T4 - Respiratory pharmacology Flashcards
Give three examples of adrenergic agonists
Salbutamol, salmeterol, formeterol
give two examples of anticholinergics
tiotropium and ipatropium
give two examples of anti-inflammatories/steroids
prednisolone and beclamethasone
name three inhaled drug devices
pressured metered dose inhalers (MDIs), dry powder inhalers and nebulisers
give three adverse effects of bronchodilators and what are these side effects controlled by?
tachycardia, tremor and irritation - usually dose dependent
which administration of bronchodilators gives the most side effects
IV
how quick does a SABA work and how long does it last?
works immediately and works for 3-5 hours
what Is the mechanism of action of a SABA?
binds B2 receptors in the lungs and relaxes bronchial smooth muscle
give two examples of a LABA and what is it used for?
salmeterol/formeterol used in asthma and COPD
what should a LABA always be given alongside in asthma?
inhaled corticosteroid
how long does a LABA take to work and how long does it last for?
takes 2-30 mins to work and lasts for 10-12 hours
what enzyme do LABAs work on?
adenylate cyclase to increase cAMP
what is the onset time of formeterol?
immediately (same as salbutamol but longer action)
what conditions would tiotropium be administered in?
stable COPD and asthma (if symptomatic despite SABAs)
how long does tiotropium work for?
24 hours (LAMA - long acting muscarinic agonist)
what is the mechanism of action of tiotropium?
inhibits M3 receptors in smooth muscle causing bronchodilator
what does theophylline inhibit and what circumstance is it used in?
inhibits phosphodiesterase and is used when patient is very sick with persistent asthma or COPD
what are zero order kinetics?
a small change in dose has a big change in levels/therapeutics of the drug
give an example of an IV/oral glucocorticoid
prednisolone
give an example of an inhaled glucocorticoid
beclametasone/furasone
what is the mechanism of action of inhaled glucocorticoids?
decrease release of inflammatory mediators, decreased WBC action, decreased airway oedema, decreased mucus production
what effect to glucocorticoids have on B2 receptors?
increase their numbers/sensitivity to cause bronchodilation
what are the two main side effects of inhaled GCs?
oral candidasis, dysphonia (hard to speak)
what effect can increased steroid use have on the immune system?
can suppress it causing increased risk of infections
what are three treatments for allergic rhinitis?
H1 antagonists, intranasal glucocorticoids and leukotriene inhibitors/decongestants
how can controlled oxygen be administered and what condition would this be relevant in?
venturi mask in COPD
what can giving COPD patients too much oxygen cause?
a decrease in their respiratory effort which can increase CO2 and result in a respiratory acidosis
give two scenarios where LMW would be used
1) decreasing risk of thrombosis (PE/DVT) if immobile
2) VTE prophylaxis
what class of antibiotics are given for respiratory infections?
penicillins
give three scenarios where amoxicillin would be given ins respiratory infection
CAP, COPD exacerbation and bronchitis
give two scenarios where doxycycline would be given
COPD exacerbation or atypical pneumonia
how does doxycycline work?
by inhibiting protein synthesis
what are the side effects of doxycycline?
GI upset, stained teeth, lipid, allergy and photosensitivity
give two examples of macrolides and when would they be given?
erythromycin and clarithromycin - given in penicillin allergy
what type of bacteria do macrolides work against?
gram positive
