Respiratory Pharmacology Flashcards

1
Q

Gives types of bronchodilators

A

Adrenergic Agonists

  • Adrenergic Agonists: Beta-2 agonists,
  • Salbutamol, salmeterol, formoterol
  • Antimuscarinic /cholinergic
  • Tiotropium, (Long-Acting Muscarinic Anti)
  • Ipratropium ( Short-Acting Muscarinic Anti)
  • Methylxanthines (Aminophylline)
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2
Q

Give types of Anti-inflammatory drugs

A

Steroids

- Prednisolone: oral

- Beclomethasone: Inhaled CorticoSteroid

Leukotriene receptor antagonist

  • Montelukast

Mucolytic agents

  • Carbocysteine
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3
Q

What type of Inhaled drug devices are there?

A
  • 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
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4
Q

What is the duration of Salbutamol?

A
  • short-acting
  • begins immediately
  • last 3-5 hours
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5
Q

What are the routes of intake for Salbutamol?

A
  • Inhaled or nebuliser: at higher doses
  • IV: rarely used prescribed in acute severe asthma unresponsive to nebulised bronchodilators and life-threatening asthma
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6
Q

Describe the mechanism of action of salbutamol

A
  • Beta-2 receptors in the lungs
  • activates adenylate cyclase
  • this increases cAMP production
  • causes relaxation of bronchial smooth muscle
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7
Q

What are the uses of Salbutamol

A
  • Asthma
  • COPD
  • terbutaline is another SABA alternative
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8
Q

What is the duration of Salmeterol?

A
  • Long-acting
  • begins with 2-30 mins
  • lasts 10-12 hours
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9
Q

What is the rate of intake and mechanism of action of Salmeterol?

A
  • Inhaled
  • Long-acting beta-adrenoceptor agonist
  • acts on Beta-2 receptor increases cAMP in the cell through adenylate cyclase.
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10
Q

ICS = inhaled corticosteroid, FEV1: air forced out of lungs in 1 sec

What is the use of Salmeterol?

A

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%)
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11
Q

What is the duration of Formoterol?

A
  • Long-acting
  • short onset like salbutamol
  • prolonged duration 10-12 hours
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12
Q

What is the route and mechanism of action of Formoterol?

A
  • inhaled
  • Long-acting beta-adrenoreceptor agonist
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13
Q

What is the use of Formoterol?

A
  • Asthma: always combined with ICS
  • COPD
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14
Q

What is the duration and rout of intake of Tiotropium?

A
  • Long-acting (24 hours): once daily
  • inhaled as: dry powder (handihaler), Mist (respimat)
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15
Q

What is the mechanism of action of Tiotropium?

A
  • Long-acting antimuscarinic agent (LAMA)
  • similar affinity to subtypes of muscarinic receptors M1-M5
  • inhibits M3-receptors at the smooth muscle –> bronchodilation
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16
Q

What is the use of Tiotropium?

A

In stable COPD: symptoms despite SABA

Asthma: if no improvement with ICS/LABA specialist advice from hospital

17
Q

Give the duration, intake ad use of Ipratropium

A
  • Short-acting Antimuscuarainic agent
  • Onset of 30 mins
  • last 6 hours
  • through nebuliser
  • nebulised for acute presentation of COPD and sometimes Asthma
  • used in an emergency in situations
18
Q

Give the duration, intake of Theophylline

A
  • Half-life of 5 hours in healthy in adults
  • Oral or Intravenous
19
Q

What is the mechanism of action of Theophylline?

A
  • Phosphodiesterase inhibitor
  • inhibits the action of Phosphodiesterase enzyme (PDEs)
  • therefore the action cAMP and cGMP is not decreased in target cells
  • therefore increased smooth muscle relaxation
  • requires monitoring through blood tests
20
Q

What is the use of Theophylline?

A

Orally

  • COPD and asthma for persistent symptoms

Intravenous

  • COPD and asthma-medical emergencies
21
Q

What are some adverse effects of Bronchodilators?

A
  • Tachycardia
  • nervousness, irritability, tremor
  • inhaled preparations have less adverse effects
  • oral and IV preparations are less commonly used but have more side effects: Tachyarrhythmias/angina
  • usually dose related
22
Q

What are the methods of delivery for oxygen and their indications?

A

Controlled: hypercapnic respiratory failure

  • venturi

Uncontrolled: pneumonia

  • Nasal
  • Hudson mask
  • Reservoir
23
Q

Give an example of systemic and inhaled Glucocorticoids and their method of administration?

A

Systemic: Prednisolone

  • IV or Oral administration

Inhaled: Beclometastone, fluticasone, budesonide

24
Q

What is the effects on the airways from Glucocorticoids?

A
  • Decrease release of inflammatory mediator
  • Decrease infiltration and action of white blood cells
  • Decrease airway oedema
  • Decrease airway mucus production
  • INcrease number of the sensitivity of beta-2 receptors
25
Q

What are the 4 main types of Allergic Rhinitis medications? Give examples.

A

Antihistamines

  • Cetirizine, Chlorpheniramine
  • H1 antagonist

Intranasal Glucocorticoids

  • Beclometasone (Beconase)
  • Montelukast: inhibits leukotriene receptors

Sympathomimetics

  • pseudoephedrine: alpha-agonist
26
Q

What are the indications and route of intake for Amoxicillin?

A
  • moderate spectrum, bacteriolytic, B lactam antibiotic
  • active against gram-negative and gram-positive bacteria
  • taken via IV or Orally
  • use in CAP typical/ COPD exacerbations/ bronchitis
27
Q

What are the indications and route of intake for a Co-amoxiclav?

A
  • amoxicillin is susceptible to degradation by B lactamase producing bacteria so can be combined with clavulanic acid
  • this is a Beta-lactamase inhibitor

Tazobactum:

  • used in hospital-acquired infections and gram-negative bacteria
  • extended-spectrum b lactam antibiotic