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Pharmacology 3A > Respiratory Medications > Flashcards

Respiratory Medications Flashcards

1
Q

Beta 2 agonists are used for what? (simple definition)

A

To prevent bronchoconstriction

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2
Q

How do beta 2- adrenoreceptor agonists work? (Mechanism of Action)

A

Beta 2-adrenoreceptor agonists stimulate beta 2-adrenergic receptors in the bronchial smooth muscle, leading to bronchodilation.

= the airway passages become wider making it easier to breathe.

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3
Q

What is the difference between short acting beta 2 agonists (SABAs) and long acting beta agonists (LABAs)?

A

Both SABAs and LABAs are bronchodilators. While SABAs are used to occasionally alleviate asthma symptoms quickly, LABAs are taken daily to help with asthma maintenance. Also, LABAs can only be used when combined with inhaled corticosteroids.

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4
Q

What are anticholinergic bronchodilators used to treat?

A

Asthma, bronchitis, and COPD

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5
Q

What are the 2 classes of medications used in the treatment of COPD and Asthma?

A
  1. Bronchodilators
  2. Preventors
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6
Q

What does the sympathetic nervous system do to the lungs and the heart?

A

Lungs - Induces Bronchodilation
Heart - Increases heart rate and contractile force

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7
Q

What does the para-sympathetic nervous system do to the lungs and the heart?

A

Lungs - Induces Bronchoconstriction
Heart - Decreases heart rate and contractile force

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8
Q

What are some examples of Beta 2 agonists?

A

Salbutamol, Terbutaline, and Salmeterol

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9
Q

Beta 1 receptors are located where?

A

In the smooth muscle of the heart

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10
Q

Beta 2 receptors are located where?

A

In the smooth muscle of bronchioles, blood vessels suppling brain - heart - kidneys - and skeletal muscles, uterus, and the liver.

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11
Q

When beta 1 receptors are stimulated what occurs?

A

Increase in heart rate and contractility

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12
Q

When beta 2 receptors are stimulated what occurs?

A

Bronchodilation
Vasodilation leading to increased blood supply and fine muscle tremors
Uterine relaxation
Glucose release

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13
Q

What are two types of SABAs?

A

Salbutamol and Terbutaline

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14
Q

What are three types of LABAs?

A

Salmeterol, Formoterol, and Indacaterol

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15
Q

How long acting are SABAs?

A

4-6 hours

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16
Q

What in the onset of action for SABAs?

A

Rapid onset
5-15mins

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17
Q

How are SABAs used?

A

For an acute asthma attack

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18
Q

How long acting are LABAs?

A

Long duration of action
12hrs

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19
Q

What is the onset of action for LABAs?

A

Slow onset of action

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20
Q

What are LABAs used for?

A

Given regularly to control symptoms over a longer period

21
Q

Common adverse side effects of B2 agonists?

A

Tachycardia
Palpitations
Headaches
Restlessness and anxiety
Tremor
Hypokalaemia and Hyperglycaemia in high doses

22
Q

What are some cautions for use of SABAs?

A

Frequent use can result in
- B1 stimulation = increased heartrate and increase in anxiety

23
Q

What are some cautions for use of LABA?

A
  • Not to be used to treat acute asthma attacks
24
Q

What are Anticholinergics?

A

drugs that block and inhibit the activity of the neurotransmitter acetylcholine (ACh) at both central and peripheral nervous system synapses.

25
Q

What is the mechanism of action of Antimuscarinic (Muscarinic antagonists)?

A

They block the parasympathetic stimulation of the vagus nerve resulting in smooth muscle relaxation and bronchodilation

26
Q

What are short acting muscarinic antagonists (SAMA)?

A

Inhaled bronchodilators that result in a relatively short-term, pharmacologically mediated improvement in lung function

27
Q

What are long acting muscarinic antagonists (LAMA)?

A

Long‐acting muscarinic antagonists (LAMA) are a class of bronchodilators which have been effective for people with chronic obstructive pulmonary disease and asthma

28
Q

What are some common adverse side effects of Anticholinergic bronchodilators?

A

Dry mouth
Metallic taste
Nausea
Constipation
Headache
Tachycardia
Glaucoma

29
Q

Why are preventors (inhaled corticosteroids) used?

A

Management of symptoms of COPD and asthma

30
Q

What is the Mechanism of Action of corticosteroids?

A

Corticosteroids bind to specific receptors, known as glucocorticoid receptors (a stress hormone), within cells throughout the body. Once inside the cell, corticosteroids can modulate gene expression and influence various metabolic and immune processes. Overall leading to anti-inflammatory and immunosuppressive effects.

31
Q

What are some types of inhaled corticosteroids we may see?

A

Fluticasone, Beclomethasone, and Budesonide

32
Q

What are some considerations for the use of inhaled corticosteroids?

A

Must be taken continuously and not stopped without consultation with prescriber

Should be taken via inhalation with a spaced to reduce systemic adverse effects

33
Q

True or False? Inhaled corticosteroids may reduce the rate of exacerbations in severe COPD

A

True - but are not usually prescribed for mild or moderate COPD

34
Q

What are some adverse side effects of inhaled corticosteroids?

A

Dysphonia (disorders of the voice)
Oropharyngeal candidiasis (oral thrush)

35
Q

What patient education should be given for inhaled bronchodilator and corticosteroid medications?

A

Patient education for bronchodilator and corticosteroid medications involves ensuring proper administration and addressing potential concerns. For bronchodilators, instruct patients on correct inhaler technique, including hand-breath coordination, proper inhalation, and device maintenance. Stress the importance of using bronchodilators as prescribed, keeping track of symptoms and medication use. Discuss recognising and managing side effects, such as rapid heartbeat or tremors. With corticosteroids, explain their purpose in reducing airway inflammation, and provide instructions for specific forms (e.g., inhalers, oral tablets). Emphasise adherence to prescribed dosage and schedule, and discuss strategies to prevent oral thrush, such as rinsing the mouth after inhaler use and proper teeth brushing.

36
Q

What are the adverse side effects of systemic steroids?

A

Altered deposition of fat and hair (moon face)
Hyperglycaemia
Muscle wasting and weakness
Osteoporosis
Increased susceptibility to infection, delayed wound healing
Peptic ulceration
Ocular changes
Psychosis
Adrenal Suppression
+more

37
Q

What is Acetylcholine and what does it cause in the airways?

A

Acetylcholine is a neurotransmitter which has a main role in the respiratory system to regulate the constriction of the bronchial smooth muscles and the secretion of mucus.

38
Q

Leukotrienes in the airways cause what?

A

Bronchoconstriction and increased mucus secretion

39
Q

Histamine in the airways stimulates what?

A

Larger bronchi, causing smooth muscle spasms, inflammation and oedema

40
Q

Allergens in the airways cause what?

A

Stimulation of mast cells in lungs to release histamines and leukotrienes

41
Q

Why are beta 2 agonists ideally administrated via the inhaled route?

A

As we are inhaling the medication straight to the site of action. We are skipping the absorption process in the body, thus it is a faster method of medication administration.

42
Q

What are some major points to include in a patient education plan for someone prescribed with respiratory medications?

A

Inhaler technique
Use of a spacer (technique and care)
Action plans for managing symptoms
ADR’s - for both inhalers and oral medications

43
Q

What is the MOA for penicillins?

A

Penicillins exert their antimicrobial action by inhibiting bacterial cell wall synthesis through binding and inactivating the enzyme transpeptidase (also known as penicillin-binding proteins or PBPs), leading to bacterial cell death.

44
Q

What is the rationale for antibiotic prescription?

A
45
Q

What patient education is required for giving an antimicrobial?

A
46
Q

What is the difference between Long Acting Beta 2 agonist and Short acting Beta 2 agonist?

A
47
Q

Where are the cholinergic receptors located and what effect does stimulation and inhibition of these receptors have on the body?

A
48
Q

How should inhalers be used?

A
49
Q

Nebulisers are not used nearly as much as they once were, why is this?

A

Pharmacology 3A (18 decks)

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