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Questions and Answers
Which medication is considered a reliever for respiratory conditions?
Which medication is considered a reliever for respiratory conditions?
Asthma is a condition that only affects adults.
Asthma is a condition that only affects adults.
False
What are the main symptoms of asthma?
What are the main symptoms of asthma?
Coughing, wheezing, shortness of breath, chest tightness
The _____ phase of an asthma attack occurs immediately after exposure to an allergen.
The _____ phase of an asthma attack occurs immediately after exposure to an allergen.
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Match the following respiratory medications with their classification:
Match the following respiratory medications with their classification:
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What are the primary symptoms of Chronic Obstructive Pulmonary Disease (COPD)?
What are the primary symptoms of Chronic Obstructive Pulmonary Disease (COPD)?
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Emphysema is characterized by the destruction of the alveoli in the lungs.
Emphysema is characterized by the destruction of the alveoli in the lungs.
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What is the role of Short-acting β2 Agonists (SABAs) in respiratory treatment?
What is the role of Short-acting β2 Agonists (SABAs) in respiratory treatment?
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Chronic bronchitis involves inflammation of the lining of the _______ tubes.
Chronic bronchitis involves inflammation of the lining of the _______ tubes.
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Match the following treatments with their type:
Match the following treatments with their type:
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Which of the following conditions is NOT a cause of COPD?
Which of the following conditions is NOT a cause of COPD?
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Short-acting Muscarinic Antagonists (SAMAs) work by stimulating β2 adrenergic receptors.
Short-acting Muscarinic Antagonists (SAMAs) work by stimulating β2 adrenergic receptors.
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Name one example of a Short-acting β2 Agonist (SABA).
Name one example of a Short-acting β2 Agonist (SABA).
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What type of medications should be avoided in COPD and asthma patients?
What type of medications should be avoided in COPD and asthma patients?
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Inhaled corticosteroids can lead to oral candidiasis, so it's important to rinse the mouth after inhaling.
Inhaled corticosteroids can lead to oral candidiasis, so it's important to rinse the mouth after inhaling.
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What condition is characterized by hypoxic conditions negatively affecting oral health and wound healing in patients?
What condition is characterized by hypoxic conditions negatively affecting oral health and wound healing in patients?
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Patients with moderate-to-severe asthma may experience increased respiratory symptoms due to the use of _______ like aspirin or ibuprofen.
Patients with moderate-to-severe asthma may experience increased respiratory symptoms due to the use of _______ like aspirin or ibuprofen.
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Match the following medications or treatments with their implications:
Match the following medications or treatments with their implications:
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What is the primary purpose of administering long-acting muscarinic antagonists (LAMAs)?
What is the primary purpose of administering long-acting muscarinic antagonists (LAMAs)?
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Inhaled corticosteroids (ICS) can be used for acute relief of bronchospasm.
Inhaled corticosteroids (ICS) can be used for acute relief of bronchospasm.
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Name one example of a long-acting beta-2 agonist (LABA).
Name one example of a long-acting beta-2 agonist (LABA).
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Montelukast and Zafirlukast are examples of _______ modifiers.
Montelukast and Zafirlukast are examples of _______ modifiers.
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Match the following medications with their primary function:
Match the following medications with their primary function:
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What is the recommended administration frequency for long-acting muscarinic antagonists (LAMAs)?
What is the recommended administration frequency for long-acting muscarinic antagonists (LAMAs)?
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Theophylline is known to have a low therapeutic window.
Theophylline is known to have a low therapeutic window.
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What is the primary mechanism of action of leukotriene modifiers?
What is the primary mechanism of action of leukotriene modifiers?
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The primary action of mast cell stabilizers is to prevent _______ and subsequent release of inflammatory substances.
The primary action of mast cell stabilizers is to prevent _______ and subsequent release of inflammatory substances.
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Which of the following is NOT a function of inhaled corticosteroids?
Which of the following is NOT a function of inhaled corticosteroids?
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Study Notes
DENT3005 Respiratory System
- Course name: DENT3005 Respiratory System
- Lecturer: Sheetal Maria Rajan
- Lecturer email: [email protected]
Acknowledgement of Country
- University of Western Australia acknowledges Noongar land
- Noongar people are the spiritual and cultural custodians of the land
- Noongar values, languages, beliefs, and knowledge are practiced
Learning Outcomes
- Broad Objective: Explain various respiratory drugs' impact on dental practice and management strategies.
- Specific Medications Covered: Asthma and COPD
Respiratory Medications
Relievers
- SABA (Short-acting β2 agonist)
- LABA (Long-acting β2 agonist with rapid onset)
Preventers
- ICS (Inhaled Corticosteroids)
- Leukotriene Modifiers
- Mast Cell Stabilizers
Add on Therapy
- LABA
- Theophylline
- Anti-immunoglobulin (IgE) – Omalizumab
- Anti-interleukin-5 (IL5) - Mepolizumab
- LAMA (Long-acting muscarinic antagonist)
Asthma
- Chronic condition inflaming and narrowing airways in the lungs
- Affects all ages
- Symptoms: coughing, wheezing, shortness of breath, chest tightness
Asthma Attacks
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Divided into early and late phases
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Early phase (10-20 minutes): IgE binds to receptors on mast cells
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Late phase (6-9 hours): Activated TH2 lymphocytes release cytokines that recruit more inflammatory cells
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Symptoms: bronchoconstriction, vasodilation, airway inflammation
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Clinical presentation: wheezing, shortness of breath, chest tightness, coughing
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Treatment: SABAs (albuterol) – relax bronchial muscles.
COPD
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Chronic inflammatory lung disease causing obstructed airflow
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Symptoms: breathing difficulty, cough, mucus production, wheezing
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Typically caused by long-term exposure to irritating gases (e.g., cigarette smoke)
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Increased risk of heart disease, lung cancer, and other conditions
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Two most common conditions
- Chronic bronchitis: inflammation of bronchial tubes
- Emphysema: destruction of alveoli (air sacs)
-
Chronic bronchitis (Blue bloaters)
- Clinical definition: productive cough for most days in two consecutive years
- Pathology: airway lumen narrowing due to mucosal thickening and excess mucus
- Symptoms: chronic productive cough, purulent sputum, cyanosis, peripheral oedema
-
Emphysema (Pink puffers)
- Pathological definition: dilatation and destruction of air spaces distal to terminal bronchioles
- Symptoms: exertional dyspnoea, minimal cough, tachypnoea, decreased exercise tolerance, pink skin, pursed-lip breathing, use of accessory muscles
Pharmacokinetics of Inhalers
- 5% of inhaled medication is deposited in the lungs
- 95% is swallowed and undergoes first-pass metabolism
Short-acting β2 Agonist (SABA)
- Relaxes airway smooth muscle
- Stimulates β2 adrenergic receptors, increasing cAMP
- Acts quickly (within minutes) to open airways
- Used as rescue inhalers for immediate relief
- Examples: Salbutamol, Terbutaline
Short-acting Muscarinic Antagonist (SAMA)
- Relaxes airway smooth muscle, induced by acetylcholine and post-ganglionic cholinergic nerves
- Blocks M3 muscarinic receptors
- Rapid bronchodilation (15-30 minutes)
- Used for acute bronchospasm, often combined with SABAs for enhanced effect
- Examples: Ipratropium Bromide
Long-acting β2 Agonist (LABA)
- Prolonged bronchodilation (up to 12-24 hours)
- Can be used as monotherapy or combined with inhaled corticosteroids
- Examples: Salmeterol, Formoterol, Indacaterol, Olodaterol, Vilanterol
Long-acting Muscarinic Antagonist (LAMA)
- Administration: Once daily (Tiotropium, Umeclidinium) or twice daily (Aclidinium, Glycopyrronium).
- Blocks muscarinic receptors in the airways, preventing bronchoconstriction and reducing mucus production
- For long-term control of COPD, sometimes combined with other medications
Leukotriene Modifiers
- Reduce airway hyper-responsiveness and eosinophil levels
- Block the action of leukotrienes (chemicals causing inflammation, bronchoconstriction, and mucus production)
- Taken orally once daily
- Examples: Montelukast, Zafirlukast
Mast Cell Stabilizers
- Stabilize mast cell plasma membranes
- Prevent degranulation and release of histamine, leukotrienes, and other substances causing airway inflammation
- Not used for acute bronchodilatory properties
- Example: Chromoglycate, Nedocromil
Inhaled Corticosteroids (ICS)
- Anti-inflammatory
- Reduces bronchial hyper-responsiveness
- Improves symptoms
- Used daily to control/prevent chronic symptoms and reduce exacerbations
- Examples: Beclometasone, Budesonide, Fluticasone, Mometasone, Ciclesonide
Theophylline
- Inhibits phosphodiesterase enzymes, increasing cAMP levels, relaxing bronchial muscles
- Methylxanthine derivative administered IV or orally
- Used for treating airway diseases
- Concerns: Low therapeutic window, drug interactions
Implications for Dentistry
- Medical History Considerations: Severe exacerbations, intubation, history of SABA, CVD, corticosteroid history
- Patient Factors: Airway obstruction, dementia, psychiatric disease
- Possible Oxygen Therapy: COPD/asthma patients, for compromised breathing
- Aspirin-Containing Compounds / NSAIDS: Should be avoided due to interaction with bronchodilators/corticosteroids.
- Opiates: Can cause bronchoconstriction and interactions with bronchodilators/corticosteroids
- Dry Mouth (Xerostomia): Medications can reduce saliva production, including anticholinergics and β2 agonists
- Oral Candidiasis: Inhaled corticosteroids increase risk of oral candidiasis
Community First Aid Protocol
- Rule of 4's for managing breathing difficulties with ABAs
- Use of spacer where possible
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Description
Test your knowledge on the respiratory system and its impact on dental practices as outlined in the DENT3005 course. This quiz covers various respiratory medications, including their classification and effects on asthma and COPD management. Prepare to enhance your understanding of the essential drug therapies related to respiratory health.
