Respiratory drugs

Question 1

Examples of SABAs used

Answer 1

Salbutamol

Question 2

Example of LABAs used

Answer 2

Formoterol BD (fastest long acting Beta agonist)
Salmeterol BD

Question 3

Fostair

Answer 3

beclometasone/formoterol

Question 4

Seretide

Answer 4

(fluticasone/salmeterol)

Question 5

Symbicort

Answer 5

(budesonide/formoterol

Question 6

Luforbec

Answer 6

(beclometasone/formoterol):

Question 7

Fobumix

Answer 7

(budesonide/formoterol)

Question 8

Flutiform

Answer 8

(fluticasone/formoterol):

Question 9

side effects of SABA / LABAs

Answer 9

Hand tremors
Tachycardia
Hyperglycemia
Hypokalemia
CVS effects eg. Prolonged QT, arrythmias, MI

Question 10

Why is inhaled steroid prescribed by brand?

Answer 10

Most potent to least potent due to decreasing particle size
Fostair>Qvar>Clenil modulite>traditional CFC free inhalers

Question 11

Side effects of inhaled ICS

Answer 11

Hoarse voice
Sore throat
Oral thrush - rinse mouth
paradoxical bronchospasm - stop and give alternative
Skin withdrawal reactions (MHRA)

Question 12

Example of LTRAs

Answer 12

Montelukast
Zafirlukast

Question 13

Side effects of LTRAs

Answer 13

Churg Strauss syndrome - marked by high eosinophils. Shows as rash, worsening pulmonary symptoms, cardiac complications, peripheral neuropathy
Liver toxicity
neuropsychiatric reactions - obsessive compulsive reactions, speech impairment, nightmares, anxiety, depression

Question 14

Theophylline and Aminophylline MOA

Answer 14

reduces airway responsiveness to histamine and allergens
Aminophylline contains theophylline and ethylenediamine

Question 15

Theophylline and Aminophylline indication

Answer 15

Asthma, reversible airway obstruction and COPD
MUST be prescribed by brand as it not bioequivalent

Question 16

Theophylline and Aminophylline monitoring

Answer 16

Plasma conc (ideally 10-20mg/L)
measure this 5 days after starting and 3 days after any dose changes

Question 17

Theophylline and Aminophylline side effects

Answer 17

Arrhythmias
Anxiety
tremour
hypokalemia
hyperuricemia
Hyperglycemia
sleep disorders

Question 18

Theophylline and Aminophylline toxicity (fast and sick)

Answer 18

vomitting, restlessness, dilated pupils, convolutions, hyperglycaemia, arrhythmias

Question 19

Theophylline and Aminophylline interactions

Answer 19

Amiodarone, antipsychotics, citalopram, macrolides, digoxin, lithium, venlafaxine = decrease K
Caffeine, heart failure, hepataic impairment, viral infections, enzyme inhibitors (- SICKFACES.COM), ciprofloxacin = increase plasma conc of theo/amino, increase risk of convolutions
Alcohol, smoking enzyme inducers( - CRAPGPsShout BS)
= decrease plasma conc of theo/amino

Question 20

Theophylline and Aminophylline contraindications and cautions

Answer 20

CVD
epilepsy, fever
hypertension
peptic ulcer
risk of hypokalemia
Thyroids disorder

Question 21

Side effects of oral ICS (ACHING BOSOM)

Answer 21

ADRENAL SUPPRESSION, APPETITE IS LARGER, ABRUPT WITHDRAWAL REACTIONS
CUSHING’S SYNDROME , CATARACTS
HYPEGLYCAEMIA (DIABETES), HYPERLIPIDAEMIA
INFECTIONS,
NERVous SYSTEM: PSYCHIATRIC REACTIONS
GLAUCOMA, Gl ULCERS

BLOOD PRESSURE INCREASE (HYPERTENSION)
OSTEOPOROSIS
SKIN THINNING
OBESITY
MUSCLE WASTING

Question 22

Brand inhalers with triple therapy: ICS, LABA and LAMA

Answer 22

Trelegy and trimbow

Question 23

example of SAMA

Answer 23

Ipratropium

Question 24

example of LAMA

Answer 24

ACLIDINILJM
GLYCOPYRONNIUM
UMECLIDINIUM
TIOTROPIUM

Question 25

Side effects of inhaled antimuscarinics

Answer 25

dry mouth
paradoxical bronchospasms
Arrhythmias; constipation; cough; dizziness

Question 26

Brands of these antimuscarinic inhalers:
ACLIDINILJM
GLYCOPYRONNIUM
UMECLIDINIUM
TIOTROPIUM

Answer 26

ACLIDINILJM (Eklira Genuair)
GLYCOPYRONNIUM (Seebri Breezhalen
UMECLIDINIUM (Incruse Ellipta)
TIOTROPIUM (Spiriva Handihaer)