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Medicine: Pharmacology > Respiratory > Flashcards

Respiratory Flashcards

1
Q

How does salbutamol work ?

A

Stimulate B2 receptors in airways (sympathetic stimulation) promoting bronchodilation
- also inhibits uterine smooth muscle contraction in premature labour

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2
Q

Indictations for salbutamol

A
  • asthma
  • chronic bronchitis
  • Premature labour
  • severe bronchospasm
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3
Q

Contraindications and cautions of salbutamol

A
  • Tachyarrhythmias
  • hypersensitivity

Caution in:

  • CV disease
  • hyperthyroidism
  • long QT
  • diabetes
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4
Q

What are the side effects of beta 2 agonists?

A
  • fine tremor (usually in hands)
  • nervous tension
  • headache
  • muscle cramps
  • palpitations
  • Hypokalaemia (rare)
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5
Q

What is the main route of elimination of salbutamol ?

A

Hepatic

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6
Q

Under what conditions is salbutamol more likely to cause hypokalaemia ?

A

If delivered by nebuliser or parenterally

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7
Q

What drug class is ipratropium bromide ?

A

Anticholinergic, antimuscarinic bronchodilator

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8
Q

Indications for ipratropium bromide

A
  • reversible airways obstruction
  • COPD
  • rhinitis
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9
Q

How does ipratropium bromide work ?

A
  • Inhibit parasympathetic impulses (from CNS and PNS) by competitively blocking acetylcholine therefore preventing contraction of smooth muscle (specifically lungs)
  • also inhibits muscarinic ACh receptors, inhibiting mucous secretion in the bronchi
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10
Q

In which patients should antimuscarinics be used with caution ?

A
  • benign prostatic hyperplasia
  • bladder outflow obstruction
  • those at risk of closed angle glaucoma
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11
Q

What are the side effects of antimuscarinic bronchodilators ?

A
  • dry mouth (most common)
  • nausea
  • headache
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12
Q

What are the possible interactions of ipratropium bromide ?

A
  • Clarithromycin and erythromycin

- Increased side effects with antidepressants

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13
Q

What class of drug is prednisolone ?

A

Corticosteroid

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14
Q

How does prednisolone work ?

A
  • Inhibits Phospholipase A2 activity = decreased arachidonic acid production (precursor for prostaglandin and leukotriene synthesis)
  • therefore less inflammatory mediators produced= anti inflammatory effect
  • immunosupressive effect (decreased B and T lymphocyte response)
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15
Q

Indications for prednisolone:

A

Suppression of inflammatory and allergic disorders:

  • IBD
  • asthma
  • croup
  • immunosupression (leukaemia, transplant)
  • rheumatic diseases
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16
Q

Contraindications of prednisolone

A
  • adrenal suppression
  • systemic infection
  • osteoporosis
17
Q

Side effects of corticosteroids

A
  • more susceptible to infections (severe with atypical presentation)
  • bruising
  • hirsutism (abn. Female hair growth)
  • moon face
18
Q

Interactions of prednisolone

A

Phenytoin and rifampicin cause decreased effects of prednisolone

19
Q

Elimination of prednisolone

A

Renal

20
Q

Why can’t prednisolone treatment be stopped abruptly ?

A

Adrenal crisis

21
Q

What drug class is oxygen ?

A

Therapeutic gas

22
Q

Indications for oxygen therapy?

A
  • resuscitation (100%)
  • acute hypoxic events e.g. MI, asthma, PE, sepsis (60%)
  • risk of hypercapnic respiratory failure e.g. COPD
23
Q

What oxygen saturation should be aimed for in those at risk of hypercapnic respiratory failure (COPD) ?

A

88-92%

24
Q

Which drug is in the brown inhaler (disease controller)?

A

Inhaled corticosteroid e.g. Beclometasone , budesonide, fluticasone

25
Q

Other than inhaled corticosteroids which other disease modifying drugs can be used ?

A

Leukotriene modifiers - prevents wheezing and shortness of breath in asthma by blocking release of leukotrienes from mast cells, basophils and eosinophils which normally cause constriction and increased mucus production

26
Q

What drug class is salbutamol ?

A

Short acting Beta-2 agonist

Medicine: Pharmacology (10 decks)

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