Respiratory

Question 1

What class is Salbutamol?

Answer 1

Beta 2 agonist

Question 2

What diseases is Salbutamol used in?

Answer 2

Asthma
COPD
Hyperkalaemia

Question 3

How does Salbutamol work?

Answer 3

Relaxes smooth muscles in bronchi, GI, uterus and vasculature via G protein coupled receptors
Stimulates sodium potassium ATPase pump in case of hyperkalaemia

Question 4

What are the side effects of Salbutamol?

Answer 4

Tachycardia, palpitations, tremor, raised glucose, cramps (long acting)

Question 5

What are the contraindications of Salbutamol?

Answer 5

If long acting treatment of asthma, must be used with corticosteroid
CVD - tachycardia can lead to angina or arrhythmias

Question 6

Important drug interactions of Salbutamol?

Answer 6

Beta blockers reduce effectiveness

Theophylline/corticosteroids can cause hypokalaemia

Question 7

What class is Tiotropium?

Answer 7

Antimuscarinic

Question 8

What is the equivalent of Tiotropium used for cardiac and GI problems?

Answer 8

Atropine, hyoscine butylbromide

Question 9

What are the role of drugs like Atropine and Hyoscine butylbromide?

Answer 9

Helping with respiratory secretions in the dying patient

Used in bradycardia and IBS (not atropine)

Question 10

What diseases is Tiotropium used in?

Answer 10

COPD, asthma

Question 11

How does Tiotropium work?

Answer 11

Competitive ACh inhibitor, reduces smooth muscle tone and reduces secretions from glands

Question 12

What are the side effects of Tiotropium?

Answer 12

Dry mouth

Question 13

What are the contraindications of Tiotropium?

Answer 13

Patients susceptible to angle closure glaucoma due to rise in IOP

Question 14

Important drug interactions of Tiotropium?

Answer 14

Low systemic absorption

Question 15

Side effects of Atropine and Hyoscine butylbromide?

Answer 15

Urinary retention in BPH patients, blurred vision, constipation, dry mouth, tachycardia

Question 16

Important drug interactions of Atropine and Hyoscine butylbromide?

Answer 16

More serious side effects when combined with TCAs

Question 17

What class is Beclometasone?

Answer 17

Corticosteroid (glucocorticoids)

Question 18

What is a systemic equivalent of Beclometasone?

Answer 18

Prednisolone

Question 19

What is a topical equivalent of Beclometasone?

Answer 19

Hydrocortisone, betamethasone

Question 20

What diseases is Beclometasone used in?

Answer 20

Asthma inc exacerbation

COPD inc exacerbation

Question 21

How does Beclometasone work?

Answer 21

Anti-inflammatory genes are upregulated
Pro-inflammatory genes are downregulated
This reduces mucosal inflammation
Widens airways
Reduces secretions

Question 22

What are the side effects of Beclometasone?

Answer 22

Oral candidiasis
Can increase risk of pneumonia
Hoarse voice

Question 23

What are the contraindications of Beclometasone?

Answer 23

Caution in children due to stunted growth

Or those with history of pneumonia

Question 24

Important drug interactions of Beclometasone?

Answer 24

Low systemic absorption

Question 25

How does Prednisolone and Hydrocortisone work?

Answer 25

``` Modify immune response Promote anti-inflammatory genes over pro-inflammatory Stimulate water and sodium retention Potassium excretion Gluconeogenesis ```

Question 26

What uses does Prednisolone have?

Answer 26

Allergy Autoimmune Cancer Hormone replacement - adrenal insufficiency

Question 27

What are the side effects of Prednisolone?

Answer 27

``` Increased risk of infection DM Osteoporosis Mood Hypertension Hypokalaemia Adrenal atrophy in prolonged treatment ```

Question 28

Important drug interactions of Prednisolone?

Answer 28

NSAIDs | Efficacy may be reduced by P450 Inducers

Question 29

What are the side effects of Hydrocortisone/Betamethasone?

Answer 29

Only most potent have side effects (betamethasone) Local skin effects: skin thinning, striae, telangietasia Can exacerbate or cause acne if used on the face

Question 30

What class is Carbocysteine?

Answer 30

Mucolytics

Question 31

What uses does Carbocysteine have?

Answer 31

Respiratory Tract infections | Mucus secreting COPD

Question 32

How does Carbocysteine work?

Answer 32

Reduces mucus viscosity | Increased sialomucin to make it easier to cough up

Question 33

What are the side effects of Carbocysteine?

Answer 33

Wheezing Dyspnoea Facial swelling Pruritic skin rash

Question 34

What are the contraindications of Carbocysteine?

Answer 34

Gastric ulcer | First trimester pregnancy

Question 35

Important drug interactions of Carbocysteine?

Answer 35

None

Question 36

What class is Theophylline?

Answer 36

Xanthine derivative

Question 37

What uses does Theophylline have?

Answer 37

Asthma COPD Lung problems in premature infants

Question 38

How does Theophylline work?

Answer 38

Competitive phosphodiesterase inhibitor Relax intercostal muscles More Diaphragm contraction Lower irritant response

Question 39

What are the side effects of Theophylline?

Answer 39

``` GI problems Insomina Irritability Tachycardia Seizures ```

Question 40

What are the contraindications of Theophylline?

Answer 40

High caffeine intake (a bit of Theophylline gets metabolised to caffeine in the liver) Smoking Alcohol Third trimester pregnancy

Question 41

Important drug interactions of Theophylline?

Answer 41

Cimetidine increases effect of Theophylline Phenytoin Erythromycin Fluoroquinalones

Question 42

What are the uses of Oxygen?

Answer 42

Hypoxia Pneumothorax CO poisoning