respiratory drugs

Question 1

what is salbutamol?

Answer 1

short acting beta agonist

Question 2

what are the side effects of SABA?

Answer 2

tachycardia (b1-mediated)
tremor (b2-mediated)
teceptor downregulation and desensitisation

Question 3

what drug should be administered prophylactically for exercise-inducted asthma?

Answer 3

SABA (salbutamol)

Question 4

what drug should be given for chronic (late) phase of asthma?

Answer 4

LABA (formoterol, salmeterol)

Question 5

what are the side effects of ICS (budesonide, fluticasone)?

Answer 5

dysphonia
oral candidiasis
Cushing’s syndrome
suppress response to infection and injury (poor wound healing)
growth suppression (use cautiously in children)

Question 6

what is the MOA of ICS?

Answer 6

1. reduced cytokine synthesis (decreased eosinophil activation)
2. reduced activity of PLA2 (precursor of prostaglandins and leukotrienes)
3. reduced COX-2 synthesis
4. reduced IgE (decreased mast cell activation, histamine release)

Question 7

what is ipratropium?

Answer 7

SAMA –> blocks vagal tone –> bronchodilation

Question 8

what is tiotropium?

Answer 8

long acting M3 antagonist (LAMA)

Question 9

what is montelukast?

Answer 9

leukotriene receptor antagonist

Question 10

what is theophylline?

Answer 10

phosphodiesterase inhibitor –> inhibit cAMP breakdown –> bronchodilation

Question 11

what drugs are indicated for acute symptoms of COPD?

Answer 11

salbutamol (SABA) or ipratropium (SAMA)

Question 12

which drugs are prescribed for additive effects in the treatment of COPD?

Answer 12

tiotropium (LAMA) and formoterol (LABA)

Question 13

what is included in the triple therapy inhaler for COPD?

Answer 13

ICS + LAMA + LABA

Question 14

what drugs are given for COPD exacerbations?

Answer 14

1. oral steroids
2. antibiotics
3. bronchodilators

Question 15

which drug inhibits bacterial cell wall synthesis by inhibiting the action of transpeptidase?

Answer 15

amoxicillin (penicillin)

Question 16

what is the MOA of clavulanate?

Answer 16

beta-lactamase inhibitor (prevent breakdown of beta lactam ring in penicillin)

Question 17

what is the MOA of doxycycline?

Answer 17

binds to 50S subunit and prevents the attachment of tRNA to mRNA-ribosome complex?

Question 18

what are the adverse effects of doxycycline?

Answer 18

1. GIT issues
2. Chelates Ca2+ (discoloured enamel, decreased bone growth)
3. renal damage, hepatotoxicity

Question 19

what is the MOA of azithromycin, clarithromycin, erythromycin?

Answer 19

binds to 50S subunit and prevents translocation of ribosome along mRNA?

Question 20

what is the MOA of oseltamivir and its indication?

Answer 20

neuraminidase inhibitor
influenza virus infection

Question 21

which TB drug involves the inhibition of bacterial DNA-dependent RNA polymerase?

Answer 21

rifampicin

Question 22

which TB drug inhibits synthesis of mycolic acids in cell wall?

Answer 22

isoniazid

Question 23

what is ribavirin indicated in and how is it administered?

Answer 23

severe acute bronchiolitis
administered via nebuliser

Question 24

what is used to treat low severity pneumonia?

Answer 24

oral combination therapy (bactericidal + bacteriostatic)
amoxicillin + doxycycline
cefuroxime + doxycycline

Question 25

what is the first-line drug to treat acute pulmonary oedema?

Answer 25

diuretics (furosemide)

Question 26

how do SABA relievers cause relaxation of airways?

Answer 26

act via beta 2 agonists to increase cAMP which reduces intracellular calcium release –> muscle relaxation

Question 27

In the treatment of asthma, leukotriene receptor antagonists:
a. cause modest bronchodilation
b. are administered as a stand-alone therapy
c. are used to relieve the acute phase of asthma
d. have a rapid onset of action

Answer 27

a. cause modest bronchodilation

b. administered with ICS/LABA
c. chronic phase of asthma