Respiratory pharmacology Flashcards
What drugs are bronchodilators
Adrenergic agonists (SABA, LABA) salbutamol, salmeterol, formeterol Muscarinic Antagonists (SAMA, LAMA) ipratropium, tiotropium Methylxanthines - aminophylline, theophylline
Anti inflammatory drugs
Steroids: oral (prednisolone), ICS (beclamethasone)
Leukotriene receptor antagonists: montelukast
Action of adrenergic agonists
Bind to beta 2 receptors, activate adenylyl cyclase, cAMP, relaxation of bronchial smooth muscles
Salbutamol
Effects begin immediately
3-5 hr duration
Inhaled/nebuliser
Used for asthma, COPD
Salmeterol/formeterol
Begins 2-30 mins
10-12 hr duration
Inhaled
Used for asthma, COPD
Muscarinic antagonists/anticholinergics
Inhibition of M3 receptors at smooth muscle - bronchodilation
Ipratropium
Onset 30 mins
Duration 6 hours
Nebuliser
Used for COPD/asthma
Tiotropium
Lasts 24 hours
used once a day
Inhaled
Used in stable COPD and non-improving asthma
Inhaled drug devices
Combination inhalers (LAMA/LABA, ICS/LABA, ICS/LABA/LAMA) Dry powder inhalers (one inhalation) Pressurised metered dose inhalers (carbon footprint)
Glucocorticoids effects
Decrease release of inflammatory mediator
Decreased infiltration and action of wbcs
Decreased airway oedema and mucous pooling
Increased sensitivity of beta 2 receptors
Systemic glucocorticoids
Prednisolone
IV/oral
Has side effects
Action unaffected by inhaler technique
Inhaled glucocorticoids
Localised action
Fewer side effects
Disease may prevent penetration of drug to affected area
Theophylline
Phosphodiesterase inhibitor
Oral for persistent symptom; IV for emergencies
Used for COPD/asthma
5 hour half life, requires monitoring