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British National Formulary > Chapter 3- Respiratory System > Flashcards

Chapter 3- Respiratory System Flashcards

1
Q

Two advantages of giving drugs via the respiratory tract

A

Dose required is smaller

Side effects are reduced

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2
Q

True or false - budesonide ans beclometasone are approximately equivalent in clinical practice

A

True but there may be variations with different drug delivery devices

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3
Q

Fluticasone and mometasone provide equal activity to beclometasone and budesonide at what dose

A

Half of the dose

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4
Q

In children, high doses of inhaled corticosteroids can be associated with what systemic side effects

A

Growth failure
Reduced bone mineral density
Adrenal suppression

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5
Q

Four symptoms of asthma

A

Cough
Wheezing
Chest tightness
SoB

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6
Q

What 3 things define moderate acute asthma

A

Increasing symptoms
Peak flow > 50-75% best or predicted
No signs of severe acute asthma

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7
Q

What 4 things define severe acute asthma

A

Peak flow 33-50% best or predicted
RR >25/min
HR >110/min
Inability to complete sentences

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8
Q

Name two inhaled short acting b2 agonists

A

Salbutamol

Terbutaline

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9
Q

Name a less selective b2agonist less appropriate for use as a bronchodilator due to risk of causing arrhythmias

A

Ephedrine/adrenaline

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10
Q

Name two long acting b2 agonists used in asthma

A

Formeterol

Salmeterol

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11
Q

Which has a quicker onset of action: salmeterol or formeterol

A

Formeterol - similar to the speed of salbutamol

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12
Q

Name 2 long acting b2agonists indicated in COPD

A

Indacaterol

Olodaterol

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13
Q

Which act quicker - SABA or SAMA

A

SABAAAA

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14
Q

Ipratroprium inhalation reaches peak effect when and lass how long

A

30-60mins after use

Lads 3-6 hours

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15
Q

Combination of b2 agonists + theophylline increase risks of what

A

HYPOkalaemia

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16
Q

List 7 indications where a lower concentration of oxygen therapy may be required

A

COPD
Advanced cystic fibrosis
Severe non CF bronchiectasis
Severe kyphoscoliosis or severe ankylosing spondylitis
Severe lung scarring from TB
Musculoskeletal disorders with respiratory weakness
Overdose of opioids, BZ or others causing resp depression

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17
Q

Name 4 types of oxygen therapy

A

Emergency oxygen
Short burst (intermittent)
Long term
Ambulatory

18
Q

What’s the caution on ipratropium

A

Acute angle-closure glaucoma : ensure to keep nebuliser solution away from eyes

19
Q

Bambuterol is a prodrug of what

A

Terbutaline

20
Q

High doses of salbutamol can cause what type of acidosis

A

Lactic acidosis

21
Q

True or false: QVAR has extra fine particles and is more potent than other beclometasone containing inhalers- it is three times as potent as clenil

A

True apart from it’s TWICE as potent as clenil

22
Q

Name three monoclonal antibodies used in severe asthma

A

Mepolizumab
Omalizumab
Reslizumab

23
Q

Name two leukotriene receptor antagonists used in asthma

A

Montelukast

Zafirlukast

24
Q

How does montelukast and zafirlukast work

A

They are leukotriene receptor antagonists so they block the effects of cysteinyl leukotrienes in the airways

25
Q

What is roflumilast

A

Phosphodiesterase type 4 inhibitor used as an adjunct in COPD

26
Q

What do you need to do when dosing aminophylline in extremes of body weight

A

Use ideal weight for height

27
Q

The plasma theophylline concentration is increased in what 3 conditions

A

Heart failure
Hepatic impairment
Viral infections

28
Q

True or false: the plasma theophylline level is increased in smokers

A

False it’s decreased in smokers

29
Q

True or false: the plasma theophylline level is decreased by alcohol consumption

A

True

30
Q

Signs of overdose of theophylline

A 
Vomiting 
Agitation
Restlessness
Dilated pupils
Sinus tachycardia
Hyperglycaemia 
Haematemesis
Convulsions
Supraventricular and ventricular arrhythmias 
Hypokalaemia
31
Q

Name 8 non-sedating antihistamines

A 
Acrivastine
Bilastine
Cetirazine 
Desloratadine 
Fexofenadine
Levocetirizine 
Loratadine
Mizolastine
32
Q

What’s the caution with high doses of the sedating antihistamine: alimemazine

A

Photosensitivity - avoid exposure to sunlight

33
Q

MHRA warning about chlorphenamine

A

Children under 6 should not be given OTC cough and cold medicines containing chlorphenamine

34
Q

True or false: many antihistamines should be avoided in acute porphyrias

A

True! - some are thought to be safe though

35
Q

MHRA warning with hydroxyzine

A

Risk of QT prolongation and torsade de pointes

36
Q

Risk factors for QT prolongation

A 
Electrolyte imbalances 
Bradycardia
CVD
Family history of cardiac death 
Concomitant drugs that prolong QT
37
Q

MHRA warning advice with promethazine

A

Children under 6 years should not be given OTC cough and cold medicines containing promethazine

38
Q

Contraindication of mucolytics

A

Active peptic ulceration

39
Q

What is dornase alpha

A

Mucolytic used in cyatic fibrosis

40
Q

What drug is indicated for the treatment of cystic fibrosis in patients who have a G551D mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene

A

Ivacaftor

British National Formulary (18 decks)

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