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Pharmacology /Pharm Y2S2 - Respiratory Part 2

Pharm Y2S2 - Respiratory Part 2

Pharmacology30 CardsCreated about 2 months ago

This flashcard deck covers key concepts and treatments related to respiratory pharmacology, specifically focusing on asthma treatment pathways, medication mechanisms of action, and side effects.

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What is the treatment for major pneumothorax?

Surgery to repair puncture | Removal of lung
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Key Terms

Term
Definition
What is the treatment for major pneumothorax?
Surgery to repair puncture | Removal of lung
Describe stage 1 of the asthma treatment pathway.
Occasional use of short acting beta agonist when required
Describe stage 2 of the asthma treatment pathway.
Use of SABA when required | Addition of low dose inhaled corticosteroid as preventer
Describe stage 3 of the asthma treatment pathway.
Use of SABA when required Low dose inhaled corticosteroid as preventer Addition of long acting beta agonist
Describe add ons at stage 4 of asthma treatment pathway.
Medium ICS dose Continuation of LABA if benefit seen Trial one of: - leukotriene antagonist - Theophylline - LAMA
What are the add ons at stage 5 of the asthma treatment pathway?
High dose ICS Addition of fourth drug: -leukotriene antagonist - theophylline - beta agonist tablet
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Pharm Y2S2 - Respiratory Part 2
TermDefinition
What is the treatment for major pneumothorax?
Surgery to repair puncture | Removal of lung
Describe stage 1 of the asthma treatment pathway.
Occasional use of short acting beta agonist when required
Describe stage 2 of the asthma treatment pathway.
Use of SABA when required | Addition of low dose inhaled corticosteroid as preventer
Describe stage 3 of the asthma treatment pathway.
Use of SABA when required Low dose inhaled corticosteroid as preventer Addition of long acting beta agonist
Describe add ons at stage 4 of asthma treatment pathway.
Medium ICS dose Continuation of LABA if benefit seen Trial one of: - leukotriene antagonist - Theophylline - LAMA
What are the add ons at stage 5 of the asthma treatment pathway?
High dose ICS Addition of fourth drug: -leukotriene antagonist - theophylline - beta agonist tablet
What is added at stage 6 of the asthma treatment pathway?
Continued use of oral steroids at lowest effective dose alongside high dose ICS
What are the symptoms of an acute asthma exacerbation?
Cyanosis Drowsiness/unconsciousness Tachycardia Severe dyspnoea PEF <50% Respiratory rate >25 Oxygen sats <92%
What is the treatment for an acute asthma exacerbation in hospital?
Ipratropium nebulisers 500mcg every 4-6 hours Single dose IV magnesium sulphate IV aminophylline/salbuatmol Oxygen 40-60%
What is the standard dose of oral steroids in acute asthma?
40-50mg daily for 5 days
What is the MOA of beta-2 adrenoceptor agonists?
Mimic adrenaline to increase cAMP levels causing relaxation of smooth muscle
Give examples of short acting beta agonists and their onset/duration of action.
Salbutamol, terbutaline Onset of 1-5 minutes Duration of 4-6 hours
Give examples of long acting beta agonists and their onset/duration of action.
Formeterol Onset 1-3 minutes Salmeterol Onset 10-20 minutes Duration of 12 hours
Give side effects of beta-agonists.
Fine tremor Headache Tachycardia
What is the MOA of corticosteroids?
Bind glucocorticoid receptors to dissociate heat shock proteins and allow receptors to travel to the nucleus where they bind to DNA blocking genes that code for cytokines for inflammation.
Give examples of inhaled corticosteroids.
Beclomethasone | Budesonide
Give examples of oral corticosteroids.
Prednisolone
Give examples of IV corticosteroids.
Hydrocortisone
What are the criteria for corticosteroid indication.
Exacerbation in the last 2 years Using SABA at least twice weekly Waking with symptoms once per week
What are the side effects of corticosteroids?
Oral candidiasis Hoarseness Adrenal suppression Skin thinning Cushing's
What is the MOA of leukotriene antagonists?
Antagonise broncho-constriction, reducing mucus secretion and airway oedema
Give examples of leukotriene antagonists.
Montelukast | Zafirlukast
What are the side effects of leukotriene antagonists?
Abdominal pain Thirst Headache
What are methylxanthines?
PDE inhibitors that prevent the breakdown of cAMP, preventing broncho-constriction
Give examples of methylxanthines.
Theophylline | Aminophylline
Why are leukotriene antagonists not 1st choice drugs in asthma? Give two reasons
Not as effective as beta-agonists | Side effect of thirst can increase risk of bedwetting in children
Why are methylxanthines not 1st choice drugs in asthma?
Narrow therapeutic window of 10-20mg/L
What are the side effects of methylxanthines with a dose over 20mg/L?
Insomnia Arrhythmia Hyperglycaemia Convulsions
What are PDE4 inhibitors?
Reduce production of matrix metallaproteinase, enhancing effects of beta-2 agonists
Give an example of a PDE4 inhibitor.
Roflumilast