Airway Control

Question 1

B2 agonists - half lives?

Answer 1

Short acting- salbutamol (immediate effect!)

Long acting- salmetriol (slow onset, long effect)

Question 2

B2 agonists - ADRs

Answer 2

Tremor, tachycardia, palpitations

Question 3

B2 agonists- DDIs?

Answer 3

B blockers (propranolol) - severe asthma, if STOP b agonist!

Question 4

Methylxanthines- mechanism?

Answer 4

Antagonise adenosine receptors -> bronchodilation

Question 5

Methylxanthines- ADRs?

Answer 5

Nausea, headache, arrythmia, fits, NARROW THERAPEUTIC WINDOW

Question 6

Muscarinic antagonists- mechanism?

Answer 6

Block M3 receptors -> stop ACh mediated bronchoconstriction and reduced mucus secretion

Question 7

Muscarinic blockers- ADRs?

Answer 7

Dry mouth, urinary retention, glaucoma

Question 8

Inhaled corticosteroids- ADRs?

Answer 8

Croaky voice, sore throat, oral thrush (spacer decreases risk)

Question 9

B2 agonists- mechanism

Answer 9

Activate B2 receptors -> Gas -> increase cAMP -> increase PKA -> inhibit MLCK -> decrease Ca2+ and muscle RELAXATION (bronchodilation)

Question 10

Problem with long acting B2 agonists

Answer 10

Worsen asthma inflammatory process in the long term if not used with an inhaled steroid!!

Question 11

Asthma treatment steps?

Answer 11

1. Short acting B2 agonist
2. ADD inhaled steroid
3. ADD LABA
4. ADD methylxanthine/muscarinic blocker/increase steroid dose
5. Oral steroids

Question 12

Acute asthma treatment?

Answer 12

High flow oxygen, nebulised salbutamol, oral prednisolone, add nebulised ipotropium bromide, add IV theophylline, IV hydrocortisone