Quiz
L15 Clinical Pharmacology of Asthma
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1Ventilation occurs by contraction and relaxation of respiratory muscles, and the elastic [blank_start]recoil[blank_end] of connective tissue in lungs. Any disease that [blank_start]inhibits[blank_end] elastic recoil can cause ventilation issues.
Obstructive diseases affect inspiratory rate (e.g. [blank_start]asthma, COPD[blank_end]), whereas restrictive diseases affect inspiratory capacity (e.g. [blank_start]pulmonary fibrosis[blank_end]).- Arecoil
- Binhibits
- Casthma, COPD
- Dpulmonary fibrosis
2Selectivity is defined as a 10 fold (2 log order) difference in affinity between receptor subtypes.
- ARichtig
- BFalsch
3Choosing a selective drug helps to reduce on-target [blank_start]side effects[blank_end]. E.g. a Beta-2 agonist will have less effect on the heart than a [blank_start]non-selective[blank_end] Beta agonist.
If excessive doses are used then selectivity will be [blank_start]overcome[blank_end] and the drug will act on other receptor subtypes. E.g. the usual inhaled dose of [blank_start]salbutamol[blank_end] for acute asthma is 100 mcg, the dose used for severe asthma is 5 mg, 50 times more, and [blank_start]tachycardia[blank_end] is expected.- Aside effects
- Bnon-selective
- Covercome
- Dtachycardia
- Esalbutamol
4Long acting beta agonists have a long half life because of their long duration of activity.
- ARichtig
- BFalsch
5Because the off-rate of binding is slow, long acting M-antagonists will be more potent (the dose will be lower than for short acting).
- ARichtig
- BFalsch
6Drugs for bronchodilation:
- Short acting beta agonists — [blank_start]salbutamol, terbutaline[blank_end]
- Long acting beta agonists — [blank_start]salmeterol, formoterol, vilanterol[blank_end]
- Short acting muscarinic antagonists — [blank_start]ipratropium[blank_end]
- Long acting muscarinic antagonists — [blank_start]glycopyrronium, tiotropium, umeclidinium[blank_end]- Asalbutamol, terbutaline
- Bsalmeterol, formoterol, vilanterol
- Cipratropium
- Dglycopyrronium, tiotropium, umeclidinium
7Side effects of bronchodilators for low dose beta agonists are an increased [blank_start]heart[blank_end] rate. Effects of high doses can include an increased heart rate, tremor, nervousness, peripheral [blank_start]vasodilation[blank_end], sleep [blank_start]disturbances[blank_end], and decreased plasma [blank_start]potassium[blank_end].
Side effects of muscarinic antagonists are an increased heart rate and a [blank_start]dry[blank_end] mouth.- Aheart
- Bvasodilation
- Cdisturbances
- Dpotassium
- Edry
8Corticosteroid (anti-inflammatory) side effects:
— Inhaled low dose < [blank_start]500[blank_end] mcg/day (budesonide equivalents) - [blank_start]oral candidiasis[blank_end]
— Inhaled high dose < [blank_start]1200[blank_end] mcg/day (budesonide equivalents) - oral candidiasis, growth [blank_start]delays[blank_end] (not certain, and minor, reversible), occasional HPA axis [blank_start]suppression[blank_end]
— Prednisone 5 mg/day, long term (>2 weeks) - [blank_start]oedema, dyspepsia, cushingoid[blank_end] symptoms.- A500
- Boral candidiasis
- C1200
- Ddelays
- Esuppression
- Foedema, dyspepsia, cushingoid
9Lung delivery from MDI:
≈ [blank_start]20%[blank_end] gets to the active locations in the lungs (bronchioles)
≈ [blank_start]50%[blank_end] deposits onto the oropharynx and can then reach the stomach and is absorbed
≈ [blank_start]30%[blank_end] either deposits to other areas or is exhaled- A20%
- B50%
- C30%
10Systemic availability from lung delivery is clinically irrelevant.
- ARichtig
- BFalsch
Informationen
- Beschreibung
- Der Nutzer hat seine Fachbereichs-Information gelöscht. Quiz am L15 Clinical Pharmacology of Asthma, erstellt von Gelöschter Nutzer am 14/04/2019.
- Autor
- Gelöschter Nutzer
- Sprache
- English
- Aufrufe
- 71
- Verlauf
- Erstellt am 14 Apr 2019 · aktualisiert am 26 Mai 2019
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