Respiratory Drugs

Question 1

Salbutamol

Answer 1

(SABA) Asthma and COPD
Short acting, inhaled (neb), IV, oral
Binds to beta(2)-receptors in the lungs relaxing bronchial smooth muscles.
Increases cAMP production by activating adenylate cyclase

Question 2

Salmeterol (formoterol)

Answer 2

(LABA) Asthma in pt req. long dose bronchodilator therapy on ICS (not PRN) COPD: persistent symptoms despite therapy (ICS/LABA combination FEV1 < 50%) - seretide
Long acting, inhaled (neb)
Long-acting beta-adrenoceptor agonist

Question 3

Tiotropium, Aclidinium bromide

Answer 3

(LAMA) Stable COPD (symptoms despite SABA), asthma
Long acting (24 hour), inhaled
Inhaled (Dry powder Handihaler/Mist resimat)
Long-acting, antimuscarinic/anticholinergic
Affinity to M1 - M5, inhibition of M3 on smooth bronchial muscle causes bronchodilation

Question 4

Ipratropium

Answer 4

(SAMA) Acute presentations of COPD/asthma (neb)

Short acting, MDI, neb

Question 5

Theophylline

Answer 5

PO in persistent COPD/asthma
IV in asthma emergencies
Phosphodiesterase inhibitor

Question 6

Adverse effects of Bronchodilators

Answer 6

Tachycardia
Nervousness, Irritability, Tremor
Oral > neb: tachyarrhythmias/Angina
Usually dose related

Question 7

Perfenidone

Answer 7

Idiopathic pulmonary fibrosis
Anti inflammatory/ Anti Fibrotic
Reduces fibroblast proliferation, reduces collagen production

Question 8

Ivakaftor

Answer 8

Cystic Fibrosis Tx

Question 9

Tazobactam

Answer 9

HAP, gram -ve (extended spectrum b lactam)

Question 10

Doxycycline

Answer 10

Tetracycline, inhibits protein synthesis, gram +ve and -ve
Useful for atypical infections eg. mycoplasma
Oral only
Side effects - GI Upset, staining teeth, lupus, allergy, photosensitivity

Question 11

Beclometasone (intranasal)

Answer 11

Allergic rhinitis

Question 12

Pseudoephedrine

Answer 12

Allergic rhinitis, alpha agonist, anticongestant, problems with abuse and combinations with MAOI

Question 13

Cetirizine, Chlorpheniramine

Answer 13

Antihistamines H1 antagonists

Se: drowsiness, dry mouth, dry eyes, confusion

Question 14

DOT and VOT

Answer 14

Directly/video observed treatment eg. for those unable to adhere with six months of treatment

Question 15

Prednisolone/Azathioprine/MMF

Answer 15

Idiopathic interstitial pneumonia

Question 16

Adverse effects of glucocorticoids

Answer 16

Oral candidiasis if inhaled
Adrenal suppression
Bone loss: exercise, Vit D, calcium
Slow growth in children, but not ultimate height
Increase risk of cataracts and glaucoma
Increased risk of infection
Gastric ulceration
Hypertension
Diabetes
Mood disturbance