Respiratory Pharmacology: LAMA and SABA

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary indication for tiotropium?

Prevention of exercise-induced bronchospasm

Long-term maintenance treatment of bronchospasm associated with asthma and COPD (correct)

Acute asthma attacks

Immediate relief during a COPD exacerbation

What is the mechanism of action of salbutamol?

Inhibiting the interaction of acetylcholine at muscarinic receptors

Promoting secretion within the airways

Stimulating β2-adrenergic receptors in smooth muscle (correct)

Blocking beta-adrenergic receptors in bronchial smooth muscle

Which of the following is an adverse effect associated with tiotropium?

Dry mouth (correct)

Increased mucociliary clearance

Insomnia

Tremors

What effect does salbutamol primarily promote in patients?

Bronchodilation Signup and view all the answers

Which medication can paradoxically worsen bronchospasm despite its intended effect?

Tiotropium Signup and view all the answers

What is a common side effect of salbutamol when used frequently?

Nausea Signup and view all the answers

Which action does ipratropium take to relieve bronchospasm in COPD patients?

Inhibits the interaction of acetylcholine at muscarinic receptors Signup and view all the answers

What is a significant adverse effect of both salbutamol and tiotropium?

Tachycardia Signup and view all the answers

What effect does ipratropium have on bronchospasm in certain individuals?

It can paradoxically worsen bronchospasm. Signup and view all the answers

Which of the following mechanisms is NOT associated with the action of fluticasone?

Stimulation of leukocyte migration. Signup and view all the answers

What is an adverse effect commonly associated with inhaled corticosteroids like fluticasone and beclomethasone?

Oral fungal infections. Signup and view all the answers

What effect does fluticasone have on bronchial smooth muscle responsiveness?

It increases responsiveness to β2-adrenergic receptor stimulation. Signup and view all the answers

Which of the following actions is NOT a desired effect of beclomethasone?

Increases capillary permeability. Signup and view all the answers

What condition can result from swallowing large amounts of fluticasone?

Adrenal suppression. Signup and view all the answers

Which symptom is commonly associated with ipratropium use?

Dry mouth. Signup and view all the answers

What is one of the primary indications for the use of fluticasone?

Long-term asthma control. Signup and view all the answers

What is the action of beclomethasone on proinflammatory cytokine production?

Inhibits its production. Signup and view all the answers

Which of the following adverse effects is shared by both fluticasone and beclomethasone?

Hoarseness. Signup and view all the answers

Study Notes

Tiotropium (LAMA)

Indications: Long-term maintenance treatment of bronchospasm associated with asthma and COPD.
Mechanism of action: Inhibits acetylcholine at muscarinic receptors on bronchial smooth muscle, preventing parasympathetic constriction of airways.
Desired effects: Bronchodilation (widening airways) and decreased secretions (reduced volume, not viscosity).
Adverse effects: Paradoxical bronchospasm, tachycardia, and dry mouth.

Salbutamol (SABA)

Indications: Treatment of acute asthma attacks ("rescue medication") and as needed for mild COPD or intermittent symptoms.
Mechanism of action: Stimulates β2-adrenergic receptors in bronchiole smooth muscle, mimicking the sympathetic nervous system's effect on airways.
Desired effects: Bronchodilation, increased mucociliary clearance (mucus removal), and prevention of exercise-induced bronchospasm.
Adverse effects (with frequent use): Tremors, anxiety, tachycardia, palpitations, nausea, hypertension, and insomnia.

Ipratropium (SAMA)

Indications: Relief and prevention of bronchospasm in COPD, and as needed for mild COPD or intermittent symptoms.
Mechanism of action: Inhibits acetylcholine at muscarinic receptors on bronchial smooth muscle, preventing parasympathetic constriction of airways. Also blocks parasympathetic receptors intranasally, reducing hypersecretion.
Desired effects: Bronchodilation and decreased secretions (reduced volume, not viscosity).
Adverse effects: Paradoxical bronchospasm, tachycardia, palpitations, dry mouth/upper respiratory irritation, and nausea/GI distress.

Fluticasone (ICS)

Indications: Asthma control (prophylactic and long-term maintenance).
Mechanism of action: Binds to the glucocorticoid receptor, promoting anti-inflammatory effects by inhibiting histamine release, preventing macrophage accumulation, reducing leukotriene release, and stabilizing leukocyte membranes.
Desired effects: Increase responsiveness of bronchial smooth muscle to β2-adrenergic stimulation (salbutamol), prevent inflammation and mediator release, prevent edema, decrease airway inflammation and secretions, decrease airway hyperresponsiveness, and decrease frequency/severity of asthma attacks.
Adverse effects: Minimal systemic absorption and adrenal suppression with inhalation. Oral fungal infections (candidiasis), hoarseness, sore throat, dry mouth, local burning, and bitter taste are common with inhalation. Systemic adverse effects with swallowing large amounts.

Beclomethasone (ICS)

Indications: Asthma prophylaxis (2 inhalations, 2-3 times/day recommended).
Mechanism of action: Enters cell nucleus, binds to and activates nuclear receptors, inhibiting proinflammatory cytokine production.
Desired effects: Reduces inflammation, decreasing asthma attack frequency, suppresses leukocyte and fibroblast migration, reverses increased capillary permeability, and stabilizes lysosomes.
Adverse effects: Dry mouth, hoarseness, altered taste, masks infections (suppresses immune response), oral fungal infections (candidiasis), and corticosteroid toxicity with long-term use (Cushing's syndrome signs).

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers the mechanisms, indications, and effects of Tiotropium and Salbutamol, two key medications in the management of asthma and COPD. Test your knowledge of their therapeutic roles, desired effects, and potential adverse reactions. Ideal for students in pharmacology or respiratory medicine.