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Pharmacology Ch. 7
Pharmacology
27
Medical
Undergraduate 1
09/19/2011

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Term
What are two other names for anticholinergic bronchodilators?
Definition
Ipratropium and tiotropium
Term
What is the indication for ipratropium and tiotropium?
Definition
Patients receiving regular treatment for COPD, chronic bronchitis and emphysema.
Term
What two drugs make up Combivent?
Definition
Ipratropium and albuterol
Term
What is the indication for Combivent?
Definition
Patients receiving regular treatment for COPD and who require additional bronchodilation for relief of airflow obstruction.
Term
In what type of asthma is ipratropium used?
Definition
Severe asthma
Term
What is the nasal spray formulation used for?
Definition
Symptomatic relief of allergic and nonallergic perennial rhinitis and the common cold
Term
What is the profile of clinical effect for ipratropium? In asthma? In COPD?
Definition
• The onset of bronchodilation begins within minutes but proceeds more slowly to a peak effect at 1 to 2 hours after inhalation.
• Ashtma: The duration of bronchodilator effect is about the same for ipratropium as for B agonists.
• COPD: the duration is longer by 1 to 2 hours.
Term
What does research show regarding the use of Combivent versus either drug alone?
Definition
The combination therapy has shown to be more effective in COPD than either agent alone.
Term
What is Duoneb?
Definition
Is available as a combination of ipratropium and albuterol base.
Term
How long is the duration of action for Spririva?
Definition

12 hrs

 

Term
Does Spiriva reduce exacerbations and hospitilizatons? Quality of life?
Definition
Spiriva reduces COPD exacerbations and hospitalizations and improves the quality of life.
Term
Key Point
Definition
The anticholinergic bronchodilators are specifically parasympathic, that is, antimuscarinic agents, blocking the effect of acetylcoline at the cholinergic receptors on bronchial smooth muscle.
Term
Key Point
Definition
The only approved anticholinergic agents for inhalation as an aerosol at this time are ipratropium, which is available as an MDI, an SVN solution, and an intranasal spray; and tiotropium, available only as a DPI.
Term
What are some examples of tertiary compounds?
Definition
Atropine sulfate, scopolamine, and L-Hyoscyamine sulfate
Term
How do tertiary compounds differ from quaternary compounds?
Definition
The amount of absorption is different
Term
Key Point
Definition
Quaternary compounds, such as ipratropium, are fully ionized and less absorbed in body tissues than tertiary compounds, such as atropine sulfate. Consequently, side effects with quaternary compounds are localized to the site of the drug exposure.
Term
Administration of parasympathomimetic agents such as methacholine can lead do?
Definition
Intensified level of bronchial tone to the point of constriction in healthy subjects and more so in asthmatic patients.
Term
What is an important point to realize with use of a blocking agent such as an anticholinergic bronchodilator?
Definition
effect seen will depend on the degree of tone present that can be blocked.
Term
Which class of drugs has a better safety profile? Quartenary antimuscarinic bronchodilators of B agonists?
Definition
Quaternary ammonium antimuscarinic bronchodilators is superior to that of B agonists.
Term
What body part must be protected from drug exposure from drug exposure with aerosol use?
Definition
Eyes
Term
Key point
Definition
The most common side effects with quaternary ammonium antimuscarinic bronchodilators are dry mouth and perhaps a cough cause by the aerosol particles.
Term
Key Point
Definition
Direct spraying in the eye must be avoided to prevent ocular effects. Subjects with COPD can show a greater response in reversibility of airflow obstruction with an anticholinergic agent than a B agonist.
Term
Which class of drug is more potent in bronchitis-emphysema?
Definition
Antimuscarinic agents were found to be more potent bronchodilators than B-adrenergic agents in bronchitis-emphysema.
Term
For COPD patients: what combination improves the forced expiratory volume in 1 second?
Definition
Short term B-2 agonist and an anticholinergic
Term
Key Point
Definition
Combined anticholinergic and b-agonist therapy may give additive bronchodilating results in COPD and in severe, acute asthma.
Term
Why is the B2 agonist given first
Definition
• B2 agonists have a more rapid onset of action than does an anticholinergic bronchodilator.
• B2 receptors are distributed in large and small airways.
Term
How important is the order of drugs given?
Definition
Not important
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