Week 2 Respiratory pharmacology


Nursing Flashcards on Week 2 Respiratory pharmacology, created by Elizabeth Then on 09/09/2017.
Elizabeth Then
Flashcards by Elizabeth Then, updated more than 1 year ago
Elizabeth Then
Created by Elizabeth Then over 6 years ago

Resource summary

Question Answer
Asthma definition Chronic inflammatory disorder of the airways Reversible airflow obstruction inflammation causes increase in bronchial hyper responsiveness
Onset of asthma Early onset- childhood late onset- adulthood
2 phases of asthma attack Early- bronchospasm, treated with bronchodilators (B2 adrenoreceptor agonists) Late- Inflammation, treated with anti-inflammatory agents (glucocorticosteroids, cromoglicate
Risk factors for asthma environments, dust, allergens, genetics
Respiratory efferent pathways smooth 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
Bronchodilators used in early phase B2 adrenoreceptor agonists anticholinergic drugs (muscarinic receptor antagonists)
Anti-inflammatory agents directed in early and late phase glucocorticosteriods cromoglicate
B2 receptor agonists bronchodilator 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
Anticholinergic 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
Anti-inflammatory agents directed against both early and late phase glucocorticoids cromoglicate
Glucocorticoids NOT 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
cromoglicate NOT 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
Xanthine 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
Leukotriene receptor antagonist e.g. accolate, montelukast mechanism: antagonism of LTD4 receptor bronchoconstriction, mucus secretion increase side effects: few, headache, GI disturbance
New 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
New 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
Stepwise approach to asthma management Once sustained control is achieved, a step down reduction therapy is considered long term aim is to promote minimum therapy-maintain controal
COPD chronic 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
COPD-treatment bronchial SM relaxation with short and long b2 adrenoreceptor agonists, anticholinergics, monitor FEV1 short b2=salbutamol long b2=salmeterol
COPD- 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
Inhaler medication advantages drug delivery to site of action immediate effect for bronchodilators small doses required to be effective with few side effects
Types of inhalers MDI- 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
inhaler assessment and education must be explained and demonstrated select most suitable device match device with capability regular review of technique
Asthma allergic/extrinsic triggered by allergen, release of histamin and leukotrienes, causes SM spasm, mucous, bronchoconstriction, inflammmation
Asthma non-allergic/intrinsic -altered autonomic nervous system function, release of histamine and leukotrienes, bronchoconstriction, mucous
Histamine in asthma cause sm spasms, inflammation, oedema, stimulate larger bronchi
Ach in asthma increase vagal tone, cause bronchoconstriction, increase mucous secretions
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