Respiratory Tract Disorders Flashcards
Meaning of COPD
Chronic Obstructive Pulmonary Disease
Characterized by airway inflammation and hyperresponsiveness to stimuli that produce brochoconstriction
Asthma
Reasons of narrowing of airways in COPD
Inflammation
Mucus Secretion
Triggers of Asthma
Allergens
Air pollution
Cigarette smoking
Upper Respiratory tract infections
Drugs (NSAIDs & Beta-blockers)
Cold Air
Exercise
A substance that is released during inflammation
Protease
Surface in between the sacs of the alveoli, this is also directly connected to the capillaries
Parenchyma
A condition wherein the partition in between every alveoli collapses (alveolar collapse)
Destruction of Parenchyma
Emphysema
Why do NSAIDs cause Asthma
Since they inhibit cox resulting to increase of LOX thus increasing leukotrienes causing constriction
Why do beta-blockers cause Asthma attack
Since Beta 2 causes bronchodilation, antagonize it then no bronchodilation
Two factors for Asthma
Genetic & Environmental
Examples of Beta Agonist Bronchodilators (SABA)
Salbutamol
Terbutaline
Levalbuterol
Fenoterol
Pirbuterol
Examples of Beta Agonist Bronchodilators (LABA)
Salmeterol
Formeterol
Indacaterol
SABAs are used for
Treating acute bronchospasms since it is fast acting
LABAs are used for
Prevention of asthma attacks
Most of them are given twice daily by INHALATION except for Indacaterol (once daily)
Example Muscarinic Antagonist Bronchodilators
Ipratropium
Tiotropium
Both are administered by oral inhalation to produce few side effects
1+1 = 3 (synergistic)
when muscarinic receptor antagonists are given on its own it is weaker than beta agonists HOWEVER when given together with beta 2 agonist they are more effective
MOA of Theophylline
Inhibition of PDE isozymes and Blockade of adenosine receptors thus increasing camp
Inhibition of calcium influx
Enhancement of catecholamine secretion
Indications of Theophylline
COPD and Asthma whose symptoms are not controlled with Beta 2 agonists and muscarinic antagonists
Adverse effects of Theophylline
Gastrointestinal distress
CNS stimulation (HA, anxiety, restlessness, seizure) caffeine like effects
Cardiac stimulation
What do Corticosteroids or steroids do
Inhibit the immune system thus lessening immune response
Indications of Corticosteroids
Long-term prevention of asthma attacks
Adverse effects of Corticosteroids(Budesonide, Fluticasone, Beclomethasone, Triamcinolone)
Oral Thrush
Risk of suppressing growth in children
Examples of Corticosteroid drugs
Budesonide
Fluticasone
Beclomethasone
Triamcinolone
MOA of Leukotriene antagonists (zafirlukast and montelukast)
Antagonize Leukotriene receptor
Inhibit Lipoxygenase (enzyme responsible for producing leukotrienes)
Examples of leukotriene antagonists
Montelukast - can be given to patients as young as 6 months old
Zafirlukast - for patients with age greater than 5 years old
Indications of leukotriene antagonists (zafirlukast and montelukast)
Preferred initial anti-inflammatory therapy since it has minimal side effects, orally administered, and it can be used for patients that are unwilling/contraindicated to use steroids
Example of Lipoxygenase 5 inhibitor
Zileuton
MOA of Zilueton
Block the formation of leukotriene
Indications of Lipoxygenase 5 inhibitor (zileuton)
Prophylaxis of asthma in adults and children (12 years and above)
Adverse effects of Lipoxygenase 5 inhibitor (zileuton)
Flu-like syndrome
Elevation of liver enzymes
Adverse effects of leukotriene receptor antagonists (montelukast and zafirlukast)
Rarely, Churg-Strauss Syndrome - treated with corticosteroids, this is developed in patients being withdrawn from glucocorticoid therapy while a leukotriene antagonist is substituted
Example of mast cell stabilizers
Cromolyn Sodium
Nedocromil
Lodoxamide
MOA of mast cell stabilizers (Cromolyn Sodium, Nedocromil, Lodoxamide)
stabilize the plasma membranes of mast cells and prevent granulation and release of histamine, leukotrienes and other substances that cause airway inflammation
Block calcium
Indications of mast cell stabilizers (Cromolyn Sodium, Nedocromil, Lodoxamide)
used as a prophylactic agent for asthma (inhaled)
Example of PDE-4 Inhibitor
Roflumilast
MOA of PDE-4 Inhibitor (roflumilast)
Increase cAMP levels
Indications of PDE-4 Inhibitor (roflumilast)
used to reduce the risk of COPD exacerbations in patients with chronic bronchitis who have a history of exacerbations
MOA of Antitussives (Dextromethorphan, Noscapine, Propoxyphene
Codeine, Butamirate Citrate, Levodroproprizine)
Inhibit the cough center in the brain: elevating cough threshold
Examples of Antitussives
Dextromethorphan
Noscapine
Propoxyphene
Codeine
Butamirate Citrate
Levodroproprizine
MOA of Expectorants (Guaifenesin, Sodium Citrate, Potassium Citrate, Ammonium Chloride)
Facilitate the coughing up of mucus and other materials from the lungs
Reduce adhesiveness and surface tension of respiratory tract secretions and thereby facilitate their expectoration
Examples of Expectorants
Guaifenesin
Sodium Citrate
Potassium Citrate
Ammonium Chloride
MOA of Mucolytics (Acetylcysteine, Bromhexine, Carbocisteine, Ambroxol)
Breaks down the bonds holding together mucus thus making the mucus less sticky and thick
Examples of Mucolytics
Acetylcysteine
Bromhexine
Carbocisteine
Ambroxol
