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Asthma & COPD Treatment / Pharmacology (Inhaler Progression)

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Get clarity on the progression of inhalers used for asthma and COPD treatment with Dr. Seheult of

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 receptors that we see on the smooth muscle we have a orange receptor here there’s another receptor in this case we’ll call it the blue receptor which is should know is that muscarinic receptors are actually going to cause smooth make sure that

We are inhibiting that so we want to make sure that there’s a big however we want to make sure that that gets excited or activated because the cause relaxation so once you know about these two receptors and you know that then you’re there now the only other one that you should know is the inhaled everywhere there is no real receptor but what it does is it reduces inflammation

Antagonists beta agonists and inhaled corticosteroids so why is that important they end with so muscarinic always end in i um so what are examples tiotropium know that has been added to that category called glycol pie relate so you l so you’ll know for mathura salmeterol albuterol all those things end in o l because it ends in o and e or own like fluticasone mometasone etc

So once you muscarinic antagonists we have the beta agonists and we have the inhaled so let’s go ahead and put those medications into the right place in okay so what does this represent this represents like proair this looks like laba l a b a then we’re going to go ahead and look at the long-acting at the inhaled corticosteroids so for those who don’t remember remember

This and these are the ones that end in i um remember glycol pie relate is also an box here with the saba this is how we’re going to look at the treatment of c o p gonna go in this direction whereas copd is gonna go in this direction so the corticosteroid and then we would ask the question is the patient using a week then we’re fine with where we are at one medication

However if the patient per week in asthma then the inhaled corticosteroid is not enough then what question again is the patient using a short-acting beta-2 agonist or albuterol not well controlled and we will add not just an inhaled corticosteroid and a antagonist at any point if we ask this question is the patient using a patient is so well controlled they don’t have to

Use the rescue inhaler that or if we’re just on the inhaled corticosteroid and the long-acting beta inhaled corticosteroid so what we’re seeing here is a ramping up or a ramping asthma you will never use a long-acting beta agonist without using an inhaled the first medication that i would add is a long-acting muscarinic antagonist so the question is the patient using the

Short-acting beta agonist if the answer agonists notice that the last thing i’m going to use in a patient with copd is long-acting muscarinic intag and this is one of the first things that we’ll use here very clearly that everybody who has a lung disease either asthma or copd carry it with 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 um medication and an ole medication for instance one medication has volant all 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 in a lab a combination now you can get l’abbĂ© by itself you can by cell meter you can see based on how i have things set up that if you’re on a lab ah you’re treating asthma or you’re gonna be coupling it with a long-acting it’s not going to be long before and they have already started working on inhaler look at the contents of

The inhaler in terms of the medications and it is and what it should be used for and see whether or not you need to escalate therapy or de-escalate therapy the one inhaled corticosteroid and that doesn’t work i will add a long-acting beta i’m gonna speed up their heart rate very quickly instead of adding a long-acting of the inhaled corticosteroid from a low potency to a

Medium or even to a high antagonist and i didn’t put that in here but i’ll just put it up here in the for okay so these are other things that you can think about but this is the for joining us

Transcribed from video
Asthma & COPD Treatment / Pharmacology (Inhaler Progression) By MedCram – Medical Lectures Explained CLEARLY