Respiratory pharmacology

Question 1

mucolytic agents?

Answer 1

carbocysteine and hypertonic saline

Question 2

mechanism of Salbutamol?

Answer 2

increases cAMP production by activating adenylate cyclase

Question 3

salmetrol onset and duration?

Answer 3

30 mins, 10-12 hours

Question 4

what is seretide?

Answer 4

combination of ICS (fluticasone) and salmeterol

Question 5

formotrerol?

Answer 5

short onset like salbutamol but prolonged duration 10-12 hours

Question 6

tiotropium is selective for?

Answer 6

M3

Question 7

ipratropium is given?

Answer 7

nebulised for acute asthma/ copd

Question 8

theophylline half life and action?

Answer 8

5 hours, phosphodiesterase inhibitor

Question 9

all bronchodilators can cause?

Answer 9

tachycardia, nervousness, irritability, tremor,

tachyarrhythmia and angina in IV

Question 10

adverse events of corticosteroids?

Answer 10

oral candidiasis, dysphonia (hoarseness)

adrenal suppression, bone loss, gastric ulcers, hypertension, mood disturbance, increase risk of infectiom, cataracts glaucoma, slow growth

Question 11

COPD prescribing?

Answer 11

1. give SABA or SAMA
2. if limitations with symptoms:
   asthmatic features/ steroid responsiveness/ raised eosinophils- LABA/ ICS

if not LABA/LAMA

3. if more exacerbations, day to day symptoms triple therapy

Question 12

treatment for allergic rhinitis?

Answer 12

SAMI
antihistamines- cetirizine
h1 antagonist

intranasal glucocorticoids- beclometasone

montelukast- inhibits leukotriene receptors, reduces inflammation bronchoconstriction, oedema, mucus, recruitment of eosinophils

sympathomimetics- pseudoephedrine (alpha agonist)

Question 13

side effects of antihistamines?

Answer 13

dry mouth dry eyes, confusion, drowsiness

Question 14

amoxicillin is used for?

Answer 14

CAP, COPD exacerbation, bronchitis
effective against gram positive and negative bacteria

Question 15

amoxicillin is suscepticle to?

Answer 15

b lactamase

Question 16

co amoxiclav is?

Answer 16

amoxicillin combined with clavulinic acid- which is a b lactamase inhibitor

Question 17

tazobactum is used when?

Answer 17

hospital acquired infection/ gram neg bacteria
tazocin has anti pseudumonal activity

Question 18

tetracyclines method of action and for what organisms?

Answer 18

inhibits protein synthesis

atypical infections- mycoplasma, legionella

Question 19

side effects of tetracyclines (doxycycline)?

Answer 19

GI upset/ staining teeth, lupus, allergy, photosensitivity

PLAGS

Question 20

quinolones mechanism of action?

Answer 20

dna fragmentation

Question 21

side effects of quinolones?

Answer 21

GI upset/c diff/ tendonitis/ liver upset/ prolonged QTc and arrthymia

plagt

Question 22

mechanism of macrolides?

Answer 22

protein synthesis inhibitors

Question 23

what are macrolides helpful for?

Answer 23

gram positive bacteria

Question 24

side effects of macrolides?

Answer 24

gi/ allergy/ liver abnormality, prolonged QTc

Question 24

side effects of macrolides?

Answer 24

gi/ allergy/ liver abnormality, prolonged QTc

Question 25

TB therapy?

Answer 25

min 6 months
2 months for all 4 RIPE
4 months rifampicin and isoniazid

if brain TB then 12 months

should be taken on an empty stomach

Question 26

rifampicin is a?

Answer 26

CYP450 inducer

Question 27

isoniazid is a ?

Answer 27

CYP450 inhibitor

Question 28

pyrazinamide can cause?

Answer 28

gout, optic neuropathy, AKI

Question 29

DOT/VOT

Answer 29

observed treatment, by a TB specialist team up to 6 month post treatment

Question 30

Interstitial lung disease treatment?

Answer 30

idiopathic interstitial pneumonias- prednisolone, azathioprine

sarcoid- prednisolone

idiopathic pulmonary fibrosis- pirfenidone- anti inflammatory/antifibrotics- reduces fibroblast proliferation and reduces collagen production

Question 31

cystic fibrosis caused by?

Answer 31

cystic fibrosis transmembrane conductance regulator (CFTR)