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Pharmacology > Block 3 respiratory slides+ SG > Flashcards

Block 3 respiratory slides+ SG Flashcards

1
Q

Respiratory disease includes:

A 
Asthma
COPD 
Lung cancer
Obstructive sleep apnoea
Bronchiectasis
Childhood bronchiolitis
Childhood pneumonia
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2
Q

Asthma in New Zealand

A
  • 1 in 9 adults and 1 in 7 children

- Māori are 3.4 times and Pacific peoples 3.9 times more likely to be hospitalised

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3
Q

COPD in New Zealand

A

-4th leading cause of death in NZ
-3.7 times higher for Māori and 2.8 times higher for
Pacific people

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4
Q

What is Asthma?

A

a chronic lung condition. a condition in which the airways are more sensitive than normal and tend to narrow in response to certain triggers

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5
Q

the narrowing of airways is due to?

A

swelling of the lining of the airway
• increased mucous in the airway
• ‘Bronchospasm’

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6
Q

what is bronchospasm?

A

contraction of the muscle layer surrounding the airway

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7
Q

COPD refers to?

A

chronic bronchitis and emphysema. co-existing diseases of the lungs result in narrowing of the airways and potential loss of viable lung tissue

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8
Q

what happens when you have COPD?

A

limitation of the flow of air to and from the lungs and

poor gaseous exchange.progressive lung disease.

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9
Q

Pharmacological therapy 2 main groups

A

Bronchodilators and Anti-inflammatory agents

-aims to improve air flow in and out of lungs, improve gaseous exchange in alveoli, provide o2 & removal of co2

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10
Q

Routes of administration

A

Inhaled (aerosols, nebules), oral (liquid, tablets), IV (injections)

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11
Q

what does bronchodilators do?

A

relieve the constriction of the bronchi allowing air into the lungs for gaseous exchange

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12
Q

when do you use bronchodilators?

A

used in acute situations
when rapid response is required (short acting) and as long-term symptom
controllers/maintenance treatment (long-acting)

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13
Q

what are the types of bronchodilators used?

A

B-adrenergic agonists, antimuscarinics, and

methylxanthines.

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14
Q

what is B2-adrenergic agonists?

A

selectively bind to B2-adrenergic receptors and

stimulate a sympathetic nervous system response leading to bronchodilation.

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15
Q

SABA (Short-acting beta-2 agonist) available in inh,nebs,inj

A

fast acting bronchodilators and are known as relievers. These are used for quick relief of bronchospasm.

  • salbutamol
  • terbutaline
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16
Q

LABA (Long-acting beta-2 agonist)available in inh,nebs,inj

A

have t½ of 6-12 hours and are administered once or twice daily. They are known as symptom controllers / maintenance
treatment and are to be used in conjunction with inhaled corticosteroids
for asthma
-salmeterol
-formeterol

17
Q

how to use inhalers

A

pressing down on inhaler, breathing in deeply as soon as medication is released,
holding your breath, exhaling

18
Q

Advantages of Using Spacer

A 
Avoids timing issue
• More drug gets into lungs
• Less drug needed for effective dose
• Fewer adverse effects
• Easier to deliver medication
19
Q

Antimuscarinics- Onset of action slower than b-agonists

A

drugs block the muscarinic
receptors involved in the parasympathetic stimulation of the
bronchioles

20
Q

Antimuscarinics drugs

A

Short Acting: ipratropium (Atrovent)

• Long Acting: tiotropium (Spiriva); glycopyrronium (Seebri)

21
Q

Therapeutic Action:

A

bronchodilation and decreased mucous secretion

22
Q

Adverse effects

A

dry mouth/throat irritation, blurred vision, tachycardia, urinary retention, constipation

23
Q

Methylxanthines drugs & MOA

-caffeine

A
  • theophylline (Nuelin) (oral) and aminophylline (injection)

- a complex mechanism by inhibiting the enzyme that degrades cAMP (second messenger system)

24
Q

Adverse effects

A

insomnia, anxiety, tremors,

tachycardia, epigastric pain, nausea (due to lack of specificity, the drugs ↑ cAMP levels in other cells)

25
Q

Anti-Inflammatory Drugs

A

reduce the inflammatory response, stabilise mast
cells, reduce release of inflammatory mediators (such as histamine,
leukotrienes) and reduce localized oedema and mucous production
-Steroids (systemic or topical)
-Mast cell stabilisers
-Leukotriene receptor antagonists

26
Q

how long does it take for Anti-inflammatory Agents to work?

A

take time to work and so are used as a preventative measure and will not give a rapid response in an acute situation.

27
Q

Steroidal Anti-inflammatory MOA & drugs

A

inhibits the rupture of mast cells, decreases the inflammatory mediators, suppresses antibody production and immune cells -Inhaled corticosteroids: fluticasone (Flixotide);
budesonide (Pulmicort); beclometasone
-Systemic corticosteroids: prednisone (tablet);
prednisolone (oral liquid); methylprednisolone (IV)

28
Q

Long term systemic administration has been associated with significant
adverse effects

A

-fluid& electrolyte imbalance,- nitrogen& calcium balance, immunosuppressive
therefore, there has been a reduction in systemic use in treating asthma.

29
Q

Inhaled corticosteroids

A

can be used alone or in conjunction with a bronchodilator as this facilitates lung penetration of the inhaled steroid.

30
Q

Systemic steroids

A

achieve better control during episodes of exacerbation or infection, but in order to avoid problems with adverse effects, they are prescribed in short courses.
-oral

31
Q

Corticosteroids + Bronchodilators Combined Formulations

A

Seretide -fluticasone and salmeterol

Symbicort- budesonide & eformoterol “SMART” therapy for maintenance &reliever.

32
Q

Mast-cell stabilisers

eg: Sodium cromoglicate
- not for acute attack

A

inhaled and used as an add-on treatment to prevent release of inflammatory mediators from sensitized mast cells.

33
Q

Adverse effects

A

minimal throat
irritation, nausea and unpleasant taste
being most common

34
Q

Mast-cell stabilisers used for?

A

used prophylactically and

reduce the incidence of acute asthma attacks

35
Q

Leukotriene Receptor Antagonists

-montelukast (Singulair)

A

mediate inflammatory reactions, thus this
class of drug acts by blocking the action of these
inflammation mediators and alleviating the symptoms

36
Q

Adverse effect

A

headache, GI upset, thirst

Pharmacology (7 decks)

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