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Respiratory Drugs Flashcards

1
Q

Which classes of drugs cause low potassium?

A

Corticosteroids, beta 2 agonists, methylxanthines (aminophylline)

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2
Q

Which drugs cause tachycardia?

A

Beta 2 agonist, methylxanthines (theophylline)- come from caffeine

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3
Q

Which classes cause hyperglycaemia in a diabetic patient?

A

Corticosteroids, beta 2 agonists

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4
Q

Which drugs cause psychiatric side effects?

A

Corticosteroids, leukotriene receptor antagonist

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5
Q

Which class causes osteoporosis?

A

Corticosteroids

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6
Q

How do selective beta2 agonists work?

A

Stimulate b2 adrenoreceptors and cause adenyl cyclase to convert ATP to cAMP which activate a protein kinase
This inhibits myosin light chain kinase inhibits smooth muscle contraction resulting in bronchial smooth muscle relaxation

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7
Q

What is different in dosing of inhaled and nebuliser?

A

Inhaled 100mcg, nebuliser 2.5mg

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8
Q

How does aminophylline work?

A

Inhibits phosphodiesterase which breaks down CAMP into AMP, therefore more protein kinase A

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9
Q

What are side effects of SABA?

A

Fine tremor, resting sinus tachycardia, hypokalaemia

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10
Q

SABA onset and duration?

A

5 minutes, last 4-6 hours

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11
Q

Onset of action of LABA?

A

15-45 mins, Formoterol

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12
Q

How do antimuscarinics work?

A

Bind to muscarinic receptors in bronchial smooth muscle (mainly M2/M3), cause bronchodilator
Tiotropium - selective to m3 due to slow dissociation

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13
Q

What should not be prescribed concurrently?

A

LAMA inhaler, and SAMA-

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14
Q

SAMA onset and duration?

A

Onset 30 mins, 3-5 hours

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15
Q

Dose of SAMA?

A

Nebuliser 500mcg QDS, inhaler 20mcg QDS

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16
Q

When using a nebuliser ipratropium what should you be cautious of?

A

Narrow angle glaucoma due to increased risk of intraocular pressure

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17
Q

Side effects of antimuscarinics?

A

Dry mouth, dry eyes, headache constipation

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18
Q

First line for COPD?

19
Q

Asthma treatment with?

A

LAMA + ICS/LABA

20
Q

Tiotropium onset duration?

A

2 hours onset, lasts 24 hours

21
Q

Which is the only LAMA licensed for COPD and asthma?

A

Respiratory 2.5mcg inhale 2 puffs in the morning

22
Q

How do corticosteroids work in asthma?

A

Decrease formation of stroking skin which activate eosinophils and are responsible for promoting production of IgE
Inhibit COX2 induction- antinflammatory
Inhibit leukotrienes, which would trigger contraction in smooth muscles

23
Q

Side effects of corticosteroids?

A

Oral candidiasis, hoarse voice,

24
Q

LAMA/LABA and ICS are for?

A

COPD patients with asthmatic features suggesting steroid responsiveness who remain breathless or have exacerbation on LABA/LAMA

25
Q

MDI vs DPI?

A

MDI- slow/ steady
DPI- quick and deep

26
Q

Acute attack of asthma/COPD?

A

Asthma- pred 40- 5 days
COPD- Pred 30 for 5-7 days

27
Q

Theophylline is metabolised by?

A

Cytochrome P450, clearance declines with age/comorbidities

28
Q

Smoking cessation …?

A

Increases serum theophylline

29
Q

Theophylline level and monitoring?

A

10-20mg/l
Oral: 4-6 hours after dose then 5 days later
IV: take 6 hours after infusion, then once daily

30
Q

Drug interactions with theophylline?

A

Metabolised by CYP1A2
So enzyme inhibitors such as macrolides, ciprofloxacin will increase levels
Enzyme inducers such as rifampicin/ ritonavir will decrease levels

31
Q

Side effects of theophylline?

A

Headache, insomnia, nausea,
hypokalaemia,
Toxicity: vomiting nausea, tachycardia, ventricular arrhythmia and convulsions
HINT hypokalamia

32
Q

Mucolytics are used in?

A

COPD, severe pneumonia, Cystic Fibrosis, bronchiectasis
carbociterine, acetylcysteine, may report itching

33
Q

How do leukotrienes work?

A

Released from mast cells and eosinophils and cause bronchoconstriction and inflammation

34
Q

LTRA work by?

A

Binding to LT receptors, and airway macrophages and eosinophils blocking bronchoconstriction and mucous secretion

35
Q

Side effects of LTRA?

A

Neuropsychiatric side effects, headaches, GI

36
Q

If hospital stays within 2 weeks treat as?

37
Q

Nicotine withdrawal can cause?

A

Insomnia, irritability, anxiety craving

38
Q

Craving satisfaction?

A

Dual NRT- long acting OD patch plus 1 short acting PRN

39
Q

Nicotine partial agonist, drug to help smoking?

A

Varenicline

40
Q

Asthma guideline?

A
  1. SABA + ICS
  2. ICS + LABA
  3. increase ICS to moderate or add LTRA
    Refer to specialist
41
Q

When to consider stepping up treatment?

A

Increased frequency attacks
x3 or more inhaled b2 agonist
Symptomatic x3 or more
Waking one night a week

42
Q

Asthmatic specialist treatment?

A

Tiotropium respimat
Long term PO corticosteroids
MAB= mepolizumab- eosinophilia asthma
Omalizumab- severe allergic asthma

43
Q

Specialist COPD drug roflumilast?

A

Phosphodiesterase 4 inhibitor

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