3c- SAMAs

Question 1

Explain how ACh contributes to constriction of smooth muscle

Answer 1

ACh –> M3 Receptor –>↑DAG + IP3 –> ↑Ca2+ –> Constriction of smooth muscle

Question 2

What are characteristics of SAMAs?

Answer 2

• 4-6hrs
• Slower onset of action
• Longer time to reach peak effects

Question 3

What is a SAMA Drug? What forms does it come in? What is its ionization?

Answer 3

• Atrovent (Ipratropium Bromide)
• MDI or NEB
• Fully ionized drug

Question 4

Atrovent (Ipratropium Bromide)

What are its times?

Answer 4

• Onset –> 15min or more
• Peak –> 1-2hrs
• Duration –> 4-6hrs

Question 5

Atrovent (Ipratropium Bromide)

What are its dosages?

Answer 5

• 20µg per puff (MDI)
• 0.25-0.50mg (NEB)

Question 6

Atrovent (Ipratropium Bromide)

What are its potential side effects?

(MC) –> More common
(LC) –> Less common

Answer 6

• Dry mouth (MC)
• Irritability/drowziness/dizzyness
• Tachycardia(LC)/Palpatations
• Cough (MC)
• Eye pain/Blurred Vision (LC)
• Constipation(LC)

Question 7

Atrovent (Ipratropium Bromide)

What are 2 things that this drug does NOT do?

Answer 7

1. Decrease mucus production
2. Dry out airways

Question 8

Atrovent (Ipratropium Bromide)

What does this drug do if it goes in the eyes?

Answer 8

1. Vasoconstriction occurs
2. Fluid builds up + ↑Pressure

Solution = NEBULE DELIVERY

Question 9

Where is atrovent used most? Why?(3)

Answer 9

• Most used inside acute care situations
  1. Slower onset vs SABAs
  2. Slower peak effects
  3. same time frame as SABAs

Question 10

Combivent

What is Combivent composed of?

Answer 10

Atrovent + Salbutamol

Question 11

Combivent (Atrovent + Salbutamol)

What receptors does it target?

Answer 11

B2 + M3 Receptors
- B2 –> Salbutamol (bronchodilation)
- M3 –> Atrovent (bronchoconstriction)

Question 12

Combivent (Atrovent + Salbutamol)

What is it used to treat?

Answer 12

1. Acute asthma exacerbations
2. COPD