DODT pt4

Question 1

Drug Class: Fentanyl

Answer 1

Opioid

Question 2

Drug Class: Salbutamol

Answer 2

SABA

Question 3

Drug Class: Theophylline

Answer 3

Adenosine receptor antagonist

Question 4

Drug Class: Metoclopramide

Answer 4

Antiemetic

Question 5

Drug Class: Omeprazole

Answer 5

Proton pump inhibitor

Question 6

Indications: Fentanyl

Answer 6

Analgesia, anaesthetic

Question 7

Indications: Salbutamol

Answer 7

Acute exacerbations of asthma (or to prevent one e.g., before exercise) + for symptom relief through reversal of bronchoconstriction).

Question 8

Indications: Theophylline

Answer 8

Chronic or poorly controlled asthma

Question 9

Indications: Metoclopramide

Answer 9

post-op (anaesthetic waring off?) or post chemo nausea and vomitting

Question 10

Indications: Omeprazole

Answer 10

GORD, peptic ulcers

Question 11

Mechanism of action: Fentanyl

Answer 11

Opioid receptor agonist (strong)

Question 12

Mechanism of action: Salbutamol

Answer 12

Beta-2 adrenergic receptor agonist - this receptor allows bronchodilation

Short + Fast acting = good for acute exacerbations

Question 13

Mechanism of action: Theophylline

Answer 13

Relaxes the smooth muscles located in the bronchial airways and pulmonary blood vessels.
Also reduces the airway responsiveness to histamine, adenosine, methacholine, and allergens

Question 14

Mechanism of action: Metoclopramide

Answer 14

Central dopamine antagonist, peripheral cholinergic agonist

Question 15

Mechanism of action: Omeprazole

Answer 15

Irreversibly inhibits the H+/K+ ATPase

Question 16

Adverse drug reactions: Fentanyl

Answer 16

Resp depression, constipation, vomiting

Question 17

Adverse drug reactions: Salbutamol

Answer 17

Adrenergic effects: tachy, palpitations, anxiety, tremor, increased glycogenolysis in the liver, increased renin release from kidneys, SVT (because it increases SAN activity -> increases HR -> lowers refractory period at AVN)

Question 18

Adverse drug reactions: Theophylline

Answer 18

Anxiety, arrhythmias, palpitations, seizure, diarrhoea, GI upset, nausea, vomiting, GORD, dizziness, headache, hyperuricaemia, skin reactions, sleep disorders, tremor, urinary disorders

Question 19

Adverse drug reactions: Metoclopramide

Answer 19

Depression, diarrhoea, drowsiness, hypotension, galactorrhoea, extra-pyramidal effects i.e., dystonia or parkinsonism

Question 20

Adverse drug reactions: Omeprazole

Answer 20

Uncommon but include headache, diarrhoea, rashes.

Acid suppression with PPIs is associated with increased risk of C diff diarrhoea

Question 21

Contraindications, Warnings, DDIs: Fentanyl

Answer 21

Warnings: drivers/heavy machinery, elderly, bedbound, asthmatics, biliary tract obstruction, resp diseases, renal impairment, pregnancy

Contrindicated in: hepatic failure, acute resp distress, comatose, head injuries, raised ICP

Question 22

Contraindications, Warnings, DDIs: Salbutamol

Answer 22

β-blockers may reduce effects of β2 agonist.

Question 23

Contraindications, Warnings, DDIs: Theophylline

Answer 23

Narrow therapeutic index (potentially life thretening complications incl. arrythmias)

CYP450 inhibitor - increases concentration of theophylline

Question 24

Contraindications, Warnings, DDIs: Metoclopramide

Answer 24

Other dopamine antagonists like levodopa

Question 25

Contraindications, Warnings, DDIs: Omeprazole

Answer 25

Is a CYP inhibitor -> reduces clopidogrel action, can increase effects of warfarin and phenytoin