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Foundations of Biomedical Science > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

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1
Q

What class of drug is Salmeterol (Serevent)?

A

Long-acting β2 agonist (LABA)

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2
Q

What class of drug is Salbutamol (Ventolin)?

A

Short-acting β2 agonist (SABA)

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3
Q

What class of drug is Fluticasone (Flixotide)?

A

Inhaled corticosteroid

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4
Q

What class of drug is Montelukast (Singulair)?

A

LT receptor antagonist

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5
Q

What class of drug is Cromoglycate (Intal)?

A

Mast cell stabiliser

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6
Q

What class of drug is Terbutaline (Bricanyl)?

A

Short-acting β2 agonist (SABA)

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7
Q

What class of drug is Eformoterol (Symbicort)?

A

Long-acting β2 agonist (LABA)

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8
Q

What class of drug is Ipratropium (Atrovent)?

A

Short-acting anticholinergic (antimuscarinic)

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9
Q

What class of drug is Tiotropium (Spiriva)?

A

Long-acting anticholinergic (antimuscarinic)

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10
Q

What class of drug is Theophylline (Nuelin)?

A

Phosphodiesterase inhibitor/non-selective adenosine receptor antagonist

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11
Q

What class of drug is Budesonide (Pulmicort)?

A

Inhaled corticosteroid

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12
Q

What class of drug is Omalizumab?

A

Recombinant humanised monoclonal antibody (directed against IgE)

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13
Q

What is the mechanism of action of Salmeterol (Serevent)?

A

Stimulation of β2 adrenergic receptors, causing smooth muscle relaxation → bronchodilation

LABAs have a longer half-life than SABAs due to their increased lipophilicity – stay in the lipid membrane and act for longer.

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14
Q

What is the mechanism of action of Salbutamol (Ventolin)?

A

Stimulation of β2 adrenergic receptors, causing smooth muscle relaxation → bronchodilation

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15
Q

What is the mechanism of action of Fluticasone (Flixotide)?

A

Modulates protein synthesis in the nucleus → inhibition of phospholipase A2 → inhibition of arachidonic acid formation → inhibition of inflammatory mediator formation → reduction of airway inflammation and bronchial hyperreactivity

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16
Q

What is the mechanism of action of Montelukast (Singulair)?

A

Inhibits the cysteinyl leukotriene receptor; antagonises airway smooth muscle contraction and inflammation caused by leukotrienes.

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17
Q

What is the mechanism of action of Cromoglycate (Intal)?

A

Acts by inhibiting release of inflammatory mediators from mast cells.

Generally well tolerated as it does not gain access to systemic circulation.

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18
Q

What is the mechanism of action of Terbutaline (Bricanyl)?

A

Stimulation of β2 adrenergic receptors, causing smooth muscle relaxation → bronchodilation

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19
Q

What is the mechanism of action of Eformoterol (Symbicort)?

A

Stimulation of β2 adrenergic receptors, causing smooth muscle relaxation → bronchodilation

LABAs have a longer half-life than SABAs due to their increased lipophilicity – stay in the lipid membrane and act for longer.

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20
Q

What is the mechanism of action of Ipratropium (Atrovent)?

A

Promote bronchodilation by inhibiting cholinergic bronchomotor tone.

Blocks muscarinic actions of ACh

21
Q

What is the mechanism of action of Tiotropium (Spiriva)?

A

Promote bronchodilation by inhibiting cholinergic bronchomotor tone.

Blocks muscarinic actions of ACh

22
Q

What is the mechanism of action of Theophylline (Nuelin)?

A

Inhibition of PDE → raised intracellular cAMP → activation of PKA → inhibition of TNF-α and LT-synthesis → reduces inflammation

23
Q

What is the mechanism of action of Budesonide (Pulmicort)?

A

Reduces airway inflammation and bronchial hyper-reactivity.

24
Q

What is the mechanism of action of Omalizumab?

A

Recombinant humanised monoclonal antibody directed against immunoglobulin E (IgE); reduces the immune system’s response to allergen exposure

25
Q

What are the side effects of Salmeterol (Serevent)?

A

Tremor

Palpitation

Headache

Tachycardia

Muscle cramps

Agitation

Insomnia

26
Q

What are the side effects of Salbutamol (Ventolin)?

A

Tremor

Palpitation

Headache

Tachycardia

Muscle cramps

Agitation

Insomnia

27
Q

What are the side effects of Fluticasone (Flixotide)?

A

Dysphonia

Oropharyngeal candidiasis (esp. if spacer not used)

Bruising

Facial skin irritation following nebulisation

Allergic reaction

28
Q

What are the side effects of Montelukast (Singulair)?

A

Headache

Abdominal pain

Diarrhoea

Allergy

29
Q

What are the side effects of Cromoglycate (Intal)?

A

Cough

Throat irritation

Bitter taste

Transient bronchospasm

30
Q

What are the side effects of Terbutaline (Bricanyl)?

A

Tremor

Palpitation

Headache

Tachycardia

Muscle cramps

Agitation

Insomnia

31
Q

What are the side effects of Eformoterol (Symbicort)?

A

Tremor

Palpitation

Headache

Tachycardia

Muscle cramps

Agitation

Insomnia

32
Q

What are the side effects of Ipratropium (Atrovent)?

A

Headache

Nausea

Taste disturbance

Dry mouth

Throat irritation

Blurred vision

Dizziness

Urinary retention

33
Q

What are the side effects of Tiotropium (Spiriva)?

A

Headache

Nausea

Taste disturbance

Dry mouth

Throat irritation

Blurred vision

Urinary retention

34
Q

What are the side effects of Theophylline (Nuelin)?

A

Nausea

Vomiting

Diarrhoea

GORD

Headache

Insomnia

Irritability

Anxiety

Tremor

Palpitations

Theophyllines have a narrow therapeutic range; toxicity is closely related to plasma concentration.

35
Q

What are the side effects of Budesonide (Pulmicort)?

A

Dysphonia

Oropharyngeal candidiasis (esp. if spacer not used)

Bruising

Facial skin irritation following nebulisation

Allergic reaction

36
Q

What are the side effects of Omalizumab?

A

Common (>1%)

  • injection site reactions
  • rash
  • bleeding (nosebleeds, heavy menstrual bleeding, haematoma)

Infrequent (0.1–1%)

  • decrease in platelet count (mild)

Rare (

  • anaphylaxis (usually occurs within 2 hours but can be delayed to >24 hours)
  • angioedema
  • urticaria
  • serum sickness-like syndrome
37
Q

What are the indications for use of Salmeterol (Serevent)?

A

Administration: puffer, accuhaler

Symptomatic relief of asthma

  • Can be used in conjunction with an inhaled corticosteroid (e.g. fluticasone)

Must be combined with inhaled glucocorticoid as monotherapy is associated with increased morbidity/mortality in asthma.

38
Q

What are the indications for use of Salbutamol (Ventolin)?

A

Administration: inhaler, nebuliser

  • Acute asthma
  • Symptom relief during maintenance treatment of asthma and COPD
  • Protection against exercise-induced asthma
39
Q

What are the indications for use of Fluticasone (Flixotide)?

A

Administration: inhaler, IV for acute severe episodes

  • Maintenance treatment of persistent asthma
40
Q

What are the indications for use of Montelukast (Singulair)?

A

Administration: oral tablet

  • Maintenance treatment in asthma
  • Allergic rhinitis
  • Prevention of exercise-induced asthma
41
Q

What are the indications for use of Cromoglycate (Intal)?

A

Administration: inhaler (MDI/DPI)

  • Maintenance treatment in persistent asthma
  • Prevention of exercise-induced asthma

Do not use for relief of acute asthma – use short-acting reliever instead.

42
Q

What are the indications for use of Terbutaline (Bricanyl)?

A

Administration: inhaler (DPI)

  • Acute asthma
  • Symptom relief during maintenance treatment of asthma and COPD
  • Protection against exercise-induced asthma

SC route may be used in acute severe asthma

43
Q

What are the indications for use of Eformoterol (Symbicort)?

A

Administration: inhaler (DPI)

  • Maintenance treatment of asthma in patients receiving inhaled or oral corticosteroids
  • Maintenance treatment of COPD
  • Symptom relief of asthma in adults already receiving inhaled corticosteroids and regular eformoterol

SC route may be used in acute severe asthma

Must be combined with inhaled glucocorticoid as monotherapy is associated with increased morbidity/mortality in asthma.

44
Q

What are the indications for use of Ipratropium (Atrovent)?

A

Administration: inhaler (DPI), nebuliser

  • Symptom relief of asthma and COPD

Contraindications: Bladder outlet obstruction

Stop ipratropium if treatment with tiotropium is required for COPD

45
Q

What are the indications for use of Tiotropium (Spiriva)?

A

Administration: inhaler (DPI)

  • COPD

Contraindications: Bladder outlet obstruction

46
Q

What are the indications for use of Theophylline (Nuelin)?

A

Administration: oral tablet, liquid

  • Maintenance treatment in severe asthma and COPD

Contraindications: Diabetes (oral liquid contains 50% sugar), GORD, Arrhythmias, Heart failure, pulmonary oedema, severe hypoxia, Thyroid dysfunction, Epilepsy, Acute infection, Treatment with β2 agonists

47
Q

What are the indications for use of Budesonide (Pulmicort)?

A

Administration: inhaler (DPI), nebuliser

  • Maintenance treatment of persistent asthma
  • Croup (nebulised budesonide)

May be used in fixed-dose combination with eformoterol (Symbicort turbuhaler)

48
Q

What are the indications for use of Omalizumab?

A

Administration: Injection (IV)

Maintenance treatment of moderate-to-severe allergic asthma in patients treated with inhaled corticosteroids and with raised serum IgE levels

Foundations of Biomedical Science (9 decks)

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