Drugs and asthma notes PDF

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13.DRUGS AND ASTHMA1. DRUGS AND THE LUNGSi. Gaseous anaesthetics ii. Oxygen iii. Respiratory stimulants iv. Muscle relaxant v. Bronchodilators vi. Antitussives vii. Nasal decongestants viii. Mucolytics ix. Cystic fibrosis2. BRITISH NATIONAL FORMULARYSection 3 respiratory system 3 bronchodilators (as...

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13.12.18

DRUGS AND ASTHMA 1. D R U G S A N D T H E L U N G S i.

Gaseous anaesthetics

ii.

Oxygen

iii.

Respiratory stimulants

iv.

Muscle relaxant

v.

Bronchodilators

vi.

Antitussives

vii.

Nasal decongestants

viii.

Mucolytics

ix.

Cystic fibrosis

2. B R I T I S H N A T I O N A L F O R M U L A 2

R Y Section 3 respiratory system 3.1 bronchodilators (asthma) A. Step 1 i. B.

Step 2 i.

C.

Inhaled steroids Step 3

i. D.

Inhaled long-acting b2-adrenoceptor agonists Step 4

i.

Leukotriene receptor antagonists

ii.

Methylxanthines

iii.

Oral long-acting B2-adrenoceptor agonists

E.

Step 5 i.

3

Inhaled short-acting B2-adrenoceptor agonists

Oral steroids

4

3. A S T H M A

4. I N H A L E R S , S P A C E R S 5

A N D N E B U L I S E R S

6

5. S H O R T A C T I N G B 2 A D R E N O C E P T O R A G 7

O N I S T S ( S A B A )

6. S A B A – M E T E R E D 8

D O S E A E R O S O L A. Dilates bronchioles – immediate relief B. Maximum effect 30 min, duration 3 -5 hours C. Propellant (99%) – hydro fluoroalkanes not CFC (boiling point up to 30C) D. In addition, may: i.

Inhibit mediator release from mast cell

ii.

Inhibit TNF-a release from monocytes

iii.

Increases mucous clearance

7. B R E A T H A C T I V A T 9

E D I N H A L E R S

8. S A B A – A D V E R S E E 10

F F E C T S

9. S T E R O I D S

11

10. INH A L E D C O R T I C O S T E R O I D S

11. INH A L E D S T E R O I D S Problems A. Slow onset (3 – 7 days) i. B.

Oral candidiasis i.

C.

Spacer less likely to give oral deposition Adrenal suppression

i.

13

Not bronchodilator, no acute relief

Fluticasone has poor absorption from G/I tract and extensive first pass metabolism

12. LO N G A C T I N G B 2 A D R E N O C E P T O R A G O N I 14

S T S ( L A B A )

15

13. LEU K O T R I E N E S

14. LEU K O T R I E N E

16

R E C E P T O R A N T A G O N I S T S

15. TH E O P H 17

Y L L I N E

18

16. ADV E R S E E F F E C T S : F L U C O C O R T I C 19

O I D S

17. AD R E N A L S U P P R E S S I

20

O N

21...