20 Questions
What are the most common devices used to administer inhaled aerosols?
Metered-dose inhaler (MDI), Soft-mist inhaler (Respimat), Small-volume nebulizer (SVN), Dry-powder inhaler (DPI)
What are the advantages of inhaled aerosols?
Smaller doses, Rapid onset of action, Targeted delivery, Fewer and less severe systemic side effects
What neurotransmitter is involved in the sympathetic system of lung control?
Norepinephrine (epinephrine)
What neurotransmitter is involved in the parasympathetic system of lung control?
Acetylcholine
What are the disadvantages of inhaled aerosols?
Number of variables affecting the delivered dose, Lack of adequate knowledge of device performance, Use among patients and caregivers
What is the method by which drugs are made available to the body through direct delivery to the respiratory tract?
Inhalation route
Which of the following medications is a combined B2 agonist and muscarinic antagonist?
Combivent
Which medication is used to reduce the risk of acute exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations?
Roflumilast (Daliresp)
Which medication promotes pulmonary vasodilation, coronary vasodilation, cardiac stimulation, enhanced diaphragmatic contractility, CNS stimulation, and diuresis?
Theophylline
Which medication is a PDE inhibitor used in COPD patients to reduce the risk of acute exacerbations?
Roflumilast (Daliresp)
Which medication is used as an adjunctive bronchodilator in patients with severe, life-threatening asthma exacerbations?
Magnesium sulfate
Which medication is a combination of umeclidinium and vilanterol?
Anoro Ellipta
Which medication is used as an add-on therapy for COPD and asthma, requiring monitoring of serum concentrations and potential for serious adverse effects?
Theophylline
Which medication does not cause bronchodilation and is not a bronchodilator, but is used to reduce the risk of acute exacerbations in COPD patients?
Roflumilast (Daliresp)
Which receptor stimulation causes vasoconstriction by adrenergic bronchodilators?
Alpha-receptors
Which bronchodilator is indicated for status asthmaticus, anaphylaxis, and acute mucosal edema?
Epinephrine
What are the adverse effects of adrenergic bronchodilators?
Tremors, headache, insomnia
What is the duration of action for short-acting adrenergic bronchodilators?
2-8 hours
What is the primary mechanism of action for anticholinergic bronchodilators?
Blocking effects of acetylcholine at muscarinic receptors
Which antimuscarinic bronchodilator is commonly indicated for COPD and acute asthma?
Ipratropium
Study Notes
Bronchodilators Classification and Usage
- Bronchodilators can be classified as agonists (stimulating agents) or antagonists (blocking agents) and are categorized as adrenergic, antiadrenergic, cholinergic, anticholinergic, and muscarinic.
- Adrenergic bronchodilators are used for relief of acute reversible airflow obstruction and maintenance bronchodilation in patients with obstructive lung disease.
- They work by stimulating alpha-receptors causing vasoconstriction, beta-1-receptors increasing heart rate, and beta-2-receptors relaxing bronchial smooth muscle.
- Sympathomimetics with an alpha-effect and corticosteroids are used to decrease mucosal edema, while sympathomimetics (B-adrenergic) provide relief for bronchospasm.
- Short-acting adrenergic bronchodilators include Albuterol and Levalbuterol, offering rapid onset within 10-15 minutes and a duration of 2-8 hours.
- Long-acting adrenergic bronchodilators include Arformoterol, Formoterol, Indacaterol, Olodaterol, Salmeterol, and Vilanterol, with durations ranging from 12 to 24 hours.
- Epinephrine and Racemic epinephrine are used for status asthmaticus, anaphylaxis, acute mucosal edema, croup, and laryngeal edema.
- Adverse effects of adrenergic bronchodilators include tremors, headache, insomnia, nervousness, palpitations, tachycardia, and hypokalemia.
- Assessment of bronchodilator therapy involves evaluating vital signs, breath sounds, breathing patterns, and the patient’s subjective response.
- Anticholinergic bronchodilators, also known as parasympatholytics, block the effects of acetylcholine at muscarinic receptors, leading to bronchodilation, increased heart rate, and drying of pulmonary secretions.
- They are used for maintenance treatment in COPD and during acute asthma attacks, often in combination with beta-agonists.
- Short-acting antimuscarinic agents include ipratropium, with a rapid onset within 15 minutes and a duration of 4-6 hours, commonly indicated for COPD and acute asthma.
Test your knowledge of bronchodilators with this quiz. Explore the classification and usage of adrenergic and anticholinergic bronchodilators, their mechanisms of action, therapeutic uses, and potential adverse effects. Gain insights into the assessment of bronchodilator therapy and the specific medications involved.
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