respiratory drugs Flashcards
(31 cards)
Beta-Adrenergic Bronchodilators
Examples of drugs
salbutamol
Beta-Adrenergic Bronchodilators
Mechanism of action
- Short-acting Beta-2 adrenoceptor agonists (SABA)
- Relaxes bronchial smooth muscle, inducing bronchodilation.
- Inhibit pro-inflammatory cytokine release from mast cells and TNF-α release from monocytes, reducing airway inflammation.
- Increase mucus clearance from the airways by stimulating cilia action.
Beta-Adrenergic Bronchodilators
Indication
Asthma
COPD
Beta-Adrenergic Bronchodilators
Side Effects
Tremor
Tachycardia / cardiac dysrhythmia
Headache
Sleep disturbances
Beta-Adrenergic Bronchodilators
Important pharmacokinetics / pharmacodynamics
Only a small percentage of inhaled drug reaches target in the airways – a spacer may improve drug delivery
Beta-Adrenergic Bronchodilators
Patienet Information
- Check inhaler technique, review the need for spacer / nebuliser.
- In exercise-induced-asthma, a dose immediately before exercise can reduce incidence of symptoms.
- If required more than once daily, treatment needs reviewed.
Beta-Adrenergic Bronchodilators
Examples of drugs
Salmetrol
Beta-Adrenergic Bronchodilators
Mechanism of action
- Long-acting Beta-2 adrenoceptor agonist (LABA)
- Relaxes bronchial smooth muscle, inducing bronchodilation.
- Inhibit pro-inflammatory cytokine release from mast cells and TNF-α release from monocytes, reducing airway inflammation.
- Increase mucus clearance from the airways by stimulating cilia action.
Beta-Adrenergic Bronchodilators
Indication(s):
Asthma
COPD
Beta-Adrenergic Bronchodilators
Side effects:
Tremor
Tachycardia / cardiac dysrhythmia
Headache
Sleep disturbances
Beta-Adrenergic Bronchodilators
Important pharmacokinetics / pharmacodynamics:
Not to be commenced in patients with rapidly deteriorating asthma – slower onset of action than SABA’s.
Beta-Adrenergic Bronchodilators
Patient information:
- Report any deterioration in symptoms following initiation of LABA.
- Do not exceed stated dose.
- Seek medical advice when stated dose fails to control symptoms.
Anti-Muscarinic Bronchodilators
Example(s) of drugs:
Tiotropium
Ipratropium Bromide
Anti-Muscarinic Bronchodilators
Mechanism of action:
- Muscarinic receptor (M3) antagonists producing bronchodilatory effects.
- Reduces mucus secretion and may increase bronchial mucus clearance by stimulating cilia.
Anti-Muscarinic Bronchodilators
Indication
Asthma
COPD
Rhinitis
Anti-Muscarinic Bronchodilators
Side effects:
Dry mouth
Cough
Constipation
Anti-Muscarinic Bronchodilators
Important pharmacokinetics / pharmacodynamics:
- Inhaled and poorly absorbed into the circulation – unable to affect systemic muscarinic/cholinergic receptors
- Nebulised Ipratropium Bromide should always be administered via a mouth piece to minimize the risk of acute angle closure glaucoma.
Anti-Muscarinic Bronchodilators
Patient information
Good inhaler technique improves efficacy.
Cough may arise.
Inhaled Corticosteroids
Example(s) of drugs:
Beclomethasone
Note that some inhaled preparations used in COPD and asthma contain both inhaled steroids and long acting bronchodilators (examples are Seretide and Symbicort).
Inhaled Corticosteroids
Mechanism of action:
- Anti-inflammatory effect on the airways.
- Decrease formation of pro-inflammatory cytokines.
- Up-regulates beta-2-adrenoreceptors in airways.
Inhaled Corticosteroids
Indication(s):
- Treatrment of COPD
- Treatment of asthma
Inhaled Corticosteroids
Side Effects
- Oral Candidiasis (thrush)
- Adrenal suppression
- Osteoporosis
Inhaled Corticosteroids
Important pharmacokinetics / pharmacodynamics:
- Takes several weeks to months for full effects of therapy.
- Spacer devices can reduce risk of thrush and improve drug delivery.
Inhaled Corticosteroids
Patient information:
If on higher dose, carry a steroid card.
Increase dose during periods of illness.
