENT OPTIONS FOR COPD
A
- BRONCHODILATORS
- INHALED GLUCOCORTICOSTEROIS
- SYSTEMIC GLUCOCORTICOIDS
- OXYGEN
15
Q
LONG TERM CONTROL OF MODERATE COPD
A
- FEV1, forced expiratory volume in one sec is between 50 and 80%
- treatment requires one or more bronchodilators
18
Q
moderate to severe high fever treatment
A
review flowchart
