Pharmacology

Question 1

SABA

Answer 1

Short acting beta 2 agonist E.g. Salbutamol

• 1st line drug for acute asthma

MOA - Binds to beta 2 adrenergic receptors, stimulates adenylate cyclase, increasing cAMP, leading to smooth muscle relaxation

SE - Tremor, palpitations, hypokalaemia, headaches

Question 2

SAMA

Answer 2

Short acting Muscarinic antagonist E.g. Ipratropium bromide

MOA - Ach antagonist, binding to receptors on smooth muscle, preventing bronchospasm and reduced secretions

SE - can cause dry mouth, cough, arrhythmia’s, palpitations

Question 3

LABA

Answer 3

Long acting beta 2 agonist E.g. Salmeterol, formoterol, indacaterol

MOA - Binds to beta 2 adrenergic receptors, stimulates adenylate cyclase, increase cAMP, leading to smooth muscle relaxation

SE -Tremors, palpitations, arrythmias

Question 4

LAMA

Answer 4

Long acting Muscarinic antagonists E.g. Tiotropium

MOA - Ach antagonist, blocks receptors on smooth muscle, antagonising bronchospasm and reducing secretions

SE - Dry mouth, cough, arrhythmias, palpitations

Question 5

Inhaled corticosteroids

Answer 5

MOA - Inhibits phospholipase A2 and COX 2 enzymes, reducing inflammation and increasing B2 receptor response

SE - sore mouth or throat, cough, croaky voice, oral thrush, stunted growth in children

E.g. Beclomethasone, fluticasone, budesonide

Question 6

COPD treatment flow chart

Answer 6

1st - SABA or SAMA:

Still breathless - LABA and ICS - continually breathless - LABA, LAMA, ICS

No breathless features - LABA and LAMA

SABA taken for acute exacerbation

Question 7

Leukotriene receptor antagonists

Answer 7

MOA - Block leukotriene receptors that prevent the action of leukotrienes that are involved in inflammation, nasal congestion and allergies (help prevent asthma, COPD and allergies)

• Leukotrienes are synthesised from arachidonic acid by the action of 5 - lipoxygenase

SE - Headache, abdominal pain, chaurg-strauss syndrome

E.g. Montelukast, Zafirlukast, zileuton

Question 8

Salbutamol

Answer 8

beta 2 agonist

Question 9

Ipratropium bromide

Answer 9

SAMA

Question 10

Salmeterol, formoterol, indacaterol

Answer 10

LABA

Question 11

Tiotropium

Answer 11

LAMA

Question 12

Beclomethasone, fluticasone, budesomide

Answer 12

ICS

Question 13

Montelukast, Zafirlukast, zileuton

Answer 13

Leukotriene receptor antagonists

Question 14

Roflumilast

Answer 14

MOA - Oral selective phosphodiesterase 4 inhibitor, increasing cAMP levels especially in lungs, reducing eosinophil and neutrophils (anti-inflammatory)

Sx - Diarrhoea, nausea, headache, weight-loss

PDE - breaks down cAMP usually

Question 15

Theophylline

Answer 15

Non - specific PDE inhibitor, cAMP levels, reducing wheezing, inflammation…