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FINALS > Prescribing - Respiratory > Flashcards

Prescribing - Respiratory Flashcards

1
Q

What drug class is salbutamol?

A

Short acting beta 2 agonist

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2
Q

How do SABA work?

A

Our agonists to the B2 adrenoreceptors in bronchial smooth muscle

causing bronchial smooth muscle relaxation and bronco dilation

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3
Q

When are SABA used?

A

In asthma or COPD

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4
Q

What are common side effects of SA BA?

A

Fine tremor
headache
muscle cramps
palpitations

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5
Q

What are important side effects of SA BA?

A

Arrhythmias
MI
hypokalaemia in high doses
lactic acidosis in high doses

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6
Q

What are contraindications to the use of SA BA?

A

Arrhythmias
hypertension
hypothyroidism
diabetes mellitus

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7
Q

What must be monitored when using S ABA?

A

If using in high doses monitor serum potassium (especially if people are taking theophylline, corticosteroids, diuretics)

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8
Q

What should be communicated to patients when taking SA BAs?

A

Salbutamol is a reliever inhaler should be used only when experiencing asthma symptoms it will not prevent attacks

explain the importance of inhaler technique if patients are having trouble with this they may benefit from the use of a spacer, dry powder inhaler, or breath activated inhaler

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9
Q

What drug class is Tiotropium bromide?

A

An inhaled anti-muscarinic/anti-cholinergic

long acting

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10
Q

What is a short acting anti-Muscarinic and/anti-cholinergic agent

A

ipatropium bromide

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11
Q

How do anti-muscarinic’s/anticholinergics work?

A

Competitive antagonist to M3 receptors

causing bronchial smooth muscle relaxation and bronco dilation

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12
Q

When are anti-muscarinic/anticholinergic’s used in resp medicine?

A

Reversible airway obstruction mainly COPD

short acting agents I use in acute bronchospasm

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13
Q

What are common adverse effects of anti-muscarinic/anticholinergic’s?

A 
Dry mouth
nausea
headache
constipation
cough
diarrhoea
sinusitis
nosebleeds
oral thrush
taste disturbances
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14
Q

What are important adverse effects of anti-muscarinic/anticholinergic’s?

A 
Atrial fibrillation
acute angle closure glaucoma
urinary retention
paradoxical bronchospasm
blurred vision
GORD
 dental caries
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15
Q

What are contraindications to the use of anti-muscarinic/anticholinergic’s?

A

Prostatic hyperplasia
bladder outflow obstruction
those at risk of acute angle closure glaucoma

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16
Q

What do anti-muscarinic/anticholinergic’s interact with?

A

None really

17
Q

What drug monitoring is required for anti-muscarinic/anticholinergic’s?

A

None really just watch out for adverse effects

18
Q

What is important to communicate patients when using anti-muscarinic/anticholinergic’s?

A

They should not exceed the prescribed daily dose

importance of inhaler technique

19
Q

What drug class is montelukast?

A

Early leukotriene receptor antagonist (LTRA)

20
Q

How do LTR A’s work?

A

Block the action of leukotrienes (which are pro-inflammatory) in airway smooth muscle cells thus reducing our information in asthma and rhinitis

21
Q

When would you use LTRA’s?

A

Persistently poor controlled asthma (step four)

symptom relief in allergic rhinitis and asthma patients

of benefit in exercise or aspirin induced asthma

22
Q

What are common side effects of LTR A’s?

A

Abdominal pain
headache
hyperkinesia (young children)
thirst

23
Q

What are important side-effects of LTR A’s?

A

Churg-strouss syndrome

hypersensitivity - including anaphylaxis and angioedema

Depression

seizures

a granulosis/ hepatotoxicity (with zafirlukast)

24
Q

What drugs do LTR A’s interact with?

A

Warfarin – increased anticoagulation

25
Q

What should be communicated to patients about LTR A’s?

A

This is for long-term prophylaxis not for acute exacerbations

should be warned of the symptoms of churg-strouss syndrome

should be warned of agranulosis symptoms

26
Q

what is charge-strouss syndome?

A

very rare but watch out for eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications, or peripheral neuropathy

27
Q

What is Chlorphenamine?

A

An antihistamine

28
Q

How do antihistamines work?

A

Compete for binding site on H1 receptors with histamine

blocking the acute inflammatory effects of histamine

these are vasodilation, increase vascular permeability

29
Q

What are common side effects of antihistamines?

A 
Drowsiness
blurred vision
dry mouth
GI disturbance
headaches
psychomotor impairment
urinary retention
30
Q

What are serious side-effects of antihistamines?

A 
Extrapyramidal effects
hypersensitivity reactions (including bronchospasm, angioedema, anaphylaxis, rashes)
31
Q

When are antihistamines contraindicated?

A

Avoid in severe liver disease, pregnancy and breastfeeding

caution with sedating antihistamines as they have significant anti-muscarinic activity (don’t use with prostatic hyperplasia, urinary retention, those at risk of angle closure glaucoma)

32
Q

What do antihistamines interact with?

A

Antidepressants - increased sedative and and whose chronic effects especially with MAOIs or TCA

33
Q

What is Pseudoephedrine?

A

A nasal decongestant

34
Q

How does Pseudoephedrine work?

A

Agonist to alpha and beta adrenal receptors meaning there is vascular smooth muscle contraction and vasoconstriction

and bronchial smooth muscle relaxation and bronco dilation

35
Q

What are common side effects toPseudoephedrine?

A 
Anxiety
 headache
 hypertension
 insomnia
 nausea
 restlessness
 tachycardia
 vomiting
36
Q

What are important side-effects to Pseudoephedrine?

A

Hallucinations
angle closure glaucoma
urinary retention

37
Q

When is Pseudoephedrine contraindicated?

A 
Diabetes
hypertension
hyperthyroidism
ischaemic heart disease
prostatic hypertrophy
anyone at risk of angle closure glaucoma
38
Q

What doesPseudoephedrine interact with?

A

Alpha blockers – reduced hypotensive effect

MAOIS - risk of hypertensive crisis absolute contraindication!!

39
Q

What is important to communicate patients about taking Pseudoephedrine?

A

can cause insomnia so do not take at night

FINALS (24 decks)

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