asthma /copd drugs

Question 1

example of a SABA?

Answer 1

salbutamol

terbutaline

Question 2

example of a inhaled corticosteroid?

Answer 2

mometasone, beclametasone, fluticasone, budesonide qnd ciclesonide

Question 3

example of a LABA

Answer 3

formeterol and salmeterol

foster, dourest and Symbicort

Question 4

example of a fast acting LABA

Answer 4

formeterol

Question 5

example of a LTRA?

Answer 5

montelukast

zafirukast

Question 6

example of a LAMA ?

Answer 6

tiotropium bromide

Question 7

example of a oral b2 agonist tablet?

Answer 7

bambuterol

Question 8

example of LABA used in COPD

Answer 8

olodaterol
indacterol
vilanterol

Question 9

side effects of LABAs

Answer 9

hand tremor, tachycardia and hyperglycaemia,

hypokalaemia -

serious cVD effects - qt prolongation, tacky, arterial hypoxia leading to MI and hypotension

caution in hyperthyroidism

Question 10

twice daily ICS vs once daily examples

Answer 10

twice: beclemetasone, budesonide, fluticasone mometasone

once : ciclesonide

Question 11

what ICS inhaler must be prescribed by brand

Answer 11

beclometasone

Qvar and clenil as not interchangeable

Qvar is 2x as potent as clenil
Qvar has extra fine particles

Fostair is more potent than clenil and Qvar as has extra fine particles

Question 12

side effects of ICS

Answer 12

hoarse voice
sore throat
oral candidiasis

Question 13

who do NICE recommend use a spacer

Answer 13

those on high dose ICS

those under 15 years

Question 14

theophylline toxicity

Answer 14

Fast and sick

T - Coarse tremor

H - Heart

• Intractable ventricular arrhythmias in adult (restless, agitated, dilated pupils)
• Children are most likely to have supraventricular tachycardia or multi-focal premature ventricular or atrial contractions.

E - Electrolyte: Hypokalemia and hyperglycemia

O - Oxidase inhibition
Metabolism of theophylline is affected by any process which alters activity of the cytochrome oxidases CYP1A2, CYP2E1, and CYP3A4 located in the liver.
(cimetidine, ciprofloxacin, erythromycin, clarithromycin, and verapamil)

P - Pain in abdomen (nausea and vomiting)

H - Headache, insomnia and seizures

Question 15

what reduces concentration of theophylline ?

Answer 15

smoking, alcohol , enzyme inducers ( rifampicin,st johns wort)

Question 16

what increases concentration of theophylline

Answer 16

heart failure, hepatic impairment, viral infections, elderly, enzyme inhibitors

Question 17

therapeutic index of theopphlyine

Answer 17

10-20mg/l (55-110mmol/L)

take a sample 4- 6 hours after dose