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Module 103, Theme 4: Physiology of the lungs and gaseous exchange. Pulmonary disorders and principles of their treatment. > Respiratory pharmacology > Flashcards

Respiratory pharmacology Flashcards

1
Q

Beta-2 agonists

A

Salbutamol

Salmeterol

Used as bronchodilators

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2
Q

Salbutamol

A

A short acting beta-2 agonist (SABA)

Stimulates increased of cAMP in bronchial smooth muscles= bronchodilation

Use: Asthma and COPD

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3
Q

Salmeterol

A

A long-acting beta-2 agonist

Also known as serevent and found in seretide.

Stimulates increased of cAMP in bronchial smooth muscles= bronchodilation

Begins working between 2-30mins and lasts for 10-12 hrs.

Route of administration”
Inhaled

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4
Q

Antiocholinergics

A

Tiotropium

Ipratropium

Used as bronchodilators, inhibits M2 receptors.

Increases cAMP by blocking M2.

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5
Q

Tiotropium

A

Long acting anticholinergic- 24 hrs

Inhibits M3 receptors in bronchus= bronchodilation.

Indications:
Stable COPD- symptoms despite SABA
Asthma- step 3 indication

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6
Q

Use of salmeterol/ serevant

A

Asthma- when requiring long-term bronchodilator therapy on inhaled corticosteroids

COPD: persistent symptoms despite therapy.

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7
Q

Methylxanthines

A

Phosphodiesterase inhibitors that raise cAMP and PKA levels in smooth muscles.

Examples:
Aminophylline

Theophyllines

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8
Q

Steriods

A

Anti-inflammatory drugs

Examples:
Prednisolone

Beclomethasone

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9
Q

Theophylline

A

Methylxanthine- phosphodiesterase inhibitor
- Prevents inactivation of cAMP. Increases cAMP= bronchial smooth muscle relaxation.

Route of administration:
IV
PO- orally

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10
Q

Indications for theophylline

A

PO- persistent symptoms for COPD and asthma

IV- medical emergencies for COPD and asthma.

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11
Q

Side effects for bronchodilators

A

Tachycardia- due to effect on L-type Ca2+ channels in the heart.

Nervousness, irritability and tremor.

More common when taken orally than inhaled:
Tachyarrythmia
Angina

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12
Q

Route of administration for salbuterol

A

Inhaled

Iv

Orally

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13
Q

Metered dose inhalers (MDIs)

A

Inhaled drug device

Method:
1. Deep exhale

  1. Inhale and puff
  2. Hold breath for slow count of 10.
  3. Exhaled slowly
  4. Wait one minute before second puff.
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14
Q

Dry powder inhalers

A

Inhaled drug device

Method:
One inhalation needed- no puff required.

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15
Q

Nebuliser

A

Inhaled drug device that administers drug via a mist.

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16
Q

Route of administration for tiotropium

A

Inhaled:

  • Dry powder hand inhaler
  • Mist respimat
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17
Q

Systemic glucocorticoids

A

Steroids.

Administration:
IV
Orally

Not affected by lung restriction

Side effects with long-term therapy.

Example: Prednisolone

18
Q

Inhaled glucocorticoids

A

Steroids that have a localised action.

Fewer side effects that systemic glucocorticoids as there is less absorption.

Disease may prevent penetration of drug to affected area

19
Q

Airway effects of glucocorticoids.

A

Decreases release of inflammatory mediators.

Decreases airway oedema and mucus production.

Increases number and sensitivity of beta-2 receptors.

Decreases infiltration and action of WBCs.

20
Q

Prednisolone

A

Systemic glucocorticoids- reduces inflammation with a stronger effect to beclometasone.

21
Q

Beclometasone

A

Inhaled glucocorticoids.

Has a more localised effect- weaker than prednisolone.

Disease may prevent its penetration to affected areas.

Indications:
Airway diseases
Allergic rhinitis

22
Q

Adverse effects of inhaled/ gargled/ spacer of glucocorticoids

A

Oral candidiasis

Dysphonia

23
Q

General adverse effects of steroids used for obstructive airway disease

A

Adrenal suppression:

Bone loss

Slow growth in children

Increased risk of cataracts and glaucoma

Increased risk of infection

Gastric ulceration

Hypertension

Diabetes

Mood disturbance

24
Q

Monteleukast

A

A leukotriene inhibitor

25
Q

Antihistamines

A

Histamine-1 antagonist:
used for allergic rhinitis medication.

Examples:
Cetirizine
Chlorpheniramine

26
Q

Side effects of anti-histamines

A

Drowsiness

Dry mouth and eyes

Confusion

27
Q

Cetirzine

A

An antihistamine

Blocks H1 receptor

28
Q

Chlorpheniramine

A

An antihistamine

Blocks H1 receptor

29
Q

Montelukast

A

Leukotriene receptor
inhibitor

Reduces:
Inflammation
Bronchoconstriction
Oedema
Mucus production
Eosinophil recruitment
30
Q

Amoxicillin

A

Penicillin used to treat certain respiratory infections- against Gram positive and negative bacteria.

Use:
Community acquired pneumonia

COPD exacerbations

Bronchitis

31
Q

Co Amoxiclav

A

Amoxicillin + clavulanic acid

Prevents degradation of beta-lactam ring in amoxicillin by beta-lactamase produced by bacteria.

Uses:
Community acquired pneumonia

COPD exacerbations

Bronchitis

32
Q

Tazobactam

A

Used to treat hospital acquired infection and Gram negative bacteria.

33
Q

Tetracyclines

A

Antibiotics that inhibits protein synthesis

Targets a broad spectrum of Gram positive and negative bacteria.

Use: atypical infections like mycoplasma.

Administration: oral

Side effects: GI upset, staining of teeth,
lupus, allergy, photosensitivity.

34
Q

Quinolones

A

Antibiotics that causes DNA fragmentation.

Bacteria targeted: Positive and negative

Administration: Oral, IV, inhaled.

Side effects: GI upset, C difficile, Tendonitis, Liver upset, Prolonged QT interval, arrhythmias.

Examples:
Ciprofloxacin
Moxifloxacin

35
Q

Macrolides

A

Antibiotics that inhibit protein synthesis.

Common used in respiratory infections.

Administration: IV, Orally.

Bacteria targeted: Gram positive, some negative.

Side effect: GI upset, Liver damage, allergy, prolonged QT interval, interactions.

36
Q

TB standard treatment

A

Duration: minimum 6 months.

Treatment has to be taken altogether on an empty stomach, 1 hr before breakfast.

Initial phase: 2 months of 
Isoniazid
Rifampicin
Pyrazinamide
Ethambutol

Continuation phase: 4 months
Isoniazid
Rifampicin

Any noted CNS involve extends the continuation phase to 10 months,

37
Q

DOT

A

Directly observed treatment

Used for cases of TB where patient is at risk of not adhering to treatment.

Professional caseworker, DOT observer or family/friend watches patient take TB medication.

38
Q

CFTR modulating drugs

A

Ivacaftor: Increases channel opening probability of G551D CFTR
Used for those with Class III mutation.

Lumakaftor: Used for Class III mutation.

39
Q

Drugs used for some idiopathic interstitial pneumonias

A

Prednisolone

Azathioprine

MMF (Mycophenolic acid)

40
Q

Treatment for sarcoidosis

A

Prednisolone

41
Q

Treatment for IPF

A

Prednisolone: anti-inflammatory.

Reduces fibroblast proliferation, thus collagen production.

Module 103, Theme 4: Physiology of the lungs and gaseous exchange. Pulmonary disorders and principles of their treatment. (16 decks)

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