Inhalation preparation Flashcards
Name SABA’s
Salbutamol, terbutaline
What is the duration of action of a SABA
4 hours
Name LABA’s
Salmeterol, Formeterol, Vilanterol
What is the duration of action of a LABA
12 hours
Whats the normal dose of beta agonists
1 to 2 puffs up to four times a day (max 8 daily)
What are the cations with beta 2 agonists
Caution in diabetes as can cause DKA, especially after IV administration
Can cause risk of arrhythmias
Can cause hypokalaemia - increase risk of QT prolongation
What are the side effects of beta 2 agonists
fine tremor, palpitations, headache, seizure and anxiety
What are the risks of beta 2 agonists with digoxin?
Can cause digoxin toxicity due to hypokalaemia
Name a SAMA
Ipratropium
Name a LAMA
Tiotropium, aclnidium, glycopyrronium, umeclinidium
What are the side effects of muscarinic antagonists
antimuscarinic side effects
constipation, dry mouth, increase occular pressure (repeat halo’s or blurred vision)
Acts on the parasympathetic pathway
What are the interactions with the SAMA/LAMA’s
Other antimuscarinic drugs
TCA
Solifenacin
Name inhaled corticosteroids
Beclomethasone, budesonide, ciclesonide, fluticisone, mometasone
How often do you take the inhaled corticosteroids
Twice a day apart from ciclesonide which is once a day
What inhaled corticosteroid should be prescribed by brand and why?
Beclomethasone
Qvar and Kelhale have 2x extra fine articles and are 2x stronger
When should a patient be provided with a steroid card?
If receiving long term treatment with high dose corticosteroids
What should you monitor in children that are taking inhaled corticosteroids?
Height and weight annually
If slow growth then paediatrician referral.
What can inhaled corticosteroids do for your taste and voice?
Alter it
How do you reduce oral thrush associated with inhaled corticosteroid use?
Use a spacer
Rinse mouth out after using
Inhaled corticosteroids can cause paradoxical bronchospasm, how can this be reduced?
Inhaling SABA beforehand
Change from aerosol formulation to dry powder inhalation
What are the side effects / MHRA warnings with LTRA?
Risk of neuropsychiatric reactions - seek medical attention of speech or behavioural changes occur
Churg-strauss syndrome
eosinophilia, vascular rash, worsening pulmonary symptoms, cardiac complications or peripheral neuropathy.
Interactions of montelukast?
CYP enzyme substrates
