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19 Cards in this Set
- Front
- Back
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What are the 4 classes of drug used to treat asthma? |
B2 agonists - salbutamol*, salmeterol* Corticosteroids - beclometasone* Leukotriene receptor antagonists - montelukast* Xanthines - theophylline* |
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B2 agonists - Mechanism of action, adverse effects |
Act on B2 adrenergic receptors = increased cAMP formation and decreased intracellular Ca = smooth muscle relaxation and dilatation
Fine tremor, anxiety, headache, muscle cramps, palpitations, hypokalaemia |
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What are the 2 types of B2 agonist, and what are some examples? |
Short acting - salbutamol
Long acting - salmeterol |
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Corticosteroids - Mechanism of action, adverse effects |
Inhibit influx of inflammatory cells in the lung, decrease mucus production, and inhibit release of inflammatory mediators from macrophages & eosinophils
Oral candida, hoarseness, bruising, increased appetite, weight gain, gastritis, osteoporosis, cataracts, adrenal suppression, glucose intolerance |
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Leukotriene receptor antagonists - Mechanism of action, adverse effects |
Block CysLT1 receptor on bronchial smooth muscle = relaxation
Churg-Strauss syndrome (vasculitic rash, respiratory Sx, peripheral neuropathy) |
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Xanthines - Mechanism of action, adverse effects |
They are phosphodiesterase inhibitors = increase cAMP = activates PKA which inhibits TNF-a = relaxation of bronchial muscle
Nausea, vomiting, GI upset, diarrhoea, palpitations, tachycardia, arrhythmias, seizures |
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What is the standard treatment regimen for asthma? (1) |
INH SABA PRN - salbutamol |
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What should be added if a SABA is being used >OD or at night? (1) |
INH corticosteroid (200-800mcg/day) |
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What should be added next if symptoms aren't controlled? (1) |
INH LABA - salmeterol |
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What should be done next if symptoms aren't controlled with a SABA, corticosteroid and LABA? (1) |
Increase dose of INH steroid |
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What should be added next if symptoms aren't controlled? (2) |
Stop LABA Increase dose of INH steroid |
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What should be added next if symptoms aren't controlled? (1) |
Leukotriene receptor antagonist |
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What should be done next if symptoms aren't controlled? (1) |
Increase INH steroid to 2000mcg/day |
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What should be added next if symptoms aren't controlled? (1) |
SR theophylline |
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What should be added next if symptoms aren't controlled? (2) |
Add oral steroid Refer |
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What is the management of acute asthma? |
Oxygen Salbutamol Hydrocortisone/prednisolone Ipratropium bromide Theophylline MgSO4 IV Emergency call to anaesthetist |
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What drugs are used to treat COPD? (8) |
SABA, LABA SAMA, LAMA - antimuscarinics more effective bronchodilators than B2 agonists in COPD Corticosteroids Leukotriene receptor antagonists Theophylline Mucolytics - if chronic productive cough |
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Give 2 examples of antimuscarinics |
Ipratropium bromide* - SAMA Tiotropium* - LAMA |
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What is the treatment for infective exacerbations of COPD? (5) |
Oxygen (sats 88-92%) Oral steroids ABx - amoxicillin (or doxycycline) Nebulised bronchodilators Non-invasive ventilation |
