Why must B2 selective agonist be inhaled for bronchodilation?
Because there are B2 receptors in the heart also which can cause arrhythmia
What occurs if you give a patient a beta 1 agonist when they are hypoxic?
It causes lethal arrhythmias
What are long acting beta 2 selective agents (inhaler)?
Salmeterol
Formoterol (Ford motor oil)
What can excess amounts of a beta 2 agonist inhaler cause?
Tachycardia and cardiac arrhythmia
What occurs with anti-cholinesterase overdose?
Mucous build-up mimicking asthma
What is the methacholine challenge test?
Testing of FEV1 for asthma
What is methacholine?
Acetylcholine derivative that is less susceptible to cholinesterase
How is the methacholine test carried out and interpreted?
Increasing amounts of methacholine administered; if FEV1 falls by 20% with the max dose of methacholine administered
What is ipratropium?
A short-acting anticholinergic (inhaled)
What is tiotropium?
Long acting anticholinergic (inhaled)
What does inhaling anticholinergics cause?
Inhibiting of parasympathetic nervous systems action on the lungs
What are the most effective long-term therapy for chronic asthma?
Glucocorticoids
Why are glucocorticoids only prophylactic?
Because they are slow and take hours to bronchodilate
How are glucocorticoids administered?
Nasal inhalation (oral are dangerous)
What happens if glucocorticoids are inhaled without a spacer?
The majority goes to mouth and GI causing fungal stomatitis (thrush); decrease bodies ability to fight fungus
When glucocorticoids are prescribed orally what is the stipulation?
They are given in decreasing doses to decrease the side effects
What are inhaled glucocorticoids?
Budesonide
Fluticasone
Where is serotonin found outside the brain?
In the GI tract a part of the enteric nervous system
What are SSRIs?
Selective Serotonin Re-uptake Inhibitors
What do SSRIs do?
Inhibit re-uptake from neurons
What does reserpine do?
Inhibits VMAT from releasing serotonin
What is cyproheptadine?
Non-selective H1 and 5-HT2 (serotonin) blocker
