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drugs y3 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Example of B2 agonist

A

salbutamol (SABA)

salmeterol (LABA)

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2
Q

how do beta agonists work

A
  • stimulates the B2 receptor located on smooth muscle of the bronchial tree, causing it to relax, causing vasodilation
  • also causes K+ to move from extracellular to intracellular, decreasing K+ concentration in the blood
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3
Q

when are beta2 agonists used

A
  • asthma
  • COPD
  • hyperkalaemia
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4
Q

contradictions for b2 agonists

A

cardiac conditions, arrhythmias

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5
Q

side effects of b2 agonists

A

tremor, muscle cramps, anxiety, palpitations, arrhythmias, tachycardia

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6
Q

possible interactions of B2 agonists

A
  • beta blockers reduce effectiveness
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7
Q

how to give salbutamol as nebs in asthma

A

with oxygen

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8
Q

how to give salbutamol as nebs in COPD

A

with air to prevent CO2 retention

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9
Q

examples of anti-cholinergics / anti-muscarinics

A

SAMA - ipratropium

LAMA - tiotropium

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10
Q

how do anti-muscarinics work

A

competitive inhibitor for AcetylCholine on muscarinic receptors, decreasing smooth muscle tone, increasing HR and conductivity and decreasing glandular and tract secretion

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11
Q

when are anti-muscarinics used

A

COPD - SAMA used to relieve, LAMA used to prevent

Asthma - SAMA added to SABA to relieve or LAMA added to LABA and inhaled corticosteroid to prevent

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12
Q

contraindications for anti-muscarinics

A

those at risk of glaucoma (due to risk of increased intra-ocular pressure), arrhythmias, urinary retention

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13
Q

side effects of anti-muscarinics

A

arrhythmias, GI disturbance, resp tract irritation, sinusitis, constipation, cough, dry mouth

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14
Q

possible interactions for anti-muscarinics

A

drugs with other anti-muscarinic effect e.g., tricyclic anti-depressants

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15
Q

example of inhaled corticosteroids

A

beclomethasone

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16
Q

how do inhaled corticosteroids work

A

enter cells and modify gene transcription, down-regulating pro-inflammatory interleukins, cytokines and chemokine and up-regulating anti-inflammatory proteins
- they decrease mucosal inflammation, widen airways and decrease mucus secretion

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17
Q

when are inhaled corticosteroids used

A

asthma and COPD - used as preventers and to decrease exacerbations

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18
Q

contraindications for inhaled corticosteroids

A

history of pneumonia and in children be cautious - can cause growth suppression

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19
Q

side effects for inhaled corticosteroids

A

oral candidiasis, pneumonia risk

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20
Q

example of systemic corticosteroids

A

prednisolone

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21
Q

how does prednisolone work

A
  • binds to glucocorticoid receptors and up regulates anti-inflammatory genes and down-regulates pro-inflammatory genes
  • mineralocorticoid effects by stimulating Na and water retention and K+ secretion in the renal tubule
22
Q

when is prednisolone used

A
  • allergic and inflammatory disorders
  • autoimmune suppression
  • cancer to decrease tumour swelling
  • HRT in adrenal insufficiency and hypopituitarism
23
Q

contraindications for prednisolone

A

infection and children (can cause growth suppression)

24
Q

side effects of prednisolone

A

immunosuppression, mood changes (insomnia, psychosis, suicidal thoughts, confusion), muscle weakness, easy bruising, DM, osteoporosis, adrenal atrophy

25
interactions of prednisolone
NSAIDs increase risk of GI bleed, cytochrome P450 inhibitors decrease efficacy
26
examples of mucolytics
carbocisteine
27
how do mucolytics work
decrease sputum viscosity, facilitating expectoration
28
when are mucolytics used
COPD (decrease eaccerbations), Bronchiectasis (via steam inhalation)
29
contraindications for mucolytics
peptic ulcers (can disrupt the gastric barrier)
30
side effects of mucolytics
peptic ulcers, rarely gastric bleed
31
examples of xanthines
theophylline
32
how do xanthines work
- competitive non-selective phosphodiesterase inhibitors, which increase intracellular cAMP, inhibiting leukotriene synthesis, thus decreasing inflammation and innate immunity - non-selective adenosine receptor antagnoist (preventing the blocking of irregular heart signals)
33
when are xanthines (theophylline) used
asthma and stable COPD as a bronchodilator
34
when are xanthines contraindicated
cardiac disease (arrhythmias), peptic ulcer disease, hyperthyroidism, hypertension, epilepsy, hypokalaemia risk
35
side effects of xanthines (theophylline)
arrhythmias, N&V, diarrhoea, gastric irritation, palpitations, tachycardia, headache, insomnia, convulsions
36
interactions of xanthines (theophylline)
may have additive effects if used with b2 agonists such as increasing chance of hypokalaemia
37
how does oxygen therapy work
increase pO2, increasing diffusion of oxygen to issues
38
when do you use oxygen therapy
- pneumothorax - CO poisoning - acute hypoxaemia - chronic hypoxaemia
39
how does oxygen therapy work in pneumothorax
O2 causes decrease in N2, increasing diffusion of nitrogen out of the body
40
how does oxygen therapy work in CO poisoning
decreases carboxyhemoglobin half life
41
contraindications for oxygen therapy
chronic type 2 resp failure (severe COPD) - can result in hypercapnia
42
side effects of oxygen therapy
discomfort
43
types of oxygen therapy
- reservoir mask (non-rebreathe) - venturi mask - nasal cannula - simple facemask - non-invasive ventilation (BiPAP / CPAP)
44
target O2 levels
94-98%
45
target O2 levels in someone with chronic type 2 RF
88-92%
46
when to use a reservoir / non-rebreathe mask
acute settings - if SpO1 <85% - continuous supply
47
when to use a Venturi mask
- oxygen and air blended | - if target is less (in CT2RF)
48
when to use a nasal cannula
- if possible | - variable O2 conc
49
when to use a simple facemask
- variable O2 conc | - if nasal cannula cannot be used
50
when to use NIV
- if CO2 retention and hypoxic | - last resort as difficult to wean off

drugs y3 (10 decks)

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