Respiratory Drugs

Question 1

What are the different administering methods of respiratory drugs

Answer 1

Inhalation
Oral
Intravenous

Question 2

What drugs can be used to improve airway patency

Answer 2

Bronchodilators

Anti-inflammatory

Question 3

What drugs are used to prevent mast cell degranulation

Answer 3

Chromoglycate

Leukotriene receptor antagonists

Question 4

Give examples of bronchodilators

Answer 4

B2 agonist

Anticholinergic

Question 5

Give an example of anti-inflammatory drugs

Answer 5

Corticosteroids

Question 6

How do bronchodilators work

Answer 6

Work to relax the tone of the smooth muscle and allow the airways to open

Question 7

How do anti-inflammatory drugs work

Answer 7

Reduce mucosal oedema and reduce mucous production

Question 8

What is the most common combination of drugs to improve ventilation

Answer 8

Bronchodilators or bronchodilators combined with a corticosteroid

Question 9

Describe a preventative strategy to improve ventilation

Answer 9

To reduce the inflammatory mediators released into the airway wall which cause narrowing of the airways

Question 10

Which drugs can impair ventilation

Answer 10

Beta-blockers

Respiratory depressants such as benzodiazepines and opioids

Question 11

How can beta-blockers impair ventilation

Answer 11

They will make the airways narrower as they will increase the effect of the smooth muscle constriction

Question 12

How can respiratory depressants impair ventilation

Answer 12

By causing muscle relaxation which will reduce the stimulus for the patient to breathe

Question 13

Which drugs are used to improve gas exchange

Answer 13

Oxygen

Question 14

How can oxygen be used to improve gas exchange

Answer 14

Oxygen diffuses from the alveoli into the blood

The higher the concentration of gas in the alveolus, the more drug will move into the blood

Question 15

What are the different methods of inhaled drug delivery

Answer 15

Meter Dose Inhaler (MDI) - Puffer

Breath Activated Device such as Spinhaler or Turbohaler

Question 16

What is the advantage of a breath activated device

Answer 16

Picks up the drug as the air moves across the device and carries it into the airway

Question 17

What are the problems with an MDI

Answer 17

Fires a jet of drug into the oropharynx to be captured by the air being breathed in
A lot of drug will be deposited around the oropharynx and may lead to local immunosuppression and sometimes candidiasis in the area

Question 18

Which drug is especially known to cause local candidiasis

Answer 18

Corticosteroids

Question 19

What are the different aids for inhalation drug delivery

Answer 19

Nebuliser

Spacer

Question 20

Describe how a nebuliser works

Answer 20

Uses a liquid version of the drug held in a small chamber and the compressor will blow air through the the tube causing it to bubble through the liquid drug
The bubble is coated in the drug and then breathed into the airway

Question 21

What is the advantage of using a nebuliser

Answer 21

Increases the amount of drug delivery to the airway and so when a patient is having an acute asthma attack and can’t use a puffer, it’s effective in getting the drug into the airway

Question 22

Describe how a spacer works

Answer 22

Allows the patient to activate the device into the chamber and then take a breath in through the chamber including the suspended drug without needing to coordinate the two effectively

Question 23

What are the different types of short acting B agonists and what are their corresponding inhaler colours

Answer 23

Salbutamol - blue inhaler

Terbutaline - blue inhaler

Question 24

Give an example of a long acting B agonist and its corresponding inhaler colour

Answer 24

Salmeterol - green inhaler

Question 25

What is the function of B agonists

Answer 25

Used to relive symptoms of asthma | Relieves bronchoconstriction through smooth muscles

Question 26

Compare the onset of short and long acting B agonists

Answer 26

Short - quick onset of 2-3 minutes | Long - slow onset of 1-2 hours

Question 27

Compare the lasting effects of short and long acting B agonists

Answer 27

Short lasts 4-6 hours | Long lasts 12-15 hours

Question 28

Compare the route of administration of short and long acting B agonists

Answer 28

Short can be administered through inhalation, orally or intravenously Long can be administered through inhalation only

Question 29

What are the difference in function between short and long acting B agonists

Answer 29

Short - used to treat acute bronchial constriction | Long - Used to prevent acute bronchial constriction (always used with an inhaled steroid)

Question 30

What is the function of anticholionergics and what is their corresponding inhaler colour

Answer 30

Inhibit muscarinic nerve transmission in autonomic nerves to cause relaxation of the smooth muscle and opening of the airways Ipratropium - grey inhaler

Question 31

What is the function of corticosteroids

Answer 31

To reduce inflammation in the bronchial walls

Question 32

Give examples of different corticosteroids and their corresponding inhaler colours

Answer 32

Beclomethasone - brown Budesonide - brown Fluticasone - orange Mometasone - pink

Question 33

What other colour can fluticasone inhalers also be found in

Answer 33

Yellow

Question 34

What are compound preparations

Answer 34

Inhaled steroid with a long acting B agonist

Question 35

Give examples of compound preparations

Answer 35

Seretide - fluticasone/salmeterol Fostair - beclomethasone/fomoterol Symbicort - budesonide/fomoterol

Question 36

When should compound preparations be used

Answer 36

MART - maintenance and reliever therapy | Use for acute episodes as well as prevention

Question 37

What other drugs can be used to treat asthma

Answer 37

Mast cell stabilisers - chromoglycate Leukotriene inhibitors montelukast Biologic medicines - xolair, nucala Oxygen