Respiratory Pharmacology Flashcards

1
Q

SABA drug name ??

A
  1. Salbutamol
  2. Albuterol
  3. Terbutaline

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2
Q

Role of Salmeterol/LABA in Asthma ??

A
  1. Long duration of action - 12hr or More
  2. Interacts with corticosteroids

Not recommended as the sole therapy for asthma

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3
Q

Ultra LABA drugs name ??

A
  1. Bambuterol

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3
Q

LABA drugs name ??

A
  1. Salmeterol
  2. Formeterol

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4
Q

Advantages of Beta 2 selective agonists ?

A
  1. Selective action
  2. Rapid action
  3. No/Less CNS CVS effects
  4. Easy to use
  5. Topical delivery

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5
Q

M/A of Beta 2 Agonists ???

A
  1. Salbutamol/Salmeterol–Bind Beta receptor
  2. Stimulates adenylyl cyclase
  3. Inc formations of Intracellular cAMP
  4. Relax bronchial smooth muscle
  5. Inhibit bronchoconstricting mediators from mast cells

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5
Q

Bronchial asthma leading to respiratory distress ??

A
  1. Bronchoconstriction
  2. Inc bronchial secretion

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6
Q

Toxicites of Beta 2 Agonits ??

A
  1. Dryness of airway
  2. Irritation of airway
  3. Oropharyngeal candiditis

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7
Q

A/E ??

A
  1. Tremor
  2. Tachycardia
  3. Hyperglycemia
  4. Hypokalemia
  5. Palpitation
  6. Arrhythmia

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8
Q

Why ephedrine is not in use now for Bronchial asthma ??

A
  1. CVS effects
  2. Less potent
  3. Duration of action more than Adrenaline
  4. Availability of new effacacious

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9
Q

AntiMuscarinic drugs name ??

A
  1. Ipratropium Br
  2. TioTrropium Br

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10
Q

Ipratropium M/A ??

A
  1. Block M3 receptors on bronchial smooth muscle & glands
  2. dec IP3 & DAG
  3. Repolarization of muscle
  4. Relaxation of bronchial smooth muscle
  5. Dec bronchial secretion
  6. Releief Bronchial asthma

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11
Q

Clinical use of ipratropium ??

A
  1. Asthma as an adjunct to Beta 2 agonists
  2. COPD long lasting
  3. For bronchospasm precipitated by Beta2Agonists

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12
Q

IV Corticosteroid drug name ??

A
  1. Hydrocortisone
  2. Dexamethasone

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13
Q

Oral Corticosteroid drugs name ??

A

Prednisolone

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13
Q

Inhalation Corticosteroid drugs name ??

A
  1. Budesonide
  2. Beclomethsone
  3. Fluticasone
  4. Triamcinolone

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14
Q

First choice for B asthma ??

A

Inhaled corticosteroids
ICS

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15
Q

Asthma association ??

A
  1. Airway inflammation
  2. Airway hyperactivity
  3. Acute bronchoconstriction

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15
Q

Severe persistent asthma requirement??

A

ICS + Oral Glucocorticoids

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16
Q

For long term control of B asthma ??

A

Fluticasone
Inhalation
+ Beta 2 agonists

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16
Q

M/A of corticosteroids???

A
  1. Inhibition of the influx of inflammatory cells into the lung after allergen exposures
  2. Inhibition of the release of mediators from M & E

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17
Q

Inhalation Corticosteroid&raquo_space; Oral steroids ??

A
  1. Oral = severe A/E = Cushing syndrome + adrenal suppression
  2. Inhalation = minimal systemic absorption = few systemic effects

To avoid systemic adverse effects

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18
Q

How to prevent oropharyngeal candiditis ??

A

Gargle water and spit after each inhaled Tx

18
Q

Risk of use of Corticosteroid inhalation ??

A
  1. Oropharyngeal candiditis
  2. Dryness of airway
  3. Irritation of airway
  4. Hoarseness of voice
  5. Osteoporosis
  6. Cataracts
  7. Slowing the rate of growth of children

311

19
Q

Prevention of risk of inhaled corticosteroids??

A
  1. Correct positioning of the inhaler
  2. Deep inspiration during puffing
  3. Shake well inhaler before use

311

20
Q

Urgent Tx of bronchial asthma ??

A
  1. Oral prednisone =(30-60) mg/day
  2. IV methylprednisolone (1mg /kg 6 hr )

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21
Q

LT R antagonists name ??

A
  1. ZafirLukast
  2. MonteLukast

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22
Q

Which one most prescribed ?»?

A

Montelukast

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22
Q

Glucocorticoids M/A ??

A
  1. Potentiate the action of acute bronchodilators
  2. Anti inflammatory action
  3. Bronchodilator agents

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23
Q

Why montelukast ??

A
  1. It can be taken without regard to meals
  2. Convenience of once daily Tx

312

24
Q

Advantages of montelukast ??

A
  1. Given to children 1 yr & older
  2. Chewable tablets
  3. Granule formulations

312

25
Q

A/E of montelukast ??

A
  1. Liver toxicity - Zileuton
  2. Zafirlukast-Warfarin interact & inc prothrombin times
  3. Churg strauss syndrome

312

26
Q

LT synthesis inhibitor name ?>

A

Zileuton

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27
Q

Montelukast M/A in BA ??

A
  1. Prophylaxis in asthma
  2. Not for immediate bronchodilation
  3. Reduce the frequency of exacerbation
  4. Steroid sparing agent
  5. Effective in persistant asthma
  6. Control symptoms during exeercise
  7. Tablet form available
  8. reduce inflammatory process

313

28
Q

Mast cell stabilzer drug name ??

A
  1. Cromolyn Na
  2. Nedocromil Na
  3. Ketotifen

311

29
Q

Drugs used in NEBULIZATION ??

BTS AI

A
  1. Budesonide
  2. Terbutaline
  3. Salbutamol
  4. Acetylcysteine
  5. Ipratropium

302

30
Q

Amount in Windel plus ??

A
  1. Salbutamol- 2.5mg
  2. Ipratropium- 0.5mg/3ml
31
Q

Indications of nebulization ??

A
  1. Acute exacerbation of COPD
  2. sEVERE ACUTE BA /Status asthmaticus

302

32
Q

Advantages ?/

A
  1. Rapid action
  2. Less sytemic effects
  3. Can use without minimum effort

302

33
Q

M/A of mast cell stabilizers ??

A
  1. Cromolyn & Nedocromil
  2. Alternation in the function of delayed Cl- channel in the cell membrane in the mast cells
  3. Entry of Cl-
  4. Hyperpolarization of the cell
  5. No mast cell activation
  6. No histamine
  7. No Bronchconstriction
  8. Prevent of asthma

311

33
Q

Parts of machine ??

A
  1. Machinr
  2. Mouthpiece
  3. Mask
  4. Hose
  5. Medicine cup

302

34
Q

Corticosteroids effects ??

A
  1. Inhibit the release of arachodonic acid by inhibiting phospholipase A2

Slide

34
Q

Clinical uses of Cromolyn & Nedocromil ??

A
  1. BA
  2. Allergic rhinoconjunctivitis

311

`

35
Q

A/E of sodium cromoglycate ??

A
  1. Bronchospasm
  2. Cough
  3. Wheezing
  4. Joint pain
  5. Swelling
  6. Rash
  7. Nausea
  8. Headache
  9. Angioedema
  10. Laryngeal edema

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36
Q

Theophylline ??

A

Tea leaves

307

37
Q

Theobromine ??

A

Cocoa chocolate

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38
Q

Caffeine

A

C seeds

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39
Q

M/A of theophylline ??

A
  1. inhibit phosphodiesterase PDE enzyme = inc cAMP = relax bronchial smooth muscle = bronchodilation
  2. inc cAMP = reduce release of Cytokines & chemokines form inflammatory cells = dec immune cell migration and activation

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39
Q

Over dose A/E Of theophylline ??

A

Seizures or fatal arrhythmia

40
Q

Indications of theophylline ??

A
  1. Severe acute BA
  2. COPD
  3. Chronic asthma
  4. Apnea in preterm baby

308

41
Q

CNS effect of theophylline ??

A
  1. Insomnia
  2. Headache
  3. Dizziness
  4. Restlessness
  5. Agitation

308

42
Q

CVS disorder of theophylline ?

A
  1. Tachycardia
  2. Hypotension
  3. Precordial pain
  4. Palpitation

308

43
Q

Why injected slowly ??

A

Aminophylline & theophylline have both chronotropic & inotrpic effetcs - so if rapid IV - sudden death – Cardiac arrhythmia

309

44
Q

Why theophylline effective bronchodilator ??

A
  1. Releive air flow obstruction
  2. Reduce the severity of symptoms

308