Respiratory Pharmacology Flashcards
Gives types of bronchodilators
Adrenergic Agonists
- Adrenergic Agonists: Beta-2 agonists,
- Salbutamol, salmeterol, formoterol
- Antimuscarinic /cholinergic
- Tiotropium, (Long-Acting Muscarinic Anti)
- Ipratropium ( Short-Acting Muscarinic Anti)
- Methylxanthines (Aminophylline)
Give types of Anti-inflammatory drugs
Steroids
- Prednisolone: oral
- Beclomethasone: Inhaled CorticoSteroid
Leukotriene receptor antagonist
- Montelukast
Mucolytic agents
- Carbocysteine
What type of Inhaled drug devices are there?
- Pressurised Metered Dose Inhalers
- deep inhale, hold for 10, exhale slowly, 1 minute before 2nd puff
- can use areochamber or spacer, has a high carbon footprint HCFCs
- Dry-powder Inhalers
- one inhalation, not a puff
What is the duration of Salbutamol?
- short-acting
- begins immediately
- last 3-5 hours
What are the routes of intake for Salbutamol?
- Inhaled or nebuliser: at higher doses
- IV: rarely used prescribed in acute severe asthma unresponsive to nebulised bronchodilators and life-threatening asthma
Describe the mechanism of action of salbutamol
- Beta-2 receptors in the lungs
- activates adenylate cyclase
- this increases cAMP production
- causes relaxation of bronchial smooth muscle
What are the uses of Salbutamol
- Asthma
- COPD
- terbutaline is another SABA alternative
What is the duration of Salmeterol?
- Long-acting
- begins with 2-30 mins
- lasts 10-12 hours
What is the rate of intake and mechanism of action of Salmeterol?
- Inhaled
- Long-acting beta-adrenoceptor agonist
- acts on Beta-2 receptor increases cAMP in the cell through adenylate cyclase.
ICS = inhaled corticosteroid, FEV1: air forced out of lungs in 1 sec
What is the use of Salmeterol?
Asthma
- those requiring long-term regular bronchodilator therapy on ICS
- always used with ICS in asthma
COPD
- when there are persistent symptoms despite SABA
- wither LABA /LAMA combination or ICS?LABA combination FEV1 <50%)
What is the duration of Formoterol?
- Long-acting
- short onset like salbutamol
- prolonged duration 10-12 hours
What is the route and mechanism of action of Formoterol?
- inhaled
- Long-acting beta-adrenoreceptor agonist
What is the use of Formoterol?
- Asthma: always combined with ICS
- COPD
What is the duration and rout of intake of Tiotropium?
- Long-acting (24 hours): once daily
- inhaled as: dry powder (handihaler), Mist (respimat)
What is the mechanism of action of Tiotropium?
- Long-acting antimuscarinic agent (LAMA)
- similar affinity to subtypes of muscarinic receptors M1-M5
- inhibits M3-receptors at the smooth muscle –> bronchodilation