Join Dr. Seheult of as he clarifies the inhalers and progression used for asthma treatment and COPD treatment.
What’s the quick and dirty on inhalers well here we’ve got a bronchus which is which limits the aperture or the lumen of that bronchus if the smooth muscle on the smooth muscle we have a orange receptor here which we’re going to call in this case we’ll call it the blue receptor which is the beta receptor so muscarinic receptors are actually going to cause smooth muscle
Contraction and inhibiting that so we want to make sure that there’s a big x that we have sure that that gets excited or activated because the beta receptor actually know about these two receptors and you know that you want to block the the only other one that you should know is the inhaled corticosteroid which will receptor but what it does is it reduces inflammation okay
So the three types of inhaled corticosteroids so why is that important well you’ll be able to muscarinic always end in -ium so what are examples tiotropium ipratropium know that has been added to that category called glycopyrrolate so you can also put -late, so if you see an -ium or a -late its a muscarinic antagonist, now on the beta agonist side end in -ol now how do you
Know whether it’s an inhaled corticosteroid you’ll know that because it ends in -one like fluticasone or together so we have the muscarinic antagonists we have the beta agonists terms of the actual clinical outcomes let’s take a look at that okay terms of this there are two types of beta agonists there’s something called a represent this represents like proair this looks
Like ventolin albuterol beta agonists so that’s laba, laba then we’re going to go ahead and look at ahead and look at the inhaled corticosteroids so for those who don’t the ones that end in -ol and these are the ones that end in -ium do i put this into this three chambered box here with the saba this is how we’re going to look at the treatment of copd and asthma okay so
As you can see if is gonna go in this direction so the first thing that we would do in asthma question is the patient using a short-acting beta agonist if the answer is at one medication however if the patient is using the short-acting beta agonist corticosteroid is not enough then what we need to do is add a long-acting beta short-acting beta- agonist or albuterol three
Or more times per week if the just an inhaled corticosteroid and a long-acting beta agonist but we’ll at question is the patient using a short-acting beta agonist and the answer have to use the rescue inhaler that means we can drop the long-acting corticosteroid in the lung i think beta agonist then we can drop the long-acting seeing here is a ramping up or a ramping down
Depending on the answer to the agonist without using an inhaled corticosteroid first okay now let’s go that i would add is a long-acting muscarinic antagonist so tiotropium or patient using the short-acting beta agonist if the answer is yes three times the last thing i’m going to use in a patient with copd is an inhaled and tagging this is one of the first things that we’ll
Use in a patient with clearly that everybody who has a lung disease either asthma or copd here is them wherever they go okay now as you can see at some point stupid they’ll know that usually one medications not enough and so what that all the time so if you pick up an inhaler and it’s a combination of a -ium medication and an -ol medication for instance one medication has
Vilanterol know this chart you’ll know that that medication is a medication that’s going side you know that on the asthma side people will be combining inhaled fluticasone and salmeterol that combination goes together and that’s laba combination now you can get laba by itself you can buy salmeterol you can see based on how i have things set up that if you’re on a laba you’re
Treating asthma or you’re gonna be coupling it with a long-acting it’s not gonna be long before and they have already started working on this all look at the contents of the inhaler in terms of the medications and you should what it should be used for and now with your patients you’ll be able to see thing that i will say is in the case of asthma if i am going down i go to
An agonist but there are exceptions to this atrial fibrillation and i’m worried that quickly instead of adding a long-acting beta agonist which could speed up their potency to a medium or even to a high potency medication alternatively i could but i’ll just put it up here in the corner leukotrienes you can think about but this is the general modality that you’ll see in the for joining us
Transcribed from video
Inhalers (Asthma Treatment & COPD Treatment) Explained! By MedCram – Medical Lectures Explained CLEARLY
