Asthma + COPD Flashcards
(52 cards)
How much medication is needed for effective delivery through inhalation vs swallowing
10-20% inhaled
80-90% swallowed
(inhalation is more effective)
______ is the preferred method of delivery of most medications used in asthma and COPD
inhalation.
medication are needed acutely so it can work quickly
Pressurized metered dose inhalers: drugs are ___ from a canister with aid of propellant. most need to be ____ before use
propelled
shaken
What do space chambers do?
reduce the volume of velocity of particles-> less swallowing and more inhaled.
Why does the inhaler need to be shaken?
Medication is a suspension. if it sits there, it clumps and not effective
Dry Powder inhalers: devices scatter a ____ _____ by air turbulence on inhalation. Need to take __________ inspiurations
fine powder
quick and deep (forceful)
Nebulizers: turn liquid to _____ and is driven by _____. Administration though _____. What population is this good for?
fine mist
stream of gas.
mask
cognitive impairment/altered mentation
Some differences between MDIs and DPIs?
liquid vs fine powder
propellant vs none
shake vs don’t shake
slow inhale vs quick + forceful
Soft mist inhalers (respimat): propels a ____ of medication without help of propellant. Contains ____ per use than MDI/DPI.
cloud
more particules
might be hard to use for cog impaired patients
up to ___ of patients cannot use their inhalers corrects
80%. counseling is crucial
Patients should wait ____ seconds between puffs
60 seconds
Which should be used first if Both are prescribed: bronchodilator + corticosteroid
bronchodilator first.
Combination inhalers combine __________ in one devide
multiple active ingredients. this is more convenient for patients and improves compliants
Short acting inhalers (rescue inhalers) active ingredients include:
short acting β agonists (SABA)- albuterol
short acting muscarinic antagonists (SAMA)- ipratropium
too much use- poorly controlled asthma/COPD
How fast do short acting inhalers work?
1-2 minutes- quickly reverse bronchoconstriction.
Long acting inhalers (maintenance inhalers) are taken _______ to prevent symptoms of asthma and COPD. They open airways and reduce swelling for ___ hours
daily or multiple times per day.
12 hours.
These are the LABAS, LAMAS, ICS
Mechansim of bronchodilators:
constrict airway smooth muscle, reverse symptoms, prevent bronchoconstriction.
What are the medication classes of bronchodilators
β 2 adrenergic agonists anticholinergic agents (muscarinic)
What are SABAs and LABAs that are on the market? (what do they end in)
“terol”
SABA: albuterol, levalbuterol
LABA: formoterol, salmeterol, vilanterol, indacaterol, olodaterol
What is the molecular structure difference between SABAs and LABAs?
large side chains on molecular structure. (more lipid-> retention in lipid layer of cell membrane)
What is the difference between albuterol and levalbuterol
albuterol is a racemic mix. leva is only R-albuterol.
IS leva better? clinical trial say unclear.
What are some side effects of Β2 agonists?
muscle tremor (B2 on skeletal- elderly) Tachycardia + heart palpitations (peripheral ZVD from atrial β2 receptors) hypokalemia (β2 stim K entry into skeletal muscle)
What are SAMA and LAMA that are on the market? (what do they end in)
“ium” (mostly)
SAMA: ipratropium
LAMA: tiotropium, umeclidinium, aclidinium, glycopyrrolate
Muscarinic antagonists have a higher selectivity for ___ receptors. These are in _____ and ____
M3 receptors
airway smooth muscle (Smooth muscle contraction) and submucosal cells (mucus secretion)
