Flashcards
Week 2 Respiratory pharmacology
Cards in this deck (27)
- 1Asthma definitionChronic inflammatory disorder of the airways
Reversible airflow obstruction
inflammation causes increase in bronchial hyper responsiveness - 2Onset of asthmaEarly onset- childhood
late onset- adulthood - 32 phases of asthma attackEarly- bronchospasm, treated with bronchodilators (B2 adrenoreceptor agonists)
Late- Inflammation, treated with anti-inflammatory agents (glucocorticosteroids, cromoglicate - 4Risk factors for asthmaenvironments, dust, allergens, genetics
- 5Respiratory efferent pathwayssmooth muscle of respiratory tract innervated by parasympathetic nerves
mediate bronchoconstriction and mucus binding (binding to ACH and muscarinic M3 receptors in SM
Is NOT innervated by sympathetic nerve - 6Bronchodilatorsused in early phase
B2 adrenoreceptor agonists
anticholinergic drugs (muscarinic receptor antagonists) - 7Anti-inflammatory agentsdirected in early and late phase
glucocorticosteriods
cromoglicate - 8B2 receptor agonistsbronchodilator
smooth muscle relaxation-inhaled aerosol
short acting drugs-salbutamol
long acting drugs-salmeterol
G-protein coupled receptor on smooth muscle of bronchioles, causes bronchodilation
cAMP activation
side-effects:
tremor, tachycardia, nervousness, insomnia - 9Anticholinergic drugs (muscarinic receptor antagonists/antimuscarinic agents)bronchodilator(early phase)
competitively inhibit Ach affect on muscarinic receptor
SM relaxation- inhaled aerosol
Ipatropium
side effects:
minimal due to low systemic absorption, urinary retention, pupil dilatation, glaucoma - 10Anti-inflammatory agentsdirected against both early and late phase
glucocorticoids
cromoglicate - 11GlucocorticoidsNOT bronchodilators
NOT effective against early phase
e.g. beclomethasone
action: prevent immune cell activation, inhibit activation of chemotaxins by leucocytes
reduce cytokines, produce anti-inflammatory effect
side effects:
oral candidiasis (need antifungal)
adrenal suppression - 12cromoglicateNOT bronchodilator
action: inhaled aerosol, poor absorption
inhibit release of histamine, depresses bronchial SM hyper reactivity
side effects: few, safe drug for asthma, irritation of upper resp tract - 13Xanthine derivatives:theophylline
aminophylline
xanthine alkaloids-coffee, tea, cocoa
SM relaxation, cAMP increase, inhibit breakdown of mast cells
Side effects:
narrow therapeutic range, insomnia, headache, GI disturbance, tachcardia - 14Leukotriene receptor antagoniste.g. accolate, montelukast
mechanism: antagonism of LTD4 receptor
bronchoconstriction, mucus secretion increase
side effects: few, headache, GI disturbance - 15New Drugs (Omalizumab)NOT effecttive against early phase
targets IgE antibodies with mast cellls
SC injection
side effects:
reduce immune response, anaphylactic reaction, increase in malignancies - 16New drugs (5-lipoxygenase inhibitors)NOT effective against early phase
inhibit enzyme 5-lipoxygenase, responsible for formation of leukotriens from arachidoic acid
side effects: headache, GI disturbance - 17Stepwise approach to asthma managementOnce sustained control is achieved, a step down reduction therapy is considered
long term aim is to promote minimum therapy-maintain controal - 18COPDchronic bronchitis and emphysema
not fully reversible airflow obstruction, progressive decline in lung function
breathlessness, cough, airway inflammation, symptoms overlap, difficult to diagnose, ongoing decline in FEV1 - 19COPD-treatmentbronchial SM relaxation
with short and long b2 adrenoreceptor agonists, anticholinergics, monitor FEV1
short b2=salbutamol
long b2=salmeterol - 20COPD- treatment (anti-inflammatory)less effective due to adverse effects
but effectively control inflammation
used to prevent lung function deterioration
oral glucocorticosteriods- short term
inhaled glucocorticosteriods- advanced stages of COPD
adverse effects: infections, osteoporosis, psychological disturbances - 21Inhaler medication advantagesdrug delivery to site of action
immediate effect for bronchodilators
small doses required to be effective with few side effects - 22Types of inhalersMDI- delivery of specific amount in aerosol form
Breath Actuated MDI- less propellant than MDI
DPI- breath actuated no propellants
nebulisr- converts liquid medication to fine mist for inhalation - 23inhaler assessment and educationmust be explained and demonstrated
select most suitable device
match device with capability
regular review of technique - 24Asthma allergic/extrinsictriggered by allergen, release of histamin and leukotrienes, causes SM spasm, mucous, bronchoconstriction, inflammmation
- 25Asthma non-allergic/intrinsic-altered autonomic nervous system function, release of histamine and leukotrienes, bronchoconstriction, mucous
- 26Histamine in asthmacause sm spasms, inflammation, oedema, stimulate larger bronchi
- 27Ach in asthmaincrease vagal tone, cause bronchoconstriction, increase mucous secretions
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- Nursing Flashcards on Week 2 Respiratory pharmacology, created by Elizabeth Then on 09/09/2017.
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- Elizabeth Then
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