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CH 32 COPD PHARM
Pharmacology, Chapter 32, COPD
| Question | Answer |
|---|---|
| What are some of the factors that can precipitate an asthma attack? | Allergens, air pollutants, cold air, certain drugs, infections, and exercise are some of the factors that can trigger an asthmatic attack. |
| List four physiological changes that can occur in the respiratory tract during and asthma attack. | - Mucosal Edema - Ciliary activity of the respiratory tract is usually depressed - Bronchoconstriction -Increased Mucus |
| What chemical mediators are released from mast cells? What effects do they produce? #1 | Histamine: causes bronchoconstriction, increased vascular permeability that contributes to mucosal edema, and infiltration of leukocytes, particularly eosinophils. |
| What chemical mediators are released from mast cells? What effects do they produce? #2 | Eosinophilic Chemotactic Factor of Anaphylaxis (ECF-A): are part of the general inflammatory and allergic reaction that often occurs in the lining of the respiratory tract in asthma. They worsen and prolong the asthmatic process. |
| What chemical mediators are released from mast cells? What effects do they produce? #3 | Prostaglandins and Leukotrienes: two different chemical mediators that are both derived from arachidonic acid. You can find arachidonic acid in cell membranes, particularly in mast cells and other inflammatory cells. |
| Continued from Chemical Mediators #3 | ....These two mediators are formed and released in inflammatory conditions such as asthma. Both mediators can cause bronchoconstriction, edema, and mucus production. |
| What are the causes of Chronic Bronchitis? | *Caused by chronic irritation of the respiratory tract (cigarette smoke and environmental pollutants) *Degenerative changes in the respiratory lining and mucociliary escalator system. *Secretions thicken and interfere with respiratory gas exchange |
| Treatment for Chronic Bronchitis | *Drug Therapy* Bronchodilators: *aimed at improving respiratory gas exchange *reducing the volume of mucus secretions |
| Symptoms of Chronic Bronchitis | Productive cough Difficulty breathing Increased respiratory infections Restriction of physical activity |
| What is Emphysema? | -Involves destruction of the alveoli -Increased by air pollution, tobacco smoke, and other irritants -Causes enlargement of the air spaces and leads to hyperinflation -Irreversible lung damage |
| Symptoms of Emphysema | Difficulty expelling air from the lungs Reduced respiratory exchange Shortness of breath |
| Treatment for Emphysema | -Respiratory exercises designed to increase the efficiency of respiration -Oxygen therapy -Drug therapy: Bronchodilators & Anti-inflammatory agents |
| What is Asthma? | Inflammatory disease: factors stimulate the release of chemical mediators from mast cells and other cells involved in the inflammatory process. |
| Which chemical mediators are two main components of Asthma? | Bronchoconstriction and Inflammation |
| Symptoms of Asthma... | SOB, Wheezing, Feeling of Suffocation (like a fish without water). ,Mucosal edema, Increased production of mucus, and Bronchoconstriction |
| Treatment for Asthma | *Drug Therapy* Bronchodilators Anti-Inflammatories Antiallergics |
| How many different types of Bronchodilators are there? | 3 Different types of Bronchodilators: Sympathomimetics Anticholinergics Methylxanthines |
| What is the main effect of a bronchodilator? | To relieve constriction! bronchodilator to "dilate" |
| Beta Adrenergic Drugs | -Epinephrine and Isoproterenol are potent beta-adrenergic drugs -Albuterol, Terbutaline are considered “rescue” drugs as they take effect almost immediately -Salmeterol is long-acting and takes effect within 10 – 20 minutes. |
| Beta what? | Beta "2" selective... because Beta 2 goes where? 2 The LUNGS! |
| Typically Beta Adrenergic Drugs are taken with... | Usually administered in combination with anti-inflammatory corticosteroids |
| Long Term Use of Beta Adrenergic Drugs have some consequences? | Yes! Long-term use has been associated with increased risk of asthma related mortality. |
| Methyl xanthine Drugs | -Produce mild stimulation of the CNS, heart and kidneys. -Bronchodilation |
| Methyl xanthine Drugs Continued: | Increases respiratory muscle contractility and mucociliary clearance, important in the treatment of chronic bronchitis and emphysema (COPD). |
| Anticholinergic Drugs | Block actions of acetylcholine Bronchodilation Reduces volume of respiratory secretions *Not as potent as Beta Adrenergic Drugs* |
| What are the first line drugs for COPD? | Anticholinergic Drugs! |
| Ipratropium Bromide (Atrovent) | is indicated for both asthma and COPD. |
| Anti-inflammatory Drugs | Referred to as “controller” drugs because they reduce and control the inflammatory response Bronchodilators are more effective and can reduce the dosage when used with anti-inflammatory drugs. |
| Corticosteroids | Considered most potent anti-inflammatory and anti-allergic drugs Inhibits the inflammatory response in the respiratory airways |
| Prednisone and Prednisolone | -provide systemic drug effects and are associated with potentially serious adverse effects. Primarily used during the initial acute phase of inflammation |
| Adverse Effects of Prednisone and Prednisolone | Fluid retention, muscle wasting, metabolic disturbances, and increased risk of infections |
| Leukotriene Inhibitor Drugs | Leukotrienes cause bronchoconstriction, mucus production, and inflammation |
| Leukotriene Inhibitors (zileuton) | -prevents the synthesis of all the leukotrienes. -Adverse Effects- *Nausea, diarrhea, rash and headaches *Most serious are related to liver intoxicity: increased liver enzymes, fever, dark urine, clay-colored stools and jaundice |
| Which Leukotriene Inhibitors are better tolerated? | Zafirlukast and Montelukast |
| Anti-Allergic Drugs | Cromolyn Sodium: interferes with the antigen-antibody reaction to release mast cell mediators. |
| More about Cromolyn Sodium | *Taken prophylactically on a daily basis *Not a bronchodilator, has no use in the treatment of acute asthma *Therapeutic effect takes several weeks to fully develop |
| Mucolytics? | liquefy bronchial mucus, allowing clearance of mucus by coughing or suctioning. |
| Which drug is an effective Mucolytic? | Acetylcysteine |
| Acetylcysteine? | - is Irritating and can cause bronchospasm. ***Bronchodilator is added to the inhalation mixture to prevent bronchospasm*** |
| Expectorants | facilitate the removal of thickened mucus from the lungs. |
| Which is the most commonly used Expectorant? | Guaifenesin |
| Action of Guaifenesin? | Increases respiratory secretions and provide relief of non-productive coughing. |
Created by:
el_millor
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