Inhalation preparation

Question 1

Name SABA’s

Answer 1

Salbutamol, terbutaline

Question 2

What is the duration of action of a SABA

Answer 2

4 hours

Question 3

Name LABA’s

Answer 3

Salmeterol, Formeterol, Vilanterol

Question 4

What is the duration of action of a LABA

Answer 4

12 hours

Question 5

Whats the normal dose of beta agonists

Answer 5

1 to 2 puffs up to four times a day (max 8 daily)

Question 6

What are the cations with beta 2 agonists

Answer 6

Caution in diabetes as can cause DKA, especially after IV administration
Can cause risk of arrhythmias
Can cause hypokalaemia - increase risk of QT prolongation

Question 7

What are the side effects of beta 2 agonists

Answer 7

fine tremor, palpitations, headache, seizure and anxiety

Question 8

What are the risks of beta 2 agonists with digoxin?

Answer 8

Can cause digoxin toxicity due to hypokalaemia

Question 9

Name a SAMA

Answer 9

Ipratropium

Question 10

Name a LAMA

Answer 10

Tiotropium, aclnidium, glycopyrronium, umeclinidium

Question 11

What are the side effects of muscarinic antagonists

Answer 11

antimuscarinic side effects
constipation, dry mouth, increase occular pressure (repeat halo’s or blurred vision)
Acts on the parasympathetic pathway

Question 12

What are the interactions with the SAMA/LAMA’s

Answer 12

Other antimuscarinic drugs
TCA
Solifenacin

Question 13

Name inhaled corticosteroids

Answer 13

Beclomethasone, budesonide, ciclesonide, fluticisone, mometasone

Question 14

How often do you take the inhaled corticosteroids

Answer 14

Twice a day apart from ciclesonide which is once a day

Question 15

What inhaled corticosteroid should be prescribed by brand and why?

Answer 15

Beclomethasone
Qvar and Kelhale have 2x extra fine articles and are 2x stronger

Question 16

When should a patient be provided with a steroid card?

Answer 16

If receiving long term treatment with high dose corticosteroids

Question 17

What should you monitor in children that are taking inhaled corticosteroids?

Answer 17

Height and weight annually
If slow growth then paediatrician referral.

Question 18

What can inhaled corticosteroids do for your taste and voice?

Answer 18

Alter it

Question 19

How do you reduce oral thrush associated with inhaled corticosteroid use?

Answer 19

Use a spacer
Rinse mouth out after using

Question 20

Inhaled corticosteroids can cause paradoxical bronchospasm, how can this be reduced?

Answer 20

Inhaling SABA beforehand
Change from aerosol formulation to dry powder inhalation

Question 21

What are the side effects / MHRA warnings with LTRA?

Answer 21

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.

Question 22

Interactions of montelukast?

Answer 22

CYP enzyme substrates