Lecture 28 - Respiratory Drugs Flashcards Preview

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Flashcards in Lecture 28 - Respiratory Drugs Deck (59)
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1

What are the changes seen in an asthmatics airway?

Epithelial damage
Mucus secretion
Mucosal inflammation + edema
Smooth muscle contraction

2

What is happening at the cellular level with allergies and the airway wall?

Allergen stimulates = Mast cell + DC
Mast cell = Stim. Neu + EOS
EOS = DC's
DCs --> Th2 --> EOS

3

What molecule causes bronchodilation?

increase in cAMP

4

What two things affect the levels of cAMP?

AC + PDE

5

What occurs at the level of AC in regards to bronchial activity?

Beta agonists stimulate = Increase in AC = Increase cAMP

6

What occurs at the level of the PDE in regards to bronchial activity?

Theophylline inhibits = Increase cAMP
Also inhibits adenosine from causing constriction

7

What are B2 agonists really good at?

Bronchodialators

8

What is the mechanism in which B2 agonists are able to cause bronchodilation?

Increase cAMP = relax smooth muscle
Inhibit histamine release from mast cells

9

What are the respiratory drug families?

Beta-2 agonists
Muscarinic antagonists
Phosphodieseterase Inhibitors
Corticosteroids
Leukotriene inhibitors
Janus Kinase Inibitors
Respiratory Stimulant
Antihistamine

10

Drugs within family: Beta-2 agonists

Albuterol
Levalbuterol
Clenbuterol
Terbutaline
Salmeterol

11

Drugs within family: Muscarinic Antagonists

Ipratopium
Tiotropium

12

Drugs within family: Phosphodiesterase inhibitors

Theophylline
Aminophylline

13

Drugs within family: Corticosteroids

Fluticasone
Budenoside
Prednisilone

14

Drugs within family: Leukotrine inhibitors

Zafirlukast
Montelukast

15

Drugs within family: JAK inhibitors

Oclacitinib

16

Drugs within family: Respiratory stimulants

Doxapram

17

Drugs within family: 1st gen. antihistamines

Diphenhydramine
Chlorpheniramine
Clemastine
Promethazine

18

Drugs within family: 2nd gen, antihistamines

Loratadine
Desloratadine
Fesofenadine
Cetirizine

19

What are the general characteristics of B2-agonists?

~4 to 6 hours of effect
Immediate action
Stops attacks

20

Which B2 agonist is NOT inhaled but rather oral?

Terbutoline

21

What is Salmeterol used for generally ?

Longer duration
Good for chronic use

22

What is Salmeterol NOT used for?

To stop attacks, doesn't work for this

23

What is an adverse affect of Salmeterol?

Down-regulation of beta receptors

24

What can be given with Salmeterol to stop the down regulation of beta-receptors?

Corticosteroids

25

What B2 agonists is thought to have the least amount of side effects?

Levoalbuterol

26

What type (adminstration wise) of B2 agonist gives the most side effects?

Oral

27

What are side effects of Beta-2 agonist use?

Tachycardia
Skeletal muscle tremors

28

Why are the side effects so few and far between with the muscarinic antagonists used in the respiratory system?

Inhaled - very large compounds so they don't get into the body

29

What are the muscarinic antagonists used for most commonly?

RAO in horses

30

How would Beta-2 agonists and corticosteroids be used together clinically?

Betas would be for rescue therapy
Given before inhaled corticosteroids to help increase the distribution when taken