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Pharm OTL > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

1
Q

What are the five criteria for good asthma control?

A
  • Minimal symptoms
  • Minimal need for relieving meds
  • No limitation to physical activity
  • No exacerbations
  • Normal lung function tests
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2
Q

State two things that need to be checked before stepping up asthma treatment

A
  • Complience with existing therapies
  • Inhaler technique
  • Elimination of trigger factors
  • Make sure the pt isn’t on ACEIs or beta-blockers
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3
Q

What is step one of asthma control?

A

Short-acting beta2 agonist when required

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4
Q

Name two examples of short-acting beta2 agonists

A

Salbutamol

Terbutaline

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5
Q

What is the MoA of short-acting beta2 agonists?

A

Reverses/prevents bronchoconstriction

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6
Q

Why shouldn’t short-acting beta2 agonists be used too frequently?

A

Reduce asthma control by increaseing mast cell degranulation in response to allergens

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7
Q

State two side effects of short-acting beta2 agonists

A

Tachycardia
Palpitations
Tremor

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8
Q

What is step two in the asthma treatment pathway?

A

Regular preventer therapy - inhaled corticosteroids

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9
Q

State the four criteria for starting regular inhaled corticosteroids

A
  • Using a beta2 agonist 3 or more times a week
  • Symptoms 3 or more times a week
  • Waking once or more a week
  • Exacerbation of asthma requiring oral steroids in the last two years
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10
Q

Name an inhaled corticosteroid used in asthma

A

Beclomethasone

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11
Q

What are the three mechanisms by which inhaled corticosteroids improve symptoms and lung function?

A
  • Increase in beta2 receptors
  • Decreased eosinophils
  • Decreased inflammatory mediators
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12
Q

What is step three in the asthma treatment pathway?

A

Long-acting beta2 agonist

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13
Q

Name two long-acting beta2 agonists

A

Salmeterol

Fomoterol (more potent and more effective)

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14
Q

What must long-acting beta2 agonists be prescribed with?

A

Inhaled corticosteroid

Can get combined inhalers

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15
Q

What are the four options in step four in the asthma treatment pathway?

A
  • High-dose inhaled corticosteroids
  • Leukotriene receptor antagonist
  • Methylxanthines
  • Long-acting anticholinergics
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16
Q

Name a leukotriene receptor antagonist

A

Montelukast

Zafirlukast

17
Q

What is the MoA of leukotriene receptor antagonists?

A

Mast cells release LT-C4 which causes bronchoconstriction, mucus secretion, mucosal oedema and recruitment of inflam cells.

By blocking the LT receptor, the drugs prevent this from happening.

18
Q

Roughly how many patients find leukotriene receptor antagonists useful as an add-on therapy?

A

15%

19
Q

State two side effects of leukotriene receptor antagonists

A 
Angioedema
Dry mouth
Arthralgia
Fever
Nightmares
20
Q

Name a methylxanthine

A

Theophylline

Aminophylline

21
Q

What is the MoA of methylxanthines?

A

Antagonise adenosine receptors

Anti-inflammatory and broncho-protective

22
Q

State two adverse effects of methylxanthines

A

Headache
Nausea and reflux
Arrhythmias
Fits

Has many DDIs

23
Q

Name a long-acting anticholinergic

A

Tiotropium bromide (SPIRIVA)

24
Q

What is the MoA of long-acting anticholinergics?

A

M3 receptor antagonist to prevent parasympathetic bronchoconstriction

25
Q

State two adverse effects of long-acting anticholinergics

A

Dry mouth
Urinary retention
Glaucoma
Constipation

26
Q

What two drugs can be added on in step 5 of the asthma pathway?

A

Oral corticosteroids

Biologics

27
Q

Name a biologic used in asthma and its action

A

Omalizumab - anti-IGE

Mepolizumab - anti-IL-5

28
Q

Which drug is used to reverse bronchospasm in COPD pts?

A

Short-acting muscarinic antagonist ipratropium

29
Q

State two non-phacological treatments of COPD

A
  • Stopping smoking
  • Pulmonary rehabilitation
  • Pneumococcal and influenza vaccine
30
Q

What is the first step in treating COPD?

A

Short-acting muscarinic antagonist or short-acting beta2 agonist

31
Q

Which three other maintainance drugs can also be offered in COPD?

A

Long-acting mucarinic antagonist
Long-acting beta2 agonist
Inhaled corticosteroid

Pharm OTL (18 decks)

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