Outline the groups of drugs that might be used in asthma and give an example of each?
- Muscarinic antagonists
- Other bronchodilators -magnesium
- Antihistamines (allergic basis)
- Leukotriene inhibitors [antagonists] – montelukast, zafirlukast,zileuton
- Heliox –changing airflow dynamics
- Other smooth muscle dilators – ketamine; calcium channel blockers
- Experimental: IgE monocloncal antibodies – omalizumab
- Must get 3 bolded groups and one other with one correct drug example per group to pass
Outline the mechanism of action of corticosteroids in asthma?
Corticosteroids do the following:
- Reduce bronchial reactivity
- Inhibition of (lymphocytic and eosinophilic) airway mucosal inflammation
- Increase airway calibre
- Must get bolded point to pass
Describe the pharmacokinetics of salbutamol?
- Absorption –complete all routes.
- Gut fast, resp tract slower
- Depends on mechanism delivery – gut 80% with Neb.
- 50% 1st pass
- No resp metabolism.
- T1/2 = 3-6hr – prolonged if resp
- Good Rapid absorption – all routes
- Metab 50% + renal
What are the pros and cons of the different routes of delivery?
Prompt: MDI vs nebuliser. Pass Criteria:
What is the mechanism of action of fluoroquinolones?
- DNA gyrase inhibitor/blocks protein production
- DNA gyrase inhibition
What are the mechanisms of resistance to fluoroquinolones?
- Resistance is due to one or more point mutations in the quinolone binding region of the target enzyme or to a change in the permeability of the organism
What are the clinical uses of ciprofloxacin?
- Bacterial diarrhoea caused by Shigella, Salmonella, toxigenic E coli,Campylobacter
- Soft tissue, bone, joint, intra-abdominal and respiratory tract infections
- Treatment against multidrug-resistant organisms (pseudomonas and enterobacter)
- Prophylaxis and treatment against anthrax
- Gonococcal infection Chlamydial urethritis or cervicitis
- TB and atypical mycobacterial infections
- Eradication of meningococcal carrier state
- Prophylaxis in neutropenic patients