The respiratory system - Pharmacology Flashcards
Name the class of drugs used to treat obstructive airway disease
Bronchodilators - Anti-cholinergic, Beta-agonists
Corticosteroids
Leukotriene receptor antagonists
Cromones
Immunoglobulin E antagonists
Methylxanthines
Phosphodiesterase inhibitors
Mucolytics
Beta-2 agonists
a) MOA
b) Route
c) Side-effects
d) 2 examples of short-acting B2 agonists
e) 2 examples of long acting B2 agonists
f) 2 examples of ultra-long acting (rarely used)
a) Bind 2 beta-2 adrenergic receptors smooth muscle of bronchial tissue. This causes increased cAMP which leads to smooth muscle relaxation
b) Inhaled, IV or oral
c) Tremor, tachycardia/palpitations, decrease in potassium
d) Salbutamol (Ventolin), Terbutaline (Bricanyl)
e) Frometerol, Serevent
f) Indacterol, Vilanterol, Olodaterol
Anticholinergic
a) MOA
b) Route
c) Side-effects
d) 1 example of short-acting anticholinergics
e) 2 examples of long acting anticholinergics
a) Binds to muscarinic acetylcholine receptors which prevents acetylcholine from binding. This leads to smooth muscle dilation
b) Inhaled
c) Dry mouth, constipation, tachycardia
d) Ipatropium
e) Tiotropium, Glycopyrronium, Aclidinium
Give 5 adverse effects of corticosteroids
- Personality changes
- Hyperglycaemia
- Moon face
- Buffalo hump
- Increase susceptibility to infection
- Males: Gynecomastia
- Osteoporosis
- CNS irratibility
- NA and fluid retention (oedema)
- GI distress - increase acid
- Females: Amenorrhea, hirsutism
- Think skin
- Purple Striae
- Bruises and petechiae
Corticosteroids
a) MOA in obstructive airway disease
b) Route
c) Give an example of one
a) Reduce inflammatory mediators, increase anti-inflammatory mediators, reduce eosinophils, macrophages, lymphyoctes
b) Inhaled
c) Beclemethasone, flucatisone
Give 5 examples of combination inhalers
Seretide - Fluticasone propionate & serevent
Symbicort - Budesonide & formoterol
Fostair - Beclomethasone & formoterol
Flutiform - Fluticasone propionate & formoterol
Relvar Ellipta - Fluticasone furoate & vilanterol
Anoro Ellipta - umeclidinium bromide & vilanterol
Leukotriene receptor antagonists
a) MOA
b) Route
c) Side-effects
d) Examples
a) Leukotriene receptor antagonists prevent inflammation by binding to the CysLT1 receptors and blocking cysteinyl leukotrienes from stimulating them (cysteinyl leukotrienes, LTC4, LTD4 and LTE4)
b) Oral
c) Cold and flu like symptoms, fatigue, GI upset, headache, nausea, ear infection
d) Montelukast, Zafirlukast, Pranlukast
Cromones
a) MOA
b) Route
c) Side-effects
d) Who is it used in?
e) Example
a) Mast cell stabiliser - inhibits degranulation of mast cells, subsequently preventing the release of histamine. Has a weak anti-inflammatory effect
b) Inhaled
c) Nasal congestion, sneezing, nasal itching, nosebleeds, rhinoconjunctivitis, and headaches.
d) Children
e) Cromoglicic acid
Provide 3 examples of anti-clonal antibodies used to treat uncontrolled asthma
Omalizumab
Mepolizumab
Benralizumab
Reslizumab
Dupliumab
Omalizumab
a) MOA
b) Indication
c) Route
d) Side-effects
a) Anti-IgE
b) uncontrolled allergic asthma
c) S/c injections 2-4 weeks
d) Local adverse effects, anaphylaxis
Mepolizumab
a) MOA
b) Indication
c) Route
d) Side-effects
a) Blocks -IL5, preventing it from binding to IL-5 receptor on eosinophils
b) Uncontrolled eosinophilic asthma
c) S/c injection
d) Headache, injection site reactions (pain, redness, swelling, itching, or a burning feeling at the injection site), back pain, and tiredness (fatigue).
Xanthines
a) MOA
b) Indication
c) Route
d) Side-effects
e) 2 examples
a) Inhibit phosphodiesterase, which increases cAMP and leads to relaxation of the smooth muscles in bronchial airways (bronchodilator)
b) Severe cases of asthma or COPD
c) Oral or IV
d) Nausea and drug interaction
e) Theophylline, aminophylline
Phosphodiesterase-4 (PDE4) inhibitors
a) MOA
b) Indication
c) Route
d) Side-effects
e) 1 example
a) Inhibits phosphodiesterase-4 which blocks the degradation of cAMP, which leads to a reduction in inflammation
b) Severe COPD
c) Oral
d) Nausea
e) Roflumilast (only PDE4 inhibitor licensed in the UK)
Mucolytics
a) MOA
b) Indication
c) Route
d) Side-effects
e) 2 example
a) Reduce the viscosity of bronchial secretions by breaking disulphide crosslinks between mucin monomers.
b) Chronic bronchitis
c) Oral
d) Dizziness, headache, drowsiness, GI upset, nausea or vomiting (rare)
e) Carbocisteine, Erdosteine, Mecysteine
Name the 3 types of inhalers
- Metered dose inhaler
- Nebuliser
- Dry powder inhaler
